Hillingdon Shared Lives

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

The last rating for this key question was good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had developed a culture where everyone was involved in learning from things that went wrong. The provider had protocols for the shared lives carers and staff to follow if a person had an accident or there was an incident. We saw shared lives carers and staff kept detailed records which showed the immediate response and follow up actions to any accidents and incidents. The registered manager monitored these and worked with everyone to help ensure people were safe and received the treatment they needed.

Shared lives carers confirmed they knew and understood protocols. They also explained staff were supportive when things went wrong. Their comments included, “If anything goes wrong, we report this and keep records” and “We have a list of numbers to call and there is always someone there to help you.” Staff showed us how they monitored records of incidents and how they updated assessments and care plans, when needed.

There were regular meetings and systems for communicating with shared lives carers. This meant the staff could discuss any common themes or warnings to help make sure everyone learnt from things that went wrong.

The provider had exceptionally well managed systems for safe transitions and pathways. People at high risk benefitted from the well managed safe transition which minimised trauma and deterioration of their mental health and wellbeing. External professionals gave us examples of how the provider had safely managed transitions in difficult situations. These included emergency placements following a bereavement of people’s family members and supporting vulnerable people who had just arrived in the United Kingdom with nowhere to go. One professional explained, “I have the deepest appreciation for the exceptional support during a critical transition for 1 person. Without the compassionate, structured and person-centred approach offered by Shared Lives, the impact on [their] wellbeing [of having to move in an emergency] would have been significant. Thanks to this incredible service, [they] have not only coped but also truly thrived.” Other comments from professionals included, “[Person] was assured by the staff and could ask any questions” and “The scheme’s approach helped [person] at a very difficult time in [their] life.”

Staff told us about how they had supported people who had moved on to live independently, and when a shared lives carer and person moved together to a different part of the country. They had worked with external professionals, the person and carer to enable safe and well-planned moves, including supporting people to access other services.

There were robust processes for assessing shared lives carers, matching them with people and supporting their move and transition into the shared lives carers’ homes. Relatives told us they thought this process had been managed very well to ensure people felt safe and comfortable. Relatives had met shared lives carers and been involved in the transition. Their comments included, “We all met together [person, shared lives carer and relative] and we could grill [shared lives carer]”, “They sent all the information so we could see if the place was suitable. The set up was perfect” and “The transition was made easy for [person] and the family. We have no worries about [person’s] care.”

A person who used the service told us they had been nervous about the change but that they were happy with the way this had been managed, and they were happy living with the shared lives carer.

Some people used the shared lives carer scheme for short stays when their main family carer was away or had a break. A relative in this situation told us the short stays were well managed, and they always had the opportunity to meet and spend time with the shared lives carers before this.

Shared lives carers also felt transitions were managed well from their perspective. They told us they were given all the relevant documents, care plans and risk assessments and had opportunities to regularly meet with the person, their families and staff.

The provider had systems to help safeguard people from abuse. Shared lives carers and staff had training to help them understand these. They were able to tell us what they would do if they had concerns about safeguarding.

Shared lives carers had spoken up when they identified concerns in the past and the provider had worked with the local safeguarding team to investigate these and take appropriate action to keep people safe.

People using the service and their relatives felt they were safe. Their comments included, “The best thing is that [person] is safe and well looked after. I know [they] are being cared for” and “I definitely feel safe.” One relative told us the shared lives carer had told them they could visit unannounced whenever they wanted, and this reassured them of the person’s safety.

The provider assessed risks to people’s safety and wellbeing. They worked with them and shared lives carers to promote positive risk taking and independence when this was safe. Relatives told us risks were appropriately managed. Their comments included, “Risks are well managed” and “Good measures were in place from day 1.”

Shared lives carers spoke about ways they supported people to stay safe, how they used equipment when needed and how they promoted choice and independence. Risk assessments were clear, person-centred and regularly reviewed.

Shared lives carers and staff had training to understand how to keep people safe, for example how to support people to move.

Staff and carers understood people’s rights not to be restrained without appropriate risk assessments and authorisations. When people did not have the capacity to make certain decisions and were at risk, staff, shared lives carers and other professionals had assessed the situation and made these decisions in people’s best interests. Shared lives carers explained how they supported people when they became distressed or upset. Their comments included, “If [person] is anxious, I give [them] more space. I speak quietly. We sit down and talk together”, “We are aware of triggers and act accordingly. If we need, we can flag with support teams” and “We would never restrain. We cooperate and listen.”

The provider made sure people’s home environments were safe and comfortable. Staff assessed share lives carers’ homes as part of the initial assessment and during regular monitoring visits. Shared lives carers were required to undertake regular checks including fire safety checks and provide evidence of these to the scheme. People and their relatives told us homes were safe, and people had their own space and facilities. Their comments included, “The home is perfect”, “I am in a better place with a shower and toilet opposite my bedroom. It is ideal” and “I have my own bedroom and a TV in it.”

Shared lives carers and staff gave us examples about adaptions the carers had made to their homes to meet people’s needs. For example, ramps, installing equipment and new bathrooms.

There were enough staff to support the shared lives carers and manage the scheme. Shared lives carers told us staff were available whenever they needed. The London Borough of Hillingdon had procedures to make sure only suitable staff were employed. All 3 staff had worked for the provider for a long time. The provider kept checks updated. These included checks to make sure they did not have any criminal records. Staff undertook regular training updates and had supervisions and appraisals of their work.

There was a robust system for recruiting shared lives carers. This included an in-depth assessment and a wide range of checks. Potential carers had to be approved by a panel. The panel included a person who used the service, the registered manager and senior managers.

When people needed a placement, the provider assessed available shared lives carers and ‘matched’ the person with carers who would best meet their needs. This could be because of skills the carers had or because of shared interests, cultural needs or language. Professionals told us this worked well with 1 professional commenting, “They are very good at matching service users with appropriate carers.” One of the shared lives carers told us the staff knew the carers so well they knew how to make the ''perfect match.''

The provider had procedures to prevent and control infection. Staff and shared lives carers completed relevant training and had supplies of personal protective equipment (PPE) to be used if needed. People using the service and their relatives told us their homes were clean. Some people were supported to be involved in household tasks when this was part of their planned care. Comments from people and relatives included, “You could eat your dinner off the floor, it is that clean”, “They do my washing and cleaning. [Carer] is marvellous” and “[Person’s] room is very beautiful and clean. The whole house is very clean.”

The provider ensured people received their medicines safely and as prescribed. Staff and shared lives carers undertook training to understand how to manage medicines safely. The provider carried out regular competency assessment checks. Shared lives carers completed records to show medicines administration. These were checked and audited by staff. People were supported to manage their own medicines when they could. People were happy with the support they had with their medicines.

Shared lives carers worked with people using the service and other professionals to monitor whether they were prescribed the right medicines. This included working with others to follow the STOMP (stopping overmedication of people with a learning disability, autism or both) principles.