Leicester City Council Shared Lives Service

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the provider met people’s needs. At our last rated inspection we rated this key question Good. At this inspection the rating has changed to Requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People did not always receive care and support which was planned, reviewed and delivered in a consistently person-centred way. Whilst Shared Lives carers generally knew people well and were able to describe their individual needs, preferences and routines, care planning systems did not always reflect people's current circumstances, goals or support requirements. We found 4 people had not had their person-centred support plans formally reviewed or updated since June 2024 despite the provider’s policy requiring annual care plan reviews and 3 month monitoring visits by Shared Lives staff. This meant the provider could not be assured records accurately reflected people's changing needs, preferences, risks or desired outcomes.

Reviews were not always completed in line with the provider's expectations and did not consistently demonstrate meaningful involvement from people, their families or relevant professionals. Care records lacked sufficient detail regarding people's aspirations, progress and what was important to them, limiting their effectiveness as a tool to guide person-centred support.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

The provider did not consistently ensure care and support was coordinated effectively to promote continuity and meet people's needs in a timely way. Whilst Shared Lives carers demonstrated a good understanding of the people they supported and care arrangements were generally stable, systems to integrate information and coordinate support across the service and wider network of professionals were not always effective. Communication between the Shared Lives scheme, Shared Lives carers and partner agencies was inconsistent, and important information was not always shared, reviewed or acted upon promptly.

Records did not consistently demonstrate how changes in people's needs or emerging risks were communicated across all parties involved in their care. There was a lack of clear oversight to ensure actions identified by external professionals were followed through and incorporated into care planning and review processes.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People were not always involved in decisions about their care.

People were not always fully involved in planning and reviewing their care and support. Although care records contained some information about people's preferences and wishes, there was limited evidence to demonstrate people had been regularly consulted about whether their support continued to meet their needs or achieve the outcomes important to them. Reviews of care plans were not always completed consistently, and records did not always show how people's views had influenced the development of their support arrangements.

The provider sought feedback from Shared Lives carers; however, arrangements to engage with Shared Lives carers were not always effective. Although meetings and virtual discussions were offered, attendance and engagement were variable, and the provider had not identified alternative approaches to ensure Shared Lives carers' views were consistently obtained and used to inform service development. One shared lives carer told us, “We used to have a lot of opportunities to meet with the managers, like virtual coffee mornings and face to face meetings. We haven’t had those for a long time. I know they are trying to start some up again, but they aren’t always easy to plan for”

Systems and processes for seeking and acting on feedback from people were underdeveloped. There were limited opportunities for people using the service to come together, share their experiences, discuss what was important to them, and influence how the service was delivered. The provider had not established robust mechanisms to enable people to contribute to service improvements or to demonstrate how feedback received had been used to drive change.

This resulted in missed opportunities to meaningfully involve people in the ongoing development of the service and to ensure their experiences directly informed decision-making. Consequently, the provider could not be assured people's voices were consistently heard, acted upon, or used to shape service delivery, reducing its ability to respond proactively to people's needs, preferences and aspirations.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Whilst Shared Lives carers showed a commitment to supporting people as individuals and promoting inclusion within their local communities, systems for monitoring and evaluating people's experiences and outcomes lacked sufficient oversight and analysis. Leaders were unable to consistently demonstrate how information gathered through reviews, support visits and quality assurance processes was used to identify inequalities, address barriers to participation or ensure people were achieving outcomes comparable to others using the scheme.

Care planning and review processes did not always capture people's aspirations, progress or lived experiences in sufficient detail to evidence whether support was effectively meeting their diverse needs. In addition, gaps in review systems and person-centred planning reduced assurance that changes in people's circumstances, preferences or desired outcomes were being consistently identified and responded to. This limited the provider's ability to understand whether people were experiencing equitable outcomes and receiving support tailored to their individual needs.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider did not consistently ensure people were supported to plan for their future in a meaningful and person-centred way. Whilst some discussions had taken place regarding people's longer-term needs and preferences, planning processes were not sufficiently robust to demonstrate how people were being supported to achieve their aspirations, develop greater independence or pursue opportunities for progression. Reviews and support planning focused predominantly on people's current circumstances and did not consistently evidence clear goals, timescales or actions to support people to move forward in their lives. This reduced assurance people were being actively supported to maximise their potential and work towards outcomes that were important to them.

Planning for potential future transitions required improvement. The provider could not consistently demonstrate how people would be supported to move on from Shared Lives arrangements, where appropriate, or how changing needs and aspirations were being considered to ensure future support remained suitable. Opportunities to explore and plan for increased independence, employment, education, community involvement or alternative living arrangements had not always been fully developed or reviewed.

There were examples of positive practice. Some people had information recorded regarding their end-of-life wishes, preferences and views, demonstrating recognition of the importance of planning for significant life events. However, this approach was not consistently reflected across wider future planning processes.