Bristol City Council Shared Lives

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.People’s needs were assessed prior to using the service. Assessments considered people’s health and communication needs, as well as the compatibility of their needs with those of others living with shared lives carers. Staff completed a matching and introductory process before shared lives arrangements started to help ensure people’s needs could be met. Shared lives carers spoke positively about the process. A shared lives carer said, “Fantastic, placements, they get them spot on. They have with me.” People were allocated a staff member who monitored their support, involved them in decisions about their care and regularly reviewed their shared lives arrangement. Shared lives carers demonstrated a good understanding of the people they supported and told us they had access to sufficient information before providing support.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s nutrition and hydration needs were not always well documented. Support plans provided some guidance to shared lives carers; however, the information was not always sufficiently detailed. For example, information about a person’s swallowing difficulties was not sufficiently documented, and people's preferences and choices relating to eating and drinking were not always recorded. People’s care was not always planned and delivered in line with best practice, including the management of medicines and people's risk assessments. The service had a range of policies and procedures; however, it did not have a positive behaviour support policy to guide staff and shared lives carers in this area. Records showed shared lives carers had not completed areas of training to meet people’s individual needs. Despite these shortfalls, staff and shared lives carers demonstrated an awareness of people's dietary needs and told us they worked with people to understand their preferences.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.Shared lives carers told us there was effective communication and they could always contact staff when support was required. They explained the service provided opportunities for carers to meet, share experiences and offer peer support to one another. Relevant information was shared between services to support transitions and continuity of care. Feedback from professionals was positive regarding partnership working. A professional working for another service under the same provider said, “The team and their manager are open and approachable, which helps achieve positive outcomes for people using the service.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.Shared lives carers supported people to attend health appointments and take part in activities to stay well. People were encouraged to make healthy choices and remain physically active according to their needs and interests. People told us how they had been supported to lose weight and stay active through accessing a gym or using a treadmill at home. Relatives told us they were kept informed, where appropriate. A relative said, “Yes, anything unusual they will let me know.” Staff and shared lives carers provided examples of how carers advocated for people and supported them when their health needs changed. They described how shared lives carers supported people during recovery and rehabilitation following a health concern. Staff used monitoring visits to discuss recent health appointments and identify whether people needed additional support.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.Shared lives arrangements were reviewed annually, providing an opportunity to record people’s progress and achievements and seek feedback from people and their relatives as part of the process. The registered manager and staff gave examples of people making progress towards their goals, including increased independence, developing friendships and participating in community activities. People and their relatives spoke positively about the support they received from the service. However, we noted people’s goals and outcomes were not well documented in people’s support plans. We raised this with the registered manager, who told us they planned to address the issue.

People’s consent to care and treatment was not always appropriately documented within support plans. We found some MCA and best interests’ decisions had not been reviewed in a timely manner. Not all written agreements relating to people’s shared lives arrangements had been signed. The registered manager told us people were aware of the agreements; however, records had not been well maintained. Despite these shortfalls, staff and shared lives carers had completed training on the principles of the Mental Capacity Act and applied these principles when supporting people. People and their relatives told us, and we observed, shared lives carers seeking people’s consent and respecting people’s wishes and preferences.