Bristol City Council Shared Lives

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent and not always effective to monitor the quality and safety of the service. The service was in breach of legal regulation in relation to good governance.

This service scored 62 (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 a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.Staff, shared lives carers and the registered manager demonstrated their commitment and passion for supporting people who used the service. A staff member said, “I want to do work which reflects my moral compass, I believe shared lives is that.” Another said, “It’s great to be a part of the progress people make, to see the impact.” The provider respected people’s human rights and promoted diversity across the service. Staff and shared lives carers worked well together and told us working relationships within the service were positive. A shared lives carer said, “Very supportive in anything we do.” A professional said, “They have a great team, and it feels like they’ve embedded a really positive and strong culture.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.The service had an established registered manager in post who demonstrated their knowledge and experience of both the service and the people supported. People, their relatives, staff and shared lives carers spoke positively about the registered manager and described them as available and supportive. A staff member said, “[registered manager] is really good at communication.” The registered manager told us they had recently recommenced visits to people and shared lives carers in their homes as part of the annual review process. A shared lives carer said, “[registered manager] comes and takes [person] for a coffee.” During our assessment, the registered manager and managers from the provider engaged openly with the assessment process. They were transparent and reflective about the shortfalls identified, welcomed challenge and expressed a commitment to making improvements. However, some staff and shared lives carers felt the provider could do more to support staff and the work of the service. Comments included, “The management above the registered manager need to be more interested and involved and understand what we do.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.The provider had processes to support staff and shared lives carers to raise concerns, including meetings, supervision sessions and monitoring visits. Staff and shared lives carers told us they felt able to raise any concerns. A staff member said, “[registered manager] always take’s things seriously.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.The provider’s policies promoted equality, diversity and human rights, guiding staff on best practice in this area. Staff told us the registered manager was supportive, inclusive and fair and shared examples of how they had responded flexibly to individuals’ health conditions and personal circumstances. A staff member said, “[registered manager] has been very good with me. Been proactive with helping me.” Staff received equality training to develop their understanding of protected characteristics and increase awareness of bullying and harassment.

The provider did not always have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.The provider's governance processes were not always effective in identifying and addressing areas for improvement. For example, support and monitoring visits and annual reviews of each shared lives arrangement had not identified or addressed the shortfalls found during our assessment, including concerns relating to medicines management, risk assessments and training. Staff completed checks on people's medicines during shared lives monitoring visits; however, records of these checks were not always detailed, and monitoring was not consistently completed at regular intervals. The provider had previously completed audits of the service; however, these lacked detail and actions were not well documented. The registered manager told us they had recognised the need to improve oversight of medicines, support plans and risk assessments. A more detailed external audit had recently been completed and had identified actions for improvement. The provider told us they would consider the findings from the external audit alongside the findings of our assessment and implement an improvement plan to address the shortfalls identified.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.The service worked in partnership with other organisations and professionals to provide effective support and joined up care. The registered manager told us how they worked with professionals such as social workers and day service providers to coordinate packages of care and meet people’s individual needs. Professionals we contacted told us they had positive working relationships with the service. A professional said, “I have been able to work collaboratively with the team around the service user's needs.” The provider also supported links within the wider shared lives community by covering membership fees for all shared lives carers to join Shared Lives Plus. Shared Lives Plus is a UK membership charity for people living and working within shared lives and provides peer support, advice and guidance to providers and shared lives carers to promote consistency and best practice across shared lives schemes. The service organised social activities for shared lives carers and people using the service. A shared lives carer said, “We tend to have a social together, we are all different, everyone is included.”

The provider had not always focused on continuous learning, innovation and improvement in the service.The provider had not developed a consistent approach to gathering formal feedback across the service. Feedback received was not routinely reviewed to identify actions or learning, and processes intended to share learning were not consistently completed. Audits and checks were not always sufficiently robust or effective in identifying areas for improvement. The provider responded positively to the shortfalls identified during the assessment; however, further work was needed to embed changes and promote a consistent culture of learning, innovation and improvement. The provider showed an understanding of how to improve the service; they told us they were updating their improvement plan to reflect the findings from our assessment and monitor progress. The registered manager told us they had conducted planning days with the team and developed links with external organisations, including other shared lives schemes. They also accessed support and attended events organised by Shared Lives Plus to support service development and improvement.