We inspected the service on 9 and 10 May 2016 and the visit was announced. We gave notice of our visit because we needed to be sure somebody would be available at the office.
The Leicestershire Shared Lives Scheme arranges accommodation and support to people to live independent lives. The support is provided by individuals in the community, known as shared lives carers (carers) who use their own homes as a base. Shared lives support can include long term accommodation and / or a short breaks service. At the time of our inspection 102 people were receiving care and support. Shared lives workers (staff) are employed by the provider to provide support and guidance to carers.
The service had a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe and they were being protected from harm and abuse by staff and carers who knew their responsibilities. For example, people’s homes and equipment were being checked by the provider to protect them from harm. Risks to people’s health and well-being had been assessed to support them to remain safe.
People’s individual needs had been considered to keep them safe during an emergency and the provider had a plan in place to make sure that the service would continue in the event of a significant event.
The provider sought to keep people safe by analysing accidents and incidents. They had looked to reduce the number of these whenever possible. For example, where a person’s level of support needed to increase due to their mental health, guidance from a social worker had been requested.
People were being supported by staff who had been checked before they had started to work for the provider. This had helped the provider to make safer recruitment decisions. When a member of the public had applied to become a carer, we found that there was a thorough process in place to check their suitability.
People received the support they required with their medicines. Staff and carers had received training to support them to handle medicines safely and there was written guidance available to them to provide safe support to people.
People received support from carers and staff who had undertaken training. However, for some staff and carers there were gaps in the required training. For example, some needed training in safeguarding people from abuse. The registered manager told us that they were addressing this.
Staff and carers received support and guidance in order to understand their responsibilities. For example, carers had regular visits from staff members. The registered manager provided staff with regular meetings to support them to carry out their roles effectively.
People’s consent to care and treatment had not always been recorded. The provider had not always undertaken assessments where people may have lacked the capacity to make decisions. This meant that the provider was not always following the principles of the Mental Capacity Act (MCA) 2005. People were being supported by staff and carers who understood the requirements of the MCA. They were able to describe how they would seek additional support if they had concerns about people’s ability to make decisions for themselves.
People chose the food they wanted. Their eating and drinking preferences and needs were known by carers. People were also being supported to remain healthy. Staff and carers knew how to do this and information about people’s health needs was available in their support plans. Where there was concern about people’s health, staff and carers knew what to do and took the appropriate action.
People were supported by carers who showed kindness and compassion. Their dignity and privacy was being respected and their confidential and sensitive care records were being stored safely.
Carers and staff knew about people’s preferences and what was important to them. People were being supported to be as independent as they wanted. For example, we saw that one person was learning how to make their own bed. This meant that people received care and support based on their preferences and abilities.
People or their representatives had been involved and had contributed to the planning and reviewing of their care and support although this had not always been recorded in their care records. The registered manager told us that they would change their procedures to make sure that this happened. Where people needed support to be involved, information and access to advocacy services had been made available to them.
People had support plans that were focused on things that were important to them and known by carers. They received care and support based on this. People were undertaking hobbies and interests that they enjoyed. For example, we saw that some people were regularly going swimming and shopping.
People knew how to complain if they had needed to. The provider took action where necessary when they had received a complaint. The registered manager was looking at how they could learn from people’s feedback to improve the service. They had issued questionnaires to some people to gain their views and experiences of the care and support offered.
Carers and staff told us that the service was well-led. There were opportunities available to them to give ideas for improvement to the provider.
Carers and staff told us, and we saw, that they were supported and were clear about their roles and responsibilities. They received regular feedback on their work in order to improve the quality of the care and support offered to people.
There was a registered manager in place who understood the requirements of their role. They had worked with the provider to regularly assess the quality of the service, although this checking was not always recorded to show what actions or learning had occurred. The registered manager had plans in place to improve the service.