We carried out a review of the data available to us about United Response, Shared Lives on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about United Response, Shared Lives, you can give feedback on this service.
United Response, Shared Lives is a shared lives scheme which provides people with long-term placements within shared lives carers own homes. At the time of our inspection there were 19 people using the service.
People’s experience of using this service and what we found
People told us they felt safe living with their shared lives carer and that they were well treated. Managers and shared lives carers understood their responsibilities for keeping people safe from the risk of abuse and they were confident about reporting any concerns about people’s safety.
People received care and support in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Risks to people were assessed and managed in a way that promoted people’s independence. Shared lives carers completed training in topics of health and safety, and they were confident in dealing with emergency situations.
Safe recruitment procedures were followed. The fitness and suitability of office-based staff and shared lives carers was thoroughly assessed before they were recruited to support people using the service, and they received the training they needed for their role. People were matched with a shared lives carer who could best meet their needs.
Safe infection prevention and control (IPC) measures were followed to minimise the risk of the spread of infection, including those related to COVID-19.
Medicines were managed safely. Shared lives carers were suitably trained to manage people’s medicines and their competency was regularly checked.
The culture of the service was person-centred and inclusive. People and shared lives carers spoke positively about the way the service was managed describing the manager as approachable and very supportive.
There were effective systems to monitor the quality and safety of the service which included obtaining the views of people and others. There was good partnership working with others to make sure people received all the care and support they needed.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The shared lives model of care maximised people’s choice, control and independence.
Right care:
• People received care which was person-centred and promoted people’s dignity, privacy and human rights.
Right culture:
• The ethos, values, attitudes and behaviours of United Response shared lives management team and shared lives carers helped ensure people lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 22 February 2018).
Why we inspected
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.
We undertook a focused inspection to only review the key questions of Safe and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The ratings from the previous comprehensive inspection for the Effective, Caring and Responsive key questions were not looked at on this occasion. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has stayed the same based on the finding from this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Kuumba Imani Millenium Centre is the office location of United Response that provides a shared lives service that matches people [supported people] predominantly with a learning disability, with host individuals and families known as shared lives carers living in the local area. There were currently 20 people being supported by 25 carers providing care and support in their homes.
The service had a registered manager who had been in post since 2016.
Care records and risk assessments were well-kept and up-to-date. Each supported person using the service had a personalised support plan and risk assessment. All records we saw were complete, up to date and regularly reviewed. We found that the shared lives carers and supported people were involved in decisions about their care and support. There was an emergency continuity plan in all files we looked at that would be used for example if the person was taken to hospital. The information was a summary of the care and support required and other relevant information. We also saw that medications were handled appropriately and safely.
The shared lives carers who actually provided the service in their homes were all self-employed and had to go through an approval process. This covered similar areas to being employed, for example the completion of an application form, sending for references and obtaining a disclosure and barring check (DBS). We found that all the appropriate records were in place to ensure that they were suitable to work with vulnerable children and adults.
People's GPs and other healthcare professionals were contacted for advice about supported people’s health needs whenever necessary. The provider had systems in place to ensure that supported people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff and shared lives carers in relation to safeguarding adults.
The service had quality assurance processes in place including audits, staff meetings and quality questionnaires. The service’s policies and procedures had been regularly reviewed by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing, safeguarding, finances and recruitment.
Supported people and shared lives carers told us they were happy with the staff and felt that the staff understood the dynamics and support needs. The supported people and the shared lives carers we spoke with had no complaints about the service. The provider had a complaints procedure in place and this was available in the ‘service user guide’.
Further information is in the detailed findings below
We carried out this announced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2012 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
Kuumba Imani Millennium Centre is located near the centre of Liverpool and provides the office base for a shared lives service provided by United Response. The shared lives service matches adults, predominantly with learning disabilities, with host individuals and families living in Liverpool and the surrounding local authority areas.
The people actually providing the service are called shared lives carers; they are self-employed and are supported by staff employed by United Response who operate the service.
A shared lives service is essentially an opportunity for someone to live in a family setting. Placements are generally long term and there are many occasions where someone has lived with a carer since shortly after their birth. Both carers and the people being supported see the relationship as being a ‘part of the family’.
At the time of our inspection 27 people were being supported by 26 carers.
The service operates as United Response and not Kuumba Imani Millennium Centre; this is simply the office address where they are based. This is an administrative error regarding their registration and will be dealt with as a separate issue. It has no impact on the service being offered. Because everyone involved with the service recognises it as United Response we have referred to it as such throughout the report.
The service has undergone a lot of change recently and some of the carers were originally recruited by Barnardo’s. As a direct consequence of the changes there hadn’t been any new placements for approximately five years. The newly registered manager and the three care co-ordinators employed by United Response were in the process of looking at expanding the service being provided and were currently assessing new carers who in turn will be matched to new people who need this kind of service.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Shared lives carers were knowledgeable as to what care was needed to keep people safe and they had been caring for them for several years. They were professional, compassionate, dedicated and well trained and supported for the role.
The shared lives carers we spoke with told us they were fully involved with the support the people living with them received and they had regular reviews with their named care co-ordinator approximately every six weeks.
All of the relationships we observed during the home visits were relaxed and warm and we saw that people were living in a caring environment.
All of the shared lives carers we spoke with said they felt confident to express concerns and complaints and were confident that management would respond quickly and take any necessary action.
Because of the nature of the service being provided the views of the people being supported were obtained via the six weekly reviews undertaken by the care co-ordinators employed by United Response.
We found that the people receiving a service were being supported by skilled and competent carers who in turn were being supported by the staff members employed by the service. This ensured that people were being protected.
We saw that the provider had arrangements in place to protect the health, welfare and safety of service users where responsibility for their care was shared with others.
The provider had a policy in place regarding medication which provided instruction to carers on matters such as handling, administration, recording, storage and disposal. Carers were given training to support them in fulfilling their role.
One carer told us 'The level of support we get is what we want and are comfortable with. We know we can approach [Shared Lives' staff] if we have a concern'. We were told all staff were 'very approachable' and 'no-one minds helping at all'. Carers expressed confidence that the provider 'deals with issues as they occur'.
The provider had a complaints procedure in place which explained how to go about making a complaint. People and their carers were given a copy of the complaints policy when the joined the service.
We found people were treated respectfully and given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do.
The people who accessed the service were supported by staff that had been provided with suitable training and support with which to undertake their roles and responsibilities. The organisation monitored the quality of the service provided on a regular basis.