Shared Lives Bedford

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 proactive and positive culture of safety, based on openness and honesty.

Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People told us they felt safe with their shared lives carer and had developed strong connections. People and their shared lives carers told us they were able to contact staff by telephone or email, and they had a number in case of emergencies.

We saw evidence of regular visits and reviews by staff where concerns and risks were discussed.

The service logged concerns raised by people and shared lives carers and recorded the actions taken to resolve the issue.

One stakeholder told us “The provider works collaboratively and promptly to concerns and is proactive in engaging with partners to bring about resolution and/or intervention as needed.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider worked with stakeholders to ensure people had appropriate support plans in place when they transitioned from child to adult services. This meant people did not experience disjointed care or any delays in having the support they needed. One stakeholder told us, “Services are well planned and transition between services is without problem to date - due to open communication and robust planning.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their shared lives carers told us they reported incidents straight away and the provider had taken the necessary action. They told us if required, staff would visit them as soon as possible. One shared lives carer said, “We’ve had safeguarding issues, and we reported it immediately and they dealt with it very well I thought.”

All shared lives carers and staff received safeguarding training which included how to support people to take positive risks. Policies and procedures, as well as discussion about keeping safe, provided people, shared lives carers and staff with guidance about how to report abuse.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us they were involved in care planning and risk assessments. One person told us, “Yes we’re involved and we’ve got a new lady now who goes through everything with us as well.”

Risks were identified and risk assessments were completed to understand the impact, likelihood and any required mitigation. Assessments of people’s needs included their choices and preferences while promoting independence and positive risk taking.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Shared lives carers completed a detailed health and safety checklist which included information on utilities and emergency procedures. This was supported, verified, signed and reviewed by a shared lives staff member.

The registered manager had a structured system in place to match shared lives carers with people. Matching profiles included clear information about the home environment, such as what the person’s bedroom would look like and their personal space to help them feel comfortable before visiting. People were provided with opportunities to spend time with shared lives carers in their home environment prior to making their choice about where they would like to live, stay or spend time.

Shared lives carers and staff received online moving and handling training. If they were supporting someone who needed equipment for example a hoist, in person practical training sessions would be arranged to ensure the safe use of equipment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and their shared lives carers told us they felt better supported now that there was another shared lives member of staff they could contact.

Staff told us they received encouragement and felt supported, and we saw collaborative supervision records completed regularly.

Robust recruitment checks were carried out for staff. There was a thorough application process for new carers with every stage of the process documented.

Shared lives carers told us they found the training they had helpful and had access to additional, specialist training. They could access learning and development support from staff, however, people told us more in person training would be beneficial which they had shared in their feedback to the provider.

The provider assessed and managed the risk of infection.

Health and safety checklists completed by shared lives carers and reviewed by staff included questions around infection prevention and control including cleanliness, hand hygiene processes and use of personal protective equipment.

Shared lives carers and staff completed annual infection, prevention and control training and the provider had guidance relating to hygiene and infection control, food safety and hygiene, safe working practices and control of substances hazardous to health.

Weekly summaries completed by shared lives carers included information on how they had provided support to people with their personal hygiene and household management including cleaning and laundry.

Care plans detailed the support people required with their medicines, however, some care plans were missing important details for example, ordering and storage of medicines and people’s preferences for medicines administration.

One person’s medicines risk assessment stated that they were at risk of refusing medicines however, there was no reference to their mental capacity to make this decision.
The provider added information to people’s support plans following the feedback from CQC.
Medicines administration record (MAR) charts did not always contain the required information for example, person’s date of birth, medicines start and end dates. Following carer feedback the service was transitioning to different MAR charts.

No medicines competency observations or spot checks were completed by the staff.
However, competency checks are being planned once carers have all transitioned to the new MAR charts being implemented.

Medication policies, guidance, risk assessments and training clearly detailed responsibilities for medication management. Staff and shared lives carers were provided with medication awareness booklets which included guidance, information and recommendations.

Staff and shared lives carers completed annual assessments to demonstrate their awareness of training and policy, administration of medicines, consent and promoting independence, selection and preparation of medication, record keeping, stock control and disposal, non-prescribed medication, accessing advice and information and dealing with errors. The outcome of their assessment was recorded and signed by the registered manager.