Archived: Shared Lives Northumberland

Shared Lives has an office base at Merley Croft in Morpeth. The service recruits and supports families who provide homes and supportive placements, within a family setting, for adults with learning disabilities. The service covers the whole of Northumberland. At the time of the inspection the registered manager told us they supported 51 people within 47 Shared Lives carers’ homes.

A registered manager was in post and had been registered with the CQC since July 2012. 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. The day to day running of the location was carried out by a service manager, who would report to the registered manager.

People indicated they felt safe living with their Shared Lives carers. Carers had received training with regard to safeguarding adults and said they would report any concerns to the service or people’s care manager. The service had dealt with any safeguarding concerns appropriately.

The provider had in place plans to deal with urgent situations. Staff said that carers could contact them any time during the week or could contact the office for support. Carers could also contact people’s individual care managers for advice. Out of hours support was provided by the local authority’s Emergency Duty Team. Carers said they were well supported and they always received a response to any concerns or queries.

Processes were in place to recruit staff and to carry out checks to ensure they were suitably experienced. Shared Lives carers went through an extensive assessment process, looking at a range of matters including their backgrounds, health and experience. All carers were required to be approved by a formal assessment panel before being matched with a person to support.

People receiving support with their medicines were assisted appropriately and carers confirmed they had received training in the safe handling of medicines.

Carers told us they had received a range of training, both as part of their induction and on an ongoing basis. They were positive about the training offered. Staff also confirmed they had access to a range of training. A new on line training system was being developed to make it easier for carers to access training and track that training was up to date.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Staff were aware of the Mental Capacity Act 2005 and issues relating to personal choice. The registered manager confirmed that no one using the service was subject to restrictions imposed by the Court of Protection. Some people had deputyship orders in place to help them manage their finances.

People were supported to maintain their well-being. Carers worked with health professionals or therapists where they were actively involved in people’s care. People were also supported to attend hospital or medical appointments. People had access to a plentiful choice of foods and drinks.

People said they were happy and well cared for. We observed relaxed relationships between people and their carers. They said their privacy and dignity was respected and they had their own rooms that they could access at any time.

People’s needs were assessed and care records called “All about me” detailed the type of support they required. Documents contained goals that people wished to achieve. There were regular reviews of people’s care. The registered manager told us there had been one recent formal complaint. This had been dealt with appropriately. People told us they were happy with the care provided and they had no complaints about the service.

The provider had in place systems to effectively manage the service and monitor quality. Regular reviews of placements took place to ensure people were receiving appropriate levels of care and support. Carers were contacted to solicit their views of the support they received from coordinators. The service was participating in research looking at extending Shared Lives services. Staff told us there were regular team meetings which covered business and care support matters. Records were up to date and stored securely.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found '

Is the service caring?

People's care files contained an "All about me" document which detailed people's likes and dislikes and also highlighted what they wanted to do and achieve through the placement. Files also contained information about people health, social and dietary needs.

We observed during our visits that people looked happy and relaxed in their homes and got on well with their carers, shared jokes, positive banter and talked about what they wanted to do. Carers told us people were treated as members of the family and were involved in all aspects of family life. One carer told us, "I couldn't imagine her not being here; she is part of the family."

People told us that they were happy living with the carers and their families. One person told us, "I love it here; you have company and a laugh. You have someone to talk to." Other people told us, 'You get a laugh all the time. I'm more happy here than anywhere else' and 'I'm happy here. I have had my ups and downs but feel I have settled in now.'

Is the service responsive?

People we spoke to told us that it was their decision if they want to participate in activities. We saw that people were asked their permission before carers carried out actions or tasks. For example, people were asked if they wished to show us there rooms and then accompanied us to show us their personal accommodation and items. One carer told us, 'She prefers her own space in the evening; she joins in family activities when she wants to.'

One supervisor told us that, once the care package had been agreed, then he would go out and spend time reading through the document with the individual to ensure they were happy and understood all about their care plan. People we spoke with told us that they had a copy of the document 'All about me' and that staff members and care managers talked to them about it.

We noted that people's care files contained copies of reports from consultants, physiotherapists and diabetic services. We noted that people had been supported to attend hospital or other health appointments. For example, we saw on person's care records indicated that they needed regular appointments with the chiropodist. We saw from reviews that the person was supported to attend appointments for foot care.

The manager told us that carers could contact the office if they had any concerns, the person's care manager or, out of hours, the emergency duty team. One carer told us, 'They are very supportive and responsive; they always ring back. They are available almost 24/7.'

On person's care manager told us that the service was, "Very supportive." She told us that if any of her clients intended to use the Shared Live service for respite then there was always an introductory visit undertaken jointly between herself and a member of the Shared Lives team.

Is the service safe?

Carers told us that supervisors from within the service visited approximately every four weeks. During these visits they checked people's diaries to ensure that activities were taking place, checked medicines records, health and safety issues and financial records and information.

We found that there was a range of training and support mechanisms in place to support the families and ensure that they had enough knowledge and understanding of people's needs. We saw that there was a comprehensive range of training undertaken by families. Training included first aid, the safe handling of medication, safeguarding vulnerable adults and equality and diversity. The manager told us that all carers had recently undertaken Non-Abusive Psychological and Physical Intervention (NAPPI) training.

We saw that the service was subject to yearly audits from the Audit and Risk Management Department, within the provider's organisation and viewed copies of the report, which reviewed a range of issues including records, risk issues and the monitoring of care.

We noted that new carers, applying to be part of the service, were subject to a review by and independent panel. We saw that this panel considered a range of aspects to ensure that the person applying had the appropriate skills and aptitude for the service.

We saw that people who used the service had been assessed in terms of their mental capacity, in line with the Mental Capacity Act 2005, by their care managers, as part of their annual review. Records showed that most people had been assessed as having capacity to make their own decisions. We saw in one person's record that a best interest meeting had taken place to consider the best course of action to take because the person was unable to make the decision themselves.

Is the service effective?

People who used the service and carers told us that staff from Shared Lives visited on a regular basis and reviewed their activity diaries to ensure they were being supported to achieve their goals.

Carers also told us that most activities revolved around ensuring that people who used the service achieved the lifestyle they wanted. People we visited showed us mementos and photographs from visits and holidays they had been on with their carers. People told us that they had been on various holidays in Britain and abroad and had further trips abroad planned.

People's daily diaries, held at their homes, showed that they were encouraged and supported to attend appointments. We saw evidence that people had been involved with counsellors, dental surgeons and physiotherapists.

We saw copies of yearly satisfaction questionnaires sent to people who used the service. We noted the questionnaires were in a format that made them easily accessible to people. We saw the results of the most recent questionnaire indicated that 18 people had returned surveys and that 17 (94%) were satisfied with the service provided.

The manager told us that there had been no formal complaints within the last 12 months, although there had been one previous complaint that had been quite involved and had only recently been completed. We saw letters and documents from the investigation of this complaint and saw that a rigorous process had been followed and a full explanation sent to the person raising the complaint.

Is the service well led?

The manager told us that the service and the carers worked with a range of professionals to ensure that people who used the service received the care that they required. The manager told us, and records confirmed that they and the carers supporting people worked closely with people's individual care managers.

People who used the service and carers told us that staff from Shared Lives visited on a regular basis and reviewed their activity diaries to ensure they were being supported to achieve their goals. Both carers and people who used the service told us that they could contact staff from Shared Lives if they had any concerns or wanted to talk about anything.

We saw that the manager also received quarterly monitoring information from within the organisation. This quarterly report covered areas such as percentage of supervision completed (100%), appraisals completed (100%); sickness days and whether staff had up to date Disclosure and Barring service checks.

We saw that staff formally employed by the service had access to a range of training, had regular supervision sessions and annual appraisals. We also saw notes from regular team meetings where a range of issues were discussed, including issues effecting families and people using the service. One staff member told us, 'There is regular supervision, every six to four weeks. It seems to appear very frequently in my diary.'

Carers told us people were involved in all aspects of family life. One carer told us, "You treat people how you would like your mum and dad to be treated." Carers also told us most activities revolved around ensuring people achieved what they wanted to. One person told us, 'I love it here. I like to go in the garden and plant plants. I would not change anything."

All the carers we spoke to confirmed that they had attended safeguarding training and were able to describe safeguarding issues and who they would contact if they had any concerns.

Staff directly employed by the provider had been through a full and proper recruitment process. We noted there was an extensive recruitment process involved in the recruitment of paid carers to the scheme, who were subject to detailed assessment, often taking six months or more and final approval by a panel.

We found people who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted upon. There was evidence that learning from incidents and investigations took place and appropriate changes were implemented.