Nottinghamshire County Council Shared Lives Scheme

Nottinghamshire County Council Shared Lives Scheme provides both short breaks and longer-term placements to adults with learning disabilities, physical disabilities and mental health needs. At the time of our inspection, there were 74 people being supported in 61 households.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People received a remarkable service from extremely compassionate carers, who were fully supported and exceptionally well-led by the management team. The registered manager and care coordinators were very passionate about people receiving a personal service in the comfort and security of a family setting.

People were cared for within loving family homes. Carers demonstrated exceptionally caring values, such as kindness, compassion, inclusion and respect. Overwhelmingly, people spoke highly of their carers and the support they received.

The management team and carers fully embraced person-centred care and made sure people were at the heart of the service. People received a unique service which met all their needs and exceeded the expectations of traditional social care support.

People had achieved multiple positive outcomes through extensive support and encouragement from their carers and the families who surrounded them. People received timely interventions from external professionals, whom carers and the management team worked in very close partnership with.

The management team strove for consistently high standards and extensively monitored the service through regular visits to people and their carers at home. The quality and safety of the service was effectively monitored through wide-ranging checks and audits.

People felt very safe living with their carers. Measures were in place to minimise the risks they faced. Carers recognised risks and reported their concerns to the management team. Safeguarding policies and procedures were in place.

The recruitment and induction process for shared lives carers was extremely thorough to ensure people would be safe and comfortable living with new families. Carers benefitted from bespoke training which was tailored to meet people’s needs. They were highly skilled, knowledgeable and very competent in their roles.

People were supported to have maximum choice and control of their lives and their carers supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published 23 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had 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 carers understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were assessed and steps put into place to reduce any known risks.

There was a sufficient number of carers available to meet people’s needs and support was provided as required to support people to safely manage their medicines.

Carers were provided with the knowledge and skills they needed to be able to care for people effectively. People received the support they required to have enough to eat and drink and were fully involved in meal planning. People were supported, where required, to arrange and attend appointments with healthcare professionals.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. We also found that carers were aware of the principles within the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

People were treated with kindness by their carers and caring relationships had been developed. People were able to be fully involved in the planning and reviewing of their care and they made day to day decisions. People were treated with dignity and respect by their carers who understood the importance of this.

People were provided with care and support that was responsive to their changing needs. Carers also encouraged people to develop independent living skills and continue with any hobbies and interests they had. People felt able to make a complaint and told us they knew how to do so. Whilst there had not been any formal complaints, the registered manager responded immediately to any concerns.

People, carers and shared lives staff gave their opinions on how the service was run and suggestions were implemented where possible. There were effective systems in place to monitor the quality of the service. These resulted in improvements to the service where required. The culture of the service was open and honest and the registered manager encouraged open communication.

We spoke to a relative of a person who was using the service and they said, "They are marvellous. At first my relative wasn't sure about it, but they [the carers] showed us where [name of relative] would be sleeping and we have built a fantastic relationship. The service has been a huge help to me.'

We spoke to three carers who were working for the Shared Lives Scheme. They told us they felt well supported by the scheme to provide care that met people's needs. One person said, '[Name of person using the service] is a family member to me. The scheme works very well. The balance of support is just right.'

We also spoke to three Shared Lives Scheme Coordinators; their role was to provide support, identify development needs for the carers and ensure the person using the service was receiving the appropriate support. The people we spoke to said they felt well supported to meet the requirements of the role. One Shared Lives Scheme Coordinator said, 'I am passionate about quality and support.'

We also found that the provider took steps to effectively assess the quality of the service being provided.