Tower Hamlets Shared Lives Scheme

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service since it was registered in June 2019. This key question has been rated good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 85 (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 consistently demonstrated exceptional kindness, empathy and compassion, with a deeply embedded culture of dignity and respect. Shared lives staff not only treated colleagues from other organisations with kindness and respect, but also fostered strong, collaborative relationships that enhanced the quality of care. The person and their shared lives carers lived together in a family setting and had done for many years. We met the person and their shared lives carer in their family home. It was clear from our observations there was a close personal bond, marked by genuine affection, emotional warmth and mutual trust. The person was visibly relaxed and comfortable in their home environment, which reflected a deep sense of belonging and emotional security.

The provider also checked how the relationship was during regular monitoring visits. Records showed the person was an active part of the family set up and fully integrated into everyday life. It also included checks around how the shared lives carer respected their privacy and dignity. The shared lives carer spoke warmly about the relationship they had developed. They added, “The key focus is all about [person]. If they are happy, then so am I. [Person] is very much an integral part of the family.” Health and social care professionals also spoke positively about their relationship. Comments included, “Whilst it is professional, it is more than that. They are more than just a person placed in their care. There is love and affection. They are a great support and very committed” and “It is the best relationship. When I visit, you can see it is a loving and caring relationship. They are very comfortable in each other’s presence and [shared lives carer] understands them so well."

People received individualised care and support. The provider treated people as individuals, whilst people were treated as members of a family and empowered to make decisions about their life. The shared lives service had a detailed ‘matching’ process, which focused on the person and the shared lives carer, what was important in their life and what were the shared interests. Where possible, the provider matched shared lives carers with people who shared similar personal, cultural, religious and social preferences. A shared lives coordinator said, “Communication is very important if it is going to be a good match. A good relationship always starts from the beginning.”

People were supported to become part of the shared lives carer’s wider family, spending time with different family members and friends of the shared lives carer. The person was supported to develop positive relationships with people that were important to them. The provider and the shared lives carer empowered the person to engage with their local community. The provider worked closely with the shared lives carer and the relevant health and social care professionals to ensure communication tools were always tailored to the person and available to them to enable them to express their views, wishes and to make decisions.

There was a strong ethos of promoting independence. The provider and shared lives carers promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. The person and their shared lives carer had positive experiences in how the provider ensured they were always fully involved in decisions related to their care. The shared lives carer told us the person had a full and active life, being fully supported to follow their interests and be fully involved in making choices about what they wanted to do. This was confirmed by health and social care professionals. From our observations, we saw the shared lives carer communicated with the person effectively to be able to understand what they wanted and empowered them to do this. For example, this included the clothes they wanted to wear, their food and drink choices and the television programmes they wanted to watch. This also included routines around attending a service centred around the person’s best interests.

The provider and shared lives carers were exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Changes in the person’s presentation, emotional state or distress which showed a possible deterioration in their health or wellbeing was expertly recognised by the shared lives carer. Due to their excellent understanding of the person, especially their communication needs, the shared lives carer took action when they identified changes and escalated them to the relevant professionals.

A health and social care professional highlighted an example of this during a hospital admission. The shared lives carer requested a side room as they were aware they were becoming distressed. They added, ‘By doing this, not only did it make sure that [person] had the space to feel more at ease, but also showed how much they truly consider their comfort in challenging circumstances.’ Another comment from a health and social care professional stated, ‘The shared lives carer is highly attuned to [person’s communication needs] and can predict changes in their behaviour. They are able to explain how or what they are trying to communicate, which has resulted in detailed input with the relevant health and social care professionals.’

The provider also made sure they were aware of how the person may respond if they were in discomfort or distress. We saw this was discussed in detail with the shared lives carer during a recent annual review. The annual review confirmed the shared lives carer had an ability to tune into the person expressed themselves and advocated on their behalf as they had a deep understanding of them. We saw records confirmed this was particularly evident during a recent health concern where the shared lives carer quickly identified a subtle change in the person’s behaviour and took immediate action to ensure they received the necessary medical attention. A shared lives coordinator said, “It is important for us to be able to understand body language, what they show through their emotions and observing changes in their mood and presentation."

The provider cared about and promoted the wellbeing of both their staff and the shared lives carers. The registered manager created a supportive work environment and supported and enabled all staff to always adopt a person-centred care approach. People were supported by a staff team and shared lives carers who felt valued and appreciated. The shared lives carer told us the registered manager and their team had a strong focus on their health and wellbeing. They said, “They are always asking how I am and if I am okay. They always encourage me to make sure I am looking after my own wellbeing. I'm incredibly fortunate with the support I get from them.” The shared lives carer also told us they had regular carer group meetings and support via instant messaging chat groups. They added, “This really helps with moral support.”

Monitoring visits also had a clear focus on the shared lives carer well-being. They discussed the positive aspects of being a shared lives carer and any difficulties they faced. They were asked about the impact this had on their life and what support was needed, including the need for scheduled breaks throughout the year. The shared lives staff team also highlighted the positive work environment that had been created and the support available to them, especially when they were dealing with their own personal circumstances. A staff member added, “[Registered manager] has a good understanding of this. They are clear on what has to be done, but they are flexible. I think they are an amazing manager.” The registered manager added, “If we can support all our staff well, they can support people in the best way. The monitoring we do is a formal way of checking in with the shared lives carers, having carer groups for peer support, including other outlets of support with meetings with the social workers."