Tower Hamlets Shared Lives Scheme

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 83 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The provider worked closely with a range of health and social care professionals and the shared lives carer to ensure they fully understood the person’s needs. There was a detailed initial assessment, which was reviewed after 6 weeks to see if any changes were needed. This was then reviewed through regular monitoring visits, with an annual review in place to identify how the placement was working and if any changes were needed. The shared lives carer was positive about the initial assessment process. They said, “It was very detailed and in-depth. It really impressed me."

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. The provider met with people, the shared lives carers and relevant health and social care professionals to gather important information about people’s medical histories and health conditions. They did this in line with legislation and current evidence-based good practice and standards. The local authority assessments were also reviewed and discussed to help develop people’s individual care plans. Where appropriate, the provider had best practice guidance available to ensure the person received a good standard of care. This involved support from the Community Learning Disability Service (CLDS), which included detailed assessments and guidance from the speech and language therapy (SALT) team.

The provider demonstrated outstanding partnership working with strong evidence of an integrated approach across the shared lives staff team, the shared lives carer and a wide range of health and social care professionals. This resulted in a highly coordinated and joined up approach to care. Assessments were carried out using a fully integrated multi-disciplinary team (MDT) approach, which involved professionals who knew the person well and contributed meaningful insights into their support needs. As the shared lives service was run by the local authority, they had direct access to health and social care professionals, enabling timely and informed decision-making, particularly when responding to changes in the person’s health and wellbeing. This included the GP, the CLDS and the Positive Behaviour Support (PBS) team. For example, the shared lives carer described how the learning disability nurse provided direct support during an AE admission, which ensured the person’s needs were understood and met in a challenging environment. The shared lives carer added, “It took becoming a shared lives carer to get this support. I don’t know what would have happened if it hadn’t been for shared lives.” The provider’s commitment to working in partnership across services reflected best practice and contributed to a positive culture of continuous improvement and high-quality care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. The shared lives carer, with the support from the shared lives staff team, supported the person to live a healthier life and where possible, reduce their future needs for care and support. The shared lives carer had an excellent understanding of the person and was proactive in reporting any changes in their health and wellbeing. They always supported the person to attend appointments, and worked with the relevant health and social care professionals to ensure appointments were made that supported the person’s routine and reduced any unnecessary confusion or distress. The registered manager had also been involved in contacting professionals to highlight if further support was needed to help manage their care needs. Monitoring visits also discussed any recent health appointments and if any additional support, for both the person and the shared lives carer, was needed.

The provider consistently demonstrated a proactive and embedded culture of improvement, with a clear commitment to achieving the best possible outcomes for people. There was a strong emphasis on meaningful involvement, where people and their shared lives carers were actively engaged in shaping their care and support. The shared lives staff team worked proactively with the person, the shared lives carer and a range of health and social care professionals to review progress to ensure care remained effective and person-centred. There was clear evidence the person experienced significantly improved outcomes as a result of the care and support they received.

For example, the person had complex care needs and there had been periods where they became distressed and upset. The shared lives carer told us how the provider’s enhanced monitoring of their concerns led to additional support being provided and praised the positive outcome. They added, “They came and observed when we had difficult times, and they saw what was needed and put plans in place. The impact has been great and this has made a massive difference in how I support [person] and manage any challenges. It has helped so much and reduced their distress. They are now much better engaged and less distressed, both at home and when out during the day. I have to highlight the level of support we have received from the shared lives team. Without it, I don't think this arrangement would have lasted and this has definitely had the most positive impact on us.”

A healthcare professional praised the level of support the person received where they helped them live better lives. They said, “[Person] is really part of the family and very much part of their lives. We had a full MDT approach as we were unsure why there were changes in their behaviour. With all the input, it has resulted in a better outcome. Things have settled and everything is going smoothly.” We saw feedback from another health and social care professional that stated, ‘[Shared lives carer] has been an empowering carer to work with. They have been amazing with both [person] and us, actively engaging with us and regularly keeping us updated. They are truly the embodiment of positive behaviour support, with constant ideas and a willingness to constantly improve [person’s] life. They truly fulfil their carer role and go above and beyond to understand [person].'

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The shared lives staff team, including the registered manager, demonstrated a clear understanding of the principles of the Mental Capacity Act (MCA) 2005 and applied them appropriately in practice. Where people lacked capacity to make specific decisions, the shared lives staff team followed a clear and structured best interest process, which fully involved the shared lives carer, the relevant health and social care professionals, and the person themselves wherever possible. This information was provided in accessible formats to support their understanding and decision-making. We saw examples where important decisions were made with careful consideration of the person’s preferences and wellbeing. The shared lives carer had an excellent understanding of their responsibilities under the MCA, with monitoring visits covering discussions around capacity and consent to ensure best practice. This helped ensure that care was delivered in a way that was lawful, respectful, and person-centred.