Tower Hamlets Shared Lives Scheme

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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 needs were met through good organisation and delivery.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service demonstrated an exceptional commitment to person-centred care, which was deeply embedded in its ethos and daily practice. People were always at the centre of their care and were consistently supported in ways that reflected their unique identities, preferences, and life experiences. Care plans were detailed and personalised, developed in partnership with key stakeholders and tailored to people’s individual needs. The shared lives staff team and the shared lives carer showed a deep understanding of the person, and we saw their relationship had been built on trust, respect, and genuine connection. People’s preferred communication styles were used so they could take part in reviews of their care. This enabled people to have their views, opinions and feedback captured and acted on.

There was strong evidence of creative and meaningful approaches to person-centred care. For example, the shared lives team, with the relevant consent, produced a video documenting the life of the person, which highlighted the positive impact of shared lives on their wellbeing, independence, and sense of identity. The video was used to help others understand and appreciate them as a person, not just someone receiving care. It powerfully illustrated how the provider celebrated individuality and promoted inclusion. A shared lives coordinator said, “This was one of the ways we could get their views and get to see them as a person.” The shared lives carer told us the person always reacted positively to watching the video and displayed positive emotions when seeing themselves on the screen.

The provider and the shared lives carer consistently went above and beyond to ensure the person was involved in decisions about their lives, from daily routines to long-term goals. They were supported to maintain relationships, pursue hobbies, and engage with their communities in ways that were meaningful to them. This strong person-centred culture resulted in the person and the shared lives carer feeling valued and empowered.

The provider upheld the principles of personalised care and avoided disruption that might have resulted from a move to an inappropriate setting. This demonstrated a commitment to personalised care that respected the individual’s history and reflected best practice in delivering joined-up, flexible support, tailored to the individual’s assessed needs. The shared lives carer said, “None of this would have been possible if they had not come over to shared lives. For [person] to continue to have a very positive lifestyle, living with myself and my family is very important. They could not manage to have an independent life sadly, so continuing to be with shared lives is a way forward for them to maintain this."

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. The person received well-coordinated and consistent care from a shared lives carer that had known them and cared for them across services for many years. The shared lives carer, with the support from the shared lives team, acted as an advocate and helped the person to organise and plan their care. All shared lives staff and the shared lives carer communicated effectively with each other and with external health and social care professionals to ensure care was integrated and seamless. For example, when the person experienced changes in their health, the service worked closely with the relevant professionals to identify what could be done and if additional support was needed. Health and social care professionals praised the level of the support provided and the positive benefits of the person being within the shared lives service. A health and social care professional said, “They are very much part of the family. It is a very positive placement."

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information about the service was available in a range of formats, including easy read documents. It was also shared with people and their shared lives carers through email and instant messaging applications. People’s communication needs were assessed and discussed during their initial assessment. There were clear and detailed records about how the person communicated and the shared lives carer had an excellent understanding of this. We saw documents within the family home that were accessible to the person. The shared lives carer was also able to use a range of communication tools and resources to be able to ensure the person was fully involved and supported to understand important decisions about their care and support. This included communication through body language, visual prompts and Makaton. Makaton is a type of sign language that uses signs, symbols and speech to help people with their communication.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people and the shared lives carers in decisions about their care and told them what had changed as a result. Although there had been no complaints from the person, the shared lives carer supported the person to assist them to understand any decisions that had been made about their care and advocated on their behalf when needed. The shared lives carer knew how to complain and told us they were given all the relevant information during the application and assessment process. They were very confident they would feel listened to and the service would take it seriously. They added, “I can contact them anytime if I have an issue and I know who to contact and when. They have always been open and responsive from day one.” The registered manager said they regularly reminded people and their shared lives carers to contact them at any time if they needed to. They added, “I would hope the culture of the service would mean that people would feel comfortable to make a complaint if they wanted to."

The provider made sure that people could access the care, support and treatment they required when they needed it. The provider had a clear ethos for the service based on human rights, anti-discrimination and equity principles, and shared lives staff and the shared lives carer understood these. The shared lives carer said, “They involve me and [person] as much as they can. We are included in everything, all of the activities, even if it isn’t possible. They are very inclusive.” We saw, with the joint working approach between the provider and the shared lives carer, they had supported the person to access community facilities. The provider had worked closely with the person and the shared lives carer to ensure additional support, including transport, was provided that enabled the person to attend services regularly throughout the week. This had resulted in positive outcomes for the person. The shared lives carer said, “[Person] loves going there, they do lots of new things, like yoga and dance. They help the support workers prepare breakfast for the other service users. They love getting on the bus….getting off the bus is a different matter!"

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Shared lives staff and the shared lives carer understood the needs of autistic people and people with a learning disability and worked hard to ensure typical barriers faced by people were removed or reduced. For example, the shared lives carer worked closely with a range of health professionals to help them understand why the person would feel more relaxed and comfortable at early morning appointments. Without this, it increased the risk of negatively impacting their wellbeing. This approach resulted in positive outcomes for the person and ensured important health appointments were not missed. We saw examples where the shared lives carer stepped in to provide care and support in healthcare settings as they were concerned the person’s needs would not be met due to communication barriers and healthcare staff not fully understanding how to communicate with the person. Where this had happened, the shared lives carer also advocated for the person and raised concerns about how they had been treated, in the hope it would result in better outcomes for other people. The shared lives carer said, “[Person] can become very frustrated when people don’t understand them, and they look to myself or family to interpret for them to show and tell people what they’re trying to say."

People were empowered and encouraged to share their views, future goals and aspirations, including any important life changes. The shared lives staff team and shared lives carers worked with people to help them make informed decisions about their future. During annual reviews, people’s goals, outcomes and aspirations were discussed, and people were able to contribute their ideas and wishes. Care records included information about people’s outcomes, with things they wanted to achieve or make a difference in their life. For example, we saw there were plans to try to book a holiday, and the person had been supported to get a passport for the first time. A shared lives coordinator told us this was discussed during the initial assessment and matching process, and then it was monitored throughout the year. They added, “We discuss the expectations of the shared lives carer being able to meet these needs and their aspirations, and we have an involvement in what the goals need to be. We discuss with the shared lives carer and they are fully aware of what [person’s] goals are.”Although the provider was not supporting people at the end stage of their life, annual reviews included discussions around this topic and any future plans involving the shared lives carer and their plans for continuing their caring arrangements.