Tower Hamlets Shared Lives Scheme

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

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 safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported any safety concerns to the relevant professionals without delay. There were processes in place for the reporting of any accidents and incidents and the registered manager was aware of the procedures to follow. The shared lives carer told us the registered manager and shared lives coordinators always listened to any safety concerns and provided valuable support and guidance when needed. They added, “If something is done wrong, they will tell me. It is done in a supportive way as there is a positive learning culture. We discuss what we can do differently to stop it from happening again.” People and their shared lives carers were given regular opportunities to provide feedback about their care experiences and how they were managing with the care arrangements.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people were supported between different services. The service had clear referral and matching processes that ensured people were placed with shared lives carers who could meet their needs safely and effectively. Transitions into and out of placements were planned collaboratively, with necessary checks and support in place. The provider and shared lives carer worked closely with local day centre services and a residential care service to ensure that respite care arrangements were safe, consistent, and person-centred. For example, when the person accessed short-term respite care, staff coordinated effectively with the residential service to ensure a smooth transition. Similarly, day centre staff were actively involved in care planning which helped to maintain continuity in daily routines and social connections. These partnerships helped reduce anxiety for the person and provided additional support for the shared lives carer. Furthermore, the provider had robust procedures in place to manage any emergencies or changes in circumstances for the shared lives carer. This enabled the person to feel secure and supported during any changes to their routine.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider had robust safeguarding procedures in place and all staff, including the shared lives carer, had a good understanding of their responsibilities. Shared lives carers completed safeguarding training and feedback confirmed they were very confident the registered manager would address any concerns immediately. Safeguarding scenarios were discussed during monitoring visits to further remind them of their safeguarding responsibilities. The registered manager said, “Safeguarding starts from the induction, with training about how to record and report any concerns. We want to make sure staff are confident in reporting concerns and who they have to report to."

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The person’s risks were assessed and staff worked closely with the shared lives carer and a range of health and social care professionals to fully understand them. There was clear and detailed guidance in place to ensure the person was supported safely with a balanced and proportionate approach that respected their choices. The shared lives carer confirmed they were fully involved when discussing risks and due to their long-standing relationship, understood how to keep them safe. The shared lives carer had experience and an in-depth understanding when managing specific risks related to the person’s health conditions. This was confirmed by all of the health and social care professionals we spoke with. One professional added, “[Shared lives carer] knows [person] so well and understands their needs. We have no concerns about their safety at all."

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider carried out a detailed home safety assessment before the shared lives placement was confirmed. This health and safety check covered the suitability of the home environment, including fire safety and emergency evacuation plans and procedures. The shared lives staff team had effective arrangements to monitor the safety and upkeep of people’s homes, which included regular spot checks and an annual review to observe the safety of the environment. The shared lives carer was responsible for carrying out a range of health and safety checks, which included weekly fire safety checks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. The provider had a clear and robust system for the safe recruitment of shared lives carers. This included a pre-application meeting, an in-depth assessment and a wide range of background checks. Due to the nature of the shared lives model, there was further oversight as potential shared lives carers had to be approved by a panel. These panels included a person who used the service, a shared lives carer from another local authority and relevant professionals, such as social workers and senior managers. Furthermore, the provider also had emergency staff cover procedures in place, which included ‘support’ carers and where needed, external care agencies, who were able to step in during an emergency.

The shared lives staff team and a range of health and social care professionals commented positively about the knowledge, skills and experience of the shared lives carer. The shared lives carer told us they had access to both online and face to face to training, with further support via regular monitoring visits. They added, “For some of the specific and complex training needs, this is carried out by the professionals. They are very responsive to any training needs and are very hot on this. The training I had around learning disabilities was excellent."

The provider had an effective approach to assessing and managing the risk of infection, with policies and training aligned with current best practice guidance. Monitoring visits checked the hygiene and cleanliness of the person’s home, with discussions with the shared lives carer around following best practice. The shared lives carer confirmed they had completed the necessary training and discussed their responsibilities during regular monitoring visits. We saw the provider had also been proactive in liaising with the local council around additional support with the disposal of clinical waste.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People’s care records included clear and accessible information about their prescribed medicines, with easy-read formats used to support their understanding and involvement. Shared lives carers received appropriate training in medicines management, which included an annual competency assessment carried out by a learning disability nurse.

During the inspection, any queries raised around medication administration records (MAR) were promptly addressed, with clear assurances regarding safe practice. Regular monitoring visits included checks on medicines processes and discussions with the shared lives carer about their responsibilities. The shared lives carer was positive about the level of support they received and told us it helped increase their confidence and reinforced good practice. There was further evidence of partnership working with pharmacies, GPs, and the Community Learning Disability Service (CLDS), particularly when changes to medicines occurred or issues were identified. This collaborative approach helped ensure people received their medicines safely and tailored to their individual needs.