PSS Shared Lives (Manchester)

Updated 30 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 and 19 July 2018 and was announced. We called the service to announce the inspection the day prior to our visit. This was because this is a small service, and we wanted to be sure someone would be available to meet us at the office and facilitate the inspection.

Inspection activity started on 17 July 2018 and ended on 20 July 2018. It included a visit to the registered office, one home visit and phone calls to relatives and shared lives carers. We visited the office location on 17 and 19 July 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

The inspection team consisted of one adult social care inspector.

Prior to our site visit, we reviewed information we held about the service. This included the report completed by the CQC registration inspector when the service was first registered with us, and any statutory notifications the service had sent to us. Statutory notifications are information the provider must send us in relation to safeguarding, police incidents, serious injuries and other significant events that occur whilst providing a service. We had not received any feedback from members of the public or people using the service prior to this inspection.

We used information the provider sent us in the Provider Information Return to help plan our inspection. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We contacted professionals and organisations for feedback about the service. This included, Healthwatch Manchester, the local authority quality, performance and contracts team, professionals with recent involvement with the service and members of the service’s independent panel for approving shared lives carers. We received positive feedback about the service’s recruitment and selection procedures from one of the independent panel members.

During the inspection we visited one shared lives carer and one person using the service at their home. In addition, we spoke with one relative, a second shared lives carer by telephone. We spoke with the registered manager, the head of quality and compliance and one shared lives worker.

We reviewed records relating to the care people were receiving. This included three people’s care files and one person’s medication administration records. We looked at records related to the running of a shared lives service, including three shared lives carer files, one staff members recruitment records, records of training and supervision, monitoring visit records, quality assurance and audit records and safeguarding records.

Updated 30 August 2018

This inspection took place on 17 and 19 July 2018 and was announced. This is the first inspection we have carried out of PSS Shared Lives Manchester since it was registered in June 2017. The service was previously registered at a different address, and we did not inspect the service at that address.

This service is a shared lives service. It provides personal care to people living with shared lives carers in their own homes. Shared lives carers are self-employed, but recruited and ‘matched’ with people using the service by PSS Shared Lives Manchester. Staff employed by the service who support the recruitment, matching and monitoring of shared lives placements are called shared lives workers.

The service primarily supports adults with a learning and/or physical disability who have either previously been supported in foster care placements as children, or who have been referred to the service as an adult. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for shared lives; this inspection looked at people’s personal care and support.

At the time of our inspection, 17 people were using the shared lives service, all of whom had long-term placements with a shared lives carer. Not everyone using PSS Shared Lives Manchester receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where people receive such support, we also take into account any wider social care provided. There were four people using the service who received support with personal care.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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.

Shared lives carers had developed close, trusting and caring relationships with the people they supported. This had been helped by the service effectively matching people and their shared lives carers based on a range of considerations. For example, staff had considered people’s interests, goals, personalities and home environments.

Relatives praised the service and shared lives carers for the positive impact they had had on their family member’s confidence, health and general wellbeing. Shared lives carers monitored people’s holistic health needs and encouraged healthy lifestyles.

Staff recognised and put measures in place to help reduce the likelihood of people being harmed. However, some risk assessments would have benefitted from including a greater level of detail. There had been no accidents reported. However, shared lives carers were aware of accident reporting procedures, and we saw systems were in place to help monitor accidents and incidents and take action if required.

The service was pro-active in its approach to safeguarding people from abuse or neglect. For example, staff had identified an area of one person’s life where they were potentially vulnerable. Staff had arranged training for this person to help them build the skills and confidence needed to keep themselves safe. This demonstrated a pro-active and empowering approach.

People’s care plans recognised their abilities and strengths as well as areas they might need support. Shared lives carers supported and encouraged people to be as independent as they could and to build new skills. This had included supporting a person to build their confidence to self-advocate and to have increasing control over their own life.

Care plans were person-centred and reflected people’s interests, likes, dislikes and preferences. Staff gave people opportunities to provide input to their care planning and reviews and to provide feedback on the service they received.

Shared lives carers and workers received a range of training that would help them provide effective and safe care to people using the service. Shared lives carer’s training and development needs were regularly reviewed, and the provider arranged training to meet any identified needs.

The service was working within the requirements of the Mental Capacity Act 2005. Where people were able, they signed to consent to their planned care and support. Best-interest decisions were taken when people could not be supported to make certain decisions for themselves.

There was a thorough process in place for checking that shared lives carers were suitable for the role. This included assessment of their skills, values, motivations and home environment, along with standard recruitment checks such as a criminal records check and references. An independent panel approved any recommendations made to appoint a shared lives carer.

The provider had robust processes in place to help monitor and improve the quality and safety of the service. This included local checks of documentation, file audits and regular monitoring visits to shared lives carers and the people they supported. The provider monitored trends of indicators such as safeguarding and accidents to help ensure timely action could be taken to any emerging concerns.

The provider had strong governance processes. They had undertaken themed and targeted audits to help identify good practice and make recommendations to improve the service. For example, they had undertaken specific work in relation to the safe management of medicines and improving their approach to equality and diversity. The provider had considered good practice guidance relevant to their services and had carried out work to ensure such guidance was implemented at service level.

Shared lives carers felt well supported by the registered manager and organisation as a whole. They told us they were always able to speak with a member of staff to get support or advice, and would not hesitate to do so.