Shared Lives

Updated 2 March 2019

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 announced inspection took place on 24, 28 and 29 January 2019 and was carried out by a single inspector. We gave the service short notice of the inspection because we wanted to visit and speak with people using the service and their Shared Lives carers (SLCs), where possible, and this allowed time for them to accommodate our request.

Before the inspection we reviewed the information held about the service, including previous inspection reports and information since the last inspection. We considered the information the provider sent us in the Provider Information Return. 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 used this information to help inform our inspection planning.

During the inspection we spoke with seven people using the service, three people in their shared lives placements and four people chose to speak with us at the scheme’s office. We spoke with 12 SLCs either visiting them at home or at the scheme office or by phone. We visited the scheme offices and spoke with the scheme’s staff including the registered manager, the scheme lead and a placement officer. We looked at a variety of records including recruitment, assessment and training details for three SLCs and three staff records, aspects of care and support records for six people using the service and other documentation relevant to our inspection.

Updated 2 March 2019

Shared Lives (Bromley) recruits, trains and supports self-employed Shared Lives Carers (SLCs) who provide placements and respite care for vulnerable adults within their own family homes in the community. Some people using the service have learning disabilities and or autism. At the time of the inspection there were 38 SLCs and 33 people using the service.

Not everyone using Shared Lives (Bromley) receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help or prompting with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

At our last inspection we rated the service good overall. At this inspection we found the service had made further progress in some areas and the evidence continued to support the rating of good in most key questions. However, we found some improvement was needed in the key question safe, to the way some risks were recorded to ensure that relevant information was available to SLCs and staff. We have also made a recommendation in relation to the management of medicines. The registered manager started to take action to address these areas during the inspection.

The service remains rated good overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us they were safe and enjoyed living with their SLCs. The SLCs and staff working on the scheme had a good understanding of the signs of possible abuse and how to report it. Most risks to people were identified, assessed and plans put in place to reduce the likelihood of the risk occurring. The provider regularly updated and monitored these to ensure people were safe. SLCs understood the importance of infection control and the need to reduce any possible risks. The registered manager and team were proactive in identifying any learning from incidents or safeguarding to make improvements to the service.

Robust recruitment processes were operated for staff and the SLCs to ensure only applicants suitable for the role were approved. There were enough staff and SLC’s to ensure people’s needs were met at all times and there were effective arrangements in place for emergencies.

SLCs received a range of training to provide them with the skills and knowledge to care for people effectively. SLCs spoke very positively about the training and support they received from the staff who worked on the scheme.

People were encouraged to eat healthily and their nutritional needs were identified and met. People had access to a range of health professional advice when needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Some people had lived with their SLCs for a number of years. People spoke very highly of the care and support they received from the SLCs. They said they were consulted about their care, that they felt part of the family and encouraged to do things independently where possible; in line with registering the right support.

People’s needs were assessed before they joined the service and they had individualised care and support plans that addressed their needs. People’s diverse needs were recognised and met and information was available in a range of formats if needed. They received highly personalised care and told us about changes and improvements they felt they had made since being part of the scheme. It was evident the scheme had improved outcomes for people.

In line with registering the right support guidance people were encouraged to be as independent as possible and to be part of their local community. SLCs were positive about the work they did and the support they received from the scheme. People were aware of how to make a complaint if they needed to.

Everyone we spoke with was complimentary about the way the scheme was managed and the leadership of the registered manager. The service had developed since the last inspection and made several improvements to the way they monitored the service and sought feedback. There was a culture of continuous improvement. The scheme worked in partnership with other professionals and agencies and looked to learn from best practice. Feedback from people and SLCs was sought to consider how to make any improvements.

SLCs told us there was a positive and open culture about the way the service was managed and we confirmed this from our findings.The service worked to deliver personalised care in a sensitive and supportive manner.