Wakefield MDC Shared Lives Service

People’s experience of using this service: The service had a very good approach which put sharing lives at the heart of what they did, and enabled people who used the service to increase their independence and sense of security. There was a focus on helping people who used the service express their views and have new experiences. People were partners in defining and reviewing their care needs, and gave positive feedback about their homes and respite placements. There were consistent examples of people being supported to achieve goals which were important to them, including moving into their own homes. The service ensured people had maximum choice and control of their lives, evident in systems to ensure people were included in decisions, were asked for consent and were supported to take positive risks.

People providing respite placements received good support to provide long and short term placements for people, who described them as ‘homes-from-home.’ Recruitment to the role was thorough, and a high standard of on-going training and support was in place. Staff who worked in the service were also recruited safely and had a good level of on-going support.

We received consistent feedback about strong leadership and a caring, inclusive culture in the service. The registered manager made good use of consultation, empowerment of staff and formal monitoring activity to ensure quality in the service was maintained and continued to develop. The service worked well with other partners in people’s care and in the wider social care environment, and ensured people providing placements had opportunities to learn about specialised areas of interest from professionals in these fields.

There were good systems and practices in place to ensure people who used the service were protected. People received an appropriate level of support with medicines and were supported to manage these themselves when it was appropriate. When any accidents or incidents occurred, they were reported diligently and investigated as necessary. When things did go wrong, the service worked to ensure the risk of any repeat occurrences was as low as possible. Everyone involved in the service understood how they could raise complaints or concerns, and the service had a proactive approach in investigating these to ensure they were resolved.

Rating at last inspection: Good. (Published in November 2016). At this inspection we have again rated the service as Good, however they had improved to Outstanding in one key question.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor the service and plan to return to re-inspect it in line with our normal timescale for this rating. We may return sooner if we become aware of increased risks to people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service recruited individuals, couples and families and supported them to provide homes and short term respite placements, within their own home, for adults with learning disabilities, physical disabilities, mental health difficulties and older people, some of whom are living with dementia.

At the time of the inspection the registered manager told us the service supported 121 people within 106 Shared Lives carers' homes. The day to day running of the service was carried out by three Share Lives social workers, one care coordinator and two administrators, who all reported to the registered manager. The service had vacancies for a further two social workers.

A registered manager was in post and she had been registered to manage a regulated activity with the CQC since February 2014. 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.

The people we spoke with told us they felt safe living with their Shared Lives carer(s). Carers had received training in safeguarding adults and told us they would report any concerns to their Shared Lives social worker or a person’s care manager within the local authority. We saw that the service had dealt with historic safeguarding concerns appropriately and notified external agencies as necessary.

Carers told us they felt well supported by the service and they always received a response to any concerns or queries they may have. Overall morale was positive.

Processes were in place to safely recruit staff and to carry out checks to ensure they were suitably skilled and experienced. Shared Lives carers went through a vigorous assessment process, including vetting checks of their backgrounds, such as health, finances and experience. All carers were required to be approved by a formal assessment panel before being matched with a person to support.

People receiving support with their medicines were assisted safely and properly and we saw carers had received training in the safe handling of medicines. Carers told us they had received a range of training, both as part of their induction and on an ongoing basis. Office staff also confirmed they had access to a range of training. The administrator showed us a training matrix which had been developed to make it easier for the office staff to access and track that carers' training was up to date.

Office staff were aware of the Mental Capacity Act 2005 (MCA) and understood their responsibilities with regards to MCA principles. The registered manager confirmed that 13 people who used the service were potentially being deprived of their liberty and applications had been made to the local authority to authorise this. This demonstrated the registered manager ensured proper and legal processes were followed with regards to the MCA.

People were supported to maintain their health and well-being. Carers worked with external health professionals to ensure needs were met. People were also supported to attend hospital appointments and social activities. People participated in a wide variety of activities which enhanced their lives.

People had access to a variety of food and drinks. The people we spoke with said they were happy, well cared for and felt part of the family. We observed relaxed relationships between people and their carer. They said their privacy and dignity were respected and they had their own personalised rooms which they could go to at any time.

People's health and social care needs were assessed and care records detailed the type of support they required. The person-centred documents contained objectives and personal goals that people wished to achieve. There were regular reviews of people's care and carers were supported with this through supervision sessions.

Regular reviews of placements and health and safety checks took place to ensure people were receiving safe and appropriate levels of care and support. Carers were contacted to gather their views of the service and the support they received from their Shared Lives social worker.

The registered manager told us there had been no complaints about the service.

People told us they were happy with the care provided and were aware of the complaints process. None of the people we spoke with raised any concerns.

The registered manager had effective systems in place to monitor the safety and quality of the service. We saw there were regular staff meetings to discuss operational issues and business development. The records we reviewed were all well maintained, accurate, up to date and securely stored.