St Anne's Community Services - Shared Lives

St Anne's Shared Lives is based in Leeds and recruits carers who can offer a home to an adult with learning disabilities, mental health issues, physical disability, alcohol issues and older people St Anne's Shared Lives match carers to people needing support. They are responsible for the recruitment, approval, supervision, and training of these carers. Shared Lives schemes offer an alternative to both residential and more traditional care at home services for people who need personal care and support with their day to day lives. The Care Quality Commission (CQC) regulates the provision of personal care for people who use the service. At the time of our inspection there were 81 people who used the service and 108 shared lives carers providing their support.

People’s experience of using this service and what we found

People told us they felt safe living with their shared lives carer and that they were well treated. Managers and shared lives carers understood their responsibilities for keeping people safe from the risk of abuse and they were confident about reporting any concerns about people’s safety.

People received care and support in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Risks to people were assessed and managed in a way that promoted people’s independence. Shared lives carers completed training in topics of health and safety, and they were confident in dealing with emergency situations.

Safe recruitment procedures were followed. The fitness and suitability of office-based staff and shared lives carers was thoroughly assessed before they were recruited to support people using the service, and they received the training they needed for their role. People were matched with a shared lives carer who could best meet their needs.

Safe infection prevention and control (IPC) measures were followed to minimise the risk of the spread of infection, including those related to COVID-19.

Medicines were managed safely. Clients were supported to manage their own medication where possible. Shared lives carers were suitably trained to manage medication should this be required.

The culture of the service was person-centred and inclusive. People and shared lives carers spoke positively about the way the service was managed describing the manager as fantastic, Knowledgeable and very supportive.

There were effective systems to monitor the quality and safety of the service which included obtaining the views of people and others. There was good partnership working with others to make sure people received all the care and support they needed.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The shared lives model of care maximised people’s choice, control and independence.

Right care:

• People received care which was person-centred and promoted people’s dignity, privacy and human rights.

Right culture:

• The ethos, values, attitudes and behaviours of United Response shared lives management team and shared lives carers helped ensure people lead confident, inclusive and empowered lives.

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

Rating at last inspection and update

The last rating for this service was good (published 12 June 2018).

Why we inspected

We inspected due to the length of time since the last inspection.

We undertook a focused inspection to only review the key questions of Safe and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The ratings from the previous comprehensive inspection for the Effective, Caring and Responsive key questions were not looked at on this occasion. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has stayed the same based on the finding from this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection in November 2015 the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going 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.

Why the service is rated Good.

People told us they felt safe and well supported. They said they were treated well. Robust and safe recruitment procedures were followed to ensure only carers who were suitable to care and support people were recruited. The provider had procedures in place for safeguarding and these were followed to protect people from abuse. Carers were provided with guidance and training about how to support people to safely receive their prescribed medicines. Detailed guidance was in place to advise carers about how to manage identified risks whilst supporting people to make choices and maintain their freedom and independence, where possible.

People were supported to have maximum choice and control of their lives and carers supported them in the least restrictive way possible. Processes to ensure carers acted in people's best interests in line with the Mental Capacity Act 2005 (MCA) were in place and followed. Carers we spoke with had an understanding of the principles of the MCA..

Carers were provided with a range of support and training to enable them to fulfil their role. This included training courses, home visits, telephone support and regular group meetings with other carers. People were supported to maintain good health and nutrition. Carers were aware of people's dietary requirements and any support they needed with their food and drink. People's healthcare needs were identified and they received regular input from healthcare professionals to maintain good health.

People told us they were happy living with their carers, enjoyed the homely environment and spoke enthusiastically about activities they enjoyed with their carers. This included holidays; both in the UK and abroad, outings to local pubs, playing pool and dog walking. People were treated with dignity and respect and their independence was encouraged. Carers spoke with warmth and fondness about people who used the service. It was clear good relationships had been formed and people were valued as individuals. All interactions we observed between people showed kindness and a caring approach.

People’s support plans were comprehensive and identified people's needs, wishes and goals. Reviews took place to ensure people remained happy with their carers and to provide an opportunity to identify any changes in needs so these could be addressed. The registered manager had given written information to people who use the service, their relatives and the shared lives carers about how to make a complaint. The registered manager ensured they regularly met with people who used the service and carers in order to identify any possible concerns.

The registered manager and project workers were knowledgeable and experienced in the management and day to day running of the shared lives scheme. People who used the service, carers and relatives spoke highly of their commitment to the success of the service. They were described as approachable, helpful and a source of inspiration and information.

The quality of the service was monitored by regular visits and reviews of people's care. We saw action was taken to address any areas identified for improvement. Feedback about the service was also sought through questionnaires. Feedback was positive about the service and support people and their carers received.

The provider made sure the registered manager and project workers were kept up to date on current good practice in shared lives schemes. The registered manager and project workers attended regional and national forums to share and identify any practices they could incorporate to further improve services.

Further information is in the detailed findings below.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person said, 'My family do all they can for me. They look after me really well.' Another person said, 'I live in the best place ever.'

People were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People spoke highly of the staff who supported them. Comments people made included, 'The staff are Gold Star' and 'They do an excellent, ace job."

The provider had an effective system to regularly assess and monitor the quality of service that people received.

People experienced care, treatment and support that met their needs and protected their rights. The care plans we looked at were detailed and related to all aspects of each person's care and welfare needs. We spoke with three people. They all told us they were happy with the care and treatment they received. One person told us, 'Everyone is really nice, good and helpful.' One person said, 'I am happy how I live.' Another person told us, 'I am happy living here.'

Medicines were prescribed and given to people appropriately. People we spoke with said that they received their medication on time and when they needed it.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work.

There was an effective complaints system in place. Complaints people made were responded to appropriately. People told us if they had any concerns or complaints they would discuss them with members