Hillingdon Shared Lives

Updated 30 April 2019

The inspection:

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

Inspection team:

The inspection was carried out by an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Hillingdon Shared Lives supports people to live with Shared Lives Carers (SLCs)

within the SLC's home in their local area. The service is part of the local authority services. The scheme recruits, trains and supports self-employed SLCs to provide care and support to adults and young people with a range of needs including learning disability and mental health needs.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service two days’ notice of the inspection site visit because the location provides a shared lives service, there is a small team working for this service and we needed to be sure someone would be available.

What we did:

Before the inspection, we reviewed the information we held about the service. This included notifications sent to us by the provider and other information we held on our database about the service such as the Provider Information Return (PIR). Statutory notifications include information about important events which the provider is required to send us by law. A PIR is a form that requires providers to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.

During the inspection we spoke with 10 people using the service and eight shared lives carers. We spoke with other staff including the registered manager and three shared lives officers. We contacted four other professionals after the inspection to seek their feedback and received a response from two of them.

We reviewed a range of documents and records including five care records for people who used the service, four staff records, as well as other records related to the management of the service such as incidents and accidents, complaints and audits.

Updated 30 April 2019

About the service:

¿ Hillingdon Shared Lives provides respite care, short and long-term care and accommodation for adults and young people over the age of 16 years. People who used the service had a range of needs including learning disability, mental health needs or were going through a difficult period in their lives and needed care and support. The service enabled people to live in the community with families (shared lives carers) in their homes. Shared lives officers coordinated this care and supported the shared lives carers as well as the people receiving the service. At the time of our inspection 38 people were using the service, 14 of whom only required occasional respite stays. There were 24shared lives carers providing a service and some were able to accommodate up to three people.

People’s experience of using this service:

¿ An experienced registered manager had been leading the service for five years and they demonstrated a sound knowledge, passion and enthusiasm for their role and the service. They led a strong team of shared lives officers who were dedicated and provided a high-quality service for people who used the service.

¿ Feedback from people who used the service was extremely positive with regards to all aspects of their care. They were very complimentary about the shared lives carers who supported them and the service in general. They told us all their needs were met and that the shared lives carers treated them with the ''utmost'' respect and promoted their independence. They said they felt part of the family in their homes and were supported to lead active lives in the community.

¿ The provider was responsive to the diverse needs of people across the borough and had embedded the ethos of promoting equality, diversity and human rights across all areas of the service, from the recruitment of shared lives carers and the matching process between people and their shared lives carers.

¿ The provider had robust monitoring systems in place to ensure the service ran effectively, which included unannounced spot checks of the shared lives carers, internal monitoring visits and medicines audits.

¿ Shared lives carers demonstrated a in depth understanding of people's needs and preferences and treated them as individuals. The shared lives officers ensured there was a thorough matching process in place which helped to ensure that placements were appropriate and successful. People and their shared lives carers were given opportunities to meet and get to know each other before placements were finalised. Arrangement agreements helped to ensure that everyone was aware of their responsibilities and the support that people would be given.

¿ Care plans contained detailed information about people’s individual needs, preferences and choices, and we saw evidence they were involved in the care planning and reviewing processes. People were supported to lead active lives, develop their life skills and take part in activities of their choice.

¿ People and shared lives carers knew how to complain about the service if they had a concern. Information was available in a pictorial and easy-read format.

¿ Where appropriate, people were consulted about their end of life choices and these were recorded in their care plan. Staff received training in end of life care.

¿ People who used the service told us they felt safe living with the shared lives carers, and they were treated well. They, the shared lives carers and shared lives officers, received training in safeguarding and there were policies and procedures to ensure people were protected from avoidable harm and abuse.

¿ Where there were risks to the safety of people who used the service, these had been assessed, and measures were in place to reduce the risk. Risk assessments and support plans were regularly reviewed and updated.

¿ Where people required support with their medicines, this was managed safely.

¿ There were robust recruitment processes for both shared lives officers and carers, and to ensure shared lives carers were suitable to provide care to people in their own homes. There was a thorough training programme which equipped shared lives carers with the skills they needed to perform their roles. Shared lives carers and officers received regular supervision.

¿ 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. People were only deprived of their liberty to receive care and treatment when this was in their best interests.

¿ People were supported to have a healthy diet and their choices were respected. They had access to healthcare professionals and were supported to remain healthy.

¿ The service was exceptional at supporting people to express their views so that staff understood their preferences, wishes and choices. Regular meetings were facilitated and people were invited and encouraged to speak up in a safe space.

¿ Feedback from health professionals was extremely complimentary. The service worked closely with health and social care professionals and other associated professionals within the council, external organisations and agencies.

Rating at last inspection: Rating at last inspection

At our last inspection we rated the service good overall and outstanding in well-led.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue our ongoing monitoring or the service and visit again in line with our schedule of inspections based on the rating of Outstanding, or sooner if needed.

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