We inspected Manchester Shared Lives on 17, 18 and 19 May 2016. As this was a ‘shared lives’ scheme, we contacted the registered manager the afternoon before the inspection. This was so that she could arrange visits for us to meet the people in their placement homes. At the last inspection in October 2013 we found the service met all the regulations we looked at.At the time of our inspection, 79 people were being supported by the shared lives scheme as long term placements. A further 18 people used the service for respite care. ‘Shared lives’ describes the arrangement whereby people either live with or near self-employed care providers who support them according to their assessed needs.
The homes care providers shared with people were located across Manchester; up to three people were supported per household. The Manchester Shared Lives office team consisted of the registered manager and six placement workers. They supported the care providers, assessed prospective care providers and matched new people to care providers who had a vacancy in their home.
The service had a registered manager. 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.
We saw that one ‘as required’ medicine did not have a medicine protocol and was not recorded on the person’s medicine administration chart. Other than this, medicines were managed properly by the care providers that supported people.
The support plans of one person who had problems swallowing food had not been updated with this information and they had no swallowing risk assessment. Two of the homes we visited did not contain copies of people’s risk assessments. Risk assessments in other people’s homes and at the office were appropriate and people were supported by care providers to take positive risks if the benefit of the activity outweighed any potential risk identified.
People we spoke with told us they felt safe in their placement homes. The relatives we spoke with agreed. The care providers and placement workers could describe the forms of abuse people using the service might be vulnerable to and said they would report any concerns appropriately.
The recruitment process for new care providers was robust; we saw all the required checks had been made and documentation was in place. There was a disciplinary policy which the registered manager had followed when addressing an issue with a care provider.
The homes where people were placed were assessed for safety and cleanliness at regular intervals.
The service complied with the Mental Capacity Act 2005; staff had a good working knowledge of the principals and how they applied to the people using the service. People were given choices and supported to make their own decisions.
Staff received the training they needed to support people safely. They also received regular supervision and an annual appraisal, all of which was documented properly. Care providers said they felt supported by their placement workers.
People told us they enjoyed the meals they had in their placement homes. People and their relatives said that people were supported to access a range of healthcare professionals and care providers showed us how they arranged and documented this for the people.
People and their relatives told us that the care providers were caring. Care providers described people as members of their families and the interactions we observed were warm and friendly.
Care providers gave us examples of how they promoted the independence of the people they supported. We saw that placement workers made referrals to advocacy services if people needed independent help or support to make decisions.
People’s support plans were individualised and person-centred and produced in a format that made them accessible to the people they related to. We saw that people who could sign their plans had done so.
People had access to a range of activities, voluntary placements and employment opportunities. All of the people we spoke with said they had lots to do and their relatives agreed. People regularly went on holidays with the care providers and their families.
No one we spoke with had ever made a complaint but all of the people and relatives we spoke with said they knew who to complain to and would do so if they had a problem.
People, their relatives and other healthcare professionals involved with the people gave us positive feedback about the management of the service. We observed that there was an open culture at the service and staff seemed happy.
There was a comprehensive system of audit and quality assurance at the service. Incidents and accidents were recorded and there was a risk register in place which was reviewed on a monthly basis.
Staff worked according to the vision and values of the service to support the people and the service was an active participant of the UK Shared Lives Plus network.