Surrey Choices Shared Lives Scheme

About the service

Surrey Choices Shared Lives Scheme is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. At the time of the inspection there were 20 people using shared lives arrangement who received support with personal care. The scheme supported people with physical and health related support needs, some of who were people with learning disability and autism or dementia.

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

This was a focused inspection that considered the safe and well-led key questions only. Based on our inspection of safe and well-led people using the shared lives arrangements received safe and person-centred support.

Right Support:

People were supported to choose their own shared lives arrangement which would suit their individual needs and preferences. People’s shared lives carers, as well as scheme staff supporting them were recruited safely and trained to provide effective support to people. Everyone knew how to raise concerns if required. The scheme worked with social services to protect people when needed.

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

Right Care:

People received safe care around their individual needs and risks. People were treated as individuals and had person-centred support plans which were regularly reviewed with them and their carers. Staff and carers knew how to safely support people with their medicines, to keep well and free of infections and to maintain a safe living environment. Carers supported people to gain new skills and develop their strengths.

Right Culture:

The scheme’s culture was positive, supportive, open and person-centred. One staff member said, “We do the maximum to support people, people are focus on what we do.”

The scheme management team and the provider ensured quality and safety of the service was continuously monitored and improved. People and their representatives, shared lives carers and scheme staff felt appreciated, involved in the service, and listened to. The scheme worked well in partnership with others to provide people with the support of their choosing safely.

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

Rating at last inspection

The last rating for this service was good (published 27 December 2019).

Why we inspected

We received concerns in relation to staffing and the level of care people received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating remained good to good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from the concerns. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Surrey Choices Shared Lives Scheme on our website at www.cqc.org.uk.

Follow up

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

Surrey Choices Shared Lives Scheme provides people living with a range of care needs with: long-term arrangments, short breaks or respite care, within shared lives carers’ own homes. They provide the service across Surrey to people aged 16 and over with a learning disability, autism, physical disability, dementia, mental health diagnosis, drug and alcohol issues or a sensory impairment. The service was providing support to 54 people, 14 of whom received the regulated activity of personal care at the time of the inspection.

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

People were provided with individualised family based care which was tailored around them and their needs and wishes. One person said, “I feel part of the family and treated like part of the family. I call this home.” The shared lives carers had a good understanding of the needs and wishes of the people they cared for. They communicated with people using the person’s preferred methods, to enable them to make decisions about their lives. People were supported to live the life they wanted to and were engaged with activities within their community.

People were provided with caring support in a way which upheld and protected their human rights. The provider ensured people with the right attitudes and values were approved to become shared lives carers. As a result people told us, “I am happy about everything.”

Potential risks to people were assessed and measures were in place to mitigate them. People were safeguarded from the risk of abuse. People received their medicines safely and where possible were enabled to take them themselves.

People received their care from suitable, trained, staff who felt well supported in their role. Delivery of people’s care was based on a holistic assessment of their needs and best practice guidance. People were supported to eat a balanced diet and to maintain good health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The service was well-led by a knowledgeable and proactive registered manager, who created a transparent and fair culture. Processes were in place to enable people and staff to contribute their ideas and views on the service which were valued and acted upon. There was a focus on continual improvement for the benefit of people.

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

Rating at last inspection

The last rating for this service was good (published 29 June 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Surrey Choices Shared Lives Scheme arranges placements with Shared Lives carers for adults with learning disabilities, physical disabilities or mental health needs. In addition to permanent residential placements, the scheme also offers short-term support, such as respite care or following discharge from hospital, or daytime support. There were 49 people using the service at the time of our inspection, 19 of whom were receiving personal care.

The scheme is responsible for supporting and monitoring Shared Lives placements and recruiting, vetting, training and supporting Shared Lives carers. The scheme had 58 approved Shared Lives carers at the time of our inspection.

There was a registered manager in place at the time of our inspection. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People felt safe and secure in their Shared Lives carers’ homes. The scheme promoted a positive approach to risk taking, which kept people as safe as possible while being supported to live their lives the way they chose.

People were protected by the provider’s procedures for the recruitment and approval of Shared Lives carers. Shared Lives carers attended training in safeguarding and were clear about their responsibilities to report any concerns they had about abuse or people’s safety. People’s finances were managed and recorded appropriately.

Accidents and incidents were recorded and reviewed by the registered manager to ensure that any actions necessary to prevent a recurrence had been taken. Where people’s care involved support with medicines, this was managed safely.

Shared Lives carers received the support and training they needed to fulfil their roles effectively, including any specific training required to meet the needs of the people they supported. They told us the provider responded positively if they requested additional training. Scheme workers had access to the training they needed to support Shared Lives carers.

People’s care was provided in accordance with the Mental Capacity Act 2005 (MCA). Shared Lives carers had received training on the principles of the MCA and how these principles applied in their work. Assessments had been carried out where necessary to establish whether people had the capacity to make decisions about their care and support. Where people lacked the capacity to make decisions, there were appropriate procedures in place to ensure that decisions were made in their best interests.

People told us they were able to choose the food they ate. They said their Shared Lives carers encouraged them to participate in grocery shopping where they could buy foods they liked. Shared Lives carers told us they encouraged people to make healthy food choices whilst enabling them to enjoy their favourite foods. Any specific dietary needs were known by Shared Lives carers and recorded in people’s care and support plans.

People’s healthcare needs were monitored effectively. People told us their Shared Lives carers supported them to make a medical appointment if they felt unwell and accompanied them to all appointments. Shared Lives carers recorded the outcomes of healthcare appointments and scheme workers checked these records at monitoring visits.

People had developed positive, lasting relationships with their Shared Lives carers and enjoyed their company. They told us they valued the family atmosphere of their placements and were included in the family lives of their Shared Lives carers. Shared Lives carers spoke with genuine affection about the people that shared their home. People said their Shared Lives carers were kind and caring and treated them with respect. They told us they could spend time on their own whenever they wished and that their privacy was respected.

People were supported in a way that promoted their independence. They were encouraged to do things for themselves where possible and given support to develop new skills. People had access to information about their care and support. There was a written agreement in place for each placement which set out the rights and responsibilities of all parties. People’s private and confidential information was managed appropriately.

People received support that was responsive to their individual needs. Each person’s needs had been assessed to ensure Shared Lives carers could provide the support they needed. Each person had an individual care plan drawn up from their initial assessment. Because care was tailored to meet people’s individual needs, the scheme had provided effective support to people whose needs may not have been appropriately met in other care settings.

People told us their Shared Lives carers supported them to take part in activities that were important to them. They said they had opportunities to enjoy an active social life and to maintain contact with their friends and families. People and their Shared Lives carers had opportunities to give their views about the scheme and the provider responded appropriately if people raised concerns.

The service was well planned and managed. The registered manager provided effective leadership and staff understood their respective roles. Shared Lives carers valued the support provided by the registered manager and scheme workers. They said scheme workers had always provided advice and guidance when they needed it and kept them up to date with training and events. Staff from the scheme had established links with other professionals to ensure that people received consistent care.

The provider had developed effective systems to monitor and improve the service, which included seeking the views of people, Shared Lives carers and staff. There was a service improvement plan, which was reviewed regularly, and a comprehensive audit framework. Audits were up to date and records were accurate and stored appropriately.

This was the first inspection of this service since its registration.