The inspection took place on 5 and 6 July 2017 and was announced. The provider was given 48 hours notice as the service is a shared lives scheme and staff are often out completing visits to people. We needed to be sure someone would be in.Newham Shared Lives Scheme is a shared lives organisation based in the London borough of Newham. At the time of inspection 49 people were living in shared lives arrangements with 37 shared lives carers.
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.
People told us they felt safe living in their shared lives arrangements. Shared lives staff and carers were knowledgeable about safeguarding adults from harm and abuse. Records showed the provider took appropriate action in response to allegations of abuse.
The level of detail in care plans and risk assessments varied. Although some contained a good level of detail to ensure people were supported in a safe, personalised way, other plans and risk assessments lacked detail and did not contain sufficient information to ensure safe care. Care plans did not contain enough information about medicines for them to be managed in a safe way.
Shared lives carers were recruited to the service in a way that ensured they were suitable to provide accommodation to people and their home environments were safe. After they had joined the scheme staff and shared lives carers were given the training and support they needed to perform their roles.
People had indicated their consent to their shared lives agreements. Where people lacked capacity to consent to their shared lives agreements appropriate processes had been followed. Some people had care plans that were restrictive in order to ensure the safety of people. The service had taken steps to ensure appropriate authorisations were in place and the principles of the Mental Capacity Act 2005 were followed.
People told us they were involved in preparing their meals in their shared lives arrangements. Records showed people were encouraged to eat healthy, balanced diets. The support people needed to maintain their health and attend health appointments was included in care plans.
People had developed strong, positive relationships with their shared lives carers. Shared lives carers and staff spoke about the people they supported with kindness and compassion. People were supported with their religious, cultural and relationships needs. Care plans contained details of how to support people to maintain their dignity. People told us their privacy was respected.
The service completed regular reviews and monitoring of shared lives agreements. However, the records kept did not consistently reflect the amount or level of support provided. Reviews did not show that people were fully involved and did not lead to care plans being updated.
The provider had a robust complaints policy and records showed complaints had been responded to in line with the policy. Shared lives carers told us it was easy to get in touch with shared lives staff who responded to their concerns in a prompt way. The provider was in the process of collecting feedback questionnaires from people and shared lives carers.
People and shared lives carers spoke highly of the registered manager and felt the service was well organised. The provider was in the process of developing the values of the organisation in a way that ensured they were embedded across the service and shared between staff and shared lives carers. The registered manager was linked with shared lives support networks and organisations who provided them with support and a network for sharing ideas and learning about best practice in the area.
During the inspection a number of issues with the quality and standard of documentation were identified. However, the registered manager was aware of all of the issues and had plans in place to address them.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of the full version of this report. We have made one recommendation about ensuring reviews are robust and people are involved in the process.