Background to this inspection
Updated
15 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection activity took place on 16, 19 and 23 July 2018. The inspection was announced.
The inspection was carried out by one adult social care inspector.
We gave the provider 48 hours’ notice of our visit because we wanted to make sure people who used the service and shared lives providers were available to speak with us. We also needed to make sure staff who were based in the provider’s office were available to support with the inspection.
Before the inspection we reviewed other information, we held about the service and the provider. This included statutory notifications we had received from the provider. Notifications are reports about changes, event or incidents the provider is legally obliged to send to CQC within required timescales. We contacted the local authority commissioners for the service, the local authority safeguarding team, the clinical commissioning group (CCG). Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we met with six people who used the scheme and eight shared lives providers in their homes. We met with the registered manager, three support managers and the schemes administrative staff.
We looked at five peoples support records and records relating to the management of the service.
Updated
15 August 2018
The inspection took place on 16,19 and 23 July 2018 and was announced. We gave the provider 48 hours’ notice of our visit because we wanted to make sure staff who were based in the provider’s office were onsite to assist with the inspection.
Durham Share Lives Scheme 1 offers adults with learning disabilities short term, long term, emergency and respite care. This is provided by people who are known as ‘shared lives providers’ who are supported by ‘support managers and the registered manager’ from the scheme. The support takes place in the home of the shared lives provider.
Not everyone using Durham Share Lives Scheme 1 receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
There was a registered manager in place who had been in their present post at the service for seventeen years. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.
The service had a robust process in place to recruit shared lives providers, which included general health checks, character checks, references, DBS checks and discussions with family members. Detailed assessments were carried out by support managers. A detailed report was then developed as to the suitability of the prospective shared live provider and presented at an independent panel to make a decision to recruit the person as a provider.
We found risks to people were assessed and detailed risk assessments were in place with support and guidance for shared lives providers to follow. The home environment of shared lives providers was also assessed to ensure it was a safe place for the person to reside. Appropriate insurance certificates were in place.
Shared lives providers and support managers were aware of safeguarding processes and knew how to raise concerns if they felt people were at risk of abuse or poor practice. Where lessons could be learnt from safeguarding concerns these were used to improve the service. Accidents and incidents were recorded and monitored as part of the provider’s audit process.
People knew how to raise concerns about their care and had access to an easy read document on abuse and neglect.
Shared lives providers received regular monitoring and supervision visits. Opportunities were available to discuss performance and development. Training was up to date for shared lives providers.
Support managers received regular supervision with the registered manager. The shared lives provider visits were used to form the basis of supervision. Support managers were able to discuss their development with the registered manager.
People’s nutritional needs were assessed were necessary and shared live providers supported people to enjoying a varied diet, with choices offered and alternatives available. People's healthcare needs were monitored and contact was made with other health care professionals when necessary. Shared lives providers helped people to lead a healthy lifestyle and supported them to attend health care appointments.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People felt the service was caring. Support was provided in a respectful manner ensuring people’s privacy and dignity was promoted. Where possible people were supported to be as independent as possible.
Support plans were in place which included people’s likes, dislikes and preferences. Plans showed people were involved in their care and set out how they wanted their support to be delivered so they could meet their set outcomes. The service followed the social workers plans for the person by way of support and plans for independence. Support plans were reviewed and discussed at regular visits between the person, the shared lives provider and support managers.
People enjoyed a range of activities both inside and outside of their placement/home. The service had positive links with the community with people accessing day services and local amenities. People enjoyed holidays, days trips out and celebrated birthdays and special events.
The provider had a complaints process in place which was accessible to people and shared lives providers. The complaints policy was available in different formats.
People and shared lives providers and support managers were extremely positive about the registered manager. They confirmed they felt supported and could raise concerns. We observed the registered manager was approachable in the office and found support managers interacted with them in an open manner. People told us they knew their support manager and could speak with them during visits.
The registered manager had systems in place for monitoring the quality of the service. This included monthly audits of all aspects of the service, such as medicines and support plans. We also saw the views of the people using the scheme, their advocates and shared lives providers were regularly sought and used in plans to improve the service.
Regular meetings for both people and shared lives providers were held to share best practice and to give information from Shared Lives Plus (The UK network for Shared Lives providers).
The provider was subject to internal monitoring to ensure good governance. Monitoring from the providers own specialist team is planned in advance. Results are circulated to the head of adult services and the registered manager.
The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers. The registered manager is a member of the North-East branch of Shared Lives Plus and is involved in multi-disciplinary team meetings to discuss the work of Shared Lives.