Shared Lives and Supported Living

Updated 12 December 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 checked 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.

This was an announced inspection which took place over three days on 29, 30 and 31 October 2018. We announced the inspection to ensure we could get consent to speak with, and visit, people in their own homes. The inspection was carried out by two inspectors over two days and one inspector and an Expert by Experience for one day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience contacted relatives by phone to seek their views.

Prior to the inspection we accessed and reviewed the Provider Information Return (PIR) as we had requested this before the inspection. The PIR 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. We also reviewed other information we held about the service.

During the inspection we attended the service’s office to conduct the inspection. We met with the manager, with two senior managers, including the Head of Operations and Head of Quality and Compliance (nominated individual for the organisation), two assistant service managers for the Shared Lives and Supported Living service, four shared lives officers, an administrator and maintenance person. We visited two people in their own home who received the Supported Living service and met with two of their support workers. On the second day of the inspection we met with nine people who received the Shared Lives service and 11 carers at a coffee morning held at the service’s office. We spoke with two health and social care professionals who gave us feedback about the service which was wholly positive.

We looked at the care records for six of the people supported, including medication records, five personnel recruitment files and other records relevant to the quality monitoring of the service such as, safety audits and quality audits.

Updated 12 December 2018

This was an announced inspection which took place over three days on, 29, 30 and 31 October 2018.

This was the first inspection of the service following its new registration in December 2017.

Shared Lives and Supported Living is a service which provides care and support to people living in their own homes including ‘supported living’ settings. ‘The Shared Lives Service enables people with learning disabilities to live in the carers’ own home to maximise their independence, health and wellbeing. People live as part of the family and this model of support for vulnerable people was previously called Adult Placement.

The supported living scheme enables vulnerable people, including those with a learning disability to live in supported accommodation which maximises their independence. People have their own tenancies, with the properties being owned by different housing associations. People are supported by support workers. The majority of people have 24-hour support, with either a support worker completing a waking night or a sleep-in at the property. The housing association is the landlord and they are responsible for the maintenance and up keep of the individual properties. They are responsible for the health and safety checks of the accommodation, including, gas, electric and water.

The service provision offers a personalised service to vulnerable adults, aged over 18 years who have learning disabilities and/or autistic disorder. This report focuses on the experiences of people who received personal care as part of their support package. CQC does not regulate premises used for these services.

A manager was in post and they were awaiting confirmation of their registration with the Care Quality Commission (CQC) for the position of 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 spoke and met with people who received the Shared Lives Service and their carers; we also met and spoke with people in their own home who received the Supported Living Service, along with their support workers who supported them. The feedback we received evidenced people were receiving good standards of individualised care and support. External professionals involved directly or in commissioning people’s care also gave positive feedback regarding the service provision.

People and their relatives felt that the service they received was safe. Support workers and carers were clear about the action they would take to report any actual or potential harm. Policies and procedures were in place in relation to safeguarding people from abuse and exploitation.

Systems were in place for the recording and monitoring of accidents and incidents to identify any trends or patterns that may occur.

People's care planning documents considered risks regarding people’s health and wellbeing and plans were in place to minimise these risks whilst encouraging people to be independent. Environmental risks were also considered within the person’s home and, for example, going out into the community and travelling in a car to ensure their safety.

Recruitment practices were robust so that only people suitable to work with vulnerable people were employed by the service.

Medicines were managed safely and people received medicines from support workers and carers who were trained and deemed competent. People were encouraged to look after their own medicines to support their independence.

There were sufficient numbers of support workers to provide support to people in their own home. We saw good examples of how having the same support workers and carers had helped improve people’s health, wellbeing and independence.

Support workers and carers had a good understanding of people’s needs, wishes and preferences which enabled support to be focused on people’s individual needs and choices.

People’s rights to privacy and dignity were respected and people were fully involved in making decisions. Support workers and carers obtained people’s consent; the service was working in line with the principles of the Mental Capacity Act 2005. This meant that people’s rights and liberties were being upheld.

Support workers and carers received training and support to ensure they had the skills and knowledge to care for people safely and effectively. Formal qualifications in care were offered to support workers, as part of their learning and development.

Communication between relatives, people being supported, support workers and carers was seen to be good. There was regular contact from the supported living team and shared lives team to support people in their own home.

Information relating to how people liked to communicate was recorded in good detail and documentation was available in easy-read or pictorial format to support people’s individual needs.

Support workers and carers had a good knowledge of people’s needs, how they wished to be supported. People we spoke with and their relatives told us that staff had the skills and approach needed to ensure people were receiving the care and support they needed.

People and relatives had access to the service’s complaints procedure. They told us they would feel confident in speaking up if they had a concern. At the time of the inspection no complaints had been received.

Policies and procedures were in place to offer guidance and direction in best practice to staff delivering the service.

Systems and processes were in place to monitor the quality of the service being provided. These were effective and appropriate action had been taken to address any identified issues. Lessons learnt had been shared with all involved with the service to improve practice.