Adult Placement Scheme/Shared Lives Scheme

Derby City Shared Lives Scheme, is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (referred to as carers in the report) own homes.

At the time of the inspection there were around 160 people being supported by the service and 80 carers. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 15 people receiving regulated activity at the time of the inspection.

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

Carers had received safeguarding training and understood their responsibilities to provide safe care. There were sufficient numbers of carers to support people’s needs, some people had more than one carer supporting them.

People received medicines safely from carers who had received training and regular competency checks.

We saw people were treated with dignity and respect by carers. Carers told us how they supported people to make choices and decisions and maintain their independence. Carers supported people to maintain relationships with friends and families.

Peoples health care needs were managed, and support plans were tailored to people’s individual needs. People received support to manage their dietary needs.

People and carers knew how to complain. People were involved in planning their support. There were systems in place to monitor the quality of the service.

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.

The service applied the principles and values and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Feedback from healthcare professionals about the service was very positive.

The service was well led and there were quality monitoring systems in place to drive improvements.

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

The last rating for this service was Good (published 1 December 2016)

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.

The Adult Placement/Shared Lives Scheme is run by Derby City Council and monitors shared lives carers to provide support to adults with learning disabilities. This support can be on a short or long term basis where the person lives with the shared lives carer in their home as part of the family. Day support is also provided where the person is supported by the shared lives carer during the day to access activities in the community. The shared lives scheme office is located in Derby City Centre. At the time of this inspection 70 people received support from shared lives carers recruited by the scheme.

There was a registered manager in post. 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.

Shared lives carers we spoke with had received safeguarding training and understood their responsibilities to provide safe care and report safeguarding concerns. Shared lives carers went through an intensive recruitment process before becoming approved as a shared lives carers. This ensured suitable shared lives carers were employed to work with people who used the service. Shared lives carers told us they had received training which helped them to understand and support people better.

People received support from sufficient numbers of shared lives carers. Shared lives carers responsible for the administration of medicines had received training to ensure they supported people safely with their medicines.

Risk assessments had been developed to minimise the potential risk of harm to people who used the service. People had care plans in place, however the shared lives carers told us this were not always detailed. The registered manager acknowledged that this had been picked up in an internal audit. They told us they would be taking action to address this.

The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005. Shared lives carers supported people to make their own decisions. However shared lives carers told us they had not undertaken training in this area, which they told us had been booked.

We saw people were treated with dignity and respect by shared lives carers. Shared lives carers described how they aimed to promote people's independence. The delivery of care was tailored to meet people’s individual needs and preferences.

People received appropriate support to manage their dietary needs. This was done in a way that met with their needs and choices. People were supported to have good health, for example shared lives carers supported people to health appointments.

The provider ensured people had access to information about how to make a complaint or express a concern about the service. People received responsive and personalised care and were involved in planning their support.

There were systems in place to monitor the quality of the service to enable the manager and provider to drive improvement. Shared lives carers felt supported by the Adult Placement Scheme/Shared Lives Scheme staff. The leadership and management of the service and its governance systems ensured consistency in the care being provided.

People using the service were very positive about the care provided to them by the shared lives carers. Comments from people about the shared lives scheme included 'I am happy with the service,' 'I have learnt new skills to make me more independent such as cooking' and 'My carer takes me out with the other people they support, we go out for lunch.'

Our observations showed that people had formed friendly and supportive relationships with the carers that they were living with or being supported by.

People's needs were assessed before a service was offered. This meant they received support in a way that met their needs.

Sufficient numbers of staff were currently employed to ensure people's needs were met effectively.

Robust recruitment procedures were not in place to safeguard people who used the service.

The provider had a number of monitoring systems in place to assess and monitor the quality of service people received.

During the visit, we met with six Shared Lives Carers (SLC) who explained the assessment process adopted by the scheme. They told us there was a process in place to support people and showed us they were very committed and enthusiastic about the support they provided.

We saw the Shared Lives Scheme had access to the medication polices as directed by Derby City Council and they were comprehensive. We saw people were being supported during their day and they appeared to be comfortable with the carer supporting them. We saw people were encouraged to express themselves through their different forms of communications and behaviours. They were fully supported by the Shared Lives Carer to do so.