Brighton and Hove City Council - Shared Lives Team

Updated 13 February 2019

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 inspection took place on 27 November 2018 and was announced. We told the registered manager a week before our inspection that we would be coming. This was because we wanted to talk with staff and people using the service. We also wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. One inspector undertook the inspection, with an expert by experience. 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 gathered feedback from four people and five shared lives carers by speaking with them over the telephone.

We used information the provider had sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make’. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted the local authority commissioning team, who had responsibility for monitoring the quality and safety of the service provided to local authority funded people. We contacted seven shared lives carers over the telephone. We received feedback from a health and social care professional who had had contact with the service.

During the inspection we visited the provider’s office and spoke with the registered manager and three shared lives officers. We also spoke with five people at one of the provider’s offices. We spent time reviewing the records of the service, including policies and procedures, six people’s care and support plans and risk assessments, the training records and supervision plan for four shared lives carers and the recruitment records for one new shared lives carer, compliments and complaints recording, accident/incident and safeguarding records. We also looked at action plans, quality assurance audits and service development plans.

At our last inspection on 25 February 2016 we rated the service Good overall.

Updated 13 February 2019

The inspection took place on the 27 November 2018 and was unannounced.

The Brighton and Hove City Council - Shared Lives Team is registered to provide personal care for children sixteen years and above, adults and older people living in Brighton and Hove. People with either a learning disability or autistic spectrum disorder, mental health issues, dementia, a physical disability or sensory impairment. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

In shared lives, people who need support and or accommodation become a regular visitor to, or move in with, an approved shared lives carer. Together, they share family and community life and in many cases the individual becomes part of a supportive family. Shared lives carers and people they care for are matched for compatibility and can develop real relationships. The shared lives carer acts as ‘extended family’, so that someone can live at the heart of their community in a supportive family setting. Care and support was offered for long-term and short-term respite placements. A ‘day share’ facility was also available where people can go to a shared lives carers home for the day who provide care, support and activities. Approximately 65 people, of which 26 received the regulated activity personal care, were supported by 37 approved shared lives carers in the scheme. Not all the shared lives carers provided the regulated activity of personal care at the time of the inspection. But were supporting people with developing access into their local neighbourhood and helping develop people’s life skills towards improved independence. Shared lives carers were supported and managed by shared lives staff employed by the scheme.

As part of the scheme staff were working on a pilot project to support care leavers from the age of 16 years plus within Brighton and Hove. Shared lives staff had been collaboratively working with another scheme also in the pilot. They were working with Shared Live Plus, the UK network for shared lives schemes on the policy and procedures to be followed. Staff were in the process of being recruited and trained. The pilot was not up and running at the time of the inspection so was not looked at on this occasion.

At our last inspection on 25 February 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the last inspection on 25 February 2016 risk assessments did not reflect the level of knowledge held by staff members, and lacked sufficient guidance. Where changes had been made these had not always been used to inform and update the information. At this inspection we found improvements had been made.

Outstanding responsive care had been provided. We were given numerous examples of where care had been outstanding in its outcomes for people. Observations, staff and a visiting health and social care professional consistently told us how the service was exceptionally personalised to meet people's individual needs. Staff spoke with pride and passion about the way people were cared for. Management and staff continuously looked-for ways to improve people's care so they received positive experiences and led fulfilling lives at the service.

The culture of the service was open and inclusive and encouraged staff to see beyond each person's support needs. The provider had clear values which the registered manager and staff promoted. The registered manager showed outstanding drive and passion, ensuring the service was continually improving and striving to be outstanding, with people at the heart of the service.

Systems had been maintained to keep people safe. One person told us, “Yes its nice. Thumbs up. Yes, I feel safe. I get help with medication.” People’s care and support plans and risk assessments continued to be developed and reviewed regularly. A shared lives carer told us, “He likes shared living. He lives with a jolly family. He likes the hustle and bustle. I’m given a care package plan with his needs and risk factors.” People remained protected from the risk of abuse because staff understood how to identify and report it. Infection control procedures were in place.

People told us they had continued to feel involved and listened to. The culture of the service remained open and inclusive and encouraged staff to see beyond each person's support needs.

The care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence.

New shared lives carers continued to undergo rigorous assessment and checks before being ‘matched’ with people who needed support. People’s equality and diversity needs had been considered when they were matched with potential carers. People told us how they liked their accommodation and enjoyed living with their shared lives carers.

Staff continued to have the knowledge and skills to provide the care and support that people needed. One person told us, “They do understand what I need and they know me very well.” Staff told us they had received supervision and appraisal’s. They had been supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.

People continued to be supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. One person told us, “Twenty-six years I’ve lived with this family. I do very much so feel safe. It is beneficial towards me. It’s company for me and I live with other people and I’m independent and I am very happy here and well settled. I do medication myself.” Shared lives staff continued to have a good understanding of consent. People spoke of continued good support to access a range of educational, work and social activities.

People continued to be supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health and access healthcare professionals when needed.

People, staff and a visiting health and social care professional told us the service continued to be well led. A shared lives carer told us, “It’s brilliant. Quite a lot of us have a wealth of experience. We all have different experience and skills.” Shared lives staff told us the registered manager was always approachable and had an open-door policy if they required some advice or needed to discuss something. The registered manager and shared lives officers had maintained a range of internal quality assurance audits to ensure the quality of the care and support provided. People and their relatives, and staff were regularly consulted about the care provided through reviews and by using quality assurance questionnaires.