Leicestershire Shared Lives Scheme

Leicestershire Shared Lives recruits, trains and monitors carers who are paid a fee to provide care and support to adults. The person lives with the carer in the carer's home. People who use the service are provided with short and long term accommodation with care in family homes.

People’s experience of using this service:

¿ People had received safe care. The registered provider followed safe recruitment procedures to ensure carers were suitable for their role. An induction process was in place with training and comprehensive written guidance via handbooks and records ensuring care was based on current practice. Carers and support officers had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. People’s medicines were managed safely. Systems were in place to ensure that people were protected by the prevention and control of infection.

¿ People received enough to eat and drink and were supported to use and access a variety of other services and social care professionals. People were supported to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

¿ People were supported to have maximum choice and control of their lives and carers supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

¿ People’s needs were assessed and planned with the involvement of the person and or their relative or representative where required.

¿ Carers and support officers promoted and respected people's cultural diversity and lifestyle choices. Care plans were personalised and provided staff with guidance about how to support people and respect their wishes. Information was made available in accessible formats such as easy read and pictorial to help people understand the care and support they could expect and what they were agreeing to.

¿ People received care from carers who were kind. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with carers who had a good understanding of their needs and preferences.

¿ The manager and provider had a clear vison and plan in place for continuous learning, improvement and growth. People and staff were encouraged to provide feedback about the service. Carers and support officers received supervision and regular meetings took place that gave them an opportunity to share ideas, and exchange information. The manager understood their responsibility to report events that occurred within the service to the CQC and external agencies.

More information is in the full report

Rating at last inspection: Good 18 June 2016

Why we inspected: This was a scheduled Inspection.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any information of concern is received, we may inspect sooner.

The Leicestershire Shared Lives Scheme arranges accommodation and support to people to live independent lives. The support is provided by individuals in the community, known as shared lives carers (carers) who use their own homes as a base. Shared lives support can include long term accommodation and / or a short breaks service. At the time of our inspection 102 people were receiving care and support. Shared lives workers (staff) are employed by the provider to provide support and guidance to carers.

The service had a registered manager in place. It is a requirement that the service has 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 felt safe and they were being protected from harm and abuse by staff and carers who knew their responsibilities. For example, people’s homes and equipment were being checked by the provider to protect them from harm. Risks to people’s health and well-being had been assessed to support them to remain safe.

People’s individual needs had been considered to keep them safe during an emergency and the provider had a plan in place to make sure that the service would continue in the event of a significant event.

The provider sought to keep people safe by analysing accidents and incidents. They had looked to reduce the number of these whenever possible. For example, where a person’s level of support needed to increase due to their mental health, guidance from a social worker had been requested.

People were being supported by staff who had been checked before they had started to work for the provider. This had helped the provider to make safer recruitment decisions. When a member of the public had applied to become a carer, we found that there was a thorough process in place to check their suitability.

People received the support they required with their medicines. Staff and carers had received training to support them to handle medicines safely and there was written guidance available to them to provide safe support to people.

People received support from carers and staff who had undertaken training. However, for some staff and carers there were gaps in the required training. For example, some needed training in safeguarding people from abuse. The registered manager told us that they were addressing this.

Staff and carers received support and guidance in order to understand their responsibilities. For example, carers had regular visits from staff members. The registered manager provided staff with regular meetings to support them to carry out their roles effectively.

People’s consent to care and treatment had not always been recorded. The provider had not always undertaken assessments where people may have lacked the capacity to make decisions. This meant that the provider was not always following the principles of the Mental Capacity Act (MCA) 2005. People were being supported by staff and carers who understood the requirements of the MCA. They were able to describe how they would seek additional support if they had concerns about people’s ability to make decisions for themselves.

People chose the food they wanted. Their eating and drinking preferences and needs were known by carers. People were also being supported to remain healthy. Staff and carers knew how to do this and information about people’s health needs was available in their support plans. Where there was concern about people’s health, staff and carers knew what to do and took the appropriate action.

People were supported by carers who showed kindness and compassion. Their dignity and privacy was being respected and their confidential and sensitive care records were being stored safely.

Carers and staff knew about people’s preferences and what was important to them. People were being supported to be as independent as they wanted. For example, we saw that one person was learning how to make their own bed. This meant that people received care and support based on their preferences and abilities.

People or their representatives had been involved and had contributed to the planning and reviewing of their care and support although this had not always been recorded in their care records. The registered manager told us that they would change their procedures to make sure that this happened. Where people needed support to be involved, information and access to advocacy services had been made available to them.

People had support plans that were focused on things that were important to them and known by carers. They received care and support based on this. People were undertaking hobbies and interests that they enjoyed. For example, we saw that some people were regularly going swimming and shopping.

People knew how to complain if they had needed to. The provider took action where necessary when they had received a complaint. The registered manager was looking at how they could learn from people’s feedback to improve the service. They had issued questionnaires to some people to gain their views and experiences of the care and support offered.

Carers and staff told us that the service was well-led. There were opportunities available to them to give ideas for improvement to the provider.

Carers and staff told us, and we saw, that they were supported and were clear about their roles and responsibilities. They received regular feedback on their work in order to improve the quality of the care and support offered to people.

There was a registered manager in place who understood the requirements of their role. They had worked with the provider to regularly assess the quality of the service, although this checking was not always recorded to show what actions or learning had occurred. The registered manager had plans in place to improve the service.

Shared lives carers were positive about the service and appreciated all the support that shared lives workers provided. We observed that people who used the service had an excellent relationship with their shared lives carer and appeared comfortable and relaxed in their homes.

We looked at the records of four people who used the service and found the service had ensured people were placed with an appropriate shared lives carer and that the placement had been monitored. We found that support had been planned and delivered appropriately with regard to people's health and safety and in accordance with their wishes.

Shared lives carers had a good understanding of the needs of people they cared for and had received support and monitoring visits from a shared lives worker. However, the service had not always ensured that shared lives carers had received on-going training to assist them in their roles.

There was an appropriate complaints handling process in place and records had been stored securely and were well maintained.

Our inspection of 4 September 2012 found that the service did not have a robust system that identified how it had matched a person to a shared lives carer. Therefore, there may have been the risk of people receiving inappropriate or unsafe care due to an inadequate matching process. We also found there was limited evidence that people's views had been gathered and therefore the service could not demonstrate how it was taking these into account when planning the delivery of care. In addition we found that placement reviews were not consistently happening and as a result there was no robust monitoring system to ensure people were protected from the risk of inappropriate or unsafe care.

At this inspection we found that the provider had made sufficient improvements to achieve compliance with the regulations.

People told us they were supported to make choices and maintain their independence as much as they were able. One person, who was having a short break with a shared lives carer at the time of our inspection, told us 'I love coming here, I can do what I want and feel part of the family'. This person also told us that before they went for a short break with the shared lives carer they had come for a visit first. They were then asked whether they wanted to go ahead with the short break stay.

People using the service told us they were happy and we saw that they were well supported by appropriate shared lives carers. We found there was a risk that people may not receive appropriate care due to an inadequate matching process. We also found people's views had not always been obtained about the service being provided and so the service could not take people's views into account when planning the delivery of care.