The Care Quality Commission
  • Services in your home
  • Homecare service

Merton Shared Lives Scheme

Overall: Good read more about inspection ratings

Merton Civic Centre 3rd Floor, London Road, Morden, Surrey, SM4 5DX (020) 8545 4003

Provided and run by:
London Borough of Merton

All Inspections

6 December 2023

During an inspection looking at part of the service

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

About the service

Merton Shared Lives Scheme provides a housing with support service and is registered to provide an accommodation based service for people that need some support in their everyday lives. The scheme is for adults aged 18 and over, with a learning disability, mental health issue, older people, and those with a sensory impairment. 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.

At the time of the inspection there were 16 people receiving personal care in different supported living settings.

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

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 was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

The service was safe for people to use and staff to work in. Staff supported people to have the maximum possible choice, control, independence, and were focussed on people’s strengths and promoted what they were able to do. This meant people were able to pursue their interests, with staff support. The quality of the service provided, was reviewed regularly, and changes were made to improve people’s care and support. This was in a way that suited people best. The service established working partnerships that promoted people’s participation and reduced their social isolation. People were enabled by staff, to access specialist healthcare services and followed best practice when supporting them with communication and making decisions.

Right Care

Staff who supported people, promoted their equality, diversity, and understood people's cultural needs and provided appropriate care. Relatives told us staff were kind, compassionate, caring, and promoted people's privacy and dignity. There were enough well trained and appropriately recruited staff to support people to live safely, whilst still enjoying their lives. Any risks to people using the service and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents and incidents and safeguarding issues were appropriately reported, investigated, and recorded. Trained staff safely administered people’s medicines.

Right culture

The service leadership and management were identifiable, transparent, and there was an open, positive, and honest culture. The provider had a clearly defined vision and values, that staff understood and followed. Staff understood people, were responsive, and supported them in their aspirations to live a quality life of their choice. This was by placing people’s wishes, needs, and rights at the heart of everything they did. Staff were aware of their responsibilities, accountability and prepared to take responsibility and report any concerns they might have.

Rating at last inspection

The last rating for this service was Good (published 22 September 2017).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good rated service for people.

The overall rating for the service remains Good. This is based on the findings at this inspection.

We did not inspect the key questions of effective, caring, and responsive.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Merton Shared Lives Scheme on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

24 August 2017

During a routine inspection

Merton Shared Lives Scheme employs shared lives carers to provide support to adults to live in the community. The office based staff team match people with carers to ensure people’s needs could be met. The scheme specialises in supporting adults with learning disabilities, mental health conditions, physical disabilities and sensory impairments. People using the service may live in the carer’s own home as part of their family or in other accommodation such as rented homes, with regular support from their carer. At the time of our inspection there were 43 people using the service of which 27 people lived in their carer’s home. The remaining 16 people lived in other accommodation. In this report we refer to the shared lives carers as 'carers' and the office based staff team as ‘staff’’.

At the last Care Quality Commission (CQC) inspection in April 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’. The service demonstrated they met the regulations and fundamental standards.

At the time of this inspection, the registered manager had recently left the service in June 2017 and the provider was in the process of recruiting a new manager. The provider had appointed an interim manager to ensure there was appropriate management support available to carers and staff. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People continued to be safe. Carers and staff received training and support to help them protect people from the risk of abuse or harm. Carers were provided with guidance on how to minimise identified risks to people's health, safety and welfare. Staff reviewed these risks regularly to ensure carers had the latest information about how to support people to stay safe.

The provider made sure people were only supported by carers that were deemed suitable. Carers and staff received relevant training so that they had the necessary skills to meet people’s needs effectively. Carers and staff had work objectives that were focused on people having their needs met. Progress against these was reviewed through supervision (one to one meeting) and appraisal so that the provider could be assured these were being achieved.

People’s choices and decisions about the support they required were used to develop an individualised support plan for them. Support plans set out how people’s needs should be met by their carer and were reviewed and updated as required. Carers and staff demonstrated a very good understanding of the specific needs of people and could explain to us in detail the support people required and why. People were happy with the quality of support received.

People were supported to stay healthy and helped to access healthcare services when they needed this. Carers and staff remained alert and acted quickly when people became unwell or needed additional assistance with their healthcare needs. People that needed prompting with the medicines prescribed to them received these in a timely manner.

Carers and staff treated people with dignity and respect and asked for their consent before providing support. Carers and staff continued to support people to build and maintain the skills they needed for independent living.

People remained active and participated in activities and events of their choosing to meet their social and physical needs. They were encouraged to maintain relationships with those that mattered to them. They were also helped to build new relationships and friendships with others.

People and carers said staff were approachable and managed the service well. They were encouraged to provide feedback about how the service could be improved. The provider acted on people’s feedback and was continuously improving the service to ensure people experienced good quality support. The provider maintained arrangements for dealing with complaints if people became unhappy or dissatisfied with the service.

Staff continued to assess, monitor and review the quality of people’s experiences. They undertook regular visits to people and their carers and checked the quality of support people experienced by asking people for their feedback and reviewing records maintained by carers.

Further information is in the detailed findings below.

8 April 2015

During a routine inspection

This inspection took place on 8 April 2015 and was announced. We told the service before our visit that we would be coming. At the last inspection of the service on 2 April 2013 we found the provider was meeting the regulations we checked.

Merton Shared Lives Scheme is provided by the London Borough of Merton. The scheme employs shared lives carers who provide support to adults to enable them to live their life in the community. Carers are supported by an office based team who are responsible for matching people with carers and ensuring people’s care and support goals can be met. The scheme specialises in looking after adults with learning disabilities, mental health conditions, physical disabilities and sensory impairments. People using the service may live in the carer’s own home as part of their family or in other accommodation such as rented homes, with regular support from their carer. At the time of our inspection there were 47 people using the service of which 34 people lived in their carer’s home. The remaining 13 people lived in other accommodation.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People said they felt safe with the support they received from the service. Carers and office based staff knew what actions they needed to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and there were plans in place to manage these to protect people from foreseeable harm.

The service ensured prospective shared lives carers were suitable to support people who use the service. Their suitability and eligibility was checked and assessed before they could join the scheme. Carers and office based staff received appropriate training and support and the registered manager ensured their skills and knowledge were kept up to date.

People’s consent to care was sought by the service prior to any support being provided. People were supported to make decisions and choices about their care and support needs. Their support plans reflected their specific needs and preferences for how they wished to be supported by their carer so that they retained as much control and independence over their lives. These plans were reviewed regularly with them by their carers and other people involved in their care to evaluate how effectively the service had been able to meet their needs. Where any changes to people’s needs required a change in their support, this was actioned promptly by the service.

People were encouraged to eat and drink sufficient amounts. Carers monitored people’s general health and wellbeing and ensured that people took their medicines as prescribed. Where they had any issues or concerns about people, they sought appropriate medical care and attention promptly from other healthcare professionals.

People told us their carers were kind and caring. People’s rights to privacy and dignity were respected. People were encouraged to take part in activities at home or out in the community aimed at increasing their confidence and level of independence. People were supported to undertake work based activities and to build and maintain social relationships.

People said they were comfortable raising any issues, concerns or complaints with their carers or with office based staff. The service had arrangements in place to deal with these appropriately.

The service promoted a positive and inclusive culture in which people and their carers felt able to share their views and experiences of the service and how it could be improved. There were systems in place to monitor the safety and quality of the support provided to people. Where any shortfalls or issues were identified through the registered manager’s checks and audits of the service, these were dealt with appropriately.

The service worked proactively with key organisations to ensure people received care and support which was joined up.

2 April 2013

During a routine inspection

We spoke with two people using the service and three carers. One of the people using the service told us 'I thought it would be quite strict when I came here, but I get a lot of freedom and choices'. Another person said 'I find it hard to work and I wouldn't survive on the streets. The scheme is looking after me and they care about us'. One of the carers we spoke with told us 'The scheme is going in the right direction. New managers have led to improvements.' Another carer said 'I think the service is unique and fantastic. I am well supported by the whole team and if I have any issues I can go to staff and they help and support me'.

We looked at the plans in place to care for and support people using the service. We saw people's specific needs were clearly identified, with guidance for carers about how these would be met. We also saw people's care and support needs were regularly reviewed by appropriate healthcare professionals and people using the service participated in these. People using the service were asked for their views and experiences and the majority of people using the service felt they were listened to. People we spoke with felt safe where they lived.

Staff received training to keep their skills and knowledge up to date. The service assessed and monitored the quality of service it provides. Staff carried out regular reviews and checks to ensure that people's care and support needs are being met in accommodation that is suitable and safe.