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 outstan

This inspection took place on 25 February and was announced.

Brighton and Hove Shared Lives Team provides long or short term personal care and support for adults in the Brighton and Hove area, who have a learning disability or a mental health need. In Shared Lives, an adult over 18 years of age who needs support and/or accommodation becomes a regular visitor to, or moves in with, a registered 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. Approximately 53 people were supported by 34 registered shared lives carers in the scheme. Shared lives carers are supported and managed by staff employed by the service.

On the day of our inspection, 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.

Since our last inspection the service had amalgamated with another service in the city of Brighton and Hove. The service was going through a significant period of change and review, where the provider and local stakeholders were looking at the service provision, what care and support was needed in the city, and how the service would best be provided in the future.

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. People’s care and support plans were detailed and reviewed regularly. Detailed risk assessments were in place to ensure people were safe within their own home and when they should receive care and support. However, we found that details of the risks identified had not been consistently used to update the care and support plan to help ensure consistency of approach. Risk assessments did not reflect the level of knowledge held by staff members. This is an area in need of improvement.

People told us they felt safe in the service. People were supported by shared lives officers and cares who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. There were systems in place that ensured this knowledge was checked and updated. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Consent was sought from people with regard to the care that was delivered. Shared lives officers and carers understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests. Referrals had been made for Deprivation of Liberty Safeguards (DoLS) and we could see that staff understood how these were implemented.

People were supported to eat a healthy and nutritious diet. People had access to health care professionals and had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

New shared lives carers underwent rigorous assessment and checks before being ‘match