Harrow Shared Lives Scheme offers a community–based service for people aged over 18 who have a learning disability, physical disability, mental health or who are elderly and need help with their day to day life.

A Shared Lives Scheme Placement can be somewhere for a person to live or to stay for a short break or to go during the daytime for support. People who receive support through the scheme are helped and supported by a Shared Lives Scheme Carer (SLSC). The SLSCs offer their home to support people as part of their family. The scheme is managed by the London Borough of Harrow.

On the day of our inspection there were 27 people using the service.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People continued to receive safe care. Recruitment processes ensured SLSCs were suitable to work with people who needed support. People were consistently protected from the risk of harm because there were arrangements in place to help safeguard them from the risk of abuse. Medicines were managed safely and procedures were in place to ensure people received medicines as prescribed. Risk assessments had been completed to enable people to be supported with minimum risk to themselves or others.

The care that people received continued to be effective. People were supported by staff who had the right skills and knowledge and were supported in their role. SLSCs had access to the support, supervision, training and on-going professional development that they required to carry out their roles. The service had continued to support people to maintain good health and nutrition.

The service had continued to operate within the legal framework of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives told us that staff were friendly and caring. They told us they had developed positive relationships with the staff who they described in complimentary terms such as ‘caring’; ‘kind’, ‘supportive’, and ‘helpful’.

People had detailed personalised plans of care in place. This enabled staff to provide consistent care in line with their personal choice and preferences. People and their relatives knew how to raise a concern or make a complaint. The service had an effective system to manage complaints.

There was an effective quality assurance system in place. This was supervised by the registered manager. Oversight of the system was also provided by a local authority quality assurance senior officer and scheme coordinator.

We spoke with three relatives of people who used the service, other professionals who work with people who use the service and four members of staff including the registered manager.

We received a mixed view from relatives regarding whether they had been involved or consented to people's care. Records showed that consent was obtained regarding people's care.

Most people commented that they were very happy with the care provided. The provider had appropriate arrangements in place to provide care that met people's needs.

Although relatives could not provide feedback on how people's medicines were managed, Shared Lives carers stored and administered medicines appropriately.

Although we received some comments that Shared Lives carers felt they were not supported as well as they wanted, training and other arrangements were in place to support staff to be able to provide care that met people's needs.

Although some relatives felt their feedback was not listened to, the provider had appropriate arrangements in place to monitor the quality of the service provided.

We spoke with three relatives of people who use the service, two carers, the registered manager and one other member of staff. All the relatives we spoke with told us that they felt people were involved in their care. They said people who use the service were able to choose what activities they took part in and the carers supported them to do this. The service treated people with privacy and dignity and ensured people were involved in their care.

Every relative we spoke with told us they were happy with the care people received. One person said about the service that they, "could not fault them in anyway, so (we are) lucky to have them." They said staff explained everything about the service and communication was always very good. The service ensured care could be provided safely.

Every relative we spoke with was confident the staff would take appropriate action if an incident occurred. All the carers we spoke with knew how to report an incident and one carer gave an example of how they had done this. The service was aware of it's legal obligations regarding safeguarding people from abuse.

The relatives we spoke with all explained how carers were matched to meet the needs and preferences of people who use the service. The service showed that all its staff were assessed and qualified to meet the needs of people.

None of the relatives we spoke with had any complaints regarding the service. The service responded appropriately and promptly to complaints.

We carried out this inspection on 26 and 27 February 2015. This inspection was announced. This meant that we gave the service short notice so that management and staff were available to assist with our inspection. During our last inspection on 4 December 2013 we found the provider to be compliant with all assessed regulations.

The Shared Lives Scheme (SLS) recruits, trains and supports Shared Lives Carers (SLC's) who provide personal care and support for people within their own family homes in the community; enabling them to live as independently as possible. When we visited the SLS was supporting 27 people who lived in family homes and 37 approved SLC's. The scheme caters for people aged over 18 who have a disability and for older adults with care needs. Shared Lives Workers (SLW) were employed by the scheme to assess, monitor and support SLC's. The scheme employed two social workers, one project co-ordinator and two registered managers.

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 told us the service was safe and relatives confirmed they felt their relatives were safe using the SLS. SLW’s and carers showed an understanding of how they could keep people safe. People told us they were encouraged to raise concerns about their safety.

SLW’s and carers understood how to recognise and respond to suspected abuse and understood their responsibility to report any concerns regarding the safety and wellbeing of people.

SLW’s and carers understood the requirements of the Mental Capacity Act 2005 and put them into practice. People could make decisions about the care they received, and risk assessments were in place to support people to have a choice in how they were supported to meet their needs.

There were safe recruitment practices because appropriate pre-employment checks were completed by Harrow Council and shared lives workers prior to Shared Lives Carers being approved into the scheme.

People were supported by SLW’s and carers who had the necessary skills and knowledge to meet their assessed needs.

SLW’s and carers were supported in their role and had regular supervisions with their manager or shared lives worker.

People were involved in choosing the shared lives carer they wanted to live with and were involved in decisions about their nutrition and hydration needs. People were supported to receive healthcare services.

SLW’s and carers involved and treated people with compassion, kindness, dignity and respect. People were listened to, felt they mattered and spoke positively of their experience with feeling involved in their care.

People’s needs were regularly assessed by the SLW’s and their records updated. People and their shared lives carers were involved in the assessment of their needs. Reviews took place regularly and people were involved in the reviews. Care plans were personalised and people had signed to indicate they had been involved in putting their plan of care together.

People had access to activities or employment opportunities that were important to them.

People knew how to make a complaint and complaints had been received and dealt with by shared lives officers and responded to in good time.

There was a clear management structure at the service. SLW’s were supported by a registered manager and were aware of the roles of the management team.

People told us the service was well managed. People and SLC’s confirmed they understood their right to share any concerns with the shared lives officers about the care and support provided.

Incidents were recorded and this information was used to monitor, investigate and take the appropriate action to reduce the risk of them happening again.

Feedback was sought from SLW’s, SLC’s and people through annual questionnaires and this feedback was used to make changes and improvements to the service.