About the service:

¿ Hillingdon Shared Lives provides respite care, short and long-term care and accommodation for adults and young people over the age of 16 years. People who used the service had a range of needs including learning disability, mental health needs or were going through a difficult period in their lives and needed care and support. The service enabled people to live in the community with families (shared lives carers) in their homes. Shared lives officers coordinated this care and supported the shared lives carers as well as the people receiving the service. At the time of our inspection 38 people were using the service, 14 of whom only required occasional respite stays. There were 24shared lives carers providing a service and some were able to accommodate up to three people.

People’s experience of using this service:

¿ An experienced registered manager had been leading the service for five years and they demonstrated a sound knowledge, passion and enthusiasm for their role and the service. They led a strong team of shared lives officers who were dedicated and provided a high-quality service for people who used the service.

¿ Feedback from people who used the service was extremely positive with regards to all aspects of their care. They were very complimentary about the shared lives carers who supported them and the service in general. They told us all their needs were met and that the shared lives carers treated them with the ''utmost'' respect and promoted their independence. They said they felt part of the family in their homes and were supported to lead active lives in the community.

¿ The provider was responsive to the diverse needs of people across the borough and had embedded the ethos of promoting equality, diversity and human rights across all areas of the service, from the recruitment of shared lives carers and the matching process between people and their shared lives carers.

¿ The provider had robust monitoring systems in place to ensure the service ran effectively, which included unannounced spot checks of the shared lives carers, internal monitoring visits and medicines audits.

¿ Shared lives carers demonstrated a in depth understanding of people's needs and preferences and treated them as individuals. The shared lives officers ensured there was a thorough matching process in place which helped to ensure that placements were appropriate and successful. People and their shared lives carers were given opportunities to meet and get to know each other before placements were finalised. Arrangement agreements helped to ensure that everyone was aware of their responsibilities and the support that people would be given.

¿ Care plans contained detailed information about people’s individual needs, preferences and choices, and we saw evidence they were involved in the care planning and reviewing processes. People were supported to lead active lives, develop their life skills and take part in activities of their choice.

¿ People and shared lives carers knew how to complain about the service if they had a concern. Information was available in a pictorial and easy-read format.

¿ Where appropriate, people were consulted about their end of life choices and these were recorded in their care plan. Staff received training in end of life care.

¿ People who used the service told us they felt safe living with the shared lives carers, and they were treated well. They, the shared lives carers and shared lives officers, received training in safeguarding and there were policies and procedures to ensure people were protected from avoidable harm and abuse.

¿ Where there were risks to the safety of people who used the service, these had been assessed, and measures were in place to reduce the risk. Risk assessments and support plans were regularly reviewed and updated.

¿ Where people required support with their medicines, this was managed safely.

¿ There were robust recruitment processes for both shared lives of

We undertook an announced inspection on 16 and 18 August 2016 and the first day was announced. The last inspection took place on 12 and 13 November 2013 where we found the service had met the previous regulations.

We told the provider two working days before our visit that we would be coming because the location provides a shared lives service, there is a small team working for this service and we needed to be sure that someone would be available.

Hillingdon Shared Lives is service which provides respite care, and short and long term care and accommodation for adults with a range of needs, including people living with dementia, who have mental health needs and learning and /or physical disabilities. The service could also offer support to young adults over the age of 16 years old. The service enables people to live in the community within a family environment. The service recruits, assesses, trains and supports shared lives carers to provide the necessary support for the people who lives with them. Shared lives carers can have up to three people living with them at any one time.

At the time of the inspection there were 46 shared lives carers employed by the service, 36 provided the main primary support for people using the service and ten who provided respite support on a short term basis. 24 people lived with their primary shared lives carers and ten people received respite support which might be when the shared lives carers were on holiday or just for one day's respite to give their relatives support and a break from caring responsibilities. Shared lives carers were entitled to take 42 days holiday each year and people would usually then stay with a respite shared lives carer.

Three shared lives officers worked in the service, two were part time and one worked full time.

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.

The service was very well run and the registered manager and shared lives team worked hard to ensure there was a positive culture where the team worked inclusively with people using the service, the shared lives carers, and other professionals. Systems were in place to obtain and act on feedback and make improvements to the quality of the service. Shared lives carers and people using the service were involved in contributing to how the service was run and where changes needed to be made.

People and shared lives carers spoke extremely positively about the registered manager and shared lives officers. They told us they felt supported and listened to by the service.

There were good monitoring audits in place to ensure the service ran effectively and records were accurate, detailed and person centred.

People using the service told us they felt safe and the shared lives carers treated them very well. People were matched with supportive shared lives carers who enabled them to lead active lives, take part in enjoyable activities and develop their life skills.

Shared lives carers had received training in safeguarding adults and there were procedures in place to ensure people were protected from avoidable harm and abuse.

Care plans and risk assessments were regularly reviewed by staff with the person using the service.

There was excellent liaison between the shared lives staff team and other professionals to help maintain placements.

Where people were supported with their medicines this was managed in a safe way.

Recruitment processes for shared lives carers were detailed and included measures that ensured they were suitable to provide care to people in their homes. The assessment process included an extremely thorough training programme which equipped shared lives carers with

We spoke with five shared lives carers (carers) and four people who live with carers. We also met with the manager and two shared lives workers (staff).

People were assessed prior to being matched to a carer. Staff at the service confirmed people met with the carer, if necessary, several times before all concerned decided that the person could move in with them. The four people who live with carers said they were part of the family and involved in their daily lives. Some people said they went on holiday with them whilst others went to regular respite carers. One person told us the carer “respects my decisions and I feel I am helped to be independent”. The four people who live with carers told us they felt safe living with them and would talk to the carer, their relatives or staff from the shared lives service if they were worried.

All the carers we spoke with confirmed they were visited by staff from the service and felt supported. One carer told us there was always staff who would provide them with advice. All the carers we spoke with said they tried to attend the carers meetings as they found them useful. They spoke of these meetings being a chance to talk about any issues and to seek advice if needed. Training was provided for carers to ensure they have the skills they need to support people appropriately.

We met with the Manager, two shared lives workers (staff), three people who live with shared lives carers and one shared lives carer. We also telephoned four shared lives carers to obtain their views about the service. We also viewed three files of the people who use the service and six shared lives carers' files.

Both the shared lives carers we spoke with and the people living with them confirmed they were fully involved in how the placements were set up and reviewed. They told us their views were asked for and they felt supported by the staff working at the service. One shared lives carer said that the service “takes into account my views”. One person who lived with a shared lives carer told us “I am happy living with my carer”; whilst another said “my carer supports me”.

Shared lives carers were assessed before they were accepted to carry out this role and people who lived with them had their needs assessed by the service prior to matching a person with a shared lives carer. This enabled the staff working at the service to ascertain if the person’s individual needs could be met and if there was a suitable shared lives carer available to support and look after them.

There were thorough recruitment checks to protect the safety of the vulnerable people living with the shared lives carers. Shared lives carers confirmed that they had gone through rigorous checks before they started working for the service.

The service had various systems in place to monitor the quality of the service. This included carrying out checks at the shared lives carer’s homes, completing monthly reports to the manager regarding what had been achieved and the priorities for the future. This ensured that the staff continuously reviewed if the service was operating well and if there were any improvements that needed to be made.

Records were comprehensive, reviewed on a regular basis and were fit for purpose.