Lewisham Shared Lives is a local authority operated service that supports adults with a learning disability and/or older people to live in the community, in the family home of their shared lives carer. Shared Lives schemes offer an alternative to both residential and more traditional care at home services for people who need personal care and support with their day to day lives. The Care Quality Commission (CQC) regulates the provision of personal care for people who use the service.

Shared Lives schemes can offer personal care and support which is a day service, an overnight service, temporary or permanent. At the time of the inspection Lewisham Shared Lives was primarily involved in supporting people with a learning disability or autistic spectrum disorder who were settled in long-term placements. The provider is responsible for appointing, training, monitoring and supporting local carers who are self-employed and receive a payment for providing people with personal care, accommodation and other assistance. A total of 18 carers had been appointed and some carers had been approved to care for more than one person.

This was the first inspection of this service since it registered with the Care Quality Commission (CQC) on 15 September 2015. The provider was given two days’ notice of our intention to conduct the inspection, as we wished to ensure that key staff were available to contribute to the inspection.

Lewisham Shared Lives is managed by a registered manager who is supported by one full-time coordinator, and an assessor who conducts assessments for new carers as required. 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 Act 2008 and associated Regulations about how the service is run. The registered manager and the coordinator were present on both days of the inspection.

Carers understood how to protect people from the risk of abuse and harm. They had received safeguarding training and were aware of how to report any concerns about people’s safety and welfare to the coordinator or registered manager. Carers were provided with guidance about how to support people to safely receive their prescribed medicines.

Systems were in place to assess and monitor any risks to people’s safety. Written guidance was in place to advise carers about how to mitigate identified risks whilst supporting people to make choices and maintain their independence, where possible.

Robust recruitment practices were in place to make sure that people who use the service were supported by carers with appropriate knowledge and skills, and a clear commitment to the principles of Shared Lives. Following an assessment process by the provider, the applications from prospective carers were presented for approval to an independent panel. People were placed with carers after the successful completion of a detailed ‘matching’ process, which included different opportunities to spend time together and reflect on whether both parties wished to proceed with a placement.

Carers were provided with a range of support to assist them to undertake the requirements of their role; this included training sessions, visits at home and telephone advice from the coordinator, and regular group meetings with other carers.

The registered manager and the coordinator understood their responsibilities in relation to the Mental Capacity Act 2005. Assessments of people’s capacity to make specific decisions were carried out when necessary and carers recognised the importance of supporting people to make day to day decisions about their lives and receive their care and support in the least restrictive manner achievable. The coordinator monitored that carers acted in people’s best interests in line with legislation.

People’s care plans showed that they were supported to