This inspection took place on 4, 5 and 7 December 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The service was last inspected in May 2016 where it was rated Good. However, we made two recommendations under well-led domain.

Shared Lives Scheme is a local authority operated service that support adults with a learning disability or autistic spectrum disorder, a mental health condition and physical disability. People using this service receive care and support by individuals, couples and families who have been approved and trained for that role, and are called shared lives carer. People using the service live with the shared lives carers in their homes. Placements can be long-term with the adult living with the carer as part of their family, or as respite care to provide regular carers with a short break.

At the time of our inspection 30 people were living in long-term shared lives arrangements, some of these people also accessed respite shared lives placements. A total 30 shared lives carers had been appointed and some carers had been approved to care for more than one person.

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.

The service had a registered manager. 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 they felt safe with the shared lives carers and trusted them. Risks to people were assessed and mitigated. Shared lives carers were provided with sufficient information to minimise risks to people and provide safe care.

Shared lives carers knew the safeguarding procedures and how to escalate concerns to external parties where necessary. People told us their needs were met by shared lives carers. People were protected from infection and lived in a clean environment. There were enough shared lives carers in place who were suitably recruited to ensure people at risk were safely supported. There were systems in place to learn and share lessons when things went wrong.

People’s needs were assessed before they were matched with shared lives carers. Shared lives carers were knowledgeable about people’s needs and supported them effectively. People were supported to maintain a nutritionally balanced diet and access ongoing healthcare services. Shared lives carers received sufficient support and training to provide effective care. The service provided care in line with the Mental Capacity Act 2005 principles.

People told us shared lives carers were caring, treated them with dignity and respected their privacy. Shared lives carers supported people with their cultural and religious needs. People were supported to remain as independent as they could.

People’s personalised needs were met by shared lives carers who were knowledgeable about their likes and dislikes. Care plans were detailed, regularly reviewed, and provided information on how to support people. The provider welcomed and encouraged lesbian, gay, bisexual and transgender people to use their service. The provider had systems and process to support people with their end of life care needs.

People and shared lives carers knew how to raise concerns and had never had to make a complaint. There was a complaint’s policy and procedure in place to ensure people’s complaints were addressed in a timely manner.

People and shared lives carers spoke posit

The inspection took place on 11, 17 and 19 May 2016 and was announced. We told the provider two days before our visit that we would be inspecting their service. The service was last inspected in November 2013 when it was found to be compliant with the outcomes inspected.

Shared Lives Scheme is a shared lives placement service, which recruits and supports paid carers to provide family based placements for people. The service currently provides support to adults with learning disabilities but has plans to expand to other groups. Placements can be long-term with the adult living with the carer as part of their family, or as respite care to provide regular carers with a short break.

The service had 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.

At the time of our inspection 32 people were living in long term shared lives arrangements, some of these people also accessed respite shared lives placements. The service had 28 approved shared lives carers.

People using the service told us they felt safe and the shared lives carers treated them well. Support plans and risk assessments were regularly reviewed by staff with the person using the service. Where people were supported with their medicines this was managed in a safe way. Shared lives carers had received training in safeguarding adults and there were robust procedures in place to ensure people were protected from avoidable harm and abuse.

Recruitment processes for shared lives carers were robust and included measures that ensured they were suitable to provide care to people in their homes. The assessment process included a thorough training programme which equipped the shared lives carers with the skills they needed to perform their roles. Shared lives carers told us they thought they received training and support required to perform their roles.

Care files contained records of consent for people receiving a service. This included assessments of capacity and best interests decisions where appropriate. Care plans were highly personalised and contained details of people's preferences, including for food and drink. Care files included health action plans and hospital passports which ensured that people were supported to have their health needs met. People told us they received support to do the things they wanted within their shared lives placements.

People and shared lives carers told us they felt they had positive, caring relationships with each other. People were supported to maintain their relationships with friends and families.

People and their shared lives carers were supported to ensure people had the support they wanted at the end of their lives.

The service had a complaints policy and people told us they knew how to make complaints if they needed to.

People and shared lives carers spoke highly of the registered manager and shared lives worker. They told us they felt supported and listened to by the service.

The registered manager knew people and shared lives carers well and used this knowledge to monitor the quality of the service.

The service did not have capacity to maintain the record keeping systems that were required by the commissioning bodies. We have made a recommendation about the resources for the service.

The service did not consistently record checks that were completed on records of care that were held in people's homes. We have made a recommendation about record keeping.

People we spoke with who were able to, told us they felt respected by their carers and they had their dignity maintained. Carers we spoke with told us they always knocked on people's bedroom doors before entering and spoke to people in an age appropriate and respectful manner.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. There was documentary evidence in people's care files which showed the Shared Lives Scheme worked with other health and social care services and professionals to ensure people received appropriate care, treatment and support.

People we spoke with told us they were happy with their carers and the care and support they received. We found carers received appropriate professional development. Carers told us they had undertaken a number of training courses to ensure their skills and knowledge were up to date. People we spoke with who were able to told us they received good care and treatment from their carers.

People we spoke with told us they could make a complaint if they wanted to and they filled out questionnaires provided by the service. We found the provider took account of complaints and comments to improve the service. There was a complaints policy in place. Shared Lives carers told us people could make a complaint if that was what they wished. People we spoke with confirmed this.