This inspection took place on 25 October 2016 and was announced.

The adult placement scheme is a service which supports carers to provide a home for people who are unable to or choose not to live on their own. They live as part of the carer’s family. Carers are not directly employed by the scheme but are paid a fee which is dependent on the amount and type of support they provide for individuals. People using the service and their shared lives carers enjoy shared activities and life experiences. Frequently, the people who use the service have a learning and/or associated disabilities.

The service is provided by the local authority. At the time of the inspection 36 people received long or short term (respite) care which included the regulated activity (personal care). There were 30 carers approved to offer support to people who required personal care as part of their needs assessment. Additionally, the service offered day care and other services which were not regulated by the Care Quality Commission.

There is a registered manager in charge of the service. A registered manager is a person who has registered with the CQC 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, carers, staff and others were kept as safe as possible because staff and carers were appropriately trained and followed health and safety procedures. They knew how to recognise and manage all forms of abuse or risks of harm. Carers and staff members knew how and when to follow safeguarding procedures. Detailed risk assessments provided guidance for people, carers and staff on how to manage and reduce risks as much as possible. The robust risk assessment process enabled people to live in domestic homes and manage the risks that this style of living involved as safely as possible. The recruitment procedure checked that staff and carers were safe and suitable to work with and provide people with care. The service carefully assessed what support people needed to take their medicine. Carers provided a range of support according to the needs of people in safe and appropriate ways.

People were involved in making decisions about their care. They chose where to live and who with. They planned their care and support with appropriate help from others. Staff made sure that carers were able to uphold people’s legal rights with regard to decision making and choice. People’s capacity to make decisions was recorded. Staff ensured carers provided people with care that met their individual needs, preferences and choices. People’s rights were protected by staff who understood the Mental Capacity Act (2005). Staff provided carers with this knowledge where necessary. This legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision.

People were respected and their privacy and dignity was protected and promoted. People’s diversity was fully understood and people’s carers and support plans reflected their particular needs. People were carefully matched with carers who could offer them a home where any specific needs could be managed in a family environment.

The service was well managed by a registered manager who was very knowledgeable about the service and the needs of people. Despite managing two services staff told us they felt supported and the registered manager was always available. Staff felt valued and supported by the registered manager and each other. The level of support and competence was reflected in the standard of support the service was able to provide to carers. The service had processes to monitor and assess the quality of the care and support provided. Any identified improvements were acted upon in a culture of continuing development.

The shared lives officers and carers made sure that people were involved in making decisions about all of their care. One person told us, ‘‘I always meet carers before I go to them and I choose whether they are right for me’’.

They took action to make sure people were supported to be as independent as they could be, as safely as possible. People told us they were helped to do things for themselves and their carers made sure they could do it.

People were offered a rewarding lifestyle and were happy living in their homes. One person described it as ‘‘a smashing life''. We saw that people were well cared for and treated with respect and dignity. One person said, ‘‘I am very proud of myself and what I have done with the help of my carer. I am happy now’’.

Staff and carers were recruited as safely as possible. All the necessary checks were completed before they were allowed to work directly with people.

We found that the service had ways of looking at the care they offered to make sure they maintained and improved it. They listened to the views of the people who used the service, staff members and carers. Carers and people who used the service told us that shared lives officers and the manager always listened to their views and took any action very quickly, if necessary.

We found that because of the nature of the service staff supported both the carers and the people who used the scheme.

People were involved in the development of their care plans and in making decisions and choices about their lives. People told us that carers knew them well and said ‘’ my carers help me to express myself properly so that I don’t get frustrated’’. People were carefully ‘matched’ to families /carers so that they could participate in their lifestyles and enjoy being part of the family. People told us that they ‘loved’ their long or short term homes. One person said,’’ I am very, very, happy in my home. I think it’s the best place for me to live. I wouldn’t want to live anywhere else’’. People told us that they always felt safe with their shared lives carers. They were able to tell us who they would talk to if they were not happy or felt unsafe. Staff and carers were supported to offer the best care to people who used the service. Some staff felt that they were ‘under pressure’ because of the complexity of the service and the reduced staffing levels. The scheme had a comprehensive complaints procedure which people knew how to use and people’s views were sought and acted on.