The inspection took place on 08 August 2017 and was announced. This was the first rated inspection for this service.

Bolton Shared Lives offers a range of services including day time support, short term care where the person goes into the home of carer for a specific period of time and longer term care when the person goes to live with a carer as a member of the family and this becomes their permanent home.

People who use the service are adults over the age of 16 and need support with day to day living because they have a disability, mental health problem or are frail.

There was a registered manager in place at the service. 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 recruitment process for staff members and carers was robust to help ensure people employed were suitable to work with vulnerable people. There was an appropriate policy and procedure in place for safeguarding, issues were reported as required and staff and carers undertook appropriate training.

Accidents and incidents were reported and recorded appropriately. Actions to follow up were undertaken where required. People’s needs were thoroughly assessed and risks and needs recorded appropriately. We saw thorough risk assessments with techniques and actions to minimise risks documented within people’s care plans.

There was a medicines policy in place and full training was given to carers to help ensure medicines were given safely.

There was a thorough staff induction process, training was on-going and mandatory courses refreshed regularly. People wishing to be carers in the community were subject to an assessment and 8 to 10 weeks of pre-approval classes in a wide range of areas.

Care plans included relevant health information and support needs of people who used the service. Consent and agreement, when required, was sought from people who used the service.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). People’s best interests were considered when decision making took place.

We observed friendly and relaxed interactions between carers and people who used the service, who spoke about the placements as ‘home’ and told us they were very happy. Carers demonstrated a high level of empathy and compassion towards the people they cared for.

People were supported with the underpinning values of equality and diversity. Confidentiality was respected by all staff and carers. People who used the service were afforded respect by their carers and we saw examples of people’s dignity being respected within the visits we made.

If people in long term placements were approaching the end of their lives, they would be supported to remain in their home, with support for the carer, if this was their wish.

The service endeavoured to match people who required the service to carers with whom they would be compatible. Where multiple placements were made within one household, the dynamics of the group already together was considered to help ensure all the people being cared for were able to receive the correct level of support.

Care plans were person centred and included information about people’s backgrounds, families, abilities and strengths, choices, likes and dislikes.

There was an appropriate complaints procedure in place and complaints and concerns received had been followed up in a timely manner with appropriate actions.

There were clear values of equality, diversity, respect and dignity running through the organisation and this was reflected in all the observations, documentation and discussions with staff and carers.

Staff were supported with regular supervision sessions, where learning needs and personal development could