In shared lives, a shared lives carer (SLC) shares their home and family life with an adult who needs care or support to help them live well. Support can include long term or short term accommodation and respite care.

East Sussex Shared Lives Scheme recruits, checks and approves paid SLCs to provide care and support to people with learning disabilities and mental health problems in the carers own home. The provider is responsible for ensuring SLCs are provided with the appropriate knowledge, skills and support to undertake this role. The provider employs Shared Lives Officers (SLOs) to carry out this role. The service operates throughout East Sussex and at the time of inspection provided care and or support to 138 clients from 79 households.

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.

This comprehensive announced inspection was carried out on 20 and 24 January 2017.

People were supported by SLCs and SLOs who knew them exceptionally well. They were continually encouraged and empowered to develop confidence and skills both in meeting their personal care needs and in developing the skills to gain independence. SLCs and SLOs worked closely with health professionals to maximise people’s health and well-being.

People were always treated as individuals and their care was personalised and tailored to their specific needs and wishes. They told us they were treated extremely well and their privacy was consistently respected. People told us that they were involved in all decisions that affected them. They said that the SLOs regularly asked them if they were happy with the care and support they received.

We received numerous examples of how the ethos of the service had a particularly positive impact on people’s lives. Through family life, people had been given real self-esteem and were supported to increase independence. For some this was in relation to achievements such as learning to shower independently and for others this included travelling for the first time or having the courage and confidence to see if they could live independently.

People were fully involved in decisions about their care and support. SLOs and SLCs understood about people's capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. SLOs had gone to great lengths, through the use of role play, to enable informed decision making. Where people were assessed as unable to make decisions for themselves, they had considered the person's capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests. Where appropriate applications had been made for Deprivation of Liberty Safeguards (DoLS) and the reasons were clearly recorded.

Everyone told us they felt safe in their individual homes and they were aware of some of the measures taken by the SLCs to ensure their safety. There were systems in place that ensured medicines were well managed and people received their medicines when they needed them. There were robust procedures to ensure that risks to people’s safety were identified, assessed and managed. When incidents occurred they were reviewed promptly to ensure the risk of a reoccurrence was minimised.

There was a thorough recruitment procedure to ensure safety in the recruitment of SLOs. All SLOs had a clear understanding of what constituted abuse and told us what actions they would take if they believed someone was at risk. New SLCs underwent rigorous assessment and checks before being 'matched' with people who needed support. Care and support was then reviewed at regular intervals to