About the service:

Gloucestershire Shared Lives provides care and support to people within a family environment. Approved Shared Lives Carers (SLC) support adults with learning and/or a physical disability; older people and people with mental health problems. People lived with their SLC on a short or long-term basis depending on their needs. There was 25 people using the service at the time of the inspection.

People’s experience of using this service:

• People told us they were happy living with their SLC and being part of a family. One person said, “I like everything and I like the dog as well.” People explained that they felt safe living with their SLC and families and confirmed that the support they received from their SLC was kind and very caring.

• People’s independence was promoted and they were given opportunities to personally develop appropriate to their needs and wishes.

• People’s relatives and health care professionals, we spoke to praised the compassionate and caring culture of the service and felt the service focused on people’s individual support needs.

• People had been involved in the assessment of their care and decisions about their support needs and where they should live. Their views and assessment was fundamental to ensure that the SLC had the skills and family life that would suit the needs of individual people.

• People’s care plans provided SLC with the information they needed to support people and the management of people’s individual risks. SLC had been trained in managing people’s medicines. Further work was being carried out to improve the service’s practices in the management and administration of over the counter medicines and the management of 'as required' (PRN) medicines.

• SLC had the support they needed to care for people. They were provided with regular breaks and had ongoing and regular support from Shared Lives Officers (SLO) and other SLC.

SLC had received regular training and had the skills to support the people they cared for. They were aware of shared lives policies and care practices and their responsibilities to protect people from harm and abuse.

• SLC, SLO and other stakeholders commented that they felt the management of service had improved. The registered manager had implemented effective systems to monitor the quality of the service, reflect on practices and drive improvement.

Rating at last inspection: Good (Last report was published on 26 August 2016).

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous Good rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 15, 18, 20 22 and 26 July 2016 and was announced. Gloucestershire Shared Lives carers shared their home, family life and community life with someone who needs care and support. Shared Lives carers support adults with learning and/or a physical disability; older people and people with mental health problems. People lived with their shared lives carer on a short or long term basis depending on their needs.

A registered manager was in place as required by their conditions of registration. 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 and associated Regulations about how the service is run.

People were supported by shared lives carers who had been vetted and robustly checked to enable them to share their lives and home with people. People’s needs were assessed and discussed before they met their shared lives carers. Opportunities for people to meet their shared lives carers were provided to ensure people and their shared lives carers were compatible. People’s placements and needs were reviewed regularly to ensure they were receiving care that met their needs. The shared lives carers had opportunities to have regular breaks.

People were supported by shared lives carers who knew them well. The shared lives carers were passionate about their role and helping people to have a good quality of life. Where appropriate people were supported to maintain relationships with their families. Staff and shared lives carers were knowledgeable in their responsibilities in protecting people from harm. People’s risks and support requirements were identified, recorded and managed in line with their needs. People were supported to maintain a healthy life by having regular health care checks and eating healthy.

People received their medicines when they required. The shared lives carers were knowledgeable about people's medicines and administered them according to their needs. However people’s medicines administration records did not always provide clear information about which specific medicines had been administered.

People were encouraged to make choices about their day such as attending activities. People’s mental capacity to make significant decisions had been assessed by staff or other health care professionals however this was not always recorded in their support plans.

Staff had been trained and supported to carry out their role. Shared lives carers were in regular contact with the shared lives office team and received an annual review of their care they provided.

There were regular opportunities for people and their shared lives carers to raise concerns about the service and the support being provided.

The registered manager supported the office team. A fully established team was now in place to support the shared lives carers after a period of staff shortages in the office team. They had attended events and had strong links with a national organisation which supported people who were involved in shared lives services. The registered manager and office team monitored the quality of the service being delivered and reviewed any accidents and incidents relating to the service.

We were not able to speak with people who used the service. We spoke to seven shared lives carers and staff from the provider's location who managed the running of the scheme.

The shared lives carers told us they felt extremely well supported by the support workers. They told us "we can contact them at anytime for advice or support", "we really value the support workers" and "they are a very good team of people". All the shared lives carers told us they would highly recommend the work they do as they found it rewarding.

We found a safe system was in place for the recruitment of shared lives carers and support workers.

A review of the scheme had recently taken place and the registered manager had an action plan in place with all the changes they planned to make.

This inspection took place on 8, 10 and 11 December 2014 and was announced. This was to ensure the Gloucestershire Shared Lives team and carers and the people who use the service would be available to speak to us.

Gloucestershire Shared Lives provided personal care and support to 38 adults during our inspection. Gloucestershire Shared Lives carers share their home, family life and community life with someone who needs care and support. Shared Lives carers support adults with learning and/or a physical disability; older people and people with mental health problems. People live with their shared lives carer on a short or long term basis depending on their needs.

A registered manager was in place as required by their conditions of registration. 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 and associated Regulations about how the service is run.

We previously inspected this service on 29 October 2013 when we found people’s care records were not personalised and focused on their individual needs, preferences and personal backgrounds. During this inspection we found information in people’s care records had significantly improved. Records reflected the person’s physical, emotional and social needs and wellbeing. The person’s plan of care and support was focused around their needs and wishes. Whilst some people’s risk assessments had not been updated and personalised we found they were being updated when people’s needs were being reviewed. .

Shared lives carers recognised the need to support and encourage people to make decisions and choices whenever possible. People’s best interests and known preferences were taken into account if they were unable to express their views or make significant decisions. However records on how people’s best interest decisions had been reached were not evident.

People’s accidents and incidents had been recorded however there was no system in place to record if there were any trends or patterns of incidents across the whole service.

The shared lives team, registered manager and shared lives officers who managed the service understood their roles and responsibilities in order to protect people from harm and abuse. Shared lives carer knew people well and how to best support them when they were upset or at risk of harm. People’s personal support needs and risks had been assessed and were being managed effectively

People’s interests and hobbies were supported and encouraged by their shared lives carers. Some people attended activities in the community and others carried out activities with their shared lives carers and families. People told us they enjoyed a well-balanced diet. They were supported to eat and drink sufficient amounts and maintain a healthy diet. Their dietary needs were catered for and reviewed. People were supported to attend health care appointments when required. Their medicines were ordered, stored and administered in a safe way.

People were supported by shared lives carers who were suitably trained and recruited to carry out their role. Shared lives carers were supported and could raise any concerns with the shared lives team and registered manager. Regular breaks and support was provided so the shared lives carers could have a break from their role as a carer.

People and their shared lives carers and families had developed warm and caring relationships. People who were able to talk to us told us they enjoyed living with their shared lives family. People had been involved in the decision to live with a shared lives carer. An introduction and trial period had been carried out to ensure people were matched with the right shared lives carer.

Shared lives carers spoke highly of the shared lives team and the registered manager. They told us that any concerns they raised were always dealt with immediately. Complaints were managed effectively and actions were put in place to prevent the concern reoccurring. Monitoring systems were in place to ensure the quality of the service. There was a supportive culture within the shared lives team. The team sought advice from other health and social care organisations disciplines when required.