The inspection took place between 26 and 28 June 2018 and was announced. At the last inspection in July 2017 we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as risk assessments were not robust and there was insufficient information about people’s medicines. We also made a recommendation about ensuring people were involved in reviewing their care. The provider had taken clear and effective action to address these concerns and followed our recommendation.

Newham Shared Lives Scheme is registered to provide people with personal care. A shared lives scheme facilitates arrangements between people with support needs and shared lives carers who accommodate people in their own homes. Not everyone using Newham Shared Lives received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’. This is help with tasks relating to personal hygiene and eating. Where they do, we also take into account any wider social care provider. At the time of our inspection 52 people were living in long term shared lives arrangements, 18 of whom received support with personal care. A further 15 families regularly used the service for respite or short breaks.

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.

Newham Shared Lives was exceptionally run in a person-centred and innovative manner that focussed on achieving outcomes for people living in shared lives arrangements. The unique governance structure established when the provider became an independent not-for-profit company having previously been an in-house local authority service enabled positive risk taking in strategic development that benefitted people and shared lives carers. As a membership organisation the views of shared lives carers and people who used the service were central and shaped the values and priorities of the organisation. There were clear plans in place to increase participation and ensure sustainable growth in line with best practice guidance for the sector.

Staff and shared lives carers received high levels of support and training to ensure they had excellent skills that met the need of people living in shared lives arrangements. Staff and shared lives carers had been supported to complete externally accredited nationally recognised qualifications. Where people living in shared lives arrangements had specialist needs staff sought additional training for shared lives carers to ensure they could meet their needs. Shared lives carers told us this benefitted their entire families as well as the person they were supporting. Needs assessments for people were holistic and highly personalised ensuring the resulting care plans were outcome focussed and considered all aspects of their lives in addition to their care needs. The process of matching people with shared lives carers was led by people who had the final say on agreements. Peoples dietary needs and preferences were clearly captured and through the matching process the provider ensured dietary needs and preferences were met. Staff supported people and shared lives carers to meet their healthcare needs and supported them to access specialist support and services where this was needed. Records showed staff facilitated shared lives carers inclusion in people’s wider support networks and ensured all organisations involved in providing support to people worked together in a holistic way. The provider ensured shared lives carers understood the Mental Capacity Act 2005 and how it applied to people living in shared lives arrangements. Where people lacked capacity to consent to their care and treatment r

The inspection took place on 5 and 6 July 2017 and was announced. The provider was given 48 hours notice as the service is a shared lives scheme and staff are often out completing visits to people. We needed to be sure someone would be in.

Newham Shared Lives Scheme is a shared lives organisation based in the London borough of Newham. At the time of inspection 49 people were living in shared lives arrangements with 37 shared lives carers.

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 living in their shared lives arrangements. Shared lives staff and carers were knowledgeable about safeguarding adults from harm and abuse. Records showed the provider took appropriate action in response to allegations of abuse.

The level of detail in care plans and risk assessments varied. Although some contained a good level of detail to ensure people were supported in a safe, personalised way, other plans and risk assessments lacked detail and did not contain sufficient information to ensure safe care. Care plans did not contain enough information about medicines for them to be managed in a safe way.

Shared lives carers were recruited to the service in a way that ensured they were suitable to provide accommodation to people and their home environments were safe. After they had joined the scheme staff and shared lives carers were given the training and support they needed to perform their roles.

People had indicated their consent to their shared lives agreements. Where people lacked capacity to consent to their shared lives agreements appropriate processes had been followed. Some people had care plans that were restrictive in order to ensure the safety of people. The service had taken steps to ensure appropriate authorisations were in place and the principles of the Mental Capacity Act 2005 were followed.

People told us they were involved in preparing their meals in their shared lives arrangements. Records showed people were encouraged to eat healthy, balanced diets. The support people needed to maintain their health and attend health appointments was included in care plans.

People had developed strong, positive relationships with their shared lives carers. Shared lives carers and staff spoke about the people they supported with kindness and compassion. People were supported with their religious, cultural and relationships needs. Care plans contained details of how to support people to maintain their dignity. People told us their privacy was respected.

The service completed regular reviews and monitoring of shared lives agreements. However, the records kept did not consistently reflect the amount or level of support provided. Reviews did not show that people were fully involved and did not lead to care plans being updated.

The provider had a robust complaints policy and records showed complaints had been responded to in line with the policy. Shared lives carers told us it was easy to get in touch with shared lives staff who responded to their concerns in a prompt way. The provider was in the process of collecting feedback questionnaires from people and shared lives carers.

People and shared lives carers spoke highly of the registered manager and felt the service was well organised. The provider was in the process of developing the values of the organisation in a way that ensured they were embedded across the service and shared between staff and shared lives carers. The registered manager was linked with shared lives support networks and organisations who provided them with support and a network for sharing ideas and learning about best practice in the area.

During the inspection a n