PSS Shared Lives Norfolk and Suffolk provides a 'shared lives' service for adults who need support and who want to live as part of a family or household. It is an alternative to residential care for people and provides a flexible form of accommodation, care or support inside or outside the Shared lives carer's home. It provides services for people with learning, physical or sensory disabilities and people with mental health conditions. The service provides long term placements, short term placements and respite care. It is responsible for co-ordination between the people who use the service and the carers with whom people live.

The service worked closely with commissioners, social workers and health professionals who were involved in the care of the people who used the service to ensure their needs were met. The staff directly employed by PSS Shared Lives Norfolk and Suffolk were responsible for recruiting and supporting the self employed carers. These carers provided care and support, in their own homes, to the people who used the service. For the purposes of this report we will refer to those who provide care and support to people who use the service as 'carers'. The support workers from PSS Shared Lives Norfolk and Suffolk, who provide support to these carers and people who use the service, will be referred to as 'staff'.

At the time of this announced comprehensive inspection on 12 December 2018 there were 123 people using the service. Of these, 85 people were receiving personal care, which is regulated by the Care Quality Commission (CQC). We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that someone would be available.

The service was registered with CQC in November 2017, this was their first inspection. The service had previously been owned by another provider. PSS Shared Lives Norfolk and Suffolk took over the commissioned care, carers and staff from the previous provider. Many changes had been made within the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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.

There were systems in place designed to provide people with safe care. Risks to people were managed, including risks from abuse and in their daily lives. Recruitment had been carried out to ensure there were enough staff to support carers and people. Carers and staff were recruited safely. Where people required support with their medicines, this was provided safely. The service learned from incidents to improve the service. There were infection control procedures in place to reduce the risks of cross infection.

People were provided with an effective service. Carers and staff were trained and supported to meet the needs of the people using the service. Where people required assistance with their dietary needs, this was provided. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service. The service understood the principles of the Mental Capacity Act 2005 and carers and staff were trained in this subject.

People received a caring service. People had positive relationships with their carers and staff. People’s dignity, privacy and independence were respected and promoted. The views of people and carers were listened to and valued.

People were provided with a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems to gain people’s end of life decisions, policies and procedures guided staff and carers on end of life care. A complaints procedure was in place and the concerns of