Wiltshire Council Shared Lives Service provides care or support to people who are unable to live in a home of their own, but who live alongside other people in a family-like setting. Services provided were for adults who may have a range of needs including people with learning disabilities, people with acquired head injuries, older people and people who use mental health services. At the time of our inspection 32 people were using the service.

This was an announced inspection which meant the provider knew we would be visiting. This was because we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

There was a service manager in post, who has applied to the CQC to be the 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.

At the last inspection in August 2014, the service was rated Good. At this inspection we found the service remained Good.

People and their shared lives carers spoke positively about the support they received from Wiltshire Council Shared Lives Service. Health and Social Care professionals who worked alongside the service told us the manager and staff were responsive and knew people and their carers well.

People told us they felt safe living with their shared lives carers and they were always available to help them. Comments included “Yes I do, it’s a lovely home. They [carers] are always here to help” and “I am very happy”.

People were kept safe because systems were in place reducing the risks of harm and potential abuse. Shared lives carers and placement officers had all received safeguarding training, and were aware of their responsibilities in reporting concerns, and the concerns of those they supported.

Risk assessments were in place to support people to be as independent as possible. These protected people and supported them to maintain their freedom.

People were protected by a safe recruitment system. All shared lives carers experienced a thorough approval process before being able to provide support to someone. This included an interview by an independent approval panel consisting of a range of professionals and a person using the shared lives service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Shared lives carers and officers had a good understanding of the Mental Capacity Act 2005.

People received effective care and support from well supported and trained shared lives carers. There was a thorough induction programme which all carers undertook before being able to support people.

Positive caring relationship had developed between people and their shared live carer. People were supported to achieve their potential and gain independent living skills. People had opportunities to take part in activities within their home as well as out in the community. People told us they felt part of the family home.

People, shared lives carers, staff and professionals working alongside the service, all spoke positively about the management of the service. They all said the manager was approachable and very supportive. The manager was keen on raising the service’s profile and to be able to recruit more carers to enable them to offer more placements to people.

We have made a recommendation about the service reviewing their systems of checking people’s financial management.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an announced inspection which meant the provider knew we would be visiting. This was because we wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf. The previous inspection was conducted in November 2013, we found no concerns at that time.

There was a registered manager in post at Wiltshire Adult Placement Service (The service is currently being renamed Wiltshire Shared lives service). A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People using the service were supported by adult placement carers. Wiltshire Adult Placement Service offers long-term support to people who are unable to live independently in their own home but would like to live with other people in a family orientated setting. The service also offers short-term ‘respite’ placements for people whose family or carers may require a break or as a stepping stone for someone returning to the community after being in hospital. The service provides a small amount of placements to people living semi-independently within the community. This is called family-kinship and offers people an advice and guidance service.

Services provided were for adults who may have a range of needs including people with learning disabilities, people with acquired head injuries, older people and people who use mental health services. At the time of our inspection there were 33 people using the service.

People using the service told us they were supported to live as independently as was possible for them. The adult placement service officers conducted regular review meetings to ensure that people’s safety was always a part of an on-going monitoring process.

People using the service told us they felt “good” about using the service and the way it worked for them. People were able to have organised visits before making a choice about whether this was the placement for them.

All of the people we spoke with, both people using the service and adult placement carers said the service was very effective in achieving the outcome of providing a good life to people. People said they thought the service worked hard to match people with the correct placement.

The adult placement service officers and adult placement carers said they felt supported and had received sufficient training and information which supported them to fulfil their roles. Adult placement carers undertook a rigorous induction programme before being approved by an independent panel. Adult placement carers could not have anyone living with them until they had been approved.

Health and social care professionals who worked with the service spoke positively about the service provided. These included social workers and community nurses who supported people accessing the service. They felt it was a person centred service which provided a great deal of support to people using it.

The adult placement service officers and the registered manager monitored the quality of care and support. Officers met with adult placement carers regularly to discuss the placement and what was working well or not. People using the service took part in yearly reviews and were encouraged to feedback on the care and support they received.

People told us they visited their new home prior to moving in, often for several hours. They said that they made the final decision of whether to move in or not. They also told us their carer always respected their privacy and dignity. One person said ‘I have my own room and lots of freedom. My carer is very supportive and has really helped me to settle in”.

The manager told us placement officers were involved in and made aware of, every aspect of the person's needs from the start of the placement process. When changes to the plan of care had to be made, a meeting was scheduled and carers and the person using the service attended. The meeting was recorded and a plan of action was created. The manager met carers annually to review the service provided. People signed to say they had attended the meeting and agreed the proposals.

The five carers we spoke with said they had felt continuously supported by the manager and placement officers from the time they commenced working. One carer told us, “I have a great relationship with my placement officer, if there are any issues I can contact them and always get a quick reply”. Another said, “The service is very supportive and they give us good advice and point us in the right direction for any help”.

The service had a full time manager and two part time placement officers, who were in turn supported by two part time assistant placement officers. All were employed by Wiltshire Council and were either based in the north or south of the county. There were 30 households approved to provide longer term placements, with two of them set up for short term or respite placements, which could be either planned or to cover an emergency.

People were made aware of the complaints system. This was provided in a format that met their needs. We saw the service user's handbook, which included a section about complaints and who to turn to for support or act as an advocate. The format included easy to read text and pictures. This was given to each person before they started on a placement.

From looking at records and talking with people we found that care was delivered in line with people's needs and preferences and with their consent.

We saw that the Adult Placement Service had policies and procedures in place that ensured people's needs and wishes were assessed and recorded prior to them being placed at a suitable location.

People's needs were recorded in a plan of care that was kept under review. Risks to people's safety were assessed and plans to reduce and monitor risks to both people using the service and others were recorded.

Staff received safeguarding training and records we looked at showed us they were aware of how and when to report any concerns.

In order to protect people using the service we saw that the service carried out an appropriate staff recruitment process and staff received training and support suitable to their role.

We were unable to speak directly with people who used the service because they were either at work or out for the day.

People we spoke to were positive about the staff team, we spoke with a visiting professional who told us, "we visit the people in placements often, they are happy and seem to settle well".

Records we reviewed showed us there were processes in place to monitor accidents and incidents and the quality of service being provided. One person had commented on a recent service questionnaire, ' I am very happy here '.