Milton Keynes Short Breaks and Shared Lives

The short breaks service provides respite and short break accommodation for people with learning disabilities and complex needs. The service is provided in two residential bungalows and is registered to provide accommodation and personal care to fourteen people. One bedroom is set aside for emergency respite placements.

The Shared Lives Service recruits people to become paid carers to support adults with a range of support needs. People stay in the carer's home and receive their support within a family environment. Shared Lives support can vary from a day a week, a day a month, overnight stays or living with someone for a short while or permanently. Staff employed by the shared lives service provide support to people and their carers.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and complex needs using the service can live as ordinary a life as any citizen.

At the time of our inspection, there were twenty-one people who regularly received support from the short breaks service and fourteen people using the shared lives service. Both services were overseen by one registered manager.

At the last inspection, on 6 January 2016, the service was rated 'Good'. At this inspection we found that the service was now rated 'Outstanding'.

There was a registered manager in post. A registered manager is a person who has registered with the 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.

The service demonstrated an excellent commitment to providing outstanding support, which put people at the heart of everything. The provider and registered manager led the staff to deliver person centred care, which had achieved consistently outstanding outcomes for people.

Staff continuously went beyond expectations to ensure that people received truly individualised care that was flexible and responsive to their needs. Staff and carers respected people's individuality and empowered people to express their wishes and make their own choices.

Staff and carers demonstrated the provider's values of offering person centred care that respected people as

individuals in all of their interactions with people. Staff and carers at all levels had a strong belief that they were providing the best possible care for people, and were confident and empowered in their roles because of the strong leadership and management across the service.

Staff and carers were innovative in their approach to support, and were enthusiastic about supporting people to overcome life's challenges. People and their relatives consistently told us that the service provided exceptional care and support to people.

There was a very effective system of quality assurance that ensured people consistently received exceptional care and support. The people receiving support from the service had an enhanced quality of life because the service worked innovatively to respond to people's feedback and enable people to have meaningful experiences.

Milton Keynes Short Breaks and Shared Lives Service went to great efforts to share their ideas and approach with other services to help encourage them to improve and provide better care for people.

Staff and carers had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. Detailed risk assessments and behaviour management plans were in place to manage all risks within a person's life. Staff were confident in supporting people with complex needs and behaviours of concern and enabled and empowered people to live as independent a life as possible safely. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People received their medicines as prescribed and people were supported to access advice and treatment from healthcare professionals when required.

Staff and carer recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. People could be assured that they would be supported by sufficient numbers of staff and carers with whom they had developed positive relationships.

Staff and carers were provided with an extensive induction and on-going training was available to ensure they had the skills, knowledge and support they needed to perform their roles. Staff were well supported by the registered manager and senior team, and had regular one to one supervisions.

People's health and well-being was monitored by staff and carers and they were supported to access health professionals in a timely manner when they needed to. People were supported to have sufficient amounts to eat and drink to maintain a balanced diet.

Staff and carers knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005). The registered manager was aware of the process to make referrals to the local authority or the Court of Protection if people lacked capacity to consent to aspects of their care and were being deprived of their liberty. Staff and carers consistently gained people's consent before providing support

People were involved in planning how their support would be provided and staff took time to understand people's needs and preferences. Care documentation provided staff and carers with appropriate guidance regarding the care and support people needed to maintain their independence.

Further information is in the detailed findings below.

The five questions we ask about services and what we found