Cheshire East Council Shared Lives Services

The care 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 autism being supported they can live as ordinary a life as any citizen.

This was an announced inspection which took place over two days on 22 and 23 October 2018. The inspection was carried out by an adult social care inspector and an 'Expert by Experience'. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

This was the first inspection of the service following its new registration in July 2016.

The service had registered managers in post for both the Reablement and Shared Live services. The registered manager for Reablement was on secondment at he time of our inspection and a temporary manager was supporting the service. 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.

We found good and consistent service delivery and support for people in both the Reablement and Shared Lives services. Managers had developed systems to assess and monitor the service ongoing and the overall governance of the service was established and effective. Managers could evidence a series of quality assurance processes. There was a clear management hierarchy and we saw that new ideas and service improvements were effectively developed and communicated.

We rated the service as Good.

We contacted carers who supported people in the Shared Lives service and we also spoke with people who were receiving support in their own homes from the Reablement service. The feedback we received evidenced people were getting good support. External professionals involved directly or in commissioning people's care also gave positive feedback which gave further evidence of a good service.

We found medicines were administered safely. Medication administration records [MARs] were completed in line with the services policies and good practice guidance. We pointed out some minor recording anomalies which were promptly addressed by managers.

There were arrangements in place for checking people's care environment to help ensure this was safe. These arrangements included regular checks and audits by senior members of the care team or 'Care Managers' – social workers directly supporting people in Shared Lives.

People using the service, relatives, professionals and staff told us they felt the culture of the organisation was fair and open and supported good care and support for people using the service.

People we spoke with said they felt safe with the staff who supported them. We were told that if any issues arose they were addressed by the managers.

We saw that any risks to care provision had been assessed and there were fully developed plans in place to help ensure they were kept safe. Staff were arranged to support this depending on each person's needs. There were sufficient staff available to support people.

We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. Appropriate applications, references and security [police] checks had been carried out.

The staff we spoke with clearly described how they recognised abuse and the action they would take to ensure actual or potential harm was reported. All the staff we spoke with were clear about the need to report through any concerns they had. This rigour helped ensure people were kept safe and their rights upheld.

We saw that peoples consent to care was recorded. The service worked in accordance with the Mental Capacity Act 2005.

Feedback from people and their relatives told us that staff seemed well trained and competent. Communication between relatives, people being supported, staff and senior management was overall effective.

Staff were supported by on-going training, supervision, appraisal and staff meetings. Formal qualifications in care were offered to staff as part of their development.

Local health care professionals, such as the person's GP were involved with people and staff from both services liaised when needed to support people. This helped ensure people received good health care support.

Staff could explain each person's care needs and how they communicated these needs. People we spoke with and their relatives told us that staff had the skills and approach needed to ensure people were receiving the right care.

People told us staff respected people's right to privacy and to be treated with dignity.

All family members and people spoken with felt confident to express concerns and complaints. Issues were dealt with and the service was responsive to any concerns raised. Concerns we relayed to managers during the inspection were followed up.

Both managers talked positively about the importance of a 'person centred approach' to care. Meaning care was centred on the needs of each individual rather than the person having to fit into a set model within the service. It was clear that the service, particularly the Shared Lives service, was meeting standards outlined in current good practice guidance including 'Registering the Right Support'.

The five questions we ask about services and what we found