BMBC Shared Lives

Community enablement service consists of two distinct service types: reablement service and shared lives scheme, provided by Barnsley Metropolitan Borough Council. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The provider told us that everyone using the service was being supported with 'personal care.'

The reablement service provided an enablement service to people in their own homes for a period of up to six weeks. The service offered support to encourage and enable people to live independently at home, often following a stay in hospital. The service also provided short term personal care support as a last resort for people that required domiciliary services while a private provided was being sourced. At the time of our inspection, 48 people were receiving the reablement service.

'Shared lives' is an arrangement whereby people either live or spend time with self-employed care providers who support them according to their assessed needs in a family environment. People receiving services from shared lives have the opportunity to live an ordinary life as part of the care provider's family. Placements can be long-term with the adult living with the care provider as part of their family, or as a respite care, day care or hourly sessional support. The shared lives service was providing support to adults and young adults with learning and physical disabilities, autism and mental health conditions. At the time of our inspection there were 189 people using the service; 54 of these were in a long-term placement. The service had 72 approved shared lives care providers who were supported by six office based shared lives officers.

There were two registered managers in place; one responsible for the reablement service and the other for the shared lives 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.'

This report covers both the reablement and shared lives services.

The registered provider wasn't fully working within the requirements of the Mental Capacity Act 2005 (MCA). The registered managers, staff and care providers were aware of the principles of the MCA and how to apply it in practice. However, the service was not routinely completing decision specific mental capacity assessments relevant to the care being delivered and was reliant on assessments from other professionals.

We also saw examples of documentation being signed by people without the legal authorisation to do so. There was no evidence people were being restricted or receiving care that was not in their best interests. The service was in contact with adult social services in relation to considering if some people required an application to the Court of Protection in relation to being deprived of their liberty as part of their care arrangements. We have made a recommendation for the provider to seek advice from a reputable source to work in line with the MCA.

Risks to people's care were identified and managed appropriately. Staff and care providers were knowledgeable about those risks and how to manage them. However, some documentation related to people's risks and needs lacked detail to evidence the care being provided.

People's records of care were managed safely but information in people's or care provider's homes did not always match the information that was available in the office.

People we spoke with told us they felt safe when supported by the reablement care workers and in their shared lives placement homes. The relatives we spoke with agreed. The reablement care workers, care providers and placement workers could describe the forms of abuse people using the service could be vulnerable to and said they would report any concerns immediately.

Some people using the services required support with their medication and the registered provider was managing this aspect of their care safely. There was a medication policy in place, staff had been trained, their competence to administer medication assessed and regular audits were conducted to ensure any issues were identified in a timely way.

The recruitment process for new care providers was robust; we saw all the required checks had been made and documentation was in place. No new reablement care workers had been recruited recently but we saw evidence that ongoing checks on the care workers' suitability to work with people that might be vulnerable were being regularly completed.

Each person's needs were assessed before their service began. Reablement care workers and care providers had the skills, knowledge and experience to meet these needs; they had an excellent understanding of the care and support needs of every person receiving the shared lives and reablement service. People had developed very positive relationships with those supporting them.

People were supported to have healthier lives and had timely access to healthcare services. People were supported to drink and eat enough to maintain a balanced diet.

People using the service were treated with kindness and compassion. People were supported to express their views and be actively involved in making decisions about their care and support. People were encouraged to be as independent as they could be; reablement care workers and care providers gave us many examples of how they promoted people's choices and independence.

People's dignity and privacy was respected and people's personal information was kept private.

People received person-centred care that was responsive to their needs. People's needs in relation to the protected characteristics under the Equality Act 2010 were taken into account in the planning of their care. People's communication needs were considered.

No one we spoke with had ever made a complaint and the registered provider told us they had not received

any complaint. The registered provider had a complaints policy in place and most people knew what to do if they wanted to make a complaint.

People had access to social interaction and a range of activities. People regularly went on holidays with the care providers and their families.

People and relatives gave us very positive feedback about the management of the service. Reablement care workers and care providers told us the service was open, focused on providing high quality care to people and that they felt well supported by their managers. There was a comprehensive system of audits and quality assurance checks being done at the service. The registered managers had developed links with the local community and were involved in projects to increase the scope and quality of the services provided.

The five questions we ask about services and what we found