Providing care through relationships

Today we launch a report looking at the successes and challenges of the Shared Lives Incubator — a social investment fund set up by Social Finance in 2015 to enable more access to Shared Lives care in England.

Shared Lives is a shared living arrangement for people with care and support needs. In a Shared Lives arrangement, someone lives with or regularly visits a Shared Lives carer, who provides a range of support including personal care, if required. It’s usually provided as an option to people who might otherwise be cared for in a residential home or another institutional setting. It is a service (carers are paid, usually by the local authority or NHS), but at its heart it’s about the relationships formed. In 2018, 96% of 132 Shared Lives schemes were rated by the CQC as good or outstanding, making Shared Lives care the highest quality form of care in England.

I was grateful to attend the Shared Lives Plus awards ceremony this year which recognised just some of the outstanding work that the Shared Lives ​‘community’ are doing for themselves and for society. The theme this year was human rights, and I was struck by how much Shared Lives enables brilliant people to have their rights supported and their voices heard. You can watch Meg, a Shared Lives Ambassador, tell NHS boss Simon Stevens (CEO of NHS England) directly about the benefits of Shared Lives, by clicking here.

Most local authorities in the UK offer Shared Lives — but not to as many people as possible. The Shared Lives Incubator was set up to test whether upfront investment and operational support could increase the provision of Shared Lives in areas where there had been none or very little previously. The Incubator provided on average £220,000 to four schemes to fund staff and other costs, with this investment repaid as the number of Shared Lives arrangements grew.

We are really proud of what has been achieved since we launched in 2015. The four schemes have succeeded in providing over 10,000 weeks of high-quality, value-for-money care. Schemes have taken in a wide range of referrals, including for people with mental health support needs. Robust quality assurance and monitoring processes are in place to ensure the safe support of over 100 people.

Overall growth has not been as high as we hoped. When we set up the Incubator, we set ambitious targets for growth, based on what had been seen in a few other schemes. In practice this proved difficult to reach, especially in the earlier years, due to a number of barriers which are explored in the report. We also identify ways these barriers have been overcome, in the hope that this helps other schemes experiencing challenges.

For example:

• Cost pressures on local authorities mean a greater proportion of those people receiving funded social care have more complex needs. Successful schemes are adapting their strategy for experienced and flexible carers, particularly recruiting those with properties that can be adapted, and achieving a critical mass of placements and carers to meet a wider range of needs.
• Shared Lives schemes can grow by working with young people as they transition to adult services, allowing them to stay with their foster families. This stability maintains young people’s support and further develops their independence (see Charlie’s story). It is therefore important for Shared Lives schemes to develop relationships with social care teams supporting transitions from children to adult social care.

We believe it is possible to grow Shared Lives and that there is a financial case for doing so. However, we conclude that longer-term, patient investment and cultural change are required to realise the benefits. This should be directed into both Shared Lives schemes and social work so that this type of person-centred, tailored care can reach as many in our communities as possible. It is difficult to hear testimonies like Meg’s and not agree that this continues to be an important shared goal as a sector.