In 1997, the last time there was a Labour landslide victory at the general election, the D:Ream song, Things Can Only Get Better, topped the charts. For people working in and drawing on social care, no song rings truer than this one after this July’s election; for social care is on its knees, and the only way really is up. Will we get a much anticipated properly funded plan for social care? We will need to wait and see.
What is working well?
What we do know is that we have an opportunity to think afresh about social care. However, this doesn’t mean we tear up everything that went before. There is much to celebrate in social care – examples of good social care exist in many places. However, they exist in pockets, often starved of the resources they need to grow. Instead, we need to look at the services we currently provide, including services which may no longer be right for the community, and decide what works, how we support the best to grow and which services we need to stop delivering.
In every area, there are bound to be great examples – such as Local Area Coordination, a form of support that connects people to one another and support in the community; Small Supports, which are community organisations helping people with significant support needs; Micro Enterprises, which are small care businesses providing highly personalised care; and community-led support, a whole systems approach to developing good social care practice that can reduce demand for formal social care.
In almost every part of the country, there will also be Shared Lives, a pioneering and proven approach to supporting people who need support in their local communities.
What is Shared Lives?
Shared Lives involves an approved, self-employed Shared Lives carer being carefully matched with someone who is seeking support. Together, the Shared Lives carer and cared-for person share family and community life. According to Care Quality Commission, 97% of Shared Lives schemes are rated ‘Good’ or ‘Outstanding’, making it the highest quality and safest form of social care in England. It is also cost effective, saving on average £19,500 per person in Shared Lives compared to residential care. Amongst those shaping our thinking on the future of health and care, it also has
influential supporters.
Discussing the impact of Shared Lives, Hilary Cottam OBE, a British innovator, author and social entrepreneur, said, ‘Shared Lives takes the idea of community support a step further for the fastest growing population group that needs support: young adults. It asks those who can, to share their homes with a person and to offer them the support they need to live as independently as possible.’
Success stories
What does this mean for those who draw upon Shared Lives? For many, it is a life transformed. Lee had a complicated and turbulent childhood, moving often between foster carers and getting into trouble at school. After many false starts, Lee eventually moved in with Shared Lives carer Maz and her family, who he had been carefully matched with. It was his first real chance at a stable home. Lee said, ‘I was scared. I was frightened of being rejected. But it’s been amazing.’
As well sharing home life with Maz’s family, Lee was also given the chance to travel the world with them. Lee continued, ‘I’ve been to Orlando, Spain, Turkey and Egypt. We went to Canada; we visited New Brunswick, Halifax, Toronto and Niagara Falls. It’s very special if you go at night because it lights up.’
Maz said the biggest change she has seen in Lee is his confidence and his ability to believe in himself. Maz said, ‘He can have discussions about things now and know he’s supported whether he’s wrong or right. If he makes a mistake, we talk it through and start again. He’s less vulnerable and not acting on impulse as frequently. He’s starting to think things through more and take more pride in himself.’
20-year-old Mollie moved in with her carer Mae through a Shared Lives scheme. Together, they share family and community life, and Mollie receives personal care and support in a place that feels like home.
Mollie explained, ‘I’d been in crisis throughout my life and then I reached breaking point. I couldn’t manage basic life skills.’ When Mollie’s social worker offered her the Shared Lives scheme, she chose to move in with Mae, an approved Shared Lives carer. Mollie lives in an annexe so has a place of her own, but with the full support of Mae and her family.
Since moving in, Mollie has grown in confidence. She said, ‘I am more positive and talkative. I have a job working in a supermarket. I have friends my own age. I am learning to drive. I am learning to cook, I do my own washing and I’m learning how to run a house, pay bills and clean my space. My mental health has improved, I feel proud of myself and I make my own choices.’
What’s the catch?
The catch, if there is one, is that Shared Lives can be difficult to grow. Whether it is to do with the problems which are faced in recruiting carers, or in finding money to invest in the service or whether its due to the challenge of getting busy social workers to buy into the model; it is never easy to grow the service. But these barriers are
not insurmountable.
Top of the challenges faced is in finding and keeping enough Shared Lives carers. Part of the problem is about the fees we pay carers, which in many parts of the country are lower than people would get for entry-level retail work – and being a Shared Lives carer is hard and skilled work. At the same time, subsistence allowances to cover food and utilities have not kept up with increases in the cost of living which have soared in recent years.
Beyond the pay issue, effective and sustained efforts to recruit carers are vital. This means exploiting every opportunity across the health and social care system to raise awareness of Shared Lives opportunities; joining up, where possible, broader health and social care recruitment activities with Shared Lives recruitment and using community networks to reach people through word of mouth. Furthermore, carers, like anyone in an intensive carer role, get tired and even burn out. Making breaks available to carers is a vital part of keeping a happy team of carers.
Increasing the demand for Shared Lives, through more frequent and better-quality referrals, is no less challenging a problem. In this instance, what is needed is sustained effort to build up the skills, knowledge and experience of social work teams so that they understand who would most benefit from Shared Lives and when is a good time to make a referral.
A call to Government
Leadership commitment is essential to making all of this happen at roughly the same time. At the top, you need committed leaders who regularly promote Shared Lives and make the case to colleagues for investing in the service. Heads of services and social care team leaders are equally vital to promoting the benefits of the service on a day-to-day basis to colleagues. Finally, registered managers who operate each scheme have a critical role to play in energising their teams and driving through innovations against significant barriers.
Leadership is an essential part of the story about the growth of Shared Lives in Devon. It started with the County Council’s leadership team building a case for investment; producing analysis which showed that if it increased the number of people supported in Shared Lives arrangements by 30 in year one, and 15 in year two, it would save the council approximately £900,000 per annum.
Then, the County Council started to work on two of the main problems confronting the service, the difficulty in recruiting carers and the lack of high-quality referrals. To address the former, the council funded its independent provider of Shared Lives to invest much more in recruitment of carers, efforts which are starting to bear fruit with increased applications. To tackle the latter, the County Council asked us to upskill its social workers by increasing their awareness of Shared Lives and how to make good referrals, which has led to a rapid increase in referrals to the service.
As the Director of Integrated Adult Social Care at Devon County Council, Tandra Forster told me about Shared Lives, ‘It will be difficult, but far from impossible, to grow Shared Lives. If we work together, share resources and learning and are creative and brave with the money we have, we can continue to invest in and grow Shared Lives, to ensure that even more people benefit from one of the highest quality and safest forms of social care in the future.’
So, can things only get better? That question will define the next five years for social care. We hope it is a resounding yes, but only if we show a willingness to back the services and models of support which are proven to work, like Shared Lives, and if we stay the course, giving these services the attention, funding and support that they will need to flourish.
Ewan King is Chief Executive at Shared Lives Plus.
Email: [email protected]
X: @SharedLivesPlus
What else can be done to increase the prominence of Shared Lives on Government’s agenda for the sector? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.