Latest Shared Lives news

Cathy Newman of Channel 4 News met a Shared Lives household: https://www.youtube.com/watch?v=wb_DyYvE9zE

Our £1.75m partnership with NHS England has been launched with funding awarded to five areas and their Clinical Commissioning Groups to develop Shared Lives as a form of healthcare.

The Shared Lives Incubator social investment programme developed in partnership with Social Finance and Community Catalysts is investing in Shared Lives in three areas.

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Reverse auctions

We live in a society which auctions the care of disabled and older people. Not to the highest, but to the lowest bidder.

This has been going for years. Sector leaders have long condemned the concept of ‘reverse auctions’ for care packages, in which a homecare or other support contract is won by the lowest bidding care provider, but care contracts can still be put out to tender using a scoring system which puts lowest price as the most important factor and the Care Provider Alliance expressed concern about this issue again this year. In other areas, when an individual is assessed as needing support, a pen portrait of their needs is circulated to care providers approved to be on the local area’s ‘dynamic purchasing system’ and those providers bid for that care package. Again, lowest price is at least one factor in their bids and providers have reported feeling that the real extent of someone’s support needs have not been made fully clear, meaning that the care package offered will not meet their needs. In some areas, only one ‘affordable’ option is presented to the individual who may not realise they are not obliged to take it. These auctions are presentable as offering ‘choice and control’ to the individual, despite the obvious limitations on that choice. Any provider which achieves a certain ‘quality score’ can enter the framework and be on the list, but it is easy inadvertently to set conditions on quality which effectively eliminate innovative and start-up services which may not have a track record of providing conventional care. (This is why the duty on councils to develop diverse provider market places in the Care Act is so important: its implementation needs much more attention.)

This was not what was envisaged by disabled people and their families who developed personalisation, which was the idea that people would plan the most effective care and support when they were in control of an individual planning process which started with what a good life looked like, not with a list of low-cost services. Planning creatively in this way enables people to make best use of their own capacity and of the family and community resources available to them. That also usually results in the most independence and lowest overall cost to the state, whereas narrow price-focused processes bring missed opportunities for independence, or lead to family care breaking down. But instead of people planning a life, and then choosing the support they need to live it, care providers in some places now compete for the individual, and an algorithm makes the choice. (Approaches like TLAP’s Making It Real are designed to push back against this kind of pretend personalisation.)

The Shared Lives model is resistant to that kind of automation, partly because it is based on matching the individual with a specific Shared Lives carer: both parties meet and make a choice to share their lives with each other before any support package starts. That resistance can be a double-edged sword though: if Shared Lives looks too complicated or ‘messy’ to include on an area’s shiny new system, it may just be omitted from the choices offered to people. In one area, commissioners have apparently described Shared Lives as a ‘luxury’ model, despite the overall package being demonstrably lower cost than traditional equivalents, sometimes by tens of thousands of pounds.

These problems are not just a symptom of the lack of money available to pay for care providers. They are also symptomatic of cuts to the teams which plan and buy care on behalf of us all. Experienced commissioners who understand how social care works are more likely to be able to recognise the value of truly personalised support and to think through the consequences of cut-price care, which can rapidly lead to a crisis and expensive medical care.

Most of us do not have to contemplate what it would be like to have a price put on our happiness, safety or dignity. There has never been greater pressure upon price in our public services. We can’t rely upon algorithms to deliver good lives: we need to develop care navigation and brokerage teams who can help people make good choices, and which can help to build community approaches like Shared Lives. People who need support will be more likely to achieve real value for money within local marketplaces, where people and local providers can connect with each other, rather than left adrift in virtual ‘emarketplaces’ or to the free market.  And we should simply outlaw processes which put lowest price first.

The canary in the coalmine

This is an extract from a blog from Ben Hall, who leads our Scotland development work. Ben and our new colleague Lesley Stevenson are working with Scotland’s Shared Lives schemes and our partner organisations to demonstrate that Shared Lives can be a viable, national alternative to models which are coming under increasing pressure in Scotland, as across the UK. Ben writes:

17,000 people who live in, or receive care from Britain’s second largest care home operator, Four Seasons, are today left in doubt about where they live, as the private equity firm Terra Firma pleads with lenders to approve a financial rescue package for it. Four Seasons was saddled with huge debts to its own owners after they bought the care provider in 2012. This £220m debt, loaned at 15%, will earn Terra Firma £660m by 2022. The financial struggles emerged today as part of the Paradise Papers leaks.

But it is the small signs, like the canary in the coalmine, that we need to listen to. Last week, Bield Housing, a high quality care provider, made the decision to withdraw from running residential care homes across Scotland, on the basis that this is no longer a viable financial business due to falling funding from local authorities.

The decision by Bield, although small by comparison, is the more profound. When a high quality provider walks away from an industry saying it is uneconomic, then our national leaders need to listen.

These two very different examples show, more clearly than ever, that we need new ways of caring in order to provide the dignity and care to our older family members.

Read the full article here.

Stroke survivor Brian gets ready to move on

This story from Shared Lives South West shows how Shared Lives is providing great health care as well as social care. The story can be found here. It’s a great contrast with the story about room renting which hit the headlines last week – see my previous blog. We are working with NHS England and 7 local NHS CCGs to develop new health care options. Here is an extract from the full story with thanks to Shared Lives South West, who continue to inspire us all:

If you rewind a year, Brian Lee’s future looked bleak. While out walking in local woods he had a stroke and ended up in intensive care and endured a four-month hospital stay.
His health deteriorated further while in hospital as he also suffered two minor heart attacks and Brian was extremely weak.

The medical trauma left him with complete memory loss and his mobility was severely compromised- making it difficult for him to walk even short distances.

Fast forward to now and his life couldn’t be more different.  Thanks to the support and care he’s received from the Shared Lives team and ultimately his Shared Lives carers Jeanette and Alan Eames as well as his own determination, Brian is well on the road to recovery.

He’s recently managed to plan and go on holiday to Thailand and is preparing to move out to his own flat and live independently.

“I was so stubborn and determined. I had to prove to myself that I can still do things,” said Brian.

“Jeanette and Alan have helped me through it all. I was decrepit feeble creature when I arrived at their home in March.

“I couldn’t walk down the drive, now I can nip up to town. I never dreamt of being so independent again when I came out hospital.

Since moving in with the Eames’ family, near Okehampton, they have been there to support him every step of the way-  from helping him with appointments to liaising with his friends to help him move forward and sorting his medication and preparing him for his trip to Thailand, where he visited with no support. It was paramount his carers got him ready for the trip and made sure he was able to manage all his medication.

The Shared Lives team were also on hand to make the match with the Eames family. They charity’s Funding and Benefits team also maximised his benefits.

“They prepared me and made me ready for life outside,” said Brian.

“I think what was most important to me was to realise limitations early on, then I think you have to scale back on your expectations, then you can move forward positively.
“The main help was with my medication, that was a key thing. With Jeanette’s help there were visits to the doctors to make sure my balance of medication was right, as when I came out of hospital it was all wrong.

“I was on knock-out drops, I wasn’t living life as it should be. By 11am I wanted to go back to sleep again. I spent most of my time just sleeping. It was too much and there was a real temptation not to take them.

“Jeanette got it sorted out for me.”

“I also made sure he was taking the right medication at the right times to start. Now he has pots and has hang of doing it all himself,” said Jeanette.

Banking also became difficult as he struggled to remember numbers.

“If you ask me about a phone number or bank details and I wouldn’t have a clue,” he said.

With advise from Jeanette, they decided to change passwords to key dates that he could remember.

“That way I could do somethings myself with support,” said Brian.

The full story is here.

More than just a room

There has been a great deal of interest in the media in a small start up company called Care Rooms, which has been developing an idea in which people would rent out their spare room to the NHS, for use by older people who are well enough to leave hospital but not well enough to return home. The hosts would be paid £50 a night and would microwave three meals a day and ‘provide conversation’. If personal care was needed, this would be provided separately by services visiting the host’s house. Shared Lives has been mentioned in some of the media coverage, which has mainly focused upon the risks of the proposal.

One of the problems with Shared Lives and Homeshare being so little known, is that people frequently ‘invent’ them, often without having thought them through that carefully. Recently we saw a think piece from a firm of public service experts describing its groundbreaking idea for younger people to live with older people: Homeshare is a decades-old international movement across 16 countries used by thousands of people.

What struck me about the reporting of Care Rooms was how little of it was from the perspective of the (mainly) older people who would be its recipients. Why would people who are well enough to leave hospital want to be a lodger in a stranger’s spare room eating microwaved meals, rather than going home? In Shared Lives, which is already being developed as home from hospital care with support from Dept Health and NHS England, the benefits to an isolated older person are that their Shared Lives carer will provide personal care (because Shared Lives is a regulated care service with the training, back up and safeguarding processes needed to do so) but perhaps more importantly, the Shared Lives ethos is that the participants get to know each other before deciding that they will get on: it’s a social arrangement in which the older person is welcomed into the household. Even when it is used for relatively short periods of post-hospital care such as stroke rehabilitation,  people can form connections which outlast the ‘formal’ care provision. That sense of belonging and community appears to lead to people recovering faster and further because health and wellbeing are closely linked. Care inspectors CQC say that incidents of neglect, poor care or harm are rare in Shared Lives households, compared to their frequency in care homes and home care services: this is partly because Shared Lives carers go through an approval process lasting several months, but also because people choose to be together and enjoy each other’s company.

That kind of ‘care’: care as an emotion rather than just an activity, cannot be bought. It does though require thoughtful selection, matching and choice-making to happen. It’s taken the Shared Lives sector 40 years and the work of tens of thousands of participants to put that in place.

Join the Shared Lives Plus team

We currently have four opportunities to join the Shared Lives Plus team, in finance, communications and our development team:

Assistant Director of Health and Development: http://sharedlivesplus.org.uk/news/vacancies/item/441-assistant-director-of-health-and-development 

Finance Director: http://sharedlivesplus.org.uk/news/vacancies/item/439-finance-director-liverpool

Communications Officer: http://sharedlivesplus.org.uk/news/vacancies/item/443-vacancy-communications-officer

Development Officer Domestic Violence:  http://sharedlivesplus.org.uk/news/vacancies/item/442-development-officer-domestic-violence

A bit more detail:

We are looking for a Finance Director to work 22.5 hours per week, based Continue reading

Ken the artist: Part 2

I shared Ken’s story courtesy of the Medway Shared Lives scheme a few days ago. I see that Ken and household have also been visited by government Minister, Tracey Crouch MP, who wrote on her Facebook page on 8 September:

I met two incredibly inspiring local ladies today – Sarah and Vicky. What is so special about them is they are carers with Medway Shared Lives, a brilliant initiative that is operated by local authorities across the country which provides longterm, short term or emergency homes for vulnerable adults.

Sarah invited me to their home to tell me about Shared Lives and what they do, the value they bring (both in terms of to the individual emotionally but also to local authorities financially) and of course the challenges they face. It was comforting to hear that Medway Council – Service updates and information has recently demonstrated their commitment to the scheme with a welcome increase in carer rates after several years of none. I met Stella (53) and Ken (70) who both have a learning disability and who Sarah and Vicky have hosted now for several years. It is as if they are part of the family and you could tell instantly that both Stella and Ken are settled and very happy.

I think the scheme is a brilliant idea and I wanted to take this opportunity to promote it more widely. If you think you could host an adult who needs just that little bit extra support so they can live independently rather than go into a residential care home, then please do click on one of these links:

http://www.medway.gov.uk/…/car…/becomeasharedlivescarer.aspx

http://www.kent.gov.uk/jobs/become-a-shared-lives-host

https://sharedlivesplus.org.uk/

Caroline’s story

This story was told to us by Sara Podmore who manages the Telford and Wrekin Shared Lives scheme:

Caroline, 26, had been in the Navy. She was being severely bullied whilst training to be a medic. She was initially thrown out of the Navy but after support from charity, Combat Stress, the Navy now supports her in getting help and treatment with severe depression, OCD and post-traumatic stress.

Initially Caroline had been allocated to a support worker in a supported living set up. She had some hours support each week but this was predominantly to help with paperwork. “I wasn’t well, I was basically put into the house and left. I ended up taking a massive overdose and then ended up being sectioned.

I had never heard of Shared Lives and my social work ended up introducing me to Linda and Owen, I don’t remember much from this time but I remember coming round for tea visits before moving in. This was April 2013.”

The Shared Lives team felt that Linda has the listening skills that would be needed to support Caroline through this period of her life. Shared Lives worker, Cath, vividly remembers those first visits. “Caroline looked so small, curled up on the sofa crying looking ill. She was in what looked like a trance. She really didn’t care.”

Caroline describes her OCD: “I stroke the light switches, I check the doors all the time. It’s better to laugh about it if I can. Linda tells me to leave it and she will check it, this really helps, otherwise I would sit by the door all night.”

Caroline says of her first few weeks living with Linda, “The family were so welcoming; it was amazing to be part of the family. I settled in really quickly. I didn’t feel like I was treading on eggshells, there was no pressure. I felt I could approach the carer and they would be non- judgemental.

“In that time I feel my confidence has changed. I’ve got a strength I’ve never had, I’ve had lots of encouragement, I’ve talked for hours with the carers, there is no such word as ‘can’t’.  I do a lot of laughing. I’ve slowly come off some of my medication too in the time I’ve been here which is great. I haven’t had any help from the mental team- Linda has been my mental health team, they have abandoned me. I’ve even managed to have contact again with my family. I see my mum again now who I couldn’t before as she couldn’t deal with me being ill. We do family holidays now too which is amazing.

“Now I work 26 hours a month and have completed my NVQ 2. I run now too. We all eat dinner together. Its important as I can chat, considering it’s their house its amazing they are always there for me. Things like Christmas are amazing we get so many gifts, I never expect it.

“At the very start of my journey I didn’t want to be in the world- but since coming into this placement it’s been great. I’ve not had a dip since I’ve been here and I’ve learnt to listen to my body.

I would tell other people when talking about Shared Lives: there is hope no matter how unhopeful you feel.”