Getting off the merry go round

Here’s a blog I wrote in my role as a Trustee of the Social Care Institute for Excellence (SCIE)

Coproduction is a clunky piece of jargon for an important concept. There are lots of good definitions out there. Personally, the way I think of coproduction is that it is about everyone who is involved in a service or organisation, including those who use it and their families, making decisions together as equals, and then working together as equals to make those decisions happen. A truly co-produced service is co-designed with full involvement of people who use it and families from the blank sheet of paper stage, it employs people with current or recent lived experience in paid delivery and leadership roles and there are elected representatives of those people on its board.

There is lots which is co-produced about the sector in which I work, but at Shared Lives Plus, we felt and still feel that we have a lot further to go.

Shared Lives is a family-based way of providing people with learning disabilities, mental health problems and other support needs with the care and support they need in ordinary households. People are carefully matched with approved Shared Lives carers and when both parties feel there is a good match, they share home and family life, with 7,000 people living with their chosen Shared Lives carer as part of the household and 6,000 regularly visiting their Shared Lives carer for short breaks or day support.

So each Shared Lives arrangement is co-produced by the individuals and families involved. What people decide to do with their time together and how they live their lives is based on a care plan, but worked out day to day by the individual and their Shared Lives carer. Like any family life, it involves negotiation and give and take. Chris says: “I go to more places than before, like we just went to Brighton – I couldn’t do that before, there would be a lot more people involved and a lot of planning. Our trip to Rome would have taken much longer to plan for example. In residential I couldn’t go out to a club without having to do a risk assessment and care plan. I feel happy living here. A lot happy. I have independence but also care when I need it.”

We felt though, that the highly co-produced nature of individual arrangements was not reflected in our work to support the sector at a national level. So we are supporting and encouraging Shared Lives schemes to build independent local groups of people involved in Shared Lives who can help make local decisions and, inspired by the work of CHANGE, we have employed seven (very) part time Ambassadors, all of whom have current or recent experience of using Shared Lives. The Ambassadors speak publicly about Shared Lives. They are drafting a Charter setting out what good Shared Lives looks like, which we will be encouraging all local schemes to adapt and adopt with local people. They are also taking part in reviews of Shared Lives schemes.

The biggest impact we have felt as a team is that a group of people who we might previously have thought of primarily as ‘service users’ are now our colleagues. Some need support to take part in our work, but they expect to be treated as colleagues. The whole team has had disability awareness training and we have all needed to think about accessibility in team meetings and the rest of our work. For most of the Ambassadors, this is their first job, so they are learning what is expected and exploring their potential as their confidence grows.

As a SCIE trustee I have seen how co-production can be built into a board and I’ve been able to learn from members of the SCIE co-production network, as well as from the co-produced nature of the Think Local, Act Personal partnership, which SCIE hosts.

It’s easy to see the extra time and resources needed to co-produce as a nice-to-have rather than as essential, especially when money and time are tight. But public service sectors are locked in a cycle of rushing urgently towards poorly thought-through goals, which fail only to be replaced by the next set of ‘reforms’. I am increasingly convinced that co-production is the only way off that merry-go-round.

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4 thoughts on “Getting off the merry go round

  1. Does your carer take sugar? July 25, 2016 / 5:16 pm

    This is fab but I wonder about security for the vulnerable person? OK we know the homeowner has security on his mortgage and he/she gets paid a salary for this work from the council but I feel a little worried for the person who thinks this is his or her home legally .I also wonder how about extending the salary to include family carers who do the same job.

    • Alex Fox July 25, 2016 / 5:36 pm

      Hi – thanks for the comment. The security of Shared Lives arrangements comes from the relationship which the individual and their Shared Lives carer has, which is why the matching process is so crucial, in which people get to know each gradually before making a long term commitment. Legally speaking, there is less security of tenure, but likely to be much more continuity of support and relationships than is the case in traditional services, where staff teams change frequently and contracts are won and lost. I regularly meet people who have lived together for 30 – 40 years and intend to live together for ever. Of course, some people want to move on, so they use Shared Lives as a stepping stone to getting their own flat, but can retain lifelong friendships.
      There are currently rules preventing a Shared Lives carer from being matched with a close family member. Personally I believe that carers should get much more support and that Carers Benefit is wholly inadequate. But I don’t think the government would ever accept the huge cost of paying currently unpaid carers a salary for looking after close family members and I wonder how it would affect family relationships if that happened. I think some carers would prefer more support to enable them to care part time and thus be able to balance caring and a paid job.
      We would like to see more former unpaid carers (and current carers who have manageable, part time caring responsibilities) becoming Shared Lives carers, because we have seen it being a way in which they can use their skills and insight into caring and it’s a form of paid work which can be very flexible around their own family responsibilities, thus helping people move back into employment, which of course can be a real struggle for people who have spent many years caring for a family member.
      Alex

    • Freddie Brockwell July 26, 2016 / 8:00 pm

      Just to clarify that Shared Lives Carers are not ‘salaried’ but have self employed status. Our last ‘adult’ that we ‘hosted’ lived with us for 22 years and only moved on to independent living at their own pace very recently.
      Their status within our home is no different from our own adult children in my eyes.
      Freddie.

  2. Does your carer take sugar? July 25, 2016 / 5:18 pm

    I think it would be wonderful to extend this scheme to family carers they after all do the same job.

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