We have launched some new support for people and organisations involved in Shared Lives and Homeshare:
A Positive Behaviour Support (PBS) helpline, staffed by experts from British Institute for Learning Disabilities (Bild) and supported by government and NHS England. Psychologist have taken the first calls helping Shared Lives carers who are finding behaviours challenging now that people are at home, with routines disrupted and day services closed.
A free subscription service for Shared Lives carers who are not members of Shared Lives Plus: this will make sure essential information and peer support gets to all Shared Lives carers during lockdown. This will run to at least June.
More regular support and network calls with all the UK’s Homeshare organisations.
Our ‘cuppa for carers’ catch up with #SharedLives carers and our support team – Tuesdays and Thursdays 3pm on Zoom – email us and click on the link we send or dial in: email@example.com
We are working hard on the issue of income replacement for self-employed Shared Lives carers, with the backing of politicians of all parties. We are liaising with Treasury officials to ensure that the Chancellor’s income support scheme works with the Shared Lives tax break.
We are supporting Shared Lives schemes to get vital PPE equipment and access to other initiatives which should be available to the whole of social care.
Across the UK, thousands of Shared Lives households are at home as self-isolation becomes mandatory. This means that disabled people, people with mental health problems and others who need significant support are living in a safe place with their Shared Lives carer and for many, this is the safest place they could be. Unlike other services which rely on a staff rota, no one need come in and out of the home and the household can be more resilient and less disrupted by self-isolation than services which lose workers who are self-isolating but currently unable to get tested.
We also know that Shared Lives households are under pressure:
80% of Shared Lives carers are over 50 and 20% are over 70 and themselves in the at-risk group.
Usually, Shared Lives should not be 24/7 care, but at the moment it is: this can mean huge pressure on households as routines are disrupted and there is no break from caring for someone who is distressed and whose behaviour may be difficult to manage.
Like others, Shared Lives households are largely without protective equipment (PPE) and facing shortages of basics and food caused by panic buying.
As short breaks and day support services are cancelled, many self-employed Shared Lives carers are without income, and the government has not yet addressed this for the self-employed. This also means there are Shared Lives carers with capacity to do more and who want to help. We’ve had members wanting to open their homes to patients and NHS staff.
At Shared Lives Plus, our team moved quickly to 100% home working and online and have been working flat out on two priorities for our members: inform and connect. People need the right information – not always easy when most government info has been unclear, incomplete or has needed to be corrected. Not helped by government making a drastic u-turn in its strategy (which was the right thing to do: their modelling turned out to be wrong) but then telling people nothing had really changed: far better to have been clear that the strategy had changed and why. Connection will be of growing importance the longer this situation continues.
We are addressing the four pressure points above:
We have issued guidance for local organisations on identifying and prioritising the households most at risk, mitigating risks where possible and planning for possible scenarios, including infections within the home and Shared Lives carers being unable to care. We have outlined fast-tracked procedures to get new support carers approved.
The key message from our guidance on supporting Shared Lives households under pressure is to help the household build its resilience and two kinds of connections: with other Shared Lives households and with neighbours. We are aiming to get a new Positive Behaviour Support advice service up and running shortly if we can resource it. We’re helping members share what’s working and the team are taking calls where people are struggling.
We have been ensuring that Shared Lives carers, and community care services more generally, are being considered along with other social care services, for PPE and giving practical advice. The UK’s failure to plan for PPE demand mystifies me and has left thousands of the people we rely on most at unnecessary risk. This appears to be being rectified, but local problems are still huge. We’ve written to all the supermarkets explaining what Shared Lives carers and Homesharers are why they need access to food.
Government announcements are imminent about support for the self-employed. In the meantime, our advice to Shared Lives schemes has been: do everything you can to support your Shared Lives carers. We will need everyone during this crisis and in the recession which will follow it. Councils have been given funding to support stability in the social care sector, and the good ones are using it to keep providers afloat and social care workers in this vital workforce. We are supporting Shared Lives schemes to identify their spare capacity and consider how Shared Lives carers who are not currently working can safely support households who are struggling, and respond where possible to the need to discharge thousands of people from hospital. Virus testing, adequate PPE and ensuring people and organisations are working as part of one team will be vital in making this work.
I’d like to thank the 10,000 Shared Lives households and 500 Homeshare households who are contributing so much to keeping people safe and well during this crisis, and the Shared Lives Plus team who have made me so proud to work for such a great charity these past couple of weeks.
The Social Value Act (SVA) allows public bodies in England to score the creation of social value when they are putting public services out to tender. Bidding companies can score extra points for the way in which they will deliver the contract, where they can show they will have a positive impact on the environment or local communities. Employing local people from low-income communities can be scored, as can volunteering, or carbon reduction.
I’ve championed the Social Value Act for several years now, arguing in the Joint VCSE Review that its powers should be used by default, rather than as an exception. What’s not to like: the taxpayer gets extra value for money, and social purpose organisations are more likely to win public service contracts?
So I was concerned when I read in the excellent report on disability services commissioning from the Voluntary Organisations Disability Group (VODG) of one charity’s experiences of the SVA being used in such a rigid way it felt almost impossible for a small organisation to demonstrate the kinds of added value being asked for. I’ve subsequently talked with the charity and seen the part of the tender specification, which accounts for 20% of the tender score – an unusually high proportion. It’s a frustrating study in what results when you see a useful , creative concept through the lens of a bureaucratic world view. The form has been written with large private sector contractors in mind, and over 8 pages itemises a host of specific kinds of social value. Some makes sense: the number of employees, apprenticeships and work placements for people from specific local communities features. But there is also a long list of prescribed kinds of employee volunteering which bidders can commit to, with a strong preference for visiting schools and giving careers talks for some reason. Each kind of social value has a multiplier applied to it, which means that each ‘unit’ of social value may be worth £1, or nearly £30,000 for some of the employment related units. It looks like it’s been derived from the NHS Sustainable Development Unit’s helpfully-intended calculator.
You can see the rationale: if social value is to be scored, there has to be some rigour to it. How do you compare carbon reduction with creating volunteering opportunities? But the problems are also obvious: what would be the point of committing to any of the kinds of social value which attract 1:1 scores, if some attract 1:30,000 scores? And for an organisation with a small staff team and low margins, the ability to commit to large amounts of employee volunteering will be much more limited than for a large corporate. The charity I talked to creates huge social value: their whole approach creates community connections, draws on volunteers and social action as its core operating function, and no public money is siphoned away from the community to offshore tax havens. But it could easily be out-competed on social value in this format by a large corporate which is clever about the way it cites its employee volunteering programme in all of its tenders.
One of the problems here is that social value is being placed in a gap where commissioning for outcomes should be: if organisations were judged on the wellbeing outcomes they created, a good social purpose organisation would already have a built-in advantage. The commissioner in this instance sees social value as something created in addition to the main purpose of the contract, which doesn’t allow them to value organisations which build social value and community impact into the way they deliver their core work. Ironically, I can find little evidence of not-for-profits being involved in designing the tools and calculators developed to enact a change in the law which was intended by parliament to work in support of those organisations.
The other problem is the balance between the need for transparency and fairness in public service contracting, which is subject to legal challenge, and the desire to value something which is valuable precisely because of its subjective, locally-decided nature. If other areas emulate the approach I saw, social value will be killed off as a concept just as it is gaining momentum. So it feels urgent that the sector, government and NHS promote good approaches such as Liverpool CCGs social value objectives (picture below) and Greater Manchester’s framework which, crucially, includes the intention to develop the voluntary sector:
Promote employment and economic sustainability – tackle unemployment and facilitate the development of residents’ skills
Raise the living standards of local residents – working towards living wage, maximise employee access to entitlements such as childcare and encourage suppliers to source labour from within Greater Manchester
Promote participation and citizen engagement – encourage resident participation and promote active citizenship
Build the capacity and sustainability of the voluntary and community sector– practical support for local voluntary and community groups
Promote equity and fairness – target effort towards those in the greatest need or facing the greatest disadvantage and tackle deprivation across the borough
Promote environmental sustainability – reduce wastage, limit energy consumption and procure materials from sustainable sources
Amongst the many pieces of advice we are being offered as the Coronavirus looms over Spring, is that infected people should ‘self-isolate’. This is a striking phrase: in my organisation, we spend a lot of our time and energy on reducing isolation. Loneliness reached pandemic proportions long before we had heard of Covid-19. Many older people and others who have mobility problems, or social challenges, are of course chronically isolated already, so on the face of it, this particular piece of advice will be hard not to follow. The virus guidance also talks of ‘social distancing’: another phenomena which has already become endemic in too many communities.
In reality of course, people with virus will need food, groceries and medicines. Even if the illness itself is relatively mild, being infected with a virus that looms so large in our minds at present is going to be a worrying experience. People with good social support networks will be able to self-isolate with less suffering than those who are already isolated: they will have friends, family and neighbours willing and able to drop off supplies, even if they can’t have physical contact. They will have people to talk with on the phone. Self-isolation will be most difficult for the most isolated. For people for whom living alone is already precarious, it will bring its own dangers.
Being ill feels like an intensely personal experience: we become wrapped up in the symptoms and feel turned in our ourselves when we are suffering. But epidemics, whether physical viruses or public health emergencies like loneliness or obesity, are social events. Michael Marmot and others have been presenting the evidence for health as being socially-determined for years.
Now would be a good time to reach out to our neighbours, and people we think may be isolated or lonely. It may be possible to establish a connection and communication channels that prove vital during the expected height of the epidemic. A period of self-isolation is no time to feel alone.
Wales was the first of the four UK nations to have Shared Lives services across almost every Local Authority area and grew nearly a quarter since 2015/16. Over 500 Shared Lives carers open their homes and lives to 1,100 people who need support with daily life across Wales, including those with dementia, mental ill health, older age or young people leaving care.
When Jen first moved in with Rachel, her Shared Lives carer in Bridgend, she didn’t go out, had few friends and needed daily insulin injections. Now Jen’s been able to reduce her diabetic medication, has made friends and enjoys yoga and tai chi: “I walk the dogs, care for the chickens and help around the house. I’m in touch with my family and stay on weekends. This is my second home.”
Rachel has supported Jen for 15 years, working with the ategi Shared Lives organisation: “My life changed and I went through a bit of an upheaval. Shared Lives gave me the chance to work flexibly, bringing up my children and giving someone else opportunities at the same time. Allowing people dignity and to protect their rights is important to me.”
Recently, we met the First Minister Mark Drakeford AM and Julie Morgan AM, Deputy Minister for Health and Social Services, to tell them that with the right support and investment, Shared Lives could create positive outcomes for up to 55,000 older people in Wales. We are now looking for local authority partners to make that happen.
The most significant growth of Shared Lives care in Wales has been in short breaks and respite to help older people and those with dementia manage better in the community. In South East Wales Shared Lives there’s been a 32% growth in support for people over 50 since 2017/18, and a 42% growth in support for people over 65 years of age. If all schemes increased support for older people in line with the rise achieved by South East Wales over 100 more older people would be supported.
My new colleague Becky Viney-Wood has joined us as our first policy officer. Becky has been blogging as she meets our members and gets to grips with policy issues on numerous fronts. Here, Becky writes about advocacy and why we should think of advocates as being as necessary in court as interpreters for people who wouldn’t be able to participate without their help:
Two young parents with learning difficulties in Birmingham were deemed to lack capacity to care for their baby, and an interim care order was made…. Read more here.
Becky has also been to meet some of our members in Milton Keynes. She’s inspired by their support for each other:
Karen, Shared Lives officer, and I visited Tim, someone who uses Shared Lives care, for a spot check, to make sure that he is happy visiting his Shared Lives short breaks carer…. Read more here