Chris’s move to our Shared Lives home

Yesterday I published Chris’ own account of his move into a Shared Lives household. Here, Alison, his Shared Lives carer, very kindly shares her story. Alison writes:

Before moving here Chris had lived for 19 years in a small residential home since his teenage years. It was an excellent home where he was well supported and enjoyed a very good relationship with staff and some residents. I wondered how he would adjust to life in a small family home and whether he would miss having a big group of people to keep him company and support him. It was daunting to know that a team of 12 carers was being replaced by just one. Me!

One year on and I can truthfully say that Chris has never looked back. Shared Lives can often change people’s lives suddenly and dramatically for the better, but at other times it makes a less obvious but no less important difference. For Chris I would say it has been a gentle shift from a subtly institutionalised life to one as an ordinary member of an ordinary family doing ordinary things.

He seems to feel a greater sense of freedom – he makes more choices, comes and goes as he pleases and stays at home alone for agreed periods of time. He seeks permission much less and more often tells me what he is going to do instead of asking. He is encouraged to make his own decisions even if I don’t agree with them – this is much harder for me than it is for Chris! We have many conversations about honesty – Chris gets better at telling me the truth rather than just what he thinks I want to hear, and understanding that if I don’t like it then that is my problem and not his!

His social circle has expanded dramatically – he has met

My Move to Shared Lives

Chris has very kindly shared his story of moving into a Shared Lives household from residential care. Thanks Chris! Tomorrow, I’ll post Shared Lives carer Alison’s account of the same move. Chris is with the Birmingham Shared Lives Scheme and he writes:

Moving from residential care to Shared Lives

When I lived in residential care I did have independence but other clients came first, I was too independent for them.

When the social worker did my annual review I only needed 23 hours support per day not 24 hours. There was some meetings with the social worker and later an advocate, we talked about good and bad points of residential against Shared Lives. I was worried about moving to a house with just a couple – what if they argued or were too much into each other and I got ignored. But in the end Shared Lives won out as there would be more independent things I could do what I couldn’t do in residential.

First I went to visit a Shared Lives carer twice but at that time he wasn’t ready for a permanent arrangement. Then Andrew who works for Shared Lives told me about Alison, then it was a visit to see if I liked her then a stop overnight. Then a final meeting to set up for moving.  At first I walked the dog sometimes. I sorted out my bedroom, my bus pass, medication and medical treatment. I got to know the area and met Alison’s family and friends.

How is Shared Lives different from residential care?

There are less forms to fill in. I am more independent. 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 how many staff and clients were going. In residential I couldn’t go out to a club without having to do a risk assessment and care plan. Since I moved in I think we have been on 9 trips. I also stay with Sylvia and Carol for respite, they are Shared Lives carers too.

I would say it is more of a family. I do get on with everybody – I get on very good with Pilui (Alison’s husband), I get on with Alison very good, I would say more of a closeness.

In residential I had to take my tablets exactly 8am and 6pm,

Tom in Japan

Today we are all at the sold-out Shared Lives Plus UK conference in Birmingham. Here’s a guest blog from ‘Tom’ who lives with one of Birmingham’s Shared Lives carers and kindly shared his story:

I came to live with my current Birmingham City Council Shared Lives Carer when I was 11 as a foster child and I had experienced a terrible time in care since I was six being moved from one carer to another which I found hard to cope with due to lots of changes.

When I became 18 social services were looking at me moving to be in independent living but I would not have coped as I need support with daily living tasks that aren’t a priority to me. My Foster Carer and family and I wanted to stay together so my Carer undertook the Birmingham Shared Lives Assessment and got Panel Approval and we both came into the scheme. Since that time I have completed my second year of a degree and my Shared Lives Carer has delivered training to other Shared Lives Carers around Autism due to her specialist knowledge.

When I was 20 my friend wanted to go to Japan again.  He had been before and knew his way round but the two of us wanted to go.  My Carer and I looked at the availability of holidays and chose a package which was very structured which is what supports me.  Every day we had a plan that told us where we were staying, what station to go to, what train to get on to get to the next town, what to see in that town, where to find our hotel, what time to leave the hotel to get to the next train etc.  Since being with my Carer she has encouraged me to read signs to help me learn and get on the right plane or train.

My Shared Lives Carer supported me to get my money ready so we packaged my money into small amounts and put them in marked envelopes for every second day and put them in order in my money belt.  I also carried my passport and tickets with my money and never took it off unless I was in a hotel room.

What if something went wrong? – My

Micro-enterprise: care and support on a scale that’s “just right”?

This is a guest blog from researcher Catherine Needham of the University of Birmingham, who is launching the first research to look at whether size of provider organisation makes a difference to outcomes and cost-effectiveness. The summary is very readable and should be of interest to all care commissioners. Dr Needham writes:

It has long been evident that large-scale care provision on a time-and-task model has not been delivering care and support which is personalised and leads to valued outcomes. This week, a team from the University of Birmingham, of which I was a part, launched findings which solidify the evidence base about the benefits of micro-enterprise over larger providers.

Twenty-seven care organisations in England were included in the study, covering a range of sizes and functions, including day activities and support in the home. Interviews were done by academic researchers working alongside people with experience of local care services on a co-research model. Among the 143 people interviewed were owners, managers, members of staff, carers, and those receiving care services, including older and disabled people.

Findings show that micro-enterprises offer more personalised support than larger care services, and contribute to better outcomes (measured using ASCOT, the Adult Social Care Outcomes Toolkit). These benefits stem from micro-enterprises having greater continuity of staff, greater staff autonomy and greater accessibility of managers compared to larger organisations. The research also found that micro-enterprises offer good value for money: their hourly rates were on average lower than the larger comparator organisations, helped by low overheads.

The micro-enterprises in our sample talked about what had helped them to get started, and what barriers they faced in staying in business. Many had benefitted from local micro coordinators, part-funded by Community Catalysts, which helped them understand care sector regulation and funding.

To keep going the micro-enterprises had to market their services to potential users as they didn’t have a formal contract with the local authority in the way a large care companies did. Most people supported by micro-providers had a direct payment or were self-funding, and had found out about the provider through word-of-mouth or local advertising. The relatively low take-up of direct payments by older people highlights the need to provide alternative routes into micro-enterprise. Social workers, GPs and other care professionals need to be informed about micro-enterprises operating close-by so that they can match up people with support in their local communities.

Like most academic studies, the research answered many questions but generated others. In particular I was struck