A key question facing commissioners of support services is how to develop personalised quality services for people within an increasingly tighter financial envelope. Some recent research published by Social Finance and Community Catalysts, may suggest one approach that could prove to be of benefit in developing community connections for people as well as reducing costs.
The researchers were looking at a cost benefit analysis of Shared Lives schemes and their findings suggest that for some people, this may offer an answer. They describe Shared Lives as an approach which offers personalised, quality care where carers share their lives and often their homes with those they support.
Carers in Shared Lives services are recruited, vetted, trained and supported by local Shared Lives schemes, which are registered with the care regulatory authorities.
Shared Lives commitments from both parties can vary from an individual being a regular daytime or overnight visitor to them actually moving in to live with the Shared Lives carer.
Shared Lives schemes focus on recruiting the right people to become Shared Lives carers, offering ongoing support and helping people to move on when those arrangements end. They suggest that each Shared Lives Officer can support around 25 arrangements At present, there are an estimated 15,000 people supported through Shared Lives schemes
Shared Lives carers are self-employed, although they work within the framework of a carer and service agreement.
On the basis of their analysis, the researchers found that the average net cost of supporting people with learning disabilities in traditional forms of long-term residential care, nursing care and supported accommodation is £60,000 per person per year whereas the average net cost of a long-term Shared Lives arrangement is £34,000 per year offering net savings from a long-term Shared Lives arrangement per-person per year of £26,000.
They suggest that investment in upfront costs of expanding schemes to offer 75 placements (50 for people with learning disabilities and 25 for people with mental health needs) would cost commissioners £250,000 but could generate savings of £1.5 million per year.
The research provides a very sound economic argument for investment in such schemes, but it is course crucial that the shared lives approach meets the needs of the person with a learning disability. Shared Lives scheme officers will need skills in person centred planning as well as matching people with carers who can meet their needs.
Schemes will also need to have clear policies and procedures in place to ensure they respond to national best-practice models; work within safeguarding frameworks and have systems to enable them to respond swiftly to changes in circumstances of the person supported and the carer.
The authors point out there are still several barriers to the expansion of Shared Lives, including:
• a lack of up-front investment
• achieving best practice in all schemes in terms of ensuring efficient but appropriate matching of carers with individuals in need of support
• poorly developed incentives for sustainable expansion within some funding models.
They conclude that their findings provide clear evidence that strong evidence of significant savings in Shared Lives schemes relative to more established forms of care.
The suggest that Shared Lives schemes may there provide an option for
“reducing costs for commissioners, and applying a focus on achieving greater independence amongst users of the service…” and that that there is a “case for expanding Shared Lives at scale in the immediate term.
Investing in Shared Lives, A Social Finance report produced in partnership with Shared Lives Plus, Community Catalysts, Macintyre and RSA 2020 Public Services