Shared Lives and personalisation

Alex Fox, CEO Shared Lives Plus

www.SharedLivesPlus.org.uk
http://alexfoxblog.wordpress.com

Karl and Clare with carers Blossom and Mike, at their wedding, before moving to live independently

www.sharedlivesplus.org.uk www.communitycatalysts.co.uk

Personalisation
The culture change towards people being in control of their services and their lives, living in and contributing to their chosen relationships, families and communities. Choice of service as part of achieving this. The mechanism change of personal budgets and Direct Payments. Increasing focus on community participation and contributions.

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Personalisation - challenges
Lack of recognition of the family as the main unit of support. Isolation and individualism: independent living doesnt always mean living alone. What about inter-dependent living? You offer a service when I need a relationship. Shared Lives introduces a distinctive choice into the market place of providers.
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Shared Lives: personalised features No clocking on and off: Shared Lives support is flexible and not paid by the hour. Mixing paid and unpaid care and support contributions. Not a professional/client transaction: a real relationship, formed after an extensive matching process. Moving away from the gift model: everyone contributes. Unpaid family care
Homeshare Shared Lives Befriending Peer support

Fostering

Professional paid hourly care

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Personal budgets (England)

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Using Direct Payments Shared Lives is compatible with personal budgets. If the Shared Lives scheme is delivered by an independent organisation, Shared Lives can be purchased using a Direct Payment. If Shared Lives is delivered by the council (in-house), in England, it is not lawful to pay for it using a Direct Payment. Solution: simply take a mix and match approach. The individual can opt to have some or all of their personal budget allocated to their Shared Lives service. Any allocation left over could be taken as a Direct Payment.
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Choice and decision making in Shared Lives What are the roles of: the individual (with their advocate(s)? The Shared Lives carer? Shared Lives workers? The care manager?
Shared Lives carer

their advocate

the person
Shared Lives worker

Care manager

their family

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Direct Payments and the suitable person Someone using Shared Lives may have a Direct Payment, a personal budget or some money of their own with which to purchase additional support. Often they will need support to manage their money and any contracts they enter into. They might get this support from a broker or someone who is named as a Suitable Person, who assumes legal responsibility for managing money, contracts and employment arrangements.

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Using Direct Payments Could a Shared Lives carer be named as the individuals Suitable Person? A Suitable Person may need to be the employer of an individuals personal assistant, but a Shared Lives carer cannot employ somebody to deliver support. Personal budgets are not always used to employ a personal assistant. But any Shared Lives carer acting as Suitable Person would need to think through any conflicts of interest and the risks to both parties. The Shared Lives carer could find themselves in control of a large part of the service users life and legally responsible for care packages.
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Using Direct Payments Its important to focus on the end goal of personalisation: offering choice and control, not using Direct Payments. There are alternatives to the Shared Lives carer managing the money of someone who lives with them: The individual could receive support from a specialist broker. The individual may have a family member or someone else to they wished to name as a Suitable Person. The individual could ask the council or another organisation to manage their budget.
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Shared Lives: how personalised is your scheme?

Shared Lives services are at different stages in ensuring that Shared Lives is delivered in a way that promotes independence, choice, meaningful activities and opportunities to progress to other settings, as well as the opportunity to establish a long term home and community. We recommend that Shared Lives providers and commissioners review the outcomes being achieved by Shared Lives and develop an action plan.

What would a highly personalised Shared Lives experience look like? And one which wasnt personalised?
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Shared Lives: how personalised is your scheme?

Highly personalised Shared Lives People are regularly enabled to set and revise personal goals and have clear action plans for achieving them. Shared Lives in need of development People who use Shared Lives have little access to independent advocacy, peer support or ongoing care management.

People access independent advocacy and Shared Lives carers feel they are left to peer support and have a clear voice in the advocate on behalf the person they development of the Shared Lives service. support. People have many opportunities to take part in meaningful activities, including volunteering, membership of clubs or activities which are not specifically for disabled people and paid employment. People spend much of their day within the Shared Lives household with few opportunities for outside activities.

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Shared Lives: how personalised is your scheme?

Highly personalised Shared Lives Shared Lives in need of development Individuals can progress to different There is an assumption that people using settings, or stay put, as the person prefers, Shared Lives for support and with choices regularly reviewed. accommodation will stay there forever. People who use Shared Lives have a strong sense of belonging within their family and community and have a number of unpaid relationships. They are able to pursue friendships and sexual relationships as they wish. People feel like tenants or service users within their homes. People are not visible or active within their community and have few unpaid relationships.

Shared Lives carers are supported to take Shared Lives carers access little or no a structured approach to helping people to training on delivering personalised support learn independent living skills. and have a poor understanding of personal budget approaches. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk

Its not Shared Lives if.

1. The Shared Lives scheme has been cut out of the arrangement. If either the commissioner or the service user contracts directly with the carer, that carer is no longer providing regulated Shared Lives care. They may be an employee, or running a small residential care home. 2. There is no intention to share family life or use the Shared Lives carers home as a resource. Shared Lives is always about sharing home and family life. The carers house feels like a family home. In Shared Lives day support, the person using the service may not wish to go to the Shared Lives carers home all the time, but the Shared Lives carer should make their home available as a resource. The Shared Lives tax break depends upon actual use of the home, not intentions. 3. There is no matching process. The matching process can take time. Rushing the matching process increases the risks of the match breaking down. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk

Comparing Shared Lives with directly employing a care worker

Paying the provider directly is a valid alternative to Shared Lives, but there are risks: 1.There may be no Plan B and no safeguarding procedures. 2.The care provider may be a residential care home or domiciliary care provider. 3.A person paid by another individual to provide regular support is very likely to be that individuals employee (not self-employed, as is the case with Shared Lives carers) regardless of any verbal or written agreement to the contrary. Consider the insurance, minimum wage National Insurance/ PAYE. 4.You cannot lawfully claim the Shared Lives tax break for work which is not carried out as part of regulated Shared Lives activity. To do so could lead to prosecution. 5.The Shared Lives exemptions to landlords regulations would not apply e.g. HMO 6.An arrangement in which a persons landlord is also their employee could easily become unhealthy for either party. 7.Shared Lives public liability insurance would be invalid. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk

Using Direct Payments

Our recommendations for those providing and commissioning Shared Lives are: 1.Raise awareness of Shared Lives as an option. 2.Consider the possibility of developing Shared Lives for a wider range of service user groups. 3.With people using the service, review the extent to which Shared Lives is delivering choice, control, independence, meaningful activities, opportunities for employment, and a sense of belonging. 4.Educate professionals about Shared Lives processes. 5.Examine the business case for developing Shared Lives locally to decrease reliance on residential care. 6.Ensure that your Resource Allocation Systems (RAS) works for Shared Lives. 7.Sound out potential partners in the NHS, older peoples services, mental health services www.sharedlivesplus.org.uk www.communitycatalysts.co.uk

Contact details Alex Fox alex@naaps.org.uk

www.SharedLivesPlus.org.uk; 07738641897 http://alexfoxblog.wordpress.com Twitter: @AlexatNAAPS

Sian Lockwood, CEO, Community Catalysts Sian.lockwood@communitycatalysts.co.uk

www.communitycatalysts.co.uk
www.sharedlivesplus.org.uk www.communitycatalysts.co.uk