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The under-developed Shared Lives programme not only enables individuals to help others who would otherwise be left on their own, but also saves money. Now, one of the RIEPs is encouraging more councils in its region to adopt the scheme, report Alex Fox and Jane Hurt Can a practice that's been around since the Middle Ages play a major role in transforming the care of adults in the 21st century? Our research* suggests that expanding Shared Lives schemes – formerly known as adult placements – could play a major role in meeting the needs of growing numbers of vulnerable adults at a time of deep public spending cuts. It shows that, to put it simply, paying people to include another adult in their family life works. Shared Lives works because carers and their families often have the flexibility to cope with complex needs which would cost much more to meet in other settings. To illustrate a Shared Lives arrangement, here are two examples... Jane has a learning disability and a new baby. Not eligible for round-the-clock support, her future looked bleak until she was matched with a Shared Lives carer, with whom Jane and her baby now live, for as long as Jane needs the support. Sarah was living alone when she suffered a severe stroke. By the time she was discharged from hospital, she was still struggling with her memory and concentration and, left alone, would sit around all day. Sarah now lives with Lisa, a Shared Lives carer in the same town. Lisa supports Sarah to keep in touch with family and friends, and to rebuild her independent living skills. Shared Lives arrangements are not ‘off the peg' services. They are highly personalised, relying on an excellent match between the person requiring support and the Shared Lives carer. By experiencing ordinary family life, a vulnerable adult can benefit from more choice and control over their lives, and greater independence. And the business case stands up, but it's more than that. Shared Lives schemes are registered and regulated, but nevertheless, manage to feel more like a life than a service. At their best, they evidence the prime minister's Big Society vision – the state playing a decreasing role as people benefit from increasing integration into family and community life. Small is beautiful indeed. That said, the financial case is impressive. Depending on the complexity of an individual's needs, Shared Lives schemes can deliver savings of between £35 and £640 a week per person in comparison with traditional services. The average saving for someone with a learning disability in residential care, for example, is 60%. We found that to develop a Shared Lives scheme to support 85 people requires investment of £620,000 over five years, but generates savings of almost £13m. We also know there are genuine economies of scale as, the larger the scheme, the greater the efficiencies. The financial case for councils is made all the more compelling by the fact that Shared Lives, unlike residential care, is a community service under the Chronically Sick and Disabled Person's Act. The individual is eligible for housing benefit and disability living allowance, which they use to pay towards their support. Many Shared Lives schemes work with a benefits team to ensure that people claim their eligible benefits, further reducing the cost to the council. The quality of Shared Lives schemes is extremely high. CSCI inspectors rated 88% of Shared Lives schemes as ‘good' or ‘excellent', 9% ‘adequate' and none as ‘poor'. This represents far better inspection results than any other regulated service. Shared Lives services can also encourage enterprise and employment. NAAPS, the national network for Shared Lives, now includes all micro-enterprises in social care. Some take the Shared Lives focus on family and community life and apply it to helping front-line workers and disabled people themselves to set up small care businesses of their own. However, we also found that Shared Lives is under-used, and awareness is often limited to the field of learning disabilities. While the number of adults in Shared Lives schemes has grown to about 20,000, 70% have learning disabilities, which represents less than 5% of all learning disability placements. The next biggest category is older people, at about 16%. But what about the potential for other groups? Shared Lives has been used with people with dementia, a physical disability, a mental illness and a substance misuse problem, as well as with ex-offenders, vulnerable mothers and their babies and foster children moving into adulthood. Whereas traditional interventions can be hugely expensive for these groups, Shared Lives can provide wrap-around care much more cheaply. However, the impression left is that Shared Lives services are under-developed for these groups. Improvement and Efficiency South East is attempting to counter this. We're working with councils in the region to encourage more Shared Lives schemes and extend existing ones. A recent conference brought together commissioning staff from councils and health with the voluntary sector, which highlighted how the statutory sector can shape markets to stimulate the growth of more Shared Lives schemes. Sometimes, the best ideas have been with us for a long time. We just haven't explored how they can be adapted to meet the needs of modern life. Shared Lives could be an old idea whose time has finally come. Alex Fox is chief executive of NAAPS and Jane Hurt is Shared Lives project manager at Improvement and Efficiency South East. A business case for Shared Lives is available at www.southeastiep.gov.uk

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Improving lives through sharing – and reducing costs

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