National Assembly for Wales / Cynulliad Cenedlaethol Cymru
Health and Social Care Committee/ Y Pwyllgor Iechyd a Gofal Cymdeithasol

Regulation and Inspection of Social Care (Wales) Bill / Bil Rheoleiddio ac Arolygu Gofal Cymdeithasol (Cymru)

Evidence from Shared Lives Plus – RISC 36 / Tystiolaeth gan Shared Lives Plus – RISC 36

Shared Lives Plus response to the:

‘Regulation and Inspection of Social Care (Wales) Bill’ consultation Health and Social Care Committee

Our View

Shared Lives Plus members are supportive of the general principles and aim of the ‘Regulation and Inspection of Social Care (Wales) Bill’. We welcome an approach which moves regulation beyond compliance with minimum standards and provides a greater focus on the quality of services and the impact which they have on people receiving them.

However, in supporting the Bill we ask that the work of Shared Lives carers is strongly considered when developing a new approach to inspection of services and that any changes do not have a detrimental effect on the valuable work of Shared Lives carers in Wales.

We believe that this is critical because:

1. The approaches already demonstrated by Shared Lives closely match many of the aims of the Social Services and Well-being Act 2014, as well as the Regulation & Inspection of Social Care (Wales) Bill

o We offer an innovative, flexible and highly citizen-centred type of support

o The person receiving support is carefully matched with a Shared Lives carer they wish to live with, and they jointly make decisions about the support provided

o Arrangements are individually negotiated and designed, providing a much more personalised form of support

2. Shared Lives delivers substantial savings when compared to other forms of care

o Shared Lives arrangements not only deliver better outcomes for people needing care, but do so at a saving of up to 60% for people with learning disabilities, 10% for older people and 30% for people with mental health problems

o In addition to these savings, people in Shared Lives arrangements often have lower usage of community and emergency health care services.

3. Shared Lives schemes consistently outperform other forms of care in quality measures

o All Shared Lives schemes in Wales exceed National Minimum Standards.

o In Scotland, where more detailed data on quality of care is already available, 94.5% of Shared Lives schemes achieve good to excellent, compared to 81.7% of care homes

4. Shared Lives is a well-established and growing service

o There are already over 600 Shared Lives Carers and around 800 people benefitting from Shared Lives arrangements across Wales. These numbers continue to grow year on year, and it is essential that the Regulation & Inspection of Social Care (Wales) Bill supports this continued rise in citizen-centred service delivery

Who are Shared Lives Plus?

Shared Lives Plus is a registered charity and the national body supporting and representing Shared Lives carers and schemes across Wales and the wider UK.

As Shared Lives carers are self-employed they don’t have a large employer to represent their interests or to make the case for the expansion of Shared Lives. This is the function of Shared Lives Plus and we undertake many projects across the UK as part of this role.

Within Wales we provide a voice for over 64% of Shared Lives carers (402/628) and 10 Shared Lives schemes covering all of the local authority areas – the first country in the UK to extend so extensively. Shared Lives Wales is the Welsh Committee for Shared Lives Plus working with the Welsh Assembly Government and national organisations in Wales to develop and promote Shared Lives (also known as Adult Placement). We work to ensure that a full understanding of the Shared Lives carer role influences the appropriate inspection of Shared Lives provision. The results have been largely successful in the 10 or so years since the introduction of regulations for Adult Placements (2004) Wales.

We are keen that this success continues for our growing membership base, and the people that benefit from the service in Wales.

What is Shared Lives?

In Shared Lives, everyone gets to contribute to real relationships and the goal is ordinary family life.

Shared Lives is a citizen focused proven alternative to home care and care homes for disabled adults and older people. It is a regulated service under Adult Placement regulations, with minimum standards enforced by government inspectors. Shared Lives carers are recruited, vetted, trained and supported by local Shared Lives schemes, who have to be registered with the government's care regulator.

Shared Lives carers are self-employed individuals (often former foster carers or care workers) who welcome people needing care into their own homes as family members. In Shared Lives, a Shared Lives carer and someone who needs support get to know each other and, if they both feel that they will be able to form a long-term bond, they share family and community life. These relationships can be lifelong. Shared Lives carers often say, "She/he is just one of the family.

Shared Lives is used by people with learning disabilities, people with mental health problems, older people, care leavers, disabled children becoming young adults, parents with learning disabilities and their children, people who misuse substances and (ex-)offenders. 76% of Shared Lives beneficiaries have learning disabilities and 12% have mental health problems.

People who use Shared Lives have often lived in many different institutions, and some have been considered too "challenging" to live in an ordinary household, but many find, for the first time, a sense of belonging with the Shared Lives carer. The main feature that distinguishes Shared Lives from other kinds of support is that, whatever the service provided by the Shared Lives Carer, the person being supported has the opportunity to

share the Carer’s family life and be part of their social networks.They will go to family events like weddings with the Shared Lives carer and get to know the Shared Lives carers' friends and neighbours.  The relationships that develop are committed and consistent and highly valued by both the person receiving the services and the Shared Lives Carers. 

Shared Lives carers are paid a modest amount to cover some of their time and expenses, but they are not paid by the hour and they do huge amounts without being paid: there is no "clocking on and clocking off".  Shared Lives arrangements not only deliver better outcomes for people needing care, but do so at a saving of up to 60% for people with learning disabilities, 10% for older people and 30% for people with mental health problems. When people labelled ‘challenging’ have moved from care homes or ‘assessment and referral units’ into Shared Lives households, annual savings of up to £50,000 per person have been realised. The average saving is £13,000 per person.

Shared Lives Schemes provide a range of services to vulnerable and disabled adults that includes:

§ Long term accommodation and support

§ Short breaks

§ Day time support

§ Rehabilitative or intermediate support

Shared Lives carers and their families are at the heart of the schemes that we represent. They are fully involved in decisions about their lives, their support and the scheme’s future. Matching between Shared Lives carers and people who use Shared Lives is central to the referral process and is a fair and transparent system. Shared Lives carers are never placed under pressure to accept matches, and people who use Shared Lives have a strong sense of belonging within their household, community and relationships.

Shared Lives carers, scheme workers and social workers have clearly defined roles and work together positively to help each individual plan and review their goals and support. As Shared Lives Plus we encourage schemes to recognise and respect Shared Lives carers as colleagues and allow them to play an active role in developing scheme policies.

Where possible we also encourage peer learning and support through carer groups, allowing Shared Lives carers to meet up, learn from each other and to influence the development of the scheme. Shared Lives carers are encouraged and supported to take part in Shared Lives Plus at both a regional and national level, including active participation within the Welsh Committee who helped to create this response.

Thank you

Shared Lives Plus are delighted at the opportunity to respond to this important consultation. We would welcome further opportunities to support the Health and Social Care Committee in their consideration of the Bill, including the forthcoming oral evidence session where we could provide a useful perspective as an  innovative and proven citizen-centred care service.

Yours Sincerely,

Colin Gabriel Batten

Wales Development Officer

Shared Lives Plus