Shared Lives as a model for housing with care and support

What is Shared Lives?

Shared Lives offers people who require care and support the opportunity to live independently in the community and can be an alternative to living in a care home, housing with care or housing with support. The Shared Lives scheme matches people who need care and support with an approved carer. The carer shares their family and community life and gives care and support to the person with care needs. Some people live with their Shared Lives carer, while others are regular day-time visitors. Some people combine day-time visits with overnight stays. Carers can support up to three people at one time. Shared Lives schemes have also been known as adult placements and were originally called ‘Adopt a Granny’.

The success of Shared Lives is largely dependent on achieving a good match between people and their carers. Shared Lives carers are carefully selected and trained by regulated Shared Lives schemes, with the goal of enabling people to benefit from an individual and highly personalised service. Shared Lives carers are trained and paid, they spend time with the individual they have chosen to be matched with, doing things they both enjoy.

Number of people accessing Shared Lives

In England in 2020 there were approximately 12,800 people being supported by Shared Lives. In 2020 approximately 10% of people in Shared Lives arrangements were older people.

Who does Shared Lives support?

Shared Lives is used by people of all ages from 16 onwards, with a wide range of support needs including learning disabilities, mental ill health, autism and dementia, older people, and young adults in transition.

While Shared Lives is available in almost every UK area, fewer older people, families and frontline NHS and council staff have heard of it, so it is not often chosen by families and levels of referral from other older people’s services, including to support hospital discharge, are very low.

Shared Lives can work in various ways and support people with varying support needs. Examples of how the schemes can work are listed below:

• They can provide an interim placement for people with mental health problems recently discharged from hospital and also help prevent readmission.
• Shared Lives carers can provide support to people with dementia in their neighbourhood enabling the person to remain in their own home. They can also offer support to family members so that the person does not have to leave their familiar surroundings.
• They can provide support for care leavers and provide a setting in which they can learn daily living skills in a very practical way, in preparation for moving on into greater independence.  
• They can support parents with a learning disability and can help to teach parenting skills, which may prevent unnecessary admission of a child to care.
• They can provide respite to unpaid family carers, an arrangement which can also help with long‐term succession planning for older family carers. The use of Shared Lives for short breaks is growing as people become more aware of the flexibility of the scheme.
• People also sometimes use a Shared Lives scheme as a way of learning the skills they need to live independently and to help them put down roots in the area or community before moving into a place of their own.

Funding

Shared Lives carers are paid a fixed fee, rather than an hourly rate, to support someone living with them. They are paid by the Shared Lives scheme they are registered with, which is usually funded by the local council or NHS.

The person being supported also contributes towards accommodation and household costs, such as food, electricity and water. This payment can come from their housing benefit part of Universal Credit, Employment Support Allowance (ESA), Personal Independence Payment (PIP), Severe Disability Premium, or other specialist pensions or support that a person may have.

Regulation

In England, Shared Lives schemes which offer personal care are regulated by the Care Quality Commission (CQC). Shared Lives has a record of 96% Shared Lives carers and schemes rated ‘good’ or ‘outstanding’.

Shared Lives carers are self-employed and are assessed, approved, trained and monitored by a registered Shared Lives scheme. The individual accommodation which is owned or rented by Shared Lives carers is not regulated.

Funding and commissioning

Care may be commissioned by the local council or NHS or funded using Personal Budgets. The person being supported contributes towards accommodation and living costs from their housing benefit part of Universal Credit, ESA, PIP, Severe Disability Premium, some people may have specialist pensions/support from the Armed Forces, NHS, police etc. People may also contribute their own money.

In the case of independent and most council-run schemes, the registered provider receives payment for the care provided and pays the Shared Lives carer. However, payments are managed, there is always a Shared Lives carer agreement between the Shared Lives carer and the scheme, and a Shared Lives agreement between the scheme and the individual using Shared Lives.

Ownership

Shared Lives offers accommodation that is lived in under an occupancy agreement where the premises are owned or tenanted by another person who has been approved as a carer under a registered Shared Lives scheme. Shared Lives carers are self-employed.

Shared Lives is often, but not exclusively, provided by local councils. Other providers are NHS trusts or independent bodies, both profit-making and non-profit making. Providers are responsible for matching people with suitable carers, making and monitoring arrangements and providing ongoing support.

Promising practice examples

• Shared Lives Lancashire Open

  Model of housing or service: Shared Lives

  Principles of excellence: person centred and outcome focused; strong leadership, culture and workforce

  Shared Lives is a service that primarily matches adults with learning disabilities, with carers and their families, to live within their home. Lancashire’s Shared Lives service is the largest local authority Shared Lives scheme in England and supports 11% of the population of adults with a learning disability in the county. In 2019, a total of 371 people were being supported in 287 households with 227 of those receiving long-term care. The Lancashire Shared Lives service has recently been recognised as ‘Outstanding’ by the Care Quality Commission (CQC).

  The service has been highly commended for its robust recruitment methods for staff and carers, its investment in staff skills and training and its commitment to integrated working. The CQC report stated that staff and carers had excellent knowledge and skills and the training made available to them ensured people's needs were extremely well met. Similarly, there were outstanding examples of when the service had worked with other healthcare professionals to achieve positive outcomes for people and to improve their quality of life.

  The service is committed to planning and promoting holistic, person-centred, high-quality care resulting in excellent outcomes for people. People receiving the service almost always remarked on how carers and staff are exceptionally compassionate and kind and how they ensured they felt part of the family. Moreover, people were encouraged to learn new skills to enhance their independence and were treated with the utmost dignity and respect. The person-centred approach enriched people’s lives through meaningful activities.

  There are a number of positive and uplifting stories of how far people have come with their new families, with some reporting having gained enough independence to secure jobs, others learning new life skills relating to transport and travel, enrolling in college and finally losing weight and becoming healthier.