At a glance 02: Improving outcomes for people in Shared Lives arrangements

Published: April 2009
Updated October 2009

Key action points for care managers and commissioners

Introduction

Shared Lives schemes are one way of providing more personalised services. Schemes recruit, assess and support Shared Lives carers who offer accommodation and/or care and support to people who use services, older people, people with mental ill health and those with learning and/or physical disabilities, in their family home. Shared Lives carers can support a maximum of three adults at any one time and are self-employed. Shared Lives schemes may be directly managed by the local authority/Northern Ireland health and social care trust or by an organisation independent of the local authority/Northern Ireland health and social care trust (usually a charity) and are regulated by the Care Quality Commission. (Note: Shared Lives schemes were previously known as adult placement schemes.)

This At a glance is a summary of SCIE Guide 14: Improving outcomes for service users in adult placement – Commissioning and care management.

What this means in practice

Keep up to date – knowledge about Shared Lives

• Knowledge about the potential for Shared Lives arrangements in local areas by care managers needs to be increased. This includes expanding awareness of Shared Lives opportunities across a region rather than just a single locality.
• local authorities/Northern Ireland health and social care trusts need to know about and embrace new policies, new regulatory requirements and new ways of working. Ensure that all those working for the organisation are kept up to date on changes and developments.
• local authorities/Northern Ireland health and social care trusts need to improve management systems and support, to ensure that Shared Lives carers and the people who use services that they support are on the IT system so they don’t ‘fall through the net’.
• Care managers need to be aware of the potential for Shared Lives as a major lever for the promotion of choice, control and personcentred planning.

Work with the schemes to make good placements - assessment and referral

• local authorities/Northern Ireland health and social care trusts need to be aware of pressures that can influence the quality of assessment and referral and ensure that these are not allowed to damage the Shared Lives service provided. Pressures include the need for a speedy placement, narrow eligibility criteria, overprotection of budget.
• local authorities/Northern Ireland health and social care trusts should develop and implement protocols between care management and the Shared Lives scheme to ensure effective and appropriate referral.
• local authorities/Northern Ireland health and social care trusts should make emergency placements only with those approved and trained to take people in an emergency.
• Care managers need to ensure schemes receive all the information that they require to make a good and safe match.
• Care managers should provide a comprehensive care management assessment and arrange and attend regular reviews.

Practice examples can be found in SCIE Guide 14: Improving outcomes for service users in adult placement – Commissioning and care management.

Care managers need to be aware of the potential for Shared Lives as a major lever for the promotion of choice.

Manage risk with the user and Shared Lives scheme - care planning, risk assessment and review

• Care managers should ensure schemes receive a full, up-to-date, care management care plan as part of the referral.
• Care and scheme managers must agree who is responsible for which aspects of the joint risk assessments and how changes to risk over time will be assessed and new risk management procedures introduced.
• Care managers should ensure risk assessments are reviewed regularly, to prevent them becoming static or rigid. Timescales for review should be clearly recorded so all involved are aware of this.
• Care managers need to ensure regular reviews are arranged and attended. This ensures adequate information can be shared to inform any decision making.
• Care managers should attend all reviews whenever possible and not rely on the appointment of a separate reviewing officer. It is essential that reviews are not just a paper exercise.
• Care managers should ensure a ‘named person’ or advocate is there to support the person using the service if a reviewing officer is appointed to attend the review.
• Care managers should ensure that the review takes account of the views of the person using the service at all times.
• Care managers need to be clear about the procedure for re-assessing needs of the person using the service if there is a major change in the placement.

Practice examples can be found in SCIE Guide 14: Improving outcomes for service users in adult placement – Commissioning and care management.

Involve and update commissioners

• local authorities/Northern Ireland health and social care trusts need to support care managers in developing relationships with people supported through Shared Lives. Care managers tend to ‘dip in’ to the role as they often find workload and funding makes more ongoing support impossible.
• local authorities/Northern Ireland health and social care trusts, particularly care managers, need to work with commissioners to determine how specific and local needs can be met through the development of Shared Lives schemes, expanding the service to other groups and also the types of service provided.
• Care managers should ensure that they keep commissioners updated about Shared Lives service availability and the potential for development.
• Care managers need to work with commissioners to gain an understanding and comparison of costs with other services, and assist them in making this information available to people who use services.

Practice examples can be found in SCIE Guide 14: Improving outcomes for service users in adult placement – Commissioning and care management.

Policy and legislation

The Commission for Social Care and Inspection has introduced changes to regulations, including registration and inspection of shared living placements. From April 2009, the new Care Quality Commission (CQC) will take over CSCI’s responsibilities.

Independence, wellbeing and choice (DH, 2005) – acknowledges the ability of shared living to deliver small, local, individualised services and promoted expansion of this area.

Our health, our care, our say (DH, 2006) and Putting people first (DH, 2007) – both acknowledge the use of and encourage the expansion of individual budgets.

You can find out more about current legislation in Northern Ireland by visiting:

The Regulation and Quality Improvement Authority (RQIA) has responsibility for the registration and inspection of Adult Placement Agencies (which includes Shared Lives schemes) placements.

Northern Ireland legislation:
The Adult Placement Agencies Regulations (Northern Ireland) 2007.

About this summary

SCIE’s At a glance guides have been developed to help you understand as quickly and easily as possible the important messages and practice advice in SCIE’s guides. The At a glance guides will give you an overview of the messages or help direct you to parts of the main guide that you may find most useful. You can also use them as training resources in teams or with individuals.

Links

• SCIE Guide 14: Improving outcomes for service users in adult placement – Commissioning and care management
• At a glance 02: Improving outcomes for people in shared living services (79kb PDF file)