Ewan King, Deputy Director, IMPACT, and Chief Executive, Shared Lives Plus
Shared Lives – where a person who needs care moves in with or regularly sees a self-employed carer – is an innovative approach to support, across the UK. A recent report by the House of Lords describes Shared Lives as one of the best examples of an innovation that has grown to scale in the UK[1]. In this respect, we at Shared Lives Plus (SLP) – the representative charity for Shared Lives – are often asked: what made the difference in growing Shared Lives (although we want it to grow much bigger!)?
Lots of factors have played a part. Strong and committed leadership was important. There are lots of leaders in social care who are strong advocates of this model of care. Important too, has been a forward-thinking approach to commissioning, which has focused on the achievement of outcomes. The fact that Shared Lives is regulated by Care Quality Commission, making it a widely trusted model of care, has made a difference.
Less often talked about, but very important has been the use of research and evidence. From as far back as 2014[2], when the Personal Social Services Research Unit (PSSRU) conducted its first key study into the cost effectiveness of Shared Lives, there has been a realisation amongst its champions that good evidence is vital to making the case to leaders to grow shared lives. Today, we often use evidence to encourage leaders, commissioners, and funders to consider how they can create the conditions in which Shared Lives flourishes.
Evidence is used in several ways to inform the development of Shared Lives. Firstly, we use economic appraisal evidence – often in the form of cost comparison studies – to show that investment in Shared Lives will save money in comparison to other types of care. Why do we do this? Because in a difficult funding climate, where there are competing priorities for money, having good economic data can make the difference to convincing funders to invest.
In 2017, a study by Nesta[3] found: ‘Shared Lives has an evidence base which clearly demonstrates the economic benefits of the model versus other forms of care. The Care Quality Commission consistently highlights Shared Lives as the most consistently high performing of all kinds of regulated care. This in turn gives local authorities the incentive to grow the model.’
This kind of statement is very helpful if you are trying to build a case for Shared Lives.
Whilst economic evidence, and for that matter statistical data is helpful, case studies and stories from people with lived experience about the difference Shared Lives makes are also important – and something we actively collect at SLP.
‘If you talk to most decision-makers in social care, you can tell they want to do things differently, but feel stuck. Telling your stories can help show them what is possible.’[4]
Meg Lewis, Person who draws on Shared Lives
In recent years, Shared Lives has evolved and diversified – for instance, once almost solely provided to people with learning disabilities, Shared Lives now caters for people with mental ill-health, dementia and young people leaving care. Once again, research and evidence has been crucial to influencing the development of these new forms of support. Staff testimony, case study research, feasibility studies and pilot evaluations, have all been used to build the evidence and define the steps to implementation which have made these new models of delivery possible.
IMPACT, which I am involved in as Deputy Head and thematic lead for national embedding, has a pivotal role to play in using evidence to influence change and encourage innovation in adult social care. What can it learn from the experience of Shared Lives?
Firstly, in developing evidence to share, it will be important – as we have done at SLP – for IMPACT to underline the economic impact of initiatives where the evidence supports this. Ultimately the outcomes are the most important consequence of social care services, but in difficult financial times, economic evidence is ever more important.
Secondly, similarly to the example of Meg who regularly writes for us about Shared Lives, the voice of people who draw on care is critical to supporting evidence use. This is why IMPACT’s commitment to co-production is so important, and a vital component of the approach we are planning to embed evidence nationally and locally.
Thirdly, evidence needs to be grounded in people’s reality – the research and evidence products we produce, as we have done at SLP, need to be practical, relevant and assessable.
IMPACT is at the start of its journey of embedding evidence in adult social care and influencing positive change on the ground. As we develop our approach, drawing on the experiences of places like SLP which have used evidence to support innovation, can only help in shaping a strategy that has a lasting impact.
[1] Innovation in Adult Social Care, POST Note, May 2022: https://researchbriefings.files.parliament.uk/documents/POST-PN-0670/POST-PN-0670.pdfhttps://researchbriefings.files.parliament.uk/documents/POST-PN-0670/POST-PN-0670.pdf
[2] Brookes, N. & Callaghan, L. Shared Lives – improving understanding of the costs of family-based support, in L.Curtis & A.Burns (eds) Unit Costs of Health & Social Care (2014), Personal Social Services Research Unit, University of Kent, Canterbury. [click here for PDF]
[3] SLP, Nesta and SCIE, Growing Innovative Models of Health, Care and Support, 2017: https://www.nesta.org.uk/blog/growing-innovative-models-of-health-care-and-support-for-adults/
[4] Taken from Blog for The King’s Fund: https://www.kingsfund.org.uk/blog/2023/02/unlock-innovation-we-need-work-people-who-draw-care