Radically different care model, Shared Lives, shown to have capacity and outcomes to support many more people with serious mental health support needs.
National charity calls on partners to help make sure Shared Lives is offered as an option for all who could choose to use it
A new independent report released today shows the Shared Lives model of care is supporting people with mental ill health to live significantly improved lives – and Shared Lives Plus believes this approach can benefit thousands more.
The National Development Team for Inclusion (NDTI) has evaluated the effectiveness of the Shared Lives mental health project (see Editors notes) as an option for people with mental ill health – and concluded that Shared Lives offers huge benefits to those involved, with significant potential to develop as an offer.
The Shared Lives Plus mental health project was funded by the Cabinet Office to support the development of Shared Lives as an option for people with mental ill health.
Seven Shared Lives schemes took part in the project to develop, demonstrate and market a financially viable and commission ready approach to Shared Lives mental health support, and demonstrate what can and does work.
Bradford, Derby, East Sussex, Lincolnshire, North Somerset, Rochdale and Telford and Wrekin Shared Lives schemes were involved in the project, and 106 people went into Shared Lives arrangements.
The project showed that the people using Shared Lives mental health support have a more positive outlook in two major areas of their life.
Half of the people who took part in the project said they now feel a part of the community and they also feel that their emotional wellbeing is better.
62% of people living in Shared Lives arrangements said they always felt part of the family and 62%. said ‘Yes, I feel part of the family. It is great,’
The report found Individuals with mental ill health have better choice and control over their lives and their support, and improved mental health and wellbeing.
They were also enabled to pursue personal interests and activities within the community that they may not have had the opportunity to do in more traditional settings.
One person living in Shared Lives said: “I was welcomed as a family member, their parents come round, I’m mates with their nephew, and I take the dog out for a walk. It’s more of a home than a lodging”. (Person in long-term Shared Lives arrangement)
The Shared Lives support model also helps families support their loved ones. The daughter of a woman in a Shared Lives short break arrangement: “It’s better than these respite places, its one person, it’s still a home, still a house. Mum wouldn’t have gone to a respite place, she prefers one to one. Also we get to know [carer] and her family, you wouldn’t get that in respite, and there would be different staff. She’s more of a friend than a carer.
Shared Lives Plus were the key partner in the project, which resulted in well over one hundred people getting support for the first time. Shared Lives Plus calculates that if the recent gains in mental health support were replicated across its national network of Shared Lives schemes, nearly 5,000 additional people would be supported, saving over £16m.
CEO of Shared Lives Plus, Alex Fox said: “This shows that Shared Lives can be a great option for people with mental ill health, and help improve the wellbeing and independence of the person, in a supportive, family environment.
“Our goal is that everyone with mental health support needs is able to choose this form of support, if they want to. This would be one of the most significant changes in mental health support and accommodation for many years.”
“When taken alongside the potential for Shared Lives to support tens of thousands more people with other support needs such as learning disabilities and conditions related to ageing, this report shows that the Shared Lives model of care is well placed to play a major role in transforming how social care looks, feels and is delivered across the UK”
The project schemes faced challenges in developing support for people with mental ill health but there is evidence of a positive impact through day support, short breaks or long-term arrangements- in terms of the person’s wellbeing and increased activity in the community. There were 37 short breaks, 31 long-term, 22 day support and 16 unspecified Shared Lives arrangement in this project. Specific cases showed that people’s mental health stabilised and hospital stays had been prevented through the Shared Lives individualised, person-centred form of care.
The Shared Lives Plus mental health project generated an increased capacity within the Shared Lives sector to support people with mental ill health, which resulted in more people in Shared Lives arrangements and better support for Shared Lives carers. The project was also successful in reaching the their target for recruiting Shared Lives carers offering mental health support.
The Head of Service for Mental Health teams stated: “We’re very focused on the personalised care agenda… you would have to have a very good reason for someone to go into residential care… We’re trying to develop a continuum of services with things like local area co-ordination and Shared Lives.”
The Shared Lives Plus mental health project also gave an insight into what works in developing more mental health support within Shared Lives. It found that well supported Shared Lives carers, good matching, compatible funding mechanisms, flexibility, becoming part of the process, having ambassadors or champions and seizing opportunities all contributed to more people with mental ill health being supported within Shared Lives.
Notes to Editors
Shared Lives is a form of social care which has historically been used primarily for people with learning disabilities. In Shared Lives, an adult who needs support or accommodation is matched with an approved Shared Lives carer, who supports and includes the individual in their family and community life. The Cabinet Office has funded Shared Lives Plus to deliver a project to support the development of Shared Lives as an option for people with mental ill health. The project has supported seven local Shared Lives schemes to develop, demonstrate and market a financially viable and commission ready approach to Shared Lives mental health support, and to generate learning about what works.
The National Development Team for Inclusion (NDTi) was commissioned to conduct an independent evaluation of the project. Drawing on data collected through a mixed methods evaluation approach, this report describes the impact and learning from the project. It is hoped that the findings reported will be of use to Shared Lives schemes looking to develop support for people with mental ill health, for Shared Lives Plus supporting schemes to develop in this area and for commissioners and mental health professionals who are interested in learning about how Shared Lives can support people with mental ill health.
Developing Shared Lives for people with mental ill health- What works?
1. Getting a “way-in” – finding a “way in” to mental health teams in order to promote Shared Lives to potential referring practitioners is crucial. This could be through making the most of existing contacts or links, sustained attempts to secure e.g. invitations to mental health team meetings, or going to the ‘top’ and making contact with those with more strategic responsibility.
2. Becoming part of the process – although this can be a challenge, especially for independent providers, becoming integrated into the process where decisions are made about support packages (whether this is through being part of panel meetings, brokerage or being on a preferred provider list) is key to growth happening at any pace.
3. Having ambassadors or champions – having enthusiastic ambassadors or champions within mental health teams can be very effective at promoting Shared Lives.
4. Seizing opportunities, filling gaps – making the most of local opportunities such as gaps in certain types of provision or drives to move away from traditional forms of support – i.e. fulfilling demand – can lead to growth at a faster rate.
5. Flexibility – being flexible about the type of arrangement that can be offered, to whom, and being flexible about the role of Shared Lives (e.g. as planned prevention, facilitated discharge or maintenance) at least at the early stages of development can open Shared Lives schemes up to a greater number of opportunities.
6. Compatible funding mechanisms – although this is not always within control of Shared Lives schemes, especially in-house local authority schemes, to maximise opportunities, Shared Lives schemes need to ensure the local funding mechanisms (block contracts, personal budgets etc.) fit with the schemes processes. Ultimately, being able to accept all forms of funding through whatever route or mechanism will maximise opportunities.
7. Good matching – a fundamental element of the Shared Lives model for people with all support needs is the importance of good matching between Shared Lives carer the person being supported, and this is no different for people with mental ill health. Good matching leads to positive outcomes and referrals follow good outcomes.
8. Well supported Shared Lives carers – the Shared Lives carer is key to making a Shared Lives arrangement work. Good support for Shared Lives carers through recruitment, assessment, induction and ongoing support through arrangements ensure they can fulfil their roles.
The data is based on a small number of people- it shows an in-depth analysis into the positive changes Shared Lives support made to their lives, in long-term arrangements, short breaks and day support . The independent report also recommends Shared Lives Plus produce high quality data about the outcomes of Shared Lives through the ‘My Shared Lives’ outcome tool.