alex fox ceo, shared lives plus co-chair, think local, act personal

www.Shared Lives Plus.org.uk www.communitycatalysts.co.uk

Alex Fox CEO, Shared Lives Plus

Co-Chair, Think Local, Act PersonalChair, Care Provider Alliance

Karl and Clare with Shared Lives carers Blossom and Mike, at their wedding, before moving to live independently

Kent Shared Lives


Shared Lives Plus is the UK network for family-based and small-scale ways of supporting adults. Our 4,500 members are Shared Lives carers and workers, Homeshare programmes and micro-enterprises.

Think Local, Act Personal is the sector-led partnership developing and implementing ‘personalisation’ in social care.

The Care Provider Alliance brings together all the representatives of independent social care providers.

Background


What is personalisation?

Personalisation is not just personal budgets or Direct Payments.

To understand what it is, we need to look at where it came from.


1970s, early ‘80s

A sector characterised by:• disabled people warehoused in long-stay institutions;• a medical model of disability and low expectations of people

with long term conditions;• ‘one size fits all’ state social care services, centrally planned

and organised, with little individual or family control.

But also:• community and whole-family social work approaches• huge contribution from unpaid family carers (was and

remains poorly recognised and valued by the state.)


Community care reforms

The Griffiths Report (1988) and others led to:• closure of nearly all long-stay institutions for people with

disabilities • huge shift of care for people with disabilities & mental health

problems, into community-based settings

But:• model remained individual (not family / community) focused• needs, not asset-based• led by professionals and decision makers, not people


SDS and personalisation

as possible in decisions which affect their lives, such as service planning.Direct Payments introduced in 1995, but take-up remained low until the development of personal budgets.

Self-Directed Support is the principle that people should have as much choice and control


Putting People First 2007

Putting People First (2007) set out a vision for ‘personalisation’ with four equal parts:1. A more universal system2. Prevention3. Social / community capital4. Self-Directed Support, choice and control for service users

Significant increase in Direct Payments (25% of personal budgets, or 44% of cash value). Huge increase in personal budgets (340,000 people; £1.57bn).

But less evidence of the whole vision. Why?


Personalisation reforms limited by ‘needs-based’ system

Adult social care system remains needs-based:• Eligibility and needs assessment: “Are you vulnerable and

needy enough for us to talk to you?”• Up-front means-testing: “Are you poor enough?”• Medicalisation and labelling: “Our experts have decided

upon your needs and category.”• Complex jargon, processes and resource allocation

systems: “You need a guide to negotiate our care pathway.”• Dependence: “We can help you as long as you have critical

needs and your family refuses to help.”• Overlooks importance of relationships and active citizenship.


From better servicesto better lives

• Choice and tailored services are important, but choice doesn’t guarantee a new range of services

• Individual budget control hasn’t led to commissioning power• Choice is illusory without family/user-led service design• …. and even a great service doesn’t guarantee a great life.• A good life usually involves choosing and contributing to a

family and community: it’s about our relationships and responsibilities, as well as our personal development and entitlements.

• eg in Shared Lives people can contribute to their household, family and community, as well as receiving support.


‘Asset-based’ or ‘strength-based’ approaches:• Look for people’s gifts, skills and resources first, rather

than their needs, vulnerability, diagnosis.• Refuse assumptions about people’s potential.• See people and communities as experts: co-production. • See connectedness to family & community as crucial

So not just the same old gift-model professional/client transactions in new locations or with new budgets.

He’s just one of the family. I get as much out of it as he does.

A strength-based approach


• social care from crisis-only to well-being system• duty on councils to develop preventative services• information, advice and decision making support• family carers are recognised in law for the first time• community contributions and active citizens• move away from medical models of care & assessment• promotion of time banking, Shared Lives, micro-enterprises,

Tyze care networks, Local Area Coordination

Care and support will … focus on people’s skills and talents, helping them to develop and maintain connections to friends and family. Communities will be encouraged and supported to reach out to those at risk of isolation.

The White Paper and draft Bill


1. Focus on supply as well as demand.2. From consultation to genuine co-production.3. From informed consumers to citizen-led commissioning.4. Communities in the lead, not just ‘community-based’.5. Underpinned by a strengths-based approach.

Does this add up to a genuine culture change? Are professionals ready to give up power and take risks?

Ways forward


• Local people working with/ for other local people• Work on a very small scale (5 or fewer people)• Community Catalysts helps councils create micro-friendly

conditions. Shared Lives Plus supports 140 members.

DanceSyndromePulp FrictionAce of Spades

Diversifying supply: micro-enterprises


• Co-production is often influencing someone else’ service – increasing numbers of people want (shared) ownership and responsibility for making a contribution.

• Not just User-Led Organisations (ULOs) but citizen-delivered services and interventions

• eg Service user, family and citizen led commissioning.• eg Stamford Forum/ Leeds Council neighbourhood network

model, pooling individual, council and community resources with social finance investment.

Ways forward: citizen ownership & leadership


• The ‘unfinished revolution’ (CSJ): communities must be involved, not just ‘community-based’ traditional services.

• Professionals need to share power and risks fairly, openly.

For instance:• Shared Lives: registered Shared Lives carers involving

family, friends and neighbours in support.• KeyRing: a community-based volunteer who helps people to

form and link up networks of support.

Ways forward: family and community


• A conversation about living a good life which looks at many different routes, with services last on the list.

• Professionals and individuals recognise the limitations of services when it comes to achieving a good life.

• eg Local Area Coordination (LAC) • eg Asset Based Community Development (ABCD)

Ways forward: strengths-based approaches


Finding abundance in austerity

• Public money is scarce.• Informal support can be abundant but…• informal support is not always spontaneous.• Community is not a place, it’s a set of relationships.


Questions for discussion

• How do services help people build their relationships? • … and avoid undermining or displacing real relationships?• Where do children and families services already take a

strengths-based approach, and where could they do so?• What could the children and families sector learn from both

the successes and limitations of personalisation?o

• What could adult social care learn from the children and families sector?

• Self-directed support• Personal budget control

• Community development • Co-production, ULOs


Alex Fox, CEO, Shared Lives Plus, [email protected] www.SharedLivesPlus.org.uk; http://alexfoxblog.wordpress.com Twitter: @alexsharedlives

Personalisation: lessons from social care, RSA: http://goo.gl/QSlDg.Redesigning the front end of social care: http://goo.gl/dcxzh.

Contact details

West Wales Adult Placement

alex fox ceo, shared lives plus co-chair, think local, act personal

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