SOCIAL INVESTMENT AND SHARED LIVES

Social Finance is authorised and regulated by the Financial Conduct Authority FCA No: 497568

Richard Todd, Associate Directorrichard.todd@socialfinance.org.uk

27 FEBRUARY 2014

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DELIVER SUSTAINABLE AND SCALABLE SOCIAL

CHANGE

We create financial structures and

implement programmes that bring stable and

sustainable funding to organisations dealing

with social issues

Change the way government seeks to

tackle problems

Help build and support growth of strong, effective social

enterprises

Expand the range of investors able to

participate in social investment

Social Finance works with government, social ventures and investors to unlock financial barriers and help drive social change.

WHAT DO WE DO?

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OUR WORK TO DATE WITH SHARED LIVES PLUS

Since late 2012, Social Finance has been working with Shared Lives Plus to support a national expansion of Shared Lives.

A proportion of this work was funded by the Cabinet Office Investment and Contract Readiness Fund.

The aim of the work has been to develop a business case for expanding Shared Lives, and an investment model to enable expansion to be delivered.

An interim summary of this work was published in the report, “Investing in Shared Lives”, highlighting the benefits of Shared Lives and a proposed model for its expansion.

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PRACTICAL APPLICATION: DEVELOPING A SOCIAL INVESTMENT MODEL

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Social investment approaches are built upon analysis of the underlying social problem:

1. What is the social need we are trying to meet?

Social investment already funds services addressing a range of social issues with new provision. These include:

• Reducing the number of adolescents entering the care system

• Supporting entrenched rough sleepers to achieve a stable lifestyle

• Helping young people at risk of being not in education, training and employment to gain qualifications and enter work

Social investment in practice

2. Are there interventions which meet this need?

3. Are there revenue streams that could support the intervention?

4. Would a new investing or contracting approach add value to service users, providers and

commissioners?

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THE SOCIAL NEED

The social care system needs to change radically if it is to meet funding challenges but also deliver better, more personalised care, built around individuals and their potential.

• This situation is particularly acute for adults with learning disabilities.

Evidence shows that community-based support enables greater independence, inclusion and choice, and that challenging behaviour lessens with the right support.

Which are the models that can support vulnerable adults, work with them to build their own capacity and unlock community resources?

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SHARED LIVES COULD BE A CENTRAL PART OF MEETING THIS CHALLENGE

Shared Lives is a form of care where individuals in a community share their family and community life with someone in need of care support.

• Arrangements are built around both the needs of individuals and their potential to develop life-skills and self-confidence in a supportive family environment.

• Users of Shared Lives are empowered to take greater control over more fulfilling lives as part of their community.

Current Shared Lives provision performs well on measures of quality, with twice as many Shared Lives schemes rated ‘Excellent’ than any other form of care1.

Today, Shared Lives arrangements represent just 2.2% of all adult residential and nursing care placements in England2.

Notes:1 – The Adult Social Care Market and The Quality of Services . Care Quality Commission (2010)2 – Adult Social Care Combined Activity Returns 2012-13. National Adult Social Care Information Centre (NASCIS)

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Average annual savings per client in Shared Lives arrangements (£k)1

THE FINANCIAL CASE FOR EXPANDING SHARED LIVES

Note: 1 – Based on a cost-benefit analysis carried out across three local authorities, comparing the local costs of Shared Lives arrangements with residential care and supported accommodation placements.

IN ADDITION TO PROVIDING HIGH-QUALITY CARE, A WELL-RUN SHARED LIVES SERVICE COULD GENERATE SAVINGS FOR LOCAL COMMISSIONERS.

In addition, our analysis has shown that Shared Lives can provide a cost-effective means of delivering high quality, person-centred care.

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5

10

15

20

25

30

Adults with learning disabilities Adults with mental health support needs

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ILLUSTRATIVE DATA ONLY

DETOUR – A SOCIAL INVESTMENT APPROACH: COLLATED SERVICE INVOICING DATA SET

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DETOUR – SOCIAL INVESTMENT APPROACH: SUMMARY OF CARE COSTS – ADULTS WITH MENTAL HEALTH SUPPORT NEEDS

Su

mm

ary

by s

erv

ice t

yp

e

(£)

0

500

1000

1500

2000

2500

Residential care

Nursing care

Supported Accommodation

Other

Service Type No of clients % of totalSpend/week

(£) % of total

Implied annual

cost (£)2Average per person

per week (£)3

All 582 100% 193,368 100% 10,082,229 332Cash Individual Budget Payments 20 3% 3,069 2% 160,005 146Day Care 5 1% 354 0% 18,440 64Home Care 113 19% 11,678 6% 608,899 96Korsakoff 32 5% 15,003 8% 782,280 469

Nursing Residential4 43 7% 27,079 14% 1,411,898 636

Residential4 138 24% 62,123 32% 3,239,106 462

Supported Accommodation5 226 39% 74,062 38% 3,861,601 328

ILLUSTRATIVE DATA ONLY

Illu

str

ati

ve s

pre

ad

of

ind

ivid

ual w

eekly

costs

(£

)

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A NUMBER OF BARRIERS STILL INHIBIT THE NATIONAL EXPANSION OF SHARED LIVES

A SOCIAL INVESTMENT MODEL SHOULD AIM TO OVERCOME THESE PROBLEMS IN SUCH A WAY SO AS TO BE ABLE TO RESPOND TO GROWING NATIONAL INTEREST IN THE SHARED LIVES MODEL

In working with many local authorities and Shared Lives services across the country, a set of common barriers have emerged:

Lack of up-front investment

Up-front investment is required in order

to fund the recruitment of new staff members and carers, training and

development

Local authorities have struggled to provide up-front

funding to invest in services before

savings are yielded

Lack of capacity and expertise

High-quality expansion can require model-

specific knowledge, such as how to best recruit and match carers with those requiring support

Few high quality independent

providers of Shared Lives services exist, limiting options for

local provision

Sustainable growth can be

challengingShared Lives

services require a strong

management team to enable continued

expansion – for instance in

recruiting high quality staff

Continued focus on performance is often lacking,

limiting the scope for development

Contracting models that limit

growth

Many services still operate within a block contracting

arrangement, which does not incentivise the creation of new

arrangements

Schemes, even when external of

local authorities, do not have financial

capabilities support innovative contracts

ISS

UE

BA

RR

IER

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THE ROLE OF THE SHARED LIVES INCUBATOR

Local authorities committed to expansion of Shared Lives

Mature Shared Lives schemes

Incubation pathway

• Advice to local authorities looking to expand Shared Lives provision

• Connection to network of incubated schemes to share learning

• On-going advice and support to schemes

• Investment in growth

Growing Shared Lives schemes

3-5 year incubation period

Schemes set up to thrive post-incubation

Enabling growth through work with

commissioners

THE INCUBATOR WILL BRING BOTH PRACTICAL EXPERTISE AND INVESTMENT IN LOCAL SERVICES TO GROW SHARED LIVES

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NEXT STEPS

We continue to work closely with multiple local authorities as they finalise their approach to expanding local schemes.

• Since launching the findings of our work, we have had interest from a number of local authorities looking to expand local provision, either through the spin-out of existing services or the development of new services.

• We have also had significant support from national stakeholders.

In order to respond to this momentum, and to have capital ready to support the first wave of scheme expansions, we are raising an initial £1m of social investment.

We have developed a pathway for local authorities to expand Shared Lives locally, and identify the most appropriate funding and contracting options.

• The first stage of this is a health-check on existing provision, the potential to expand services and a developing an outline pathway to expansion.

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THANK YOU