At the end of January, I was delighted to attend a Parliamentary reception in Holyrood, to celebrate Shared Lives in Scotland. Sponsored by Richard Lochhead MSP, the event brought together Shared Lives Shared Lives carers, service users, scheme staff and members of the Scottish Parliament to celebrate all that Shared Lives schemes in Scotland have achieved over the past year.
For me personally, it was a privilege to see the event being used to launch an independent report commissioned by Shared Lives Plus - funded by the Life Changes Trust - about the Shared Lives service that we have developed here in Moray, and the impact it has on older people and those living with dementia.
Shared Lives is a form of social care that has historically been used to support people with learning disabilities. In Shared Lives, an adult who needs care and support moves in with, or regularly visits, an approved and self-employed Shared Lives carer. Together they share family and community life. The outcomes can be startling, with people reporting feeling settled, valued and like they belong for the first time in their lives.
Shared Lives Moray offers support to vulnerable adults to remain in their own homes, or with family carers, for as long as possible. Our main focus has been providing day support to older people, the majority of them living with dementia.
Relationships are a key part of the service, and we prioritise matching the Shared Lives carers’ skills with the needs and interests of the people they support. As the report puts it: “At the heart of this service is the relationship between the person with dementia and the Shared Lives carer”. For family carers, too, this relationship is critical, and they report valuing the trust, responsiveness and continuity of care that Shared Lives provides.
Dementia is an isolating condition, and the person-centred nature of Shared Lives is crucial in supporting people living with dementia to remain engaged in their communities and connected to the interests they had before they developed dementia. Almost all the participants in the study described the stimulating nature of the service and spoke of rediscovering a sense of themselves that had been lost through their dementia. This was particularly evident in the case of one man, an artist, who had stopped sketching when he developed dementia, but had taken it up again after accessing the Shared lives service, and had even started teaching his Shared Lives carer.
Shared Lives is based on relationships where people can share real and ordinary, family and community life and experience highly successful outcomes. The combination of a stable home and community support improves health, wellbeing and strengthens social networks for a broad range of people in very different situations. It is such a flexible model that it is capable of supporting people with a wide range of support needs. Indeed, here in Moray, we are looking to develop our Shared Lives service, by extending provision for people with learning disabilities, and long-term live-in placements.
While the costs of Shared Lives day care appear broadly comparable to residential forms of care, the savings associated with long-term placements are significant. Independent research conducted in 2013 found that there were potential savings of £26,000 per person per year for someone with a learning disability in a long-term arrangement, and £8,000 per person per year for someone with mental ill health.
These figures are cash savings and do not capture the additional benefits that invariably come with a Shared Lives match. The report on the Moray Shared Lives service showed that these are many and various. It described how the service improves the self-esteem of people with dementia and increases their social interaction: it supports the wellbeing of family carers; it supports people to live at home for longer and delay accessing residential care; and it helps combat social isolation. As one family carer said: “Loneliness is a terrible thing. Shared Lives extends the natural way to connect”.
Shared Lives is one solution to the challenge of offering choice, quality and personal support at a time of falling resources and rising support need. The development and expansion of Shared Lives offers a way in which local authorities can support the personalisation agenda, offering high-quality care at reasonable cost. Shared Lives’ strength in providing bespoke local arrangements also makes it suitable to support small numbers of clients with multiple and complex needs – clients that other care settings struggle to accommodate in a cost-effective manner.
By its very nature as a personalised, community-based service, Shared Lives supports the Scottish Government’s nine national health and wellbeing outcomes: it enables people to live they life they choose as part of their local community; and allows them to shape the care and support they receive. It has a successful track record in delivering improved – and often transformative – outcomes for individuals and represents a highly cost-effective alternative to traditional forms of residential care.
Shared Lives is growing in Scotland, but its potential to grow further is great. And why wouldn’t it? After all, for local government, it is that valuable thing – a model that saves money, while improving people’s lives.
Jane Mackie is Head of Community Care at Moray Council.