Lessons from personalisation
Alex Fox, CEO
Shared Lives Plus
www.SharedLivesPlus.org.uk
http://alexfoxblog.wordpress.com
Karl and Clare with carers Blossom and Mike, at
their wedding, before moving to live independently
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Who are we?
Shared Lives Plus is the UK network for family-based and
small-scale ways of supporting adults. Our members are
Shared Lives carers and workers, Homeshare programmes
and micro-enterprises.
Shared Lives is UK wide and used by 15,000 people. The
micro-enterprise sector is much less well established.
Shared Lives Plus was established in 1992 and has 4,500
members UK-wide.
Community Catalysts: our sister Community Interest Company,
helping councils create micro-enterprise friendly areas.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Pre-Community Care reform
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.)
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
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
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Putting People First 2007
Four equal quadrants:
1. a universal offer of advice and information to help people
make informed choices;
2. a focus on developing inclusive and supportive
communities (‘social capital’);
3. a focus on investing in prevention;
4. introducing choice and control through the introduction of
personal budgets.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Putting People First 2007
Of the four quadrants, only number four - personal budgets became truly embedded:
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340,000 personal budget holders;
£1.57bn in personal budgets;
up 100% on 2010.
25% (44% of the cash value) are Direct Payments
(ADASS 2011).
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Supply as well as demand
What of the intended culture change: individuals in control of
their services and their lives, living in and contributing to their
chosen relationships, families and communities?
• Only partially facilitated by the mechanism change of
personal budgets and Direct Payments.
• For some people, life has been transformed out of all
recognition, often via PAs (new market of provision).
• But for some, the changes represent more hassle, risk and
red tape, without real increase in choice (no new providers).
• We need an increasing focus on relationships, community
participation, volunteering, employment.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Huge successes
• Near eradication of long term, institutional care for disabled
people (but older people’s residential care market growing);
• Principles of choice, control and independence for all service
users firmly embedded in sector’s values;
• The rise of user-led or user-owned organisations
• People involved in decision-making at every level;
• Increasing satisfaction of the majority of users and families;
• Some examples of a more plural and creative market;
• Some community development & asset-based approaches;
• little evidence of increasing fraud or inappropriate spending.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Huge challenges
• Misunderstandings of values and aims of personalisation
• perverse implementations of the new mechanisms and
everyone focused upon the money;
• variable uptake of personal budgets and Direct Payments
• Destabilising the provider market can lead to reduced
provider diversity, loss of small/ niche providers;
• Increased pressure upon unpaid family carers leading to
poor health and unemployment;
• Low employment rates remain largely untouched;
• Increasing isolation for some people living ‘independently’
(alone); and (rare) instances of hate crime.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Ways forward: market diversity
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Focus on supply as well as demand – market build
E.g. develop and ‘scale out’ micro-enterprises
Local people working with/ for other local people
May be led/ owned by service users/ families.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Ways forward:
citizen ownership & leadership
• 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
o CHANGE’s job-share model, working with parents with learning
disabilities.
o Co-op and mutually owned models of service delivery.
• Service user, family and citizen led commissioning.
o Stamford Forum/ Leeds Council neighbourhood network model.
o Local Area Coordination (LAC) and other Asset Based Community
Development (ABCD) approaches.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Ways forward:
family and community
• The ‘unfinished revolution’ (CSJ): communities involved, not
just ‘community-based’ traditional services.
• Professionals need to share power and share the risks.
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.
• Partnership with families: training, breaks, information
sharing (with permission), family group conferencing.
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk
Contact details
Alex Fox, CEO, Shared Lives Plus,
alex@SharedLivesPlus.org.uk
www.SharedLivesPlus.org.uk;
07738641897
http://alexfoxblog.wordpress.com
Twitter: @alexatnaaps
www.Shared Lives Plus.org.uk
www.communitycatalysts.co.uk