Hampshire Shared Lives Scheme Policy and Procedure 44
Shared Lives Guidance
Recruitment and Assessment
of Shared Lives Carers
The Hampshire Shared Lives Scheme aims to provide good quality support and/or care to
people in Shared Lives arrangements. An important part of making this happen is making
sure that Shared Lives Carers have the skills, knowledge and abilities to support each
person effectively. The recruitment and assessment of Shared Lives Carers has therefore
been designed with this in mind. The service is committed to recruiting and assessing
Shared Lives Carers in ways that promote equality of opportunity and anti-discriminatory
practice.
How will this happen?
Shared Lives Carers are recruited through a process which includes:
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Attending a pre-assessment meeting
Completion of an application form
Proof of identity including a recent photograph
Checking whether the person has the right to work in the UK
Taking up at least 2 written personal references from people who have known them
at least 2 years
A reference from their last employer
If the person has worked in social care before, checking why they left their last job
Requesting confirmation that they are physically and mentally fit to carry out their role
Requesting confirmation that they have their landlord or mortgage lenders permission
to provide a Shared Lives arrangement at their address and/or is not in arrears with
their rent or mortgage
Checking whether they have a valid driving licence, where relevant
Carrying out an enhanced Disclosure and Barring service check and other required
safeguarding checks
Cross-references to the Health Care Professions Council or other professional
bodies where appropriate
A full assessment (see assessment form below)
Completion of the programme of induction training which is necessary before
placements are made
Recommendation for approval by the Shared Lives Panel
Prospective Shared Lives Carers are given a copy of the written guidelines for the
assessment and approval process and information about how to challenge a decision not
to approve them.
The assessment of Shared Lives Carers covers:
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Their personal backgrounds and life histories
Their home
Their family and community links
Their previous experiences and educational and working histories, including
explanation for any gaps in their working history
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Hampshire Shared Lives Scheme Policy and Procedure 44
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What kinds of care and/or support they are able to offer (including any specific
limitations to this)
Evidence of the knowledge and skills and abilities which will enable them to support a
person in a Shared Lives arrangement.
The assessment report will be discussed with prospective Shared Lives Carers and they
will have the opportunity to comment or add to it before it is presented to the Shared Lives
Panel. They will also be given a copy of the final report.
People who use the service are involved in the assessment and approval of Shared Lives
Carers through representation on the Shared Lives Panel and in any shadowing
opportunities that are offered to prospective Carers.
Shared Lives Carers will have the opportunity to continue to develop their knowledge and
skills through ongoing / post-approval training, through regular monitoring and support
visits from their Shared Lives Manager and through an annual review of their work which
will include an individual learning and development plan.
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Hampshire Shared Lives Scheme Policy and Procedure 44
Appendix 1
Shared Lives Carer Recruitment and Assessment Process
The Shared Lives Scheme’s selection process should transparent, with full regard for
equality and diversity. The process should ensure that Shared Lives Carers have the
competencies and qualities required to meet the Service User’s needs and to carry out the
tasks they are expected to do, and that they meet the standards of conduct and practice
and any qualification requirements set by the sector skills council for the country.
The selection process requires successful completion of the following:
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Pre-assessment home visit
Completion of a Carer application form
Satisfactory reference checks
Completion of a Hampshire County Council Adult Services’ induction training
programme
Completion of a programme of assessment
A recommendation for Approval from the Shared Lives Panel
Confirmation of Approval by the Scheme Manager
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Hampshire Shared Lives Scheme Policy and Procedure 44
Private and Confidential
Carer Application Form
1.
Applicant details
1st Applicant
2nd Applicant
First name
Surname
Known as
Former names
(if applicable)
Date of birth
Age
Current Address
Home telephone
Work telephone
Mobile number
E-mail address
How long at
current address
2.
Other members of your household
Name
3.
D of B
Age
Relationship to you
Work experience (paid and unpaid)
Applicant 1
Description of your work experience
Continue on a separate sheet if necessary
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Start and finish dates
Current occupation
Hampshire Shared Lives Scheme Policy and Procedure 44
1.
Applicant 2
Private and Confidential
Description of your work experience
Start and finish dates
Continue on a separate sheet if necessary
2.
What support would you like to provide
What Service User
group would you like
to support? Eg older
people, people with a
learning disability
What sort of support
would you like to
provide?
Eg long term, short term,
day support
3.
References
1st Applicant
2nd Applicant
1st Applicant
2nd Applicant
Medical reference
Please note the name, address and
telephone number of your GP
Employer’s reference
Personal references
Please give details of two people
who you have known for more than 2
years
State name and address and
telephone number. Also how long
they have known you and in what
capacity
Please note
Relatives or partners cannot act as
personal referees
4.
History
Have you ever applied to
become a Shared Lives
Carer in the past?
Have you ever been a
provider regulated by CQC,
CSSIW,RQIA or SCRC or
their predecessors
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Hampshire Shared Lives Scheme Policy and Procedure 44
5.
Tell us more about you
1st Applicant
2nd Applicant
What are your hobbies and
interests?
Why do you want to
become a Shared Lives
Carer?
What do you have to offer?
6.
Consent and agreements
Applicant 1
I declare that I have no criminal convictions or (delete as applicable) / I have criminal
convictions that I (even those that are deemed to be spent) am willing to discuss
I declare that I know of no conflict of interest that may affect my application as a Shared
Lives Carer or (delete as applicable) / I am aware of a potential conflict of interest that may
affect my application as a Shared Lives Carer that I am willing to discuss
I consent for detailed checks and references to be taken up to support my application to
become a Shared Lives Carer. I understand that these checks could involve information
about myself of a confidential medical and personal nature.
I consent for information about me to be kept by the Shared Lives Scheme both in paper
and on a computer database
I consent to information being passed by the Scheme to the regulatory body as required
I am eligible to work in the UK and my NI number is:
Signature of applicant
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Hampshire Shared Lives Scheme Policy and Procedure 44
Applicant 2
I declare that I have no criminal convictions or (delete as applicable) / I have criminal
convictions that I (even those that are deemed to be spent) am willing to discuss
I declare that I know of no conflict of interest that may affect my application as a Shared
Lives Carer or (delete as applicable) / I am aware of a potential conflict of interest that may
affect my application as a Shared Lives Carer that I am willing to discuss
I consent for detailed checks and references to be taken up to support my application to
become a Shared Lives Carer. I understand that these checks could involve information
about myself of a confidential medical and personal nature.
I consent for information about me to be kept by the Shared Lives Scheme both in paper
and on a computer database
I consent to information being passed by the Scheme to the regulatory body as required
I am eligible to work in the UK and my NI number is:
Signature of applicant
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Date
Hampshire Shared Lives Scheme Policy and Procedure 44
Private and Confidential
Equal Opportunities Monitoring Form
The Scheme wishes to better understand both the age and the increasing variety of
backgrounds of its Carers. We then will be able to plan how to meet any changing
demands for Shared Lives and how to best support our Shared Lives Carers and the
people they support.
We would ask each applicant to complete this form and return it with your application (in a
separate envelope if you wish). This information will be separated on receipt and held in
confidence and the Shared Lives Panel will not see it. There is no obligation to complete
this form and not doing so will have no effect upon your application.
The information we would like is:
Scheme you are applying to: ..................................................
Country: ....................................
Year of Birth ............................................................................
Gender .....................................
We would also be grateful if you could circle the relevant options below.
Are you registered disabled or consider yourself to have a disability
1st
Carer
2nd
Carer
1st
Carer
ETHNICITY
Yes
No
2nd
Carer
Asian or British Pakistani
Asian or British
Bangladeshi
Any Other Asian British
Background
Black or Black British
Caribbean
Black or Black British
African
Any Other Black
Background
1
1
White British
9
9
2
2
White Irish
10
10
3
3
11
11
4
4
12
12
5
5
13
13
6
6
14
14
7
7
15
15
Chinese
8
8
16
16
Any Other Ethnic Group
Any Other White
Background
Mixed White and Black
Caribbean
Mixed White and Black
African
Mixed White and Asian
Any Other Mixed
Background
Asian or British Indian
RELIGION
20
20
Christian
24
24
Buddhist
21
21
Hindu
25
25
Jewish
22
22
26
26
Sikh
23
23
Muslim
Any other religion
(please state)
SEXUALITY
30
30
Bisexual
33
33
Gay Man
31
31
Lesbian/Gay Woman
34
34
Heterosexual/Straight
32
32
Transgender
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Hampshire Shared Lives Scheme Policy and Procedure 44
Record of Pre-assessment Meeting
Name of Carers
Address
Assessor
Information given about
Shared Lives (Shared
Lives)
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The role of the
Scheme
Aims and objectives
The role of the Carer
Regulation
Policies and
procedures
People who use the
service
Information about the
selection process:
 Assessment
 Training and
learning
 Panel
Advice given eg
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Suitability
Household and
property
Skills and
experience
Regulation
Potential
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Date of visit
Hampshire Shared Lives Scheme Policy and Procedure 44
The accommodation
(if applicable):
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Regulations
Limitations
Potential matching
issues
Questions or concerns
Agreeing the way forward
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Hampshire Shared Lives Scheme Policy and Procedure 44
Assessment Process
(including checks and references)
Summary
1. Introduction
Name of Carer/s
Name of assessor/s
Date application made
Date report completed
Details of any delays or
difficulties in the
assessment process
2. Meetings and interviews with applicants
Date
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Location of meeting
Topics Covered
Hampshire Shared Lives Scheme Policy and Procedure 44
3. Meetings and interviews with other household members
Date
Meeting with
Relationship to Carers
4. Meetings and interviews with other people, eg friends, family, referees
Date
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Meeting with
Relationship to Carers
Hampshire Shared Lives Scheme Policy and Procedure 44
5. Training or learning done by Carers as part of assessment
Date
Name
Method and subject of learning
6. Voluntary work or other experience gained by Carers as part of assessment
Date
Name
Experience gained
7. Meetings attended by Carers as part of assessment
Date
Name
Meeting attended
8. Written information given to Carers as part of assessment
Date
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Written information given
Hampshire Shared Lives Scheme Policy and Procedure 44
9.
Record of checks and references
9.1 Identity
1st Applicant
2nd Applicant
Name
Date Seen
Date Seen
Birth certificate
Passport or other
photographic evidence of
identity
Marriage certificate
(to be seen only where the
name has changed as a
result)
Evidence of divorce
(decree absolute)
9.2
Checks
Protection of vulnerable
adults check (if not part of
Criminal Record Check
Criminal Record check
Check employment history
to account for all gaps and
address all issues
Comments (if any)
9.3 References
First personal reference
Name of referee
Address
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1st Applicant
2nd Applicant
Hampshire Shared Lives Scheme Policy and Procedure 44
Reference/s attached
Assessment pack
number…………..
Assessment pack
number…………..
1st Applicant
2nd Applicant
Assessment pack
number…………..
Assessment pack
number…………..
1st Applicant
2nd Applicant
Comments
Second personal
reference
Name of referee
Address
Reference/s attached
Comments
Medical reference
Name of referee
Address
Date reference seen
Comments
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Current employer
reference(if applicable)
Name of referee
Address
1st Applicant
2nd Applicant
Assessment pack
number…………..
Assessment pack
number…………..
Date Reference/s seen
Comments
Past employer reference(if 1st Applicant
applicable)
Name of referee
Address
Date Reference/s seen
Comments
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2nd Applicant
Hampshire Shared Lives Scheme Policy and Procedure 44
10. Accommodation
Date
Comments
Date seen
Comments
Health and safety checklist
completed
Confirmation that Mortgage
lender or landlord in
agreement
Adequate buildings
insurance cover
Comments
11. Transport
Vehicle registration number
Current road tax
Current insurance cover
Current MOT
Driving license/s
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12. Summary of checks and references
Supporting information attached as part of the assessment
pack
Assessment report
Personal reference 1 for 1st applicant
Personal reference 1 for 2nd applicant
Personal reference 2 for 1st applicant
Personal reference 2 for 2nd applicant
Current employer reference 1st applicant
Current employer reference 2nd applicant
Past employer reference 1st applicant
Past employer reference 2nd applicant
Completed checks and references record
Completed health and safety checklist
Community connections map
Personal profile done by 1st applicant
Personal profile done by 2nd applicant
Day in the life of’ written outline
June 2014
Tick if
attached as
part of this
assessment
Attachment
number in
assessment
pack
Hampshire Shared Lives Scheme Policy and Procedure 44
Private and confidential
Carer Assessment Form
1.
Shared Lives Scheme
Name of assessor
Scheme/Line Manager
Address
Phone number
E-mail
2.
Carer Details
1st Applicant
Name
Gender
Previous names
Known as
Date of birth
Address
Previous address if
less than 5 years at
current
Phone number
E-mail
Partnership/Marital
status
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Hampshire Shared Lives Scheme Policy and Procedure 44
Length of current
partnership
Language/s spoken
at home
Nationality/Ethnic
background
3.
Carer Employment
1st Applicant
Current occupation
Current employer
Hours worked
Proposed Hours
Once approved as
Shared Lives Carer
Dates and details of
last employment
(please include
explanation for leaving
jobs and any gaps in
employment)
4.
Approval sought
Age of Service User/s
Gender Service Users
Service User group
Number of Service
Users
Types of services
offered
Specific needs Carer
able to support
Specific needs Carer
unable to support
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Hampshire Shared Lives Scheme Policy and Procedure 44
5.
Other members of the household
Name
Gender
Date of birth
Relationship to
Carer
Occupation status
Understanding of
Shared Lives and
implications to the
household
Willingness and
ability to support
Carer/s
6.
Accommodation and locality
Type of property
eg bungalow, flat
Description of
property
eg number rooms,
layout, storeys
Does the property
meet standards and
regulations?
Accessibility
Garden or outside
space
Proposed sleeping
arrangements
Bathrooms and
toilets
Details of locality
Describe the area
Health and safety
checklist completed
7.
Community and relationships
Amenities and
facilities available
locally
Community Groups
operating locally
Carer contacts and
community networks
– network map
completed
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Friends and family
contacts of the Carer
who wish to support
the placement
Stability of the
relationships
between the Carers
(if applicable)
Please detail
evidence
Relationship
between household
members
Please detail
evidence
Family lifestyles –
Day in the Life of
completed
8.
Transport
Able to drive?
Access to vehicle
Age and type of
vehicle
Public transport
facilities available
locally
9.
People who can support the Carer (family friends and others identified who
may be able to support the Shared Lives Carer)
1. Name of
supporter and
relationship
What support they
could offer?
Require formal
approval as Support
Carer?
2. Name of
supporter and
relationship
What support they
could offer?
Require formal
approval as Support
Carer?
3. Name of
Supporter and
relationship
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Hampshire Shared Lives Scheme Policy and Procedure 44
What support could
they offer?
Require formal
approval as Support
Carer?
4. Name of
Supporter and
relationship
What support could
they offer?
Require formal
approval as Support
Carer?
5. Name of
Supporter and
relationship
What support could
they offer?
Require formal
approval as Support
Carer?
6. Name of
Supporter and
relationship
What support could
they offer?
Require formal
approval as Support
Carer?
10
Knowledge and skills
10.1 Where and how Carers live
Balance the needs and lifestyles of all people in the household
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
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Provide a healthy and safe place to stay
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
10.2 Personal skills
Communicate effectively
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
Build positive relationships with other people
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
Support people to manage their finances
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
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Support people to access education, employment and leisure facilities
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
10.3 Values
Understand and challenge prejudice, discrimination and oppression
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
Understand and respect confidentiality and privacy
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
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10.4 Working with Shared Lives
Keep clear and accurate records
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
Understand Shared Lives including roles and responsibilities of Carers and
Schemes
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
Understand policies, procedures and legal requirements and work positively with
Shared Lives Scheme to put these into practice
Assessor’s view of Carer’s knowledge and Evidence the Manager has to support this
skills in this area
view
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11. Assessor’s summary and recommendations
Summary of applicant/s
family circumstances
Summary of Carer’s
strengths including
knowledge, skills,
experience and
emotional resilience to
work as a Carer
Any other issues
Summary of learning
and development needs
Summary of matching
considerations
Recommendation of
assessor
12. Comments from applicants
1st Applicant
Comments from applicants
on this assessment
Signatures to agree content
of assessment
Date
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2nd Applicant
Hampshire Shared Lives Scheme Policy and Procedure 44
13.
Comments and recommendation from Panel
1st Applicant
Comments and/or
recommendation from
Panel
Signature (Panel Chair)
Date
14. Manager’s Decision
Comments and
decision of Manager
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Hampshire Shared Lives Scheme Policy and Procedure 44
Private and confidential
A Day in the Life of Sheet
Please outline below details of an average or typical day in the life of your household.
Make this as informal or formal as you like. Let us know what happened in that day,
people you saw, places you went, things you did and problems you solved.
This exercise is designed to give a picture to the Shared Lives Manager and independent
Panel of the sort of people you are and how you live your life. This is important if you are
to share your life and/or household with a disabled or vulnerable person as a Shared Lives
Carer.
Use as little or as much of the space as you like and feel free to write it by hand or type it,
whichever suits you best.
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Hampshire Shared Lives Scheme Policy and Procedure 44
Private and confidential
Personal profile
Please outline below a profile of you as a person. Think about your strengths and
weaknesses, your likes and dislikes, your dreams and fears and what motivates you. If
you find it difficult to write about yourself, maybe outline how you think your friends and
family would describe you.
This exercise is designed to give a picture to the Shared Lives Manager and independent
Panel of the sort of person you are and what makes you tick. This is important if you are
to share your life and/or household with a disabled or vulnerable person as a Shared Lives
Carer.
Use as little or as much of the space as you like and feel free to write it by hand or type it,
whichever suits you best
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Hampshire Shared Lives Scheme Policy and Procedure 44
Private and confidential
Carer Community and Network Map
Work
Neighbourhood
and community
Carer/s name
Family
June 2014
Leisure and education