Outsourcing Shared Lives Commissioners Guide

Contents What is Shared Lives? ...................................................................................................................... 1 Overview of this guide....................................................................................................................... 2 Understanding the current and potential outcomes of Shared Lives ................................................ 3 What are the pros and cons of outsourcing? .................................................................................... 5 Current and potential unit costs ........................................................................................................ 7 Who to involve in decisions ............................................................................................................... 9 Shared Lives is not a service: its a way for people to live their lives. Alison and Mark run a pub in a seaside town. Neil, who has a learning disability, spent a lot of time drinking in pubs around the town, and gradually spent more and more time at Alisons pub. Alison and Neil were concerned about his drinking, his behaviour and increasingly, his safety. He even began sleeping rough on their doorstep. Alison and Mark approached the council and were told about Shared Lives. They put themselves through the recruitment, training and approval procedures and became registered Shared Lives carers. For the first time, Neil now looks people in the eye. He takes care of his appearance and has control over his drinking; people say they can now understand his speech. He has achieved longheld ambitions like going to Wembley. Neil says Now I know what I wanted: what I wanted was a family. Alison says His behaviour has changed completely. He brings a whole new dimension to our lives, we get as much pleasure as he does in our family. We are even thinking of getting out of the pub trade to become full time carers. You can find more stories from Shared Lives at: www.sharedlivesplus.org.uk and www.communitycatalysts.co.uk The Guardian: http://bit.ly/fhHV3L The Sunday Telegraph: http://bit.ly/dvYdkZ Community Care magazine: http://bit.ly/9I50Ki The Social Care Institute for Excellence (video): http://bit.ly/gpUJkM Our blog: http://alexfoxblog.wordpress.com

What is Shared Lives?

Shared Lives is where an individual or family is paid a modest amount to include an older or disabled person in their family and community life. In many cases that person goes to live with a Shared Lives carer and their family, although Shared Lives is also used to support people living in their own homes, as day support, as respite care for unpaid family carers, as home from hospital care and as a stepping stone for someone to get their own place. There are around 10,000 SL carers in the UK, of which 3,800 are Shared Lives Plus members (www.sharedlivesplus.org.uk). Shared Lives carers are recruited, trained and approved by a Shared Lives scheme, which is regulated by that nations care regulator. Shared Lives is unique in regulated adult support, in that Shared Lives carers and those they care for are matched for compatibility and then develop real relationships, with the carer acting as extended family, so that someone can live at the heart of their community but in a supportive family setting.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 1 Registered charity: 1095562. Registered company: 4511426

The Care Quality Commission (CQC), the governments social care inspectors for England, gave 38% of Shared Lives schemes the top rating of excellent (three star). This is nearly double the percentages for other forms of care. 83% of all forms of support were rated good or excellent, whereas 95% of Shared Lives schemes were good or excellent. Uniquely, no Shared Lives scheme has been rated as poor for the last two years. The inspection regimes in the other nations dont allow for explicit comparisons of this kind, but rate Shared Lives strongly. Shared Lives Plus, with Improvement and Efficiency South East, has produced a business case which demonstrates the savings created by using Shared Lives rather than other forms of support, available on www.naaps.co.uk/en/publications/surveys-and-research. Depending upon the complexity of an individuals needs, Shared Lives schemes can deliver savings of between 35 and 640 a week per person in comparison to traditional services. The average saving for someone with a learning disability in residential care for example is 60%. 10 new long term arrangements generate pa savings of between 23,400 (older people) and 517,400 (learning disabilities). To develop a Shared Lives scheme to support 85 people requires investment of 620,000 over five years but generates savings of almost 13 million. The larger the scheme, the greater the efficiencies. Shared Lives Plus is the UK network of very small, family and community based care and support solutions for older and disabled people: it is all about ordinary people and families contributing to the care and support of local people, sometimes in extraordinary ways. As well as 4,000 Shared Lives carers and schemes, our membership includes Homeshare and micro-enterprise. Shared Lives Plus has established a social enterprise, Community Catalysts, which is bringing their values and messages to new audiences and taking forward its aim to enable people wherever they live to have real choice of high quality local individualised support. Community Catalysts works across the UK through local partners to support local enterprise. A major focus of its work currently is with local authorities and health trusts keen to create an environment within which micro entrepreneurs can flourish but its skills and knowledge are also being used by a range of other organisations including regional and national providers interested in unlocking the potential of staff teams and of the people that they support and Shared Lives Schemes exploring expansion and development opportunities. Community Catalysts offers a consultancy service for organisations which are looking for in-depth advice and help: www.communitycatalysts.co.uk

Overview of this guide

Shared Lives has been recognised by governments across the UK as crucial to the future of personalised care and support systems. Most Shared Lives schemes are delivered in-house by councils and many will continue to be. Outsourcing, however, is becoming more common, particularly in England, where the proposed right to challenge would make it much harder for councils to keep services in-house, if a voluntary organisation expressed an interest in running that service. In addition, the new right to provide requires local authorities to respond positively to requests from staff members to take services outside the authority. English councils are expected to increase personal budget uptake with most people to be enabled to take their personal budgets as a Direct Payment, which cannot be spent on an in-house council service (unlike in Scotland, where it can). The policy direction for Wales and Scotland is less explicit on these issues but in all nations, outsourcing can be seen as a way of introducing new providers and competition into previously closed markets. Some schemes have in the past driven the move to independence themselves, seeing it as a positive opportunity.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 2 Registered charity: 1095562. Registered company: 4511426

This guidance does not intend to encourage outsourcing, nor discourage it. Shared Lives Plus is neutral on that issue: we see examples of strong Shared Lives schemes delivered by councils and by independent schemes and there is evidence of significant investment in both kinds of scheme in some areas, as local authorities are becoming more aware of the savings and improved outcomes which high quality Shared Lives can deliver. So we see this time of change as one of opportunity for Shared Lives services to reach many more groups and communities with their unique brand of personalised, family and community based care and support. But Shared Lives is distinct from other forms of care and support. Without those differences and values being understood, there is a real risk that the gains in outcomes and reductions in costs being achieved by good in-house Shared Lives schemes will be lost. Some key differences between Shared Lives and other services are: A service is not Shared Lives unless the appropriate processes are in place, managed by a regulated Shared Lives scheme. Shared Lives carers are self-employed, not employees of the council. They are free, in theory, to contract with any registered Shared Lives scheme they wish. An effective Shared Lives service is a partnership between the Shared Lives carers and their scheme. The quality of the support delivered by the scheme and of the relationship between the scheme workers and carers is crucial to the quality of the Shared Lives service. Shared Lives carers dont clock on and off. They typically provide much more than they can be said to have been paid for. They expect to feel valued and they need regular breaks. Shared Lives carers and service users are matched for compatibility. Successful matches pay huge dividends: they may be lifelong supportive relationships. But matching involves an up-front investment of time. Shared Lives carers have family homes, not vacant beds to be filled.

Shared Lives is regulated as home care, not residential care and funded through council funds and also benefits, including Housing Benefit. This makes it highly competitive in comparison to residential care and enables it to be offered to groups with lower personal budget allocations. This guide suggests ways in which commissioners can improve decisions on outsourcing, in particular through genuinely involving Shared Lives workers, carers, service users and their families at every stage in decision making.

Understanding the current and potential outcomes of Shared Lives

If a council is to achieve good value for money from potential providers of its Shared Lives scheme, it will first need to understand the cost-benefit of the existing scheme. This will involve understanding the schemes: Costs: including hidden costs. Outputs: eg how many people receiving which kinds of support. Quality: systems for planning, gathering evidence, acting on feedback, safeguarding etc. Outcomes: evidence of the differences made to peoples lives. Capacity: current and potential.

There are a number of questions to ask about a schemes capacity: Is the scheme at or exceeding capacity? Is the service well used by all potential service user groups? Could shared lives carers vacancies be used more effectively?

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 3 Registered charity: 1095562. Registered company: 4511426

Would investment in additional capacity allow the scheme to become more productive?

Shared Lives Plus is aware of a number of in-house schemes who are being asked to support well over the optimum number of Shared Lives arrangements. This has two negative impacts. Firstly, the quality of placements can deteriorate because of inadequacies in setting up and monitoring matches. Secondly, the scheme has no capacity to improve productivity through more efficient working, or to innovate and develop new services. Good schemes achieve positive outcomes in areas such as: Mental and physical health Involvement in employment/ training Ability to self-care/ independent living skills Number, quality, strength of unpaid relationships Self-determination/ efficacy - ability to make and act on choices Contribution to family and community life Resilience, ability to cope with crises/ change

In-house Shared Lives schemes have not always been asked to gather evidence of outcomes or even outputs data routinely, so commissioners may need to work with the existing scheme to gather evidence of outputs and outcomes before decisions are taken about development possibilities and outsourcing options. Even schemes who lack formal or academic evidence of outcomes, should be able to gather evidence from a number of sources: the schemes inspection results and safeguarding record; quotes from service users and their families; feedback from referrers; notes taken during placement reviews or needs assessments; feedback collated from annual satisfaction surveys of users, carers, referrers; case studies which give examples of positive outcomes; formal surveys of the outcomes above: eg the number of unpaid relationships an individual has at referral and six or 12 months later.

Some schemes reach a wide range of communities and service user groups; others have had a narrower focus. It would be useful to understand the current and potential scope of Shared Lives in your area. Around the UK, there are examples of Shared Lives services delivering outstanding outcomes for: people with learning disabilities; older people with dementia; people with mental health problems and people with substance misuse problems; disabled children in transition to adulthood and care leavers; parents with learning disabilities; day care and breaks as well as long-term arrangements; the provision of intermediate care (re-ablement) to improve hospital discharge; arrangements aimed at developing peoples independent living skills which demonstrably lead on to more independent living arrangements.

Shared Lives services can be highly effective in delivering low cost high quality solutions in areas where there is unmet need and specialised requirements. For instance, Shared Lives schemes providing day support in rural areas can reduce the need for transport to central day facilities, as well as delivering personalised outcomes for the individuals involved. Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 4 Registered charity: 1095562. Registered company: 4511426

What are the pros and cons of outsourcing?

Outsourcing, like any model of provision, can be done well or badly. There are a number of high quality, well-funded independent Shared Lives schemes in the network of Shared Lives Plus members who were previously in-house (council-run) and where both scheme and local authority consider the move to have been an extremely positive one. There are also examples where a poor outsourcing process seems to have resulted in a reduction in the quality and effectiveness of the Shared Lives service. Selecting a provider through a competitive tendering process presents challenges if Shared Lives carers do not buy into the process, because they are self-employed people and can work with the scheme of their choice (see above).

Spin outs or tendering?

There have been some very successful transfers (spin outs) of in-house council schemes into new independent organisations. Some of the most effective of the current independent schemes used this model and their strength has allowed them to generate significant efficiencies for their local authority customers. This is an option which should be discussed with staff, particularly in England if the new rights to challenge come into place with the enactment of the Localism Bill. The development of a new independent Shared Lives scheme goes through distinct phases: setting up and / or transfer; early development, probably still with close local authority support; growth; full independence as the scheme stand on its own feet and contracts are renegotiated.

There are many unpredictable variables, particularly in the early stages if the scheme is new or starting from a small scale base. A small independent scheme may not become cost-effective and may be very vulnerable to fluctuations or challenges until it has grown. Shared Lives Plus and our social enterprise Community Catalysts offer in-depth advice and support to councils considering the spin out route, drawing on our experience not only of outsourcing Shared Lives but also of supporting micro-enterprises, which are often set up by former employees of councils. Whatever the form of outsourcing, it will be crucial to arrive at the best form of contracting or combination of contracts. Will support be commissioned as a block contract, spot contract, or framework contract, or will funding be entirely personal budget based. Different approaches will have implications for the choice and control of service users, but also for the risks taken by the scheme, and therefore for the successful delivery of Shared Lives in the area. How will those risks be shared between the scheme and the commissioning body? The council might wish to put safeguards against problems occurring in place, particularly in the early stages.

The opportunities and risks of outsourcing

When outsourcing is managed well it can achieve these outcomes: The ability to attract non-statutory funding (particularly if outsourced to a charity or CIC). The involvement of Shared Lives carers, people who use the service and families in governance, leading to improvements in carer recruitment and retention. A new flexibility to respond to need and develop services for new service user groups and communities.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 5 Registered charity: 1095562. Registered company: 4511426

Contracts can involve a clearer definition of outputs and outcomes and careful monitoring of delivery against targets.

None of these advantages are a given: they will require a well-planned organisation with strong management and governance. There are also risks which should be considered. Authorities planning a staff spin out will need to consider the skills of the current team and those required in the new organisation: entrepreneurial and marketing skills; influencing and lobbying skills; strong business and financial management skills; a good understanding of governance responsibilities.

Additional risks to be considered include: The schemes new freedom could lead to mission drift. Many external providers are used to providing services with a very different culture and value base and may struggle to adapt to the expectations of Shared Lives. If Shared Lives carers have not been effectively engaged in the process, they may reject the new organisation and move to another scheme or leave caring altogether.

The risks above point to a need for the commissioner to have a good understanding of the strengths and flexibilities of Shared Lives and of the factors which are important to an effective Shared Lives service. There is also clearly a requirement for an established, formal role for Shared Lives carers, service users, families and other stakeholders to play in the outsourcing process and in developing the new provider. In-house service managers sometimes express fears about the impact on quality of any outsourcing decision. It is Shared Lives Plus view that quality is not guaranteed by any particular model of delivery, and that there are example of high quality services in both the council-run and independent sector and both are subject to the same inspection regime. It is useful to consider: What is currently in place in terms of Quality Assurance (QA)? What evidence do you have of the impact of this? What QA system will the new provider be expected use?

In addition to inspection and other quality measures, many small and medium not for profits use PQASSO or a similar QA tool to monitor and improve the quality of their structures, functions, finances and governance. The regulation and inspection regime for Shared Lives, of course, remains the same for all models of provision.

After a contract has been awarded

Whatever the chosen form of outsourcing, commissioners should be aware that the process may take months or years from a contract being issued until the new scheme is fully independent. This will require boundaries and expectations to be continually reviewed: simply issuing a contract and seeing the scheme as no longer the councils responsibility is likely to result in the early failure of the new scheme. So it is important to establish the ongoing relationship between the scheme and the lead commissioner, with regular meetings about issues and clear boundaries about responsibilities. Eg what will be the councils responsibility for the well-being of service users using the new scheme?

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 6 Registered charity: 1095562. Registered company: 4511426

Current and potential unit costs

Alan is a 22-year-old young man in South Tyneside with a diagnosis of Aspergers Syndrome. Following a breakdown within his family home and then in a residential placement, his behaviour deteriorated and he began to drink to excess despite the best efforts of a number of expensive out of area placements. The Care Management team approached South Tyneside Shared Lives scheme. Alan told them, I hate it here and want to get out. Some health professionals felt that Alans support needs could not be met in a family home, but potential Shared Lives carers were identified and the matching process commenced. This involved a number of social get-togethers leading to an overnight try out stay, weekend stays, then a week-long stay, until both Alan and the Shared Lives carers felt the match could be positive. Alan has now been supported within the scheme for three months without any incidents. He has stated that he is very happy and wants to stay with his carers for the rest of his life. He has begun accessing community education classes and leisure centres and is also contemplating a work experience placement. The cost saving to the Local Authority by providing support within the Shared Lives Scheme rather than the Residential Care Home is a staggering 49,000 per annum (965 per week). There are three elements to the unit cost of Shared Lives: 1. 2. 3. the payment to the Shared Lives carer. the full cost of the time team member(s) spend supporting that carer to deliver support. the schemes overheads.

Note that the gross cost of the service is the total payment to the Shared Lives carer, plus the costs of running the scheme. The net cost to the local authority, will be the gross cost less the contribution the service user makes through Fairer Charging for their personal care, and also less any additional payments they make to the Shared Lives carer for rent, food, heating, lighting. Shared Lives will not necessarily meet all an individuals support requirements. For instance, where Shared Lives is meeting an individuals long term support and accommodation needs through providing stable family life, that individual should nevertheless have the opportunity to take part in activities outside of their home during the day. A scheme may have several different units of support, such as a week of support and accommodation, a day of day care, or a 48 hour break. The costs of those units might also differ according to the persons level of support need. Some schemes have a clear, banded system of costs, with, for instance Band A being high need, Band B, medium need and Band C, low need It is likely that an independent scheme would need a system of this kind, so it may be worthwhile moving to that system ahead of any outsourcing decision. Shared Lives Plus have produced a guide to carer payment models for members. Schemes should be able to estimate how many staff members were needed to deliver each kind of support and commissioners should discuss with managers whether that ratio was efficient, realistic and sustainable. Shared Lives Plus have produced guidance on calculating optimum staff workloads. The payment to the Shared Lives carer is made up of several elements: The users contribution to rent, food, heating and lighting, paid for from the persons own money and/ or their benefits including Housing Benefit.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 7 Registered charity: 1095562. Registered company: 4511426

The social care-funded element, paid by the council to the carer, or paid to the individual as a personal budget, which they then pay to the carer via the Shared Lives scheme. Under Fairer Charging rules, the service users ability to contribute to this will be assessed and they may be charged for part or all of this cost. Anything else the scheme pays to the carer, to cover: o any training or supervision they are paid to attend; o travel expenses o covering when they are sick; o their respite; o their insurance; o CRB checks; o their Shared Lives Plus membership.

Local arrangements as to what the Scheme covers from the list above and what the carer pays for themselves will vary. Within an area, the cost of individual carers will also vary. For instance, some may attend more training or use more sickness cover. Some carers and support arrangements need more support than others (see Shared Lives Plus Support Profiling Tool and Workload Analysis tool). Full costs of staff members may have the potential to change if there was a move from in-house to outsourcing, as councils have very different infrastructure costs to not for profits. Any potential bidder will need to work out its costs on a full cost recovery basis. This could include estimating marketing costs, finance teams time, payroll, proportion of a senior manager, CQC registration, public liability insurance. Remember that all of these figures will necessarily be estimates and averages, with a considerable margin of error, so overly detailed calculations of current and potential unit costs are likely to be misleading and counter-productive.

Comparing unit costs

The Shared Lives Plus Business Case for Shared Lives gives good evidence that Shared Lives tends to have a lower unit cost than other forms of support: 10 new long term arrangements generate pa savings of between 23,400 (older people) and 517,400 (learning disabilities). A new scheme for 85 people costs 620k over 5 years, generates savings of nearly 13m.

The full range of savings by service type on page 16: www.sharedlivesplus.org.uk/en/publications/surveys-and-research. However, the actual costs in your area will differ from the costs in the Business Case, which was based on care costs in the South East of England at a particular moment in time. Laing and Buisson estimated that the average residential care home fee was 482 per week in England in 2009 (684 for nursing homes). For support to review your high cost placements and to consider lower-cost family and communitybased alternatives, contact Community Catalysts: 01423 790126, www.communitycatalysts.co.uk.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 8 Registered charity: 1095562. Registered company: 4511426

Who to involve in decisions

People who use services and their families
Councils who are considering outsourcing, should have regard to the rights of people using Shared Lives services and their families to be involved in decisions about their lives. People in long term Shared Lives arrangements are often regarded as settled and can lack ongoing access to advocacy, so it may be necessary to work with a local advocacy organisation to get a clear sense of service users and families views on Shared Lives provision now and for the future. Decisions which affect the ability of people who use Shared Lives to continue to live in what they have come to regard as their family home are open to challenge under Human Rights legislation. As social care provision moves towards personal budget approaches, there is more than ever a need to build a strong, clear relationship between Shared Lives carer, scheme worker, care manager and service user (and their advocates). People who use Shared Lives and their families should be supported to form an independent consultative group, or have a strong presence within other local advocacy groups.

Shared Lives carers

Shared Lives is a partnership between the Shared Lives carers and their scheme and heavily dependent upon the quality of the relationship between the scheme and carers. Councils that decide to transfer the Shared Lives service to a new scheme, or made drastic changes to the existing scheme, should take account of the impact of these decisions on Shared Lives carers. Carers are self employed and in the past, where these changes have been badly handled, have not always decided to continue their involvement in the service. This is a huge loss of value to the area and very disruptive for service users living, breaks or day care arrangements. During a recent outsourcing process, senior managers involved a parent of a service user in interviews with tendering organisations, but did not feel that Shared Lives carers should be involved, as they felt this was a conflict of interest. There is no basis for this objection. In another area, Shared Lives carers were not involved in an outsourcing decision, with the result that a number became disaffected and left Shared Lives. Shared Lives Plus recommends that Shared Lives services support Shared Lives carers to form an independent group. The independence and strength of this group will become particularly important for Schemes undergoing or considering major changes, as it will provide the vehicle through which Shared Lives carers to can become involved in the decision making on outsourcing. Full and open involvement at every stage will help to ensure that outsourcing is a positive process and leads to the least possible disruption in the Shared Lives service. In one London Borough, the well-established Shared Lives carers group insisted on a meeting with the Director of Adult Services. They raised concerns about the outsourcing process and it was agreed that two representatives could represent carers views at tendering meetings and during the decision-making process. The Shared Lives carers felt able to ensure that standards of support which were essential to the sustainability and quality of their work would be maintained, with bidding organisations assessed on the relevant aspects of their bids. The scheme was put out to tender and two representatives still meet on the quarterly contract monitoring meetings with the council and the charity who won the contract. This involvement was made possible because the Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 9 Registered charity: 1095562. Registered company: 4511426

Shared Lives carer group, which held regular support groups and Quality Days, was wellestablished and assertive. In one local authority run scheme in Wales, Shared Lives carers have been supported to elect representatives to a group which liaises with the scheme and council decision makers. Shared Lives Plus Shared Lives carer members have highlighted the elements of a successful scheme: Systems to ensure full information about service users needs is given to prospective Shared Lives carers, including any needs which could have safeguarding implications. Terms and conditions which reflect the value placed upon Shared Lives carers and on which Shared Lives carers have been consulted. Clear transparent information about how Shared Lives carer fees are calculated for different kinds of support and people with different levels of need. Simple, proportionate recording systems which avoid unnecessary intrusion into family life. Staff who understand the particular insurance requirements of Shared Lives carers. Staff providing carers with the right information, including information about Shared Lives Plus. Support for an independent Shared Lives carers group and a commitment to listening to their collective voice. A programme of training and learning opportunities, which are available flexibly. A clear procedure for investigating allegations whilst providing service users, families and Shared Lives carers themselves support during any investigation.

The Shared Lives staff team

Where the preferred method of outsourcing is a staff team spin out, the process is necessarily staff team-led. This involvement is, however, equally important in tendering processes. As the processes, systems, staffing ratios and values of Shared Lives are significantly different from those of other forms of regulated care, the existing staff team of any scheme hold a great deal of the value of the scheme and have a lot to contribute to any decision making process. The relationship between the scheme workers and carers are vital to the effectiveness of the Shared Lives service, so any outsourcing process should include both to maintain quality and productivity. The cultural shift to working in a charity with a board of trustees should also not be underestimated for staff who have worked for a council for a long time. For instance, the Shared Lives team will have insight into: The culture and practice of Shared Lives and how they differ from those of other services; Handling the relationship between self-employed Shared Lives scheme and the scheme; The breaks and respite requirements of Shared Lives carers; The regulation regime as it applies to Shared Lives schemes. In England, CQC has bought Shared Lives Plus good practice guidance for its inspectors to use in inspections. The Shared Lives Plus/ CQC joint statement on Shared Lives, Scottish National Care Standards, National Minimum Standards in Wales and Regulations in Northern Ireland are all informed by Shared Lives Plus and its members work. The recruitment, assessment, approval and support of Shared Lives carers and the time and costs involved in the matching process.

Our scheme is going to be outsourced. So far the independent consultants have asked me for a battery of facts and figures but have yet to meet with me, my team, Shared Lives carers or service users. I know nothing of the process and feel things are about to be 'done to' our service. Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 10 Registered charity: 1095562. Registered company: 4511426

When to involve people in decisions

Commissioners should involve Shared Lives carers, service users and their families in decisions about: whether to outsource a service; the process for outsourcing spin outs or tender; the design and establishment of the new spin out or... what form of tendering to use and how tenders will be assessed; what the tender specification will look for, including: o good recruitment, approval, matching and support processes; o good referral, matching and settling in support for people using Shared Lives; o training, respite and payment of Shared Lives carers; o advocacy and offering choice to service users and their families; o expectations of the service being led or shaped by Shared Lives carers, service users and families; which user groups should be the focus of development of the new Shared Lives scheme; assessing the bids and awarding the contract; monitoring the contract.

Shared Lives Plus UK Ltd 2010. www.sharedlivesplus.org.uk www.communitycatalysts.co.uk | 11 Registered charity: 1095562. Registered company: 4511426