Outsourcing Shared Lives Shared Lives carers guide

What are the pros and cons of outsourcing?...................................................................................2 Can we set up our own Shared Lives scheme?...............................................................................2 What are the different kinds of outsourcing?..................................................................................3 Key stages at which you should be involved...................................................................................4 Why should Shared Lives carers be involved in decisions?.........................................................4 What do Shared Lives carers think makes a successful scheme?..............................................5 Who else should be involved in decisions?.....................................................................................6 Contact us for advice and support ....................................................................................................6 . Introduction

Shared Lives is increasingly recognised by governments across the UK as crucial to the future of personalised care and support systems. Most Shared Lives schemes are currently organised by council employees (or in-house). Many will continue to be. Outsourcing is where an outside organisation takes over the running of a service previously run by the council (or NHS). Sometimes a new charity or not-for-profit organisation is created to be the new home for a council service. Or existing local charities can be invited to bid for the contract to run a council service for a set period of time, in exchange for funding to do so. In Shared Lives, it is co-ordinating the scheme which can be outsourced: Shared Lives carers are already selfemployed and would remain so. Outsourcing is becoming more common, particularly in England, where councils are being encouraged to outsource services, sometimes to save money. Outsourcing can result in a very effective independent Shared Lives scheme being developed, but sometimes Shared Lives workers and Shared Lives carers find they have little chance to influence the process. This guidance suggests steps we think you and your scheme should take, to prepare for the possibility of your council deciding to consider outsourcing the running of your Shared Lives scheme. This guidance does not intend to encourage or discourage outsourcing. Shared Lives Plus is neutral on that issue: we see examples of strong Shared Lives schemes delivered by councils and by independent schemes. But we do feel that outsourcing is a prospect for which it is wise to have prepared. And where outsourcing happens, we think it is essential that Shared Lives carers and the people you support are fully involved in decision-making: no scheme can be successful without the support and full involvement of its Shared Lives carers. This guide gives some information about what outsourcing is, how it works and about how you should be involved in decision making. If you are not invited to be involved in any major decision about your Shared Lives scheme, we encourage you to contact your council and demand to be involved! We will support you to do this (see pages 6 & 7).

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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, including some who have previously been in-house and consider the move to have been an extremely positive one. When outsourcing is successful, there can be some positives: The new scheme may have less red tape, which could give it the opportunity to be more flexible in responding to local needs and opportunities. Schemes run by charities can raise funds and find it easier to attract volunteers. Shared Lives carers, people who use the service and families can be involved in planning and should be represented on the board of Trustees (also called nonExecutive Directors) of the scheme.

None of these advantages are a given though: they will require a well-planned organisation with strong management and good governance from its board of Trustees. There are also risks: The scheme may have less access to training and other support from the council. It could be easier for the council to cut funding or negotiate hard on price the independent scheme may be reluctant to argue too much with its council funders. The schemes freedom could lead to it losing sight of its core purpose and values. Shared Lives carers may have concerns about the possibility of changes to processes, fees or the staff team.

Council services and independent schemes are subject to exactly the same inspection requirements from government inspectors. Can we set up our own Shared Lives scheme?
We have had a few enquiries from Shared Lives carers who are unhappy with their existing scheme and who want to know if Shared Lives Plus could support them to set up their own new one. Setting up a new scheme is very challenging. First, you would need to set up a charity or company, then that new organisation would need to successfully register with your nations regulator as a Shared Lives provider. Next, the new scheme would need to persuade a significant number of Shared Lives carers to join it and would need to either win referrals or funding from the council, or attract Direct Payment holders to use it. These steps would be feasible if you have the support of your council, start-up funding and the involvement of people experienced in setting up and managing social care organisations. However, if, as Shared Lives carers, you are unhappy with your existing scheme, we recommend that you first set up an independent representative group and seek Shared Lives Plus assistance to raise concerns with your existing scheme and if necessary contact senior managers. Even serious disagreements between scheme workers and Shared Lives carers can often be resolved with mediation, to the benefit of service users, families and Shared Lives carers.

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What are the different kinds of outsourcing? If a council decides to outsource a service, this can be done in a number of different ways: The council can create a charity or social enterprise (a kind of non-profit company) specifically to deliver the outsourced service. SWAPS in Devon and ASA in Lincolnshire are Shared Lives schemes which are very successful examples of what are increasingly being referred to as spin outs from statutory services. In England, council employees and community groups will soon be able to challenge the council to put a council service out to tender. So it may become possible for a group of Shared Lives workers or carers to form an organisation and request the opportunity to set up their own scheme, but, see the note on page 2 about the challenges of doing this and the benefits of pursuing less radical approaches. The council can write a tender specification and issue an open invitation to tender (ITT), to which any existing organisation can respond. Some councils have outsourced all of their services in one go, creating a single large independent company to deliver them, which receives its funding mainly from the council.

Where a council takes the tendering route, there are two common types: a b Open tendering, where a contract is widely advertised for any organisation to apply. Restricted tendering, where a contract is advertised and bids invited only from organisations on a preferred provider list of those who have met certain criteria.

If a council decides to outsource a service through tendering, it might follow these steps: Step 1. Step 2. Step 3. Step 4. Step 5. The council should consider a range of outsourcing options. It will choose one outsourcing option (see above). It will write a tender specification, which outlines the desired service. The invitation to tender is advertised to potential bidders. Potential bidders fill in a pre-qualification questionnaire (PQQ) to show that they meet minimum requirements. Only those who do so are invited to tender. Step 6. A formal invitation to tender (ITT) is issued to qualifying organisations. Step 7. Tenders from bidders are returned and evaluated by the council. Step 8. The contract is awarded to the successful organisation. Step 9. Staff from an existing in-house service may move across to work for the new organisation, which must honour their employment terms and conditions. Step 10. After a set time, the contract will end and may be re-tendered.

After a contract has been awarded, there will need to be ongoing meetings between the council and the new service to ensure that everything is working well and to address any problems that arise. Shared Lives carers can and should be involved at every stage. Shared Lives carers will bring an expert perspective on what makes an effective and sustainable Shared Lives scheme. Below we set out how Shared Lives carers could get involved.

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Key stages at which you should be involved Shared Lives carers, service users and their families should be involved in decisions about: whether or not to outsource a service deciding which process for outsourcing is used and the timetable the design and type of any new organisation how tenders will be assessed what the council will look for in bids to run the service, such as: o good recruitment, approval, matching and support for Shared Lives carers 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 how the service will be led or shaped by Shared Lives carers, service users and families which user or age groups your (new) Shared Lives scheme should focus on assessing the bids and awarding the contract monitoring the contract, deciding whether the new organisation has kept its promises and what to do if things go wrong

Good Shared Lives schemes routinely involve and consult with Shared Lives carers, so hopefully your council will invite Shared Lives carers and the people who use Shared Lives to be involved in any major decision about your scheme. It is in their interests to listen to your expertise about what makes a good scheme and to ensure that you will be on board with the scheme as it moves forwards. However, if you are not invited to be involved, we recommend that you contact your council and ask to be involved. A good starting point would be to ask the Shared Lives scheme manager for the contact details of the person is in charge of the decision-making process at the council. You could also approach elected councillors about the issue and you may wish to enlist the support of local disabled peoples or carers organisations. Whilst all Shared Lives schemes are independent (so Shared Lives Plus has no power over them), we will support you in requesting your right to be involved in decisions about your Shared Lives scheme and can get in touch with council officials, or write to senior managers, on your behalf if more informal approaches do not work. As noted on page 2, we find that negotiation and mediation are usually the most effective approaches to difficulties, so would always explore those avenues first. Why should Shared Lives carers be involved in decisions? Councils are expected to involve local people in major decisions and there are no reasons why Shared Lives carers and the people they support should not be involved in all decisions taken about Shared Lives schemes. A Shared Lives scheme was cost-effective and carers and family members very complimentary about the support they received. Its manager received a phone call inviting them to a meeting a
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few days later, at which they were told their scheme would be outsourced. There had been no consultation with Shared Lives carers or service users. 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 that concern. Shared Lives is a partnership between the Shared Lives carers and their scheme and heavily dependent upon the quality of that relationship. 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. In West Wales, Shared Lives carers elect representatives onto a consultative group to ensure the group is accountable and represents their views. A strong group of Shared Lives carers can help to ensure that senior managers and elected councillors take Shared Lives seriously. An independent group will have the freedom to lobby on behalf of the scheme and those who use it, at crucial points. Shared Lives Plus recommends that local schemes strengthen the independence of existing Shared Lives carer groups and support carers to set up new groups where there is not one already. Shared Lives Plus would be happy to advise Shared Lives carers and schemes on developing your local carer group. Schemes can help Shared Lives carers to attend groups by providing help with transport, activities for service users and help to hold teleconferences as well as face to face meetings. In one London Borough, the well-established Shared Lives carers group insisted on a meeting with the Director of Adult Services. They raised concerns 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 carer group, which held regular support groups and Quality Days, was well-established and assertive. What do Shared Lives carers think makes a successful scheme? Shared Lives Plus Shared Lives carer members have highlighted these elements:

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 clearly value Shared Lives carers and on which they 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. Consistent support from skilled, knowledgeable and respectful staff. Access to information about tax, insurance and information about Shared Lives Plus. Support for an independent Shared Lives carers group and a commitment to listening to
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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.

Who else should be involved in decisions? Councils who are considering outsourcing should consider 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 we recommend that councils 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. We recommend that all schemes support people who use Shared Lives and their families to form an independent consultative group to represent their views. It is also important that the schemes staff team is involved and consulted during decisions. 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 will between them hold much expertise and learning and have a lot to contribute to any decision-making process. Contact us for advice and support If you are a Shared Lives carer with any concerns or questions about the issues raised in this guide, please contact Judith Holman, our support and development Officer for Shared Lives carers. Judiths contact details are: Address: Shared Lives Plus, GO4, The Cotton Exchange, Old Hall Street, Liverpool, L3 9JR Tel: 01512273499 mob: 07764469349 Email: judith@sharedlivesplus.org.uk If you are not yet a Shared Lives Plus member, Shared Lives carer membership costs 50 for individuals and 65 for couples and includes: Use of the free Shared Lives carers confidential helpline where you can obtain information advice and support from a dedicated national Carers Development Worker. FREE legal expenses cover (up to a maximum of 25,000) if you have an allegation made against you as a Carer resulting in you being taken to court and/or your Scheme is seeking to de-approve you as a Carer. Free access to a legal helpline for advice on any relevant legal issue. Public Liability Insurance at a preferential rate as well as access to other insurance provision developed to meet the needs of Shared Lives Carers. Three Shared Lives Carer newsletters a year via post, which keep you up to date.

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The opportunity to meet or get in touch with other carers, including through meetings, telephone conferences, our email group and a message board. A members-only area of the website containing resources which are free to members (in development 2011). Access to a wide range of guides and resources at members-only prices. Access to our annual Shared Lives carers breaks and conference. A conference for your home nation and/or for the UK, with a limited number of places for Shared Lives carers at supported rates. An open invitation to attend national network meetings (and regional meetings in England). At least one seat on the board of Shared Lives Plus for an elected Shared Lives carer. A voice with local, regional and national decision makers and a programme of awareness-raising about Shared Lives and the work of Shared Lives carers.

To find out more, contact Jackie and Lisa in our Liverpool Office: Address: Shared Lives Plus, GO4, The Cotton Exchange, Old Hall Street, Liverpool, L3 9JR Telephone 0151 227 3499 or visit: www.sharedlivesplus.org.uk

This version was written: July 2011 and updated with the name Shared Lives Plus in October 2011.

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