Transcript Richard Todd Presentation
SOCIAL INVESTMENT AND SHARED LIVES 27 FEBRUARY 2014
Richard Todd, Associate Director
Social Finance is authorised and regulated by the Financial Conduct Authority FCA No: 497568
WHAT DO WE DO?
Social Finance works with government, social ventures and investors to unlock financial barriers and help drive social change.
2 We create financial structures and implement programmes that bring stable and sustainable funding to organisations dealing with social issues Change the way government seeks to tackle problems Help build and support growth of strong, effective social enterprises Expand the range of investors able to participate in social investment DELIVER SUSTAINABLE AND SCALABLE SOCIAL CHANGE ©Social Finance 2014
OUR WORK TO DATE WITH SHARED LIVES PLUS
Since late 2012, Social Finance has been working with Shared Lives Plus to support a national expansion of Shared Lives.
A proportion of this work was funded by the Cabinet Office Investment and Contract Readiness Fund.
The aim of the work has been to develop a business case for expanding Shared Lives, and an investment model to enable expansion to be delivered.
An interim summary of this work was published in the report, “Investing in Shared Lives”, highlighting the benefits of Shared Lives and a proposed model for its expansion.
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PRACTICAL APPLICATION: DEVELOPING A SOCIAL INVESTMENT MODEL
Social investment approaches are built upon analysis of the underlying social problem:
1. What is the social need we are trying to meet?
Social investment in practice
4 2. Are there interventions which meet this need?
3. Are there revenue streams that could support the intervention?
4. Would a new investing or contracting approach add value to service users, providers and commissioners? ©Social Finance 2014 Social investment already funds services addressing a range of social issues with new provision. These include: • • • Reducing the number of adolescents entering the care system Supporting entrenched rough sleepers to achieve a stable lifestyle Helping young people at risk of being not in education, training and employment to gain qualifications and enter work
THE SOCIAL NEED
The social care system needs to change radically if it is to meet funding challenges but also deliver better, more personalised care, built around individuals and their potential.
This situation is particularly acute for adults with learning disabilities.
Evidence shows that community-based support enables greater independence, inclusion and choice, and that challenging behaviour lessens with the right support.
Which are the models that can support vulnerable adults, work with them to build their own capacity and unlock community resources?
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SHARED LIVES COULD BE A CENTRAL PART OF MEETING THIS CHALLENGE
Shared Lives is a form of care where individuals in a community share their family and community life with someone in need of care support.
Arrangements are built around both the needs of individuals and their potential to develop life-skills and self-confidence in a supportive family environment.
Users of Shared Lives are empowered to take greater control over more fulfilling lives as part of their community. 6
Current Shared Lives provision performs well on measures of quality, with twice as many Shared Lives schemes rated ‘Excellent’ than any other form of care 1 .
Today, Shared Lives arrangements represent just 2.2% of all adult residential and nursing care placements in England 2 .
Notes: 1 – The Adult Social Care Market and The Quality of Services. Care Quality Commission (2010) 2 – Adult Social Care Combined Activity Returns 2012-13. National Adult Social Care Information Centre (NASCIS) ©Social Finance 2014
THE FINANCIAL CASE FOR EXPANDING SHARED LIVES
In addition, our analysis has shown that Shared Lives can provide a cost-effective means of delivering high quality, person-centred care.
Average annual savings per client in Shared Lives arrangements (£k) 1
30 7 25 20 15 10 5 0 Adults with learning disabilities Adults with mental health support needs IN ADDITION TO PROVIDING HIGH-QUALITY CARE, A WELL-RUN SHARED LIVES SERVICE COULD GENERATE SAVINGS FOR LOCAL COMMISSIONERS.
©Social Finance 2014 Note: 1 – Based on a cost-benefit analysis carried out across three local authorities, comparing the local costs of Shared Lives arrangements with residential care and supported accommodation placements.
DETOUR – A SOCIAL INVESTMENT APPROACH: COLLATED SERVICE INVOICING DATA SET ILLUSTRATIVE DATA ONLY 8 ©Social Finance 2014
DETOUR – SOCIAL INVESTMENT APPROACH: SUMMARY OF CARE COSTS – ADULTS WITH MENTAL HEALTH SUPPORT NEEDS
ILLUSTRATIVE DATA ONLY 9
Service Type All
Cash Individual Budget Payments Day Care Home Care Korsakoff Nursing Residential 4 Residential 4 Supported Accommodation 5
No of clients 582
20 5 113 32 43 138 226
% of total 100%
3% 1% 19% 5% 7% 24% 39%
Spend/week (£) 193,368
3,069 354 11,678 15,003 27,079 62,123 74,062
% of total 100%
2% 0% 6% 8% 14% 32% 38%
Implied annual Average per person cost (£) 2 per week (£) 3 10,082,229 332 160,005 18,440 608,899 782,280 146 64 96 469 1,411,898 636 3,239,106 3,861,601 462 328
2500 2000 1500 1000 500 0 ©Social Finance 2014 Residential care Nursing care Supported Accommodation Other
A NUMBER OF BARRIERS STILL INHIBIT THE NATIONAL EXPANSION OF SHARED LIVES
In working with many local authorities and Shared Lives services across the country, a set of common barriers have emerged:
10 Lack of up-front investment Lack of capacity and expertise Sustainable growth can be challenging Contracting models that limit growth Up-front investment is required in order to fund the recruitment of new staff members and carers, training and development High-quality expansion can require model specific knowledge, such as how to best recruit and match carers with those requiring support Shared Lives services require a strong management team to enable continued expansion – for instance in recruiting high quality staff Many services still operate within a block contracting arrangement, which does not incentivise the creation of new arrangements Local authorities have struggled to provide up front funding to invest in services before savings are yielded Few high quality independent providers of Shared Lives services exist, limiting options for local provision Continued focus on performance is often lacking, limiting the scope for development Schemes, even when external of local authorities, do not have financial capabilities support innovative contracts A SOCIAL INVESTMENT MODEL SHOULD AIM TO OVERCOME THESE PROBLEMS IN SUCH A WAY SO AS TO BE ABLE TO RESPOND TO GROWING NATIONAL INTEREST IN THE SHARED LIVES MODEL ©Social Finance 2014
THE ROLE OF THE SHARED LIVES INCUBATOR
Enabling growth through work with commissioners
Local authorities committed to expansion of Shared Lives Incubation pathway
3-5 year incubation period
Growing Shared Lives schemes
Schemes set up to thrive post-incubation
Mature Shared Lives schemes • Advice to local authorities looking to expand Shared Lives provision • On-going advice and support to schemes • Investment in growth • Connection to network of incubated schemes to share learning THE INCUBATOR WILL BRING BOTH PRACTICAL EXPERTISE AND INVESTMENT IN LOCAL SERVICES TO GROW SHARED LIVES ©Social Finance 2014
We continue to work closely with multiple local authorities as they finalise their approach to expanding local schemes.
Since launching the findings of our work, we have had interest from a number of local authorities looking to expand local provision, either through the spin-out of existing services or the development of new services.
We have also had significant support from national stakeholders.
In order to respond to this momentum, and to have capital ready to support the first wave of scheme expansions, we are raising an initial £1m of social investment.
We have developed a pathway for local authorities to expand Shared Lives locally, and identify the most appropriate funding and contracting options.
The first stage of this is a health-check on existing provision, the potential to expand services and a developing an outline pathway to expansion.
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