Key messages for Scotland “An independent review of Shared Lives for older people and people living with dementia” – January 2018 Key messages for Scotland For more information, please find the full report at www.sharedlivesplus.org.uk

- Unsustainable care market - People not getting enough respite as they should be - 2016 Carers Act emphasises duty of local authorities to provide support for carers - New care standards focusing on user experience - Personalised care - Flexible care - Value for money What the Shared Lives offer for respite care and day care means for Scotland Challenges Shared Lives offer Outcomes Family/unpaid carers Service users Commissioners Increased wellbeing Reduced social isolation Reduced carer breakdown Increased independence, wellbeing, choice Reduced social isolation, confusion Increased sustainability of care provision Potential healthcare utilisation savings

Key message 1 Respite care is important; the challenge is that individuals are not getting as much respite as they should, with “traditional” respite not achieving its full potential Personalised A review of literature suggests that “traditional” respite is not achieving its full potential: greater personalisation is needed. Variation Whilst quality of care services have improved overall, there is significant variation in the quality of services. The recent CQC State of Health and Care report stated that 25% of carers have not received a single day away from caring in five years. Lack of access

Key message 2 Evidence shows that Shared Lives is able to offer a good quality, high impact solution to this challenge Quality Shared Lives respite care and day support provides a personalised, flexible service, which has been shown to deliver high quality care to service users, carers, and commissioners. Carers For carers, the Shared Lives model has been shown to deliver increased wellbeing, reduced feelings of social isolation, and reduced likelihood of carer breakdown. For service users, the Shared Lives model has been shown to deliver a variety of benefits, including increased independence, choice, and control Service users

Key message 3 The costs of the Shared Lives approach are on average cheaper than “traditional” day care and respite provision Value The evidence suggests that Shared Lives day care provision is on average cheaper than “traditional” forms Affordable Local authority-run Shared Lives respite schemes are on average cheaper in Scotland than “traditional” forms. £8.50 hourly cost for day care for a Shared Lives local authority-run scheme compared to £9.17 for "traditional" forms £77.40 per short break for a Shared Lives local authority-run scheme compared to £80.54 for "traditional" forms. Costs

Key message 4 Shared Lives is likely to be an important option for commissioners seeking to meet their market sustainability duties Legislation Legislation (e.g. 2016 Carers Act) puts emphasis on the duty of local authorities to provide support for its carers. Comparison Pricing approach offered by “traditional” providers of respite care may cross-subsidise, and not take into account the “true cost”, Sustainable Shared Lives’ approach focuses on ensuring costs are fully recovered so that the service can be both sustainable, and available

Key message 5 The Shared Lives approach has great potential to make savings in terms of reduced reliance on more expensive health services Impact Evidence suggests that carer breakdown or fatigue was a significant factor behind 62% of hospital readmissions Solution The positive outcomes from Shared Lives could lead to reduced requirement for health services Savings Reducing usage of health services has the potential to lead to cashable savings for health commissioners