The challenge of scaling-up social work innovations: A case study of Shared Lives schemes in England

Abstract Innovation is routinely presented as a response to pressure on public services. This article considers the development of Shared Lives (SL) schemes in English adult social care (ASC), a model of care that has been consistently promoted as innovative. SL seeks to replicate ‘ordinary family life’ for adults who need support. Evidence of positive outcomes for people supported, and of cost-effectiveness compared to other models, has attracted the attention of national policymakers and local authority (LA) ASC leaders. Most LAs now operate or commission a SL scheme. Despite this wide ‘spread’, SL remains a very small model that has not yet been ‘scaled-up’ to the extent that many have hoped. Drawing on interviews with fifty people involved in SL, including from four contrasting local schemes in 2021–2023, we highlight four interconnected sets of ‘organisational capabilities’ and resources needed for schemes to grow: (1) collaborative working with social workers; (2) leadership at different levels; (3) mechanisms to harness knowledge and evidence; and (4) investment in the workforce of scheme staff and carers. We propose these factors help schemes become locally embedded in communities. However, our study also highlights the fragility of the model to socio-economic changes and social work practice imperatives.