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Blake Lapthorn personalisation seminar - 28 September 2010

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Blake Lapthorn, in partnership with JBurns Associates, held a seminar entitled 'personalisation: bene

Blake Lapthorn, in partnership with JBurns Associates, held a seminar entitled 'personalisation: bene

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  • The way we will undertake the care management function for those people who meet our eligibility criteria. Aim to have 50% of users on SDS by end March 2011. Piloted approach in Basingstoke for 18 months First stage of roll out is for long users at point of review. NE went live on 6 April SE go live on 6 July SW go live in October Currently developing business process for other parts of the care management function Reminder – a Individual budget is the pooling together of different funding streams and a Personal Budget is the social care element of the financing.
  • All of our legal and statutory duties still apply – MCA, safeguarding, duty of care Designed new assessment and resource allocation system Direct payment either to themselves or a suitable person Managed account where care is commissioned and organised by a care manager A third party Individual Service Fund (ISF)
  • The way we will undertake the care management function for those people who meet our eligibility criteria. Aim to have 50% of users on SDS by end March 2011. Piloted approach in Basingstoke for 18 months First stage of roll out is for long users at point of review. NE went live on 6 April SE go live on 6 July SW go live in October Currently developing business process for other parts of the care management function Reminder – a Individual budget is the pooling together of different funding streams and a Personal Budget is the social care element of the financing.
  • All of our legal and statutory duties still apply – MCA, safeguarding, duty of care Designed new assessment and resource allocation system Direct payment either to themselves or a suitable person Managed account where care is commissioned and organised by a care manager A third party Individual Service Fund (ISF)
  • For someone to have real choice and control there needs to be tings for them to choose. Traditional care - such as residential care, nursing care, domiciliary agency care at home Informal care – a person can directly employ someone they already know such as a family member or friend to be their personal assistant Non traditional support – this could be services such as gym membership, or taxis This work is closely linked to the county councils’ strategic commissioning role.
  • I’d like to share with you 2 quotes from the Tower Hamlets – Look ahead pilot. For me these crystallise the shift in relationship between the individual and the commissioners & providers that is fundamental to personalised services. Look Ahead – personalising a block contract proving support for 20 people with mental accommodation base service – complex needs – SP & PCT funding I make the decisions & I tell the staff – a person who is very much In Control – this isn’t someone who is having things done for them. Tennis example Susan – MS – personal assistant – phsyio, aromatherapy - an individual budget
  • Quote some figures - IBSEN – IB pilots IN Control The charity, which has pioneered personalisation, said 68% of users reported their lives had improved since they started using a personal budget (PB) and 58% said they were spending more time with people they wanted to. Example for commissioner – concerns about abuse – disempowered – a few cases I an still relevant & ‘the conflicts I had perceived are non existent’. & provider – more quality time & job satification because better outcomes - IB pilots + SP pilot
  • No sign of this changing
  • Burstow, said: “What we are going to be saying is that it’s not about spending more money. It’s about focusing on what matters. If [people] want to spend £350 on a laptop and that allows them to reconnect with their friends if they have a disability and have not been able to leave the house – we recognise it’s the small things which make a huge difference.” I
  • Describe shop4support harrow – saves money Add need for brokerage Raise awareness – learn from the private sector Tremendous opportunities - New services – hairdressing, personal training, etc Non client specific services provide more choices – people don’t fit into boxes –Hants web site Customers shaping the market – maybe ……don’t fit into boxes VFM – essential
  • Forum for sharing good practice Promote & advertise good practice Info – advertise – not only on the web Encourage joint tenders & service development - specify or incentivise
  • Develop effective coms skills Pilot / experiment
  • Tell Kieran's story - a young person who had moved around quite a bit & hasn’t found it easy to settle at anything. Sometimes difficult to ask for help. There programme changed all that – I was able to choose my rep & have total input into the things I need & how to achieve my personal ambitions.

Blake Lapthorn personalisation seminar - 28 September 2010 Blake Lapthorn personalisation seminar - 28 September 2010 Presentation Transcript

  • Personalisation seminar 28 September 2010 Robert Wassall Partner and Head of Social Housing
  • Personalisation “starting with the person as an individual with strengths, preferences and aspirations and putting them at the centre of the process of identifying their needs and making choices about how and when they are supported to live their lives.”
  • Personalisation
    • About all public services
    • ‘Putting People First: a shared vision and commitment to transforming care services
    • The Commission on Personalisation
    • A number of recommendations including Self Directed Support and the “Universal Offer”
  • The Universal Offer
    • What does the Adult Services Department offer to people who are not eligible for Social Care.
    • Jane Evans will discuss the offer for people who are eligible
    • Simon Crouch will discuss the impact on SP
    • This is about what the offer to non eligible people may be
  • Universal Offer
    • Financial Climate
    • Prevention – what are the arguments
    • Doing more earlier saves money later
    • Organising services outside the care system can be quicker and easier eg adaptations
    • Not in addition but instead of
  • Advice on Physical Activity & Falls Prevention Delivered through: Better Balance for Life Project Information on home delivered meals Delivered through: Care Choice Website Information and help on healthy eating Delivered through: Nutrition Strategy (in development) Information and advice on substance misuse Delivered through: Hampshire DAAT Directory Healthy Living Access to Neighbourhoods Neighbourly help in local communities (e.g. driving to hospital, picking up prescriptions, walking dog, cutting grass, etc) Delivered through: Good neighbours groups Parking Permit Delivered through: Blue Badge Appraisal of driving skills Delivered through: Older driver appraisal scheme Social activities Delivered through: Brendoncare Club Hampshire Support to get out and about Delivered through: Floating Support Help and support to bridge the gap between local communities and services Deliver through: Village Agents (Pilot) Free local bus travel Delivered through: Concessionary Travel (From April 2011) Practical help with daily living Information, advice & guidance The ‘Offer’
    • The offer (listed below) can currently be accessed via:
    • Hantsdirect
    • through signposting from CIT, OPAL and other services
    • and directly
    Information and Signposting Delivered through: Care Choice Website OPAL CIT Bettertime Web Pages Hampshire Now Special Edition Age Concern Hampshire Support Planning Delivered through: CIT Information on reliable trades people and gardeners Delivered through: Buy with Confidence Signposting to information and support around economic wellbeing Delivered through: All of the above Housing with care and or support Delivered through: Extra Care Housing Sheltered Housing Support at Home Delivered through: Floating Support Help with housing needs Delivered through: Locality Housing Officers Support if your home needs repair, maintenance or adaptation Delivered through: Safe, Warm and Secure ( pilot) INtouch Home Improvement Agency INtouch Handypersons Service Project Adapt (From April 2011) Help with Gardening Delivered through: Shaw Trust Telecare and Community Alarms Delivered through: Telecare providers Community Alarm providers Support after doorstep crime Delivered through: Trading Standards Quick Response Team Support to return home after a stay in hospital Delivered through Home from Hospital It is recognised that there is still much work to be done to ensure that Hantsdirect and other HCC staff are aware of the wide range of services and information available to older people, and are making the most efficient use of these, and signposting appropriately.
  • Information, advice & guidance Information and Signposting Delivered through: Care Choice Website OPAL CIT Bettertime Web Pages Hampshire Now Special Edition Age Concern Hampshire Support Planning Delivered through: CIT Information on reliable trades people and gardeners Delivered through: Buy with Confidence Signposting to information and support around economic wellbeing Delivered through: All of the above
  • Practical help with daily living Housing with care and or support Delivered through: Extra Care Housing Sheltered Housing Support at Home Delivered through: Floating Support Help with housing needs Delivered through: Locality Housing Officers Support if your home needs repair, maintenance or adaptation Delivered through: Safe, Warm and Secure ( pilot) INtouch Home Improvement Agency INtouch Handypersons Service Project Adapt (From April 2011) Help with Gardening Delivered through: Shaw Trust Telecare and Community Alarms Delivered through: Telecare providers Community Alarm providers Support after doorstep crime Delivered through: Trading Standards Quick Response Team Support to return home after a stay in hospital Delivered through Home from Hospital
  • Access to Neighbourhoods Neighbourly help in local communities (e.g. driving to hospital, picking up prescriptions, walking dog, cutting grass, etc) Delivered through: Good neighbours groups Parking Permit Delivered through: Blue Badge Appraisal of driving skills Delivered through: Older driver appraisal scheme Social activities Delivered through: Brendoncare Club Hampshire Support to get out and about Delivered through: Floating Support Help and support to bridge the gap between local communities and services Deliver through: Village Agents (Pilot) Free local bus travel Delivered through: Concessionary Travel (From April 2011)
  • Healthy Living Advice on Physical Activity & Falls Prevention Delivered through: Better Balance for Life Project Information on home delivered meals Delivered through: Care Choice Website Information and help on healthy eating Delivered through: Nutrition Strategy (in development) Information and advice on substance misuse Delivered through: Hampshire DAAT Directory
  • The Universal Offer
    • Seen as a positive
    • The services are a barrier
    • But these are early days – CSR & SP
    • Need to justify every bit of expenditure
    • We may have fewer services but we want them to be properly funded
  • Personalisation
    • Choice is important
    • It is important to have options
    • Commissioning must ensure the balance between options and efficiency
    • Personalisation is more than individual budgets
  • Jane Evans Self-directed Support Programme Team
  • SDS - What’s it all about ?
    • It is a new model for people who meet the (national ) eligibility criteria to have the social care they need
    • The person has control of their personal budget to meet their care needs
    • Improves the lives of vulnerable people by giving them more choice and control
    • A person centred approach rather than service led
  • Eligibility
    • Critical - risk to independence or safety of person (or others) and/or high risk that the person will not be able to remain in their current accommodation, leading to admission to care home or hospital
    • Substantial - risk to independence or safety of person or others is present now or in foreseeable future and without support a critical risk will develop
  • SDS – How does it work?
    • Assess need and identify social care outcomes for a person
    • Give a financial value to those outcomes (personal budget)
    • The person is supported to plan their care and choose how to best achieve their outcomes
  •  
  • Key changes
    • Supported self assessment to maximise service user involvement
    • Assessment of social care needs leading to an agreed set of outcomes
    • Objective calculation of cost using a Resource Allocation System
    • Support planning process to ensure that individuals have a direct say in how their support is planned and provided
    • Personal budget to meet eligible needs and achieve agreed outcomes
  • Personal budget
    • People can choose how this is managed
      • direct payment
      • commissioned care
      • Individual Service Fund
      • a combination of DP and commissioned
    • Other options are in development
  • Experience so far
    • SDS pilot in Basingstoke (2008 to 2010)
    • NE area went live in April
    • SE area went live in July
    • West area goes live in mid October
  • Experience so far
    • Service users need support through the change
    • Positive response to increased choice
    • 75% choosing to have commissioned care
    • Gradual increase in the uptake of direct payments
  • Social care outcomes
    • I am able to manage the day to day running of my home life
    • I have my personal care done in a way that suits me
    • I am able to get new or maintain the relationships I already have
    • I am able to take part in activities in my local area
    • I am able to learn new things or get a job
    • I feel safe at home and have the right support/equipment to stay safe
    • I get help so that I don't hurt myself or others
    • I am able to get enough to eat and drink
    • I am able to get help to make decisions when I need it
    • I am able to get support when I need it
  • Principles (1)
    • Holistic approach
    • The person is at the centre of everything we do
    • Recognition of the persons strengths, preferences and aspirations
    • Enabling the person to have choice and control
  • Principles (2)
    • Co-production
    • Consistent high quality care across Hampshire
    • Appropriate and accessible information
    • Wellbeing and prevention
    • Prevention of dependence
    • Transparency
  • Market Development
    • For choice to be real there must be things to choose from including:
      • Traditional care
      • Informal care
      • Non-traditional support
    • The role of the local authority changing from ‘managing the care market’ to ‘shaping the market’ 
  • Support
    • Business development toolkit
    • Organisational development
    • Training (PaCT) programme
    • Outcome focussed framework contracts
    • Economic development
  • More information
    • www3.hants.gov.uk/market_development.htm
    • www3.hants.gov.uk/adult-services/aboutas/sds.htm
    • www3.hants.gov.uk/pact.htm
    • www.action.hants.org.uk/index.php?id=440
  • Personalisation & Supporting People – Hampshire’s Perspective Simon Crouch SP Co-ordinator (Fareham & Gosport) , HCC Supporting People Team
  • The Hants SP Programme
    • 1 county, 11 districts.
    • 392 services delivering housing related support
    • c.13,000 service users
    • 126 service provider organisations
    • Triennial Cluster Strategic Review commissioning cycle
    • Block contracts + financial re-conciliation
    • Varied range of stakeholders across two tiers
    • Quality, Performance & Outcomes frameworks
  • Hants SP – The Financial Context
    • Significant Budget Reduction- c.30% p.a. forecast reduction by 2015 ( £30.3m down to c.£21.8m)
    • £41 per person per week?
    • Assumes constant SP % of Area Based Grant
    • Less resource to address Need
    • October CSR awaited
    • Ensuring resources for a non statutory function
  • Personalisation Exists Within SP Services
    • Person centred support is a specified requirement of contracted services.
    • Service user involvement within service delivery : individual, service, and strategic levels.
    • The value of the support planning process.
    • Scope for choice of providers where possible.
    • Providers work to make services personalised:
    • - De-tox & LD sheltered case examples
    • QAF support for Personalisation: Respecting equality & diversity, safeguarding, support planning, complaints re-dress, risk management.
    • Learning from Hants IB pilots
  • Personalisation & Individualised Budgets : Considerations For SP
    • Universal access & eligibility
    • Brokerage infrastructure
    • Micro-management capacity
    • Safeguarding capacity.
    • Service model viability: Accommodation based services e.g. Direct Access / DA refuge / Sheltered Housing.
    • Ensuring service quality
  • Personalisation & Individualised Budgets : Considerations For SP contd.
    • Whose Outcomes? Independence & client choice.
    • Maintaining strategic coherence & integrity – what gap is actually being filled here?
    • Who is the customer?
    • Budget Management & Stakeholder Accountability.
    • Future commissioning mechanisms - The Big Society, competing funding pressures, and alternative funding opportunities ( e.g. Social Impact).
  • To Take Personalisation Further ISFs & Individual Budgets
    • Reliance on the service provider spectrum.
    • Identifying & accounting individual resource application.
    • Recognising and costing ISF / IB management function.
    • Ensuring real, informed, and unfettered, client choice.
    • Access to brokerage & advocacy
    • Critically reviewing resource allocations
    • Contracting for ISFs / IBs – quantifying “core” hours, hours “at risk” to providers, & evidencing outcomes.
    • The HR dimension
    • The service user perspective
  • Market Development
    • A provider market:
    • Capable of delivering on a broad social care fronts
    • Able to respond to HR challenges
    • Able to market what is on offer.
    • Able to manage varying revenue levels
    • Able to access other revenue
    • That promotes client exercise of choice, even where that means a loss of revenue to provider
    • That can evidence outcomes
  • Hants SP – Moving Forward
    • Recognising appropriate contexts: for IBs / ISFs (i.e. L-T, non-accommodation based service delivery).
    • Earmarking revenue for more personalised service options– e.g. Move-On Services
    • Service delivery flexibility & creativity – e.g. location , accessibility of services, maintaining an outcome focus.
    • Listening to providers and listening to the customer
    • Sharing identified good practice
    • Providing commissioning flexibility
    • Joint commissioning: Removing service “gaps”
    • Promoting WRAP – a user led wellness and recovery tool.
    • Jumping together? How signed up to this are stakeholders?
    • Moving Forward -
    • What are your thoughts?
    • Contact: Your local SP Co-ordinator
    • http://www3.hants.gov.uk/supporting-people/sp-contact.htm
    • or: [email_address]
    • Tel: (01962) 832174
  • Personalisation and Southampton Matthew Waters Commissioner for Supporting People and Adult Care Services
  • The Personalisation Agenda
    • The vision in Putting People First states that:
    • “ people who use social care services and their families will increasingly shape and commission their own services’’
    • While specific to social care services, the personalisation agenda is intended to have a much broader impact on the way that local authorities and others deliver services
  • Personalisation - terms
    • Personalisation Agenda
      • To produce services adapted to suit an individual
    • Self Directed Support
      • Individuals have choice, control and power over services
    • Individualised Budgets
      • An allocation of money combining several funding sources
    • Personal Budget
      • An individual budget made up solely of social care funding
    • Direct Payments
      • A cash payment paid directly to an individual to acquire their own service
  • Impacts of personalisation – Experience so far
    • Philosophically
      • Choice provides whole new prospects for care and choice
      • Potential to change nature of care provision
    • Experience so far
      • Impacts are greater for some groups than others
      • Still need to meet outcomes within care plans
      • People are realistic – change at the margins
      • Focus on customer care
  • Range of projects
    • Personalisation in Mental Health services
    • Personalisation in in-house Day Care services
    • Personalisation in Drugs services
    • Personalisation in Supporting People services
    • Personal Health Budgets
  • Southampton SDS and IBR Project findings
    • Having the ability to respond to needs by having some financial resources, provided a range of positives:
    • Raised self-esteem, with users focusing on options
    • People made practical choices that led to improvements
      • Health, travel etc
    • Individuals felt invested in
      • Led to improved outcomes
    • Group work enabled users to share choices and objectives
    • Raised positive perceptions of their current services
  • New services - extending Supporting People
    • The local SP programme has funded a range of projects that underpin but are not direct support services
    • Focus on employment opportunities and skills development
    • Enabling the achievement of better outcomes
      • Social Enterprise work
      • Employment initiatives
      • OP project
      • Access Promotion/IT skills development
  • SP personalised contracts
    • Specifications for the new model of SP services for Mental Health and Drugs mark a new departure
    • For the first time, contracts will include a fully personalised element
    • Approximately 10% of the overall contract value will be made available in cash form for the provider to use in conjunction with service users
    • New Learning Disability and Physical Disability services will have similar arrangements in place (currently being tendered)
  • Future SP contracts
    • Two key elements:
      • Cash being available - Personalised
      • Delivery being flexible – When users define
    • Should enable the creation of support services that are more responsive to user needs and wishes
    • This will be a key line of enquiry through the tender process
    • Anticipated that all future contracts will develop in this way
  • Short-term approach - Personalisation Resource
    • A short term approach to creating more opportunities for service users to shape their support
    • Will provide small additional financial input to support plans
    • Will help SP providers to develop capacity in this area
      • In advance of when a greater level of personalisation is likely to be contracted for
    • Will enable the local programme to assess impact across non-care groups
      • And to assess future options for expenditure
  • Outcomes to be achieved
    • To promote the concept of personalisation within SP services To enable service users to achieve clearly defined outcomes
    • To achieve:
      • moves from higher to lower cost services
      • move on from SP services
      • Diversion from SP services where practical
    • To promote access to employment
    • To promote the wellbeing of individuals
    • To promote social inclusion
  • Investment in groups of service users
    • The research pilot identified examples where groups of users achieved more by working together
    • Resources for specific groups will be considered where:
      • A number of individuals are identified as having similar needs and outcomes
      • Working together they will achieve better value for money
      • Better outcomes are likely to be achieved
      • Broader objectives can be shown to be met
        • E.G. City safety, crime reduction, hospital discharge, wellbeing
  • Specific outcomes - example 1 £135 for sports kit
    • To complete the Football Association level 1 qualification, which means that he can potentially be paid for coaching
    • Saints in the Community will pay for Level 2 & 3 courses after completing level 1 and also a refereeing course
    • To gain experience in refereeing and coaching and widen employment opportunities
    • This will help to maintain his mental health, as he had a history of depression
    • This will help to maintain his accommodation in the long-term and keep him out of SP services.
  • Specific outcomes - Example 2 £500 for 2 nd hand laptop/peripherals/broadband
    • Improve Information Technology skills through completing courses available online
    • Widen employment, training, and volunteering opportunities
    • Improve contact with family in America and Spain to help alleviate loneliness and isolation
    • Access social networking sites to help alleviate loneliness
    • Help maintain sobriety as level of boredom is likely to be reduced
    • Help maintain accommodation
    • Improve quality of life regarding mobility i.e. could do internet shopping when the weather is bad and he is housebound
    • Reduces reliance on SP services
  • Commissioning for Choice Project
    • Accessing, reshaping and incentivising a socially responsible marketplace
    • Ensuring providers are in a position to take part in personalisation
    • To ready the market for future changes
    • October 2010: Commissioning for Choice Strategy and Plan
  • Impacts for providers
    • Immediate impact and longer term changes
    • Government and political driver
      • Should be a business driver
    • Social care market will expand
      • Changing demographics – Older people, people with disabilities
      • Impact of free personal care?
    • Future business planning
      • Flexibility of care and support
      • Personal Budgets are not constrained by geographical boundaries
  • Personalisation Irene Thomas Solicitor, Health and Care
  • Introduction
    • Impact of Personalisation
    • Outcome is intended to enable independent living and facilitate choice
    • Understand the impact this has on the relationship between service user and the service provider
    • Better understanding assisting with managing risk and creating opportunities
  • Role of Service User and Service-Provider
    • Service-User
    • Employer?
    • Abuse/Capacity
    • Contractual relationship – directly between service user and provider
    • Service Provider
    • Change in the way the services and bought and paid for
    • Adapt the way the Service-Provider will sell/market services
    • Adapt the way the Service-Provider receives payment
    • Competition
  • Contractual Relationship
    • Capacity
    • Impact on contracts with Service-Providers – who contracts? Family member/carer/other relative
    • Policy: prevention of abuse
  • Terms of the Contract
    • Similar in many ways to most commercial contracts
    • Unfair terms and the Consumer
    • Office of Fair Trading – possibility of a repeat of recent history?
  • Dispute Resolution
    • Non payment – upfront payment
    • Recovery of debt
    • Dispute regarding services received
    • Negative Publicity
  • Employment
    • Statutory obligations
    • Pre-employment checks
    • Data Protection – registration with the Information Commissioner
    • Transfer of Undertakings (Protection of Employment) Regulations 2005 or “TUPE”– possible application?
  • New Opportunities
    • Enable independent living and choice
    • Opportunities for Service Providers as well
    • Protect income streams by reviewing contracts at the outset and keep contracts under review
  • Personalisation What’s in it for me ? Jackie Burns Housing Care & Support Consultancy
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  • In Control
    • I make the decisions and I tell the staff
    • Look Ahead Tower Hamlets pilot
    • My plan is working very well and I am enjoying the flexibility of it & being able to decide when & what I want.
    • Susan - North Lanarkshire
  • Outcomes of pilots
    • More control & improved quality of life
    • Improved job satisfaction
    • Cost neutral / savings
    • Barriers – systems and funding streams
  • Where are we heading?
    • The tide of expectation can’t be held back. It’s a social phenomenon. The people who are becoming older now won’t be pushed around. We professionals will have no choice but to change our ways.
    • John Dixon Director of Social & Caring Services, West Sussex.
  • Where are we heading?
    • The Coalition government have announced the expansion of personal budgets from November.
    • Paul Burstow, Minister of State for Care Services, has admitted that the transition to this new culture may be difficult but stressed that “localism and personalisation will help change social care for the better over the next few years."
  • What will this look like ?
  • What will this look like ?
    • New services & service models
    • Accessible information – shop4support
    • Improved VFM
  • What should commissioners do?
    • Work with providers, service users and other commissioners
    • Simplify systems & funding streams
    • Make information more accessible
    • Drive innovation and collaboration
  • What should providers do ?
    • Seize the opportunity
    • Develop new skills and services
    • Innovate
    • Collaborate
    • Learn from other sectors
    • Focus on what you’re good at
  • It’s all about ……
    • I’m working now. I’ve passed my bike test and I’m living in my own flat. There are still changes to be made and things I want to achieve. The biggest difference to me though is feeling much more confident and able to decide my own future.
    • Kieran - In Control