Blake Lapthorn personalisation seminar - 28 September 2010

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

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

Blake Lapthorn personalisation seminar - 28 September 2010

by Blake Lapthorn on Sep 29, 2010

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Blake Lapthorn personalisation seminar - 28 September 2010 — Presentation Transcript