Self directed approaches lessons from a uk provider

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  • 1. Self Directed Approaches Lessons from a UK provider Steve Scown CEO Dimensions
  • 2. The UK context • Number of Local Authorities (LAs): 152 • LA adult social budgets: £19b (34.2B AUD) • Number of provider organisations: 12,700 (86% have less than 50 employees) • Number of people employed in social care: 1.63m • Number of adults receiving social care support with a personal budget: 605,000 (over 100,000 employ their own care staff)
  • 3. Dimensions • Support adults, young people and children with learning disabilities and who experience autism • Support and accommodate over 3500 people • We offer support via residential homes, supported living, short breaks, day services and supported employment • Work in 70 Local Authority areas • Employ approximately 5000 staff • Budgeted turnover in 14/15 of £110m
  • 4. Our Challenges • Traditional services have offered secure income • Traditional services are less and less in demand by people who exercise choice • People want personalised services • Personalised services have small and fixed margins • Local authorities have less money to fund increased need
  • 5. The Provider Conundrum Managing yesterday’s services today whilst developing new ways of listening and responding to tomorrow’s customer – and accepting less money for doing it.
  • 6. The LA commissioned service Paul lives in a home with 4 other people Local Authority pays Dimensions £50k per annum Home has a team of 5 staff – there is 1 staff member there all the time during the day and 1 sleeps in at night There are 40 hours of shared support per week Paul wanted to go abroad for a holiday and a group of 8 people decided if that was OK Paul spends 2 days a week at the local learning disability day centre and the rest at leisure. 6
  • 7. What Paul wants Paul has an Individual Budget of £34k. Paul pays Dimensions £22k a year for:  Support in the mornings whilst his Mum is at work  Support 2 days a week whilst he works in a garage keeping the floor clean and the place generally tidy  Support every 4th weekend whilst he goes away for short breaks – either camping or on a city break One of his support workers is his cousin at his family’s insistence. Paul is offering a one-off £3k payment if Dimensions can find him a job which he can keep for 6 months. 7
  • 8. “So basically you’re moving from wholesale to bespoke retail!” 8
  • 9. Our initial market prediction Now B2B B2C Future B2B B2C
  • 10. 10 Our current experience £ Local Authority Customer
  • 11. “It is not the strongest of the species that survive, nor the most intelligent, but the one that is most responsive to change” Charles Darwin
  • 12. Our first journey 12
  • 13. The key questions we posed ourselves • How will Paul and his Circle of Support know about Dimensions? • What do we want Paul and his Circle of Support to think of us? • Can we provide what Paul and his Circle of Support will want to buy? • How do we cost and then price very different models of support / products? • How different will Dimensions and our staff have to be?
  • 14. Your offer - one-off products Something a family may purchase which may or may not lead on to further business:  Facilitation of a PCP  Support Design  Behaviour Analysis Review  AT Assessment  Holidays  Service Design  Benefit Review  H&S Environment Review  Housing Brokerage 14
  • 15. Your offer - defined term products Something a family may buy for a fixed period of time with a pre-determined outcome: • Life skills training • Community integration • Active support • Job skills training • Facilitation of PC Review
  • 16. Your offer - ongoing products Something a family would purchase without an end timeframe:  Personal care & support  Sleep-in  Live-in Support  Short Breaks  Training of PAs  Quality Assurance  Waking night  Housing related support  Recruitment of PAs  Management of team of PAs  On-call & out-of-hours support 16
  • 17. Costing the offer Overhead activity Activity Based Costing/Insurance Premiums Client Group/Postcode Specials Refunds/Discounts/Free offers
  • 18. Human Resources Bespoke - Person Specification - Job Description - Employment Contract - Rates of Pay 18
  • 19. You Decide – We Employ 19 Human Resources
  • 20. Our second journey
  • 21. 21
  • 22. 22
  • 23. Plan 23
  • 24. So what changed for Anne Marie? • New people in her relationship map • Voluntary work • Unpaid support • New places • Re-connected with old friends • Busier and happier • Better relationship with estranged sister
  • 25. Reflections on our learning so far • Ensure all leaders and key organisational players are actively engaged and prepared for the change. • Establish what good will look like - for your organisation, the people you support and your staff - as soon as possible. • Be realistic about what you try to achieve - major change takes courage, determination and time.
  • 26. Reflections on our learning so far • Be prepared to feel comfortable with discovering some things that are not good enough and must change. • Be prepared to engage in honest and open dialogue and avoiding the ‘blame game’. • Develop your organisational response to dealing with a member of staff whom nobody wants to support them.
  • 27. Reflections on our learning so far • Develop your own views very early as to how you will manage and account for individual income streams • Consider the impact upon your organisation when the people you support decide how you spend your funding. • Staff find change easier when engaged in the process of change and receive support, training and independent challenge.
  • 28. Reflections on our learning so far • Everyone, including business support, but particularly every member of operations must be familiar with and ‘fluent’ in person-centred thinking tools. • Help your staff understand they must have their own personal offer for the people they are supporting. If they haven’t got one, help them to develop one. • Incorporating feedback from people being supported and their families into individual supervision and appraisal is very beneficial when trying to change staff attitude and behaviour.
  • 29. Managing through the tough times • It is easy to under-estimate the impact of broader organisational change upon local services and their attempts to improve how they provide support. • Find anchor points that are real and use stories and journeys to connect people to change. • Accept it will never be right and just keep on going.
  • 30. “If you want something different to happen, you have to do something different” Sharon Di Santo
  • 31. • steve.scown@dimensions-uk.org • @sscown #OzAdventure • www.dimensions-uk.org