Self directed approaches lessons from a uk provider


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Self directed approaches lessons from a uk provider

  1. 1. Self Directed Approaches Lessons from a UK provider Steve Scown CEO Dimensions
  2. 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. 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. 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. 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. 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. 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. 8. “So basically you’re moving from wholesale to bespoke retail!” 8
  9. 9. Our initial market prediction Now B2B B2C Future B2B B2C
  10. 10. 10 Our current experience £ Local Authority Customer
  11. 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. 12. Our first journey 12
  13. 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. 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. 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. 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. 17. Costing the offer Overhead activity Activity Based Costing/Insurance Premiums Client Group/Postcode Specials Refunds/Discounts/Free offers
  18. 18. Human Resources Bespoke - Person Specification - Job Description - Employment Contract - Rates of Pay 18
  19. 19. You Decide – We Employ 19 Human Resources
  20. 20. Our second journey
  21. 21. 21
  22. 22. 22
  23. 23. Plan 23
  24. 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. 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. 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. 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. 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. 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. 30. “If you want something different to happen, you have to do something different” Sharon Di Santo
  31. 31. • • @sscown #OzAdventure •