Your SlideShare is downloading. ×
Citizen Directed Support
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Citizen Directed Support

1,143
views

Published on

Slides from talks given to Anglesey Council on how to develop Citizen Directed Support locally and in Wales. Covering (1) problems in design of welfare state (2) history of innovations (3) key ideas …

Slides from talks given to Anglesey Council on how to develop Citizen Directed Support locally and in Wales. Covering (1) problems in design of welfare state (2) history of innovations (3) key ideas and reforms (4) challenge of making changes work.


0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,143
On Slideshare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
28
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • Transcript

    • 1. Citizen Directed Supportcitizenship, community & enterprise Dr Simon Duffy ■ The Centre for Welfare Reform ■ Anglesey ■ 21st May 2012 ■ Full Slide Set
    • 2. Key points1.Introductory remarks2.Background3.Outline of key reforms4.Thinking about change
    • 3. 1. Introductions• 22 years working on reforming welfare systems, especially with people with learning difficulties and their families• The Centre focuses on encouraging innovations to redesign the welfare state & promote citizenship, family, community and fairness.
    • 4. not that new
    • 5. no panaceas...• Scotland, England, Australia, US, Europe...• much we can learn from the developing world• Challenge is to learn from others• ...and do better
    • 6. real problems in England1.Hidden services, hidden budgets2.Increasing bureaucracy & control3.Poor engagement with community4.Growing inflexibility5.Poor use of service providersnevertheless, momentum continues...
    • 7. Wales has made a good startAbove all, I think the idea ofcitizenship should remain at the centreof modern political debates aboutsocial and economic arrangements.The concept of a citizen is that of aperson who can hold their head highand participate fully and with dignity inthe life of their society. Professor Jeremy Waldron
    • 8. 2. Where did this begin?• Welfare state needs to evolve• Changing circumstances, different thinking• Negative impact on specific groups, leading to resistance, innovation and reform
    • 9. The welfare state is a goodthingit’s just designed wrong
    • 10. 1945 2012 post-war landscape problems of plenty predictable social structures: diverse social structures:marriage, family, work & church individuality and change faith in professional elites assertion of individual rights limited information sources the interneteconomic growth as the engine community sustainability industrial and mechanistic ecological perspective thinking faith in central planning age of uncertainty
    • 11. Pruitt-Igoe Projects in 1955 About 20years later...
    • 12. major design flaws include• complexity and silo-thinking• growing inequalities• locking people into poverty• wasteful centralisation• undermining citizenship
    • 13. £25 bn. on poverty reduction (2.5% GDP)Vast majority of welfare spending is on salaries
    • 14. poverty net
    • 15. Professional Gift Model Citizenship Model Individual has deficits Individual has giftsDoesn’t fit in community Community needs themNeeds professional help May need help to get inProfessionals are experts Individual is expertProfessionals take control Individual stays in control INSTITUTION COMMUNITY
    • 16. Photos from“Christmas in Purgatory”
    • 17. People were not free... ...people were not really included.
    • 18. The Spectrum of Services£200,000£150,000£100,000 £50,000 £0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
    • 19. Numbers using services400320240160 80 0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
    • 20. Expenditure£15,000,000£11,250,000 £7,500,000 £3,750,000 £0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
    • 21. The balance8% 92% Segregated Services Community Services
    • 22. In the UK we made the mistake ofthinking that the institution was thebuilding...we didn’t leave the institutionbehind, we took it with us
    • 23. The system didn’t make senseIt spentpeople’s moneyfor them onthings theywouldn’t buyfor themselves
    • 24. in particular, problems for• disabled children• people with learning difficulties• disabled people• older people• people with mental illness• people managing health conditions• women and families• people who are dying
    • 25. international developments• individualised funding• peer support• ordinary housing, supported living• independent living, use of PAs• supported employment• person-centred planning• inclusive education• and many more innovations...
    • 26. Change was not inspired bygovernment - it was inspired bypowerful ideas.Government doesn’t lead - it follows- and when government takes overwe often lose the plot
    • 27. 3. Some critical changesa) Changing how money worksb) Opening up new points of controlc) Offering the right supportd) Connecting to communitye) Creating a new understanding
    • 28. a) Changing how money works whose money is it?
    • 29. Clear entitlements make a difference
    • 30. Place N Change6 Sites Phase I Report 60 -18%17 Sites Phase II Report 128 -9%13 Sites IBSEN Report 203 -6%Northants 17 -18.7%City of London 10 -30%Worcestershire 73 -17%
    • 31. Flexibility creates the efficiencies
    • 32. Growing inflexibilities...1. public money fallacy2. just for services or PAs3. just what’s in the ‘support plan’4. what’s approved by panel5. not for health, home, school etc...6. separate accounts, audits etc.
    • 33. inefficiency is the price of inflexibility from push to pull economics
    • 34. the madness of the RAS...
    • 35. b) Opening up new points of control
    • 36. use Individual Service Funds
    • 37. c) Offering the right support Community brokerage
    • 38. Who is the best planner? Indi vi dual Fami l y/Fri ends 17% 23% Provid er Broker Soci al Worker 12% 13% 34%N = 801
    • 39. Who is the best organiser? Indi vi dual 9% 16% Fami l y/Fri ends Provid er Broker Soci al Worker 17% 31%N = 774 28%
    • 40. SDS Processes Support Planning RAS Care ManagementProtection/Safeguarding Responsibilities Annual Reviews Joint Assessment Processes Eligibility Criteria & Resource Panels Care Planning Monitoring Systems Comprehensive Assessments Mental Capacity LawSocial Care Law for Children and Adults
    • 41. re-scripting social work
    • 42. simple ways to do less
    • 43. The real innovators aredisabled people & their familiesJohn O’Brien
    • 44. d) Connecting to community• Schools• Peer support systems• Community organisations• Advocacy• Local Area Coordination
    • 45. Jonathan’s storyFor the 3 years before 150 days in hospital -responding to problems with breathing.In the 3 years after leaving hospital he has spentonly 2 nights in hospital - for elective dentaltreatments.Personalised learning - on the job - 2 City & GuildsQualifications.Saving NHS, LA & Education•Over £100,000 in hospital stays•Over £300,000 in residential care costs•Over £100,000 of funding contributed by the LSC
    • 46. A couple of weeks ago in Sheffield, I met awonderful woman called Katrina. Shes got threedisabled sons. The oldest is Jonathan, a charming,warm hearted young man of 19. He cant walk ortalk clearly, or feed himself alone. Hes had abreathing tube in his neck since he was a toddler....Now hes doing work with a local charity, attending amusic group, has his own personal assistant...Finally as a young man, engaged in life in a way heand his mother never thought possible. Katrina toldme with the biggest smile Ive ever seen, she said:Weve gone from having nothing to havingeverything. I wish every childs needs would betaken this seriously.Nick Clegg, 17 September 2008.
    • 47. Local Area Coordination
    • 48. communities are not products
    • 49. e) Creating a new understanding• Citizen• Professional• Commissioning
    • 50. right to be a citizen - full “I have a right to live my life in a way that1. Independent living makes sense to me” access to ordinary life right to enough support “I have a right to enough support and a2. Entitlement right not to be over supported” to achieve citizenship “I have a right to make decisions about right to be in control of how I live my life and to be supported by3. Self-determination people who know me and love me to our own lives make those decisions for and with me” “I have a right to be told clearly and rules & systems should simply how the system works and how4. Openness any rules affect me; including how much be clear and fair money I am entitled to for my support” “I have a right to use my money in any free to use our money as way that helps me to live my life;5. Flexibility including the freedom to take risks, make we see fit mistakes and learn from them” we should share what “I have a responsibility to share with6. Learning others what I have learnt works for me we are learning and what doesn’t work for me” we should each make a “I have a right and a responsibility to use7. Contribution my skills, talents and knowledge to play a contribution full part as a citizen in my community”
    • 51. Co-production
    • 52. Real Wealth
    • 53. Wards 40 %Average Population 1,700Over 65 376 22.1%15 and under 308 18.1%seriously misusing drugs or alcohol 14 0.8%limiting long-term illness 383 22.5%children SEN statements 7 0.4%people in homes in private ownership (incl. rental) 1,365 80.3%in poor health 181 10.6%deaths in a year 20 1.2%crimes 88 5.2%looked after children 2 0.1%use social care 78 4.6%working age people on benefits 177 10.4%Children social services budget £60,000 £6,666.67Adult social services budget £490,000 £6,282.05Health, housing, education, prisons, work
    • 54. You can’t start playing a new game incrementally... youmust stop playing cricket andstart playing rugby... even if(to begin with) you don’t feel very competent.
    • 55. But play to people’s strengths
    • 56. Find your own language!
    • 57. For more information go towww.centreforwelfarereform.org These slides are © Simon Duffy 2012 ■ Publisher is The Centre for Welfare Reform ■ Slides can be distributed subject to conditions set out at www.centreforwelfarereform.org ■