Transcript Personalisation - Hampshire County Council

Personalisation –
Moving forward
From Back Seat into the Driving Seat
What is personalisation?
Government View
• The ability to tailor a range of services to meet an
individual’s specific needs
• Self directed support adds the principle that involving
the individual in the planning process is a key way to
increase personalisation
• Personal budgets are the key vehicle for self directed
support in social care – they extend control as well as
choice
What is personalisation?
Social care view
• “Personalisation means starting with the individual as a
person with strengths and preferences who may have a
network of support and resources, which can include
family and friends”
• It means “starting with the person rather than the
service”
SCIE (Oct 08) Personalisation: A rough guide
http://www.scie.org.uk/publications/reports/report20.asp
It’s not rocket science
• Personalisation: personalisation means
taking something general and changing it
so it suits you better.
Personalisation is a philosophy,
not a set of rules and procedures
• Starts with what is
important to the person and
is outcome focused.
• Individually tailored
support, building on the
person’s strengths.
• The person is in control
and takes decisions.
• It means being part of a
community.
• It requires a shift in the
balance of power.
People are experts in
their own experiences
Personalisation umbrella
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Service user engagement
Person centred planning
Co-production
Self directed support
Individual budgets (IB)
Individual Service Fund
Personal budgets (PB)
Service user engagement
• Able to respond and be flexible to the group of
individuals you are engaging with
• A fluid, dynamic and negotiated process
• “A way of doing things, and an end result”
(Novas Ouvertures 2001)
• Requirements of
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Quality Assessment Framework
Homes and Community Agency
Care Quality Commission
Good practice
Person Centred Planning
• "Person Centred Planning discovers and acts on what is
important to a person. It is a process for continual
listening and learning, focussing on what is important to
someone now and in the future, and acting on this in
alliance with their family and their friends"
Thompson J. Kilbane J. Sanderson H. (2008) Person Centred Practice for Professionals.
Open University Press
Defining Co-Production
“Co-production means designing
and delivering services in an
equal and reciprocal relationship
between professionals, people
using services, their families and
their neighbours.”
New Economics foundation
D. Mello’s Co-production equation
E + P = C
Expertise
Bring what
we know and
the best we
have to offer
Partnership
Working together
as equals,
celebrating each
other’s expertise
Creation
With the
objective of
producing
something
By Augusto D. Mello in partnership with Look Ahead Housing and Care
Centre for Welfare Reform – www.centreforwelfarereform.org
Self directed support
• Individuals having control over the support they need to
live the life they choose
• Tailor support to meet needs, preferences and
aspirations with appropriate assistance
• Use a framework of identified needs and outcomes
agreed with those providing funding
– Direct / Indirect payments
– Individual budget
– Personal budget
Individual Budgets
• The individual receives an integrated budget which is
intended to purchase services to achieve the goals
identified.
• May require housing related support and/or Social Care
• There is no distinction between the various funding
streams
• Enables people to purchase services from a single
provider, if they wish to do so.
• Very effective in delivering joined-up services.
Individual Service Fund
• Money is held by a provider on
individual’s behalf
• Provider is accountable to individual
• Can be used in accom. based scheme
• Person decides how to spend the
money and can change this
• Person has reports of their account
• Money only to be spent on that
individual service
• Providers can respond to individual
contracts or transform block contracts
Personal Budget (PB)
• Personal Budget is when there is only ASC funding
involved
• Not the same as direct payments
• Some may decide to have it as direct payment
• PB = how much £, what outcomes, how and when spent
• Can be part direct/part indirect
Direct Payments
• A payment directly into a bank account
controlled by the individual to the value of
reasonably meeting assessed needs.
• Can be held by a third party on behalf of the
individual
• DP’s can be used to secure any service or
equipment in order to meet an assessed need.
– Employing personal assistants - Employers responsibilities.
– Socially inclusive activities.
– Purchase of equipment e.g. computer to enable online shopping
• The individual has control
Indirect Payments
• A payment made on behalf of the
individual - individual service fund or
• Money is retained by the Council:
Council Managed Budget
• Provider is also the broker of services /
goods on the individuals behalf
• Individual service agreement in place
that forms the basis of the support plan.
• Control remains with the individual in
that they may change provider if things
don’t work out.
How it fits together
The process by which public services
can be adapted to suit you
Personalisation
Self directed support
Individual
budgets
Personal
budgets
Support that is determined and
controlled by you, based on an
assessment of need by the state.
(Includes receiving cash, spending
on services that meet your needs, to
choosing which service you would
like to purchase )
Like an IB but solely
made up of social
care funding
Direct
payments
An indicative amount of
money that can combine
several funding sources that
you can use to purchase
services, from the public,
private or voluntary sector
A cash payment paid directly to you so you can
acquire your own services, rather than having them
delivered by the council
Resource Allocation System
• Tool used by LAs to assess how much money to allocate
to a personal or individual budget.
• The grounds for allocating resources must be
transparent, and people must know the amount of
available funding before they begin to plan how to use it.
• Need to define a clear and fair process for allocating cash
to particular levels of need; this is called the resource
allocation system (In Control, 2005).
Personalisation : Why Bother
• Right thing to do
• Person planning their own support - greater
engagement/control/choice
• Government direction of travel - past 15 years
• Contractual changes - forcing change
Vision for Adult Social Care:
DH Nov 2011
“Individuals not institutions take control of their care.
Personal budgets, preferably as direct payments, are
provided to all eligible people.
“Information about care and support is available for all
local people, regardless of whether or not they fund their
own care”.
“Personal Budgets for all by April 2013”
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Putting People First
 ‘Putting People First: A shared vision
and commitment to the transformation
of adult social care’ - through
personalisation, prevention and early
intervention
 Systems wide transformation with
significant progress expected by 2011
 Signed by 6 government departments,
the Local Government Association
(LGA) and the Association of Directors
of Adult Social Services (ADASS)
Putting People First
 Supporting people to live in their own
homes for longer
 Universal information, advice and
advocacy services
 Common assessment processes –
more self-assessment
 Telecare as integral not marginal
 Self directed support as the mainstream
– personal budgets for all, direct
payments for more people
 Greater role for voluntary sector and user
led organisations
 Renewed concentration on safeguarding
adults
Think Local Act Personal
• Concordat how sector will move forward with
Government's vision for adult social care
• Builds on learning from Putting People First
• Personalised community based approach for
all connected to preventative approaches
• Framework for action
• Provider blueprint
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People
Money
Support
Community
- learning and change
- back office
Reasons for continuing to
commission/purchase services
• Continuity and security
• Size of budget – smaller/limited amount
available for individuals to spend
• Anxiety over new ways of spending/new
providers
• Managed funded users more likely to opt for
mainstream services
Right to Control Trailblazers
• RtC included a number of funding streams
– Access to Work
– Work Choice (Jobcentre Plus specialist disability employment
programme late 2010)
– Housing related-support (Supporting People)
– Disabled Facilities Grants
– Independent Living Fund.
– Community Care Funding (e.g. Integrated Community
Equipment Service)
• Pilot authorities
• Barnsley, Sheffield, Essex, Greater Manchester,
Leicester, Barnet, Newham and Surrey
DCLG work on personalisation
• Personalisation working group
• Sub groups working on
resources for the sector
– Provider transformation
– Market management
– Co-production
• Microsite
• Festival of Ideas
• Learning events
Ongoing Issues
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Commissioners approach
Quality assessment
How is support going to be planned
Risk management
– Protection from Abuse and Safeguarding
• Money –
– How to achieve an equitable allocation of resources?
– Is there enough for people to achieve their outcomes?
– Who pays for brokerage?
Challenges in Supported Housing
• How to personalise accommodation based services?
• How much flexibility is there in schemes where high
levels of support are required 24 hours a day
• How much flexibility is there is schemes where levels
of support required are low
• Possibilities
– Still have a choice of support worker,
activities, room, food, etc.
– Person centred support plan
– Independent living and purchase support services from
different provider e.g. floating support
– Low support: scope for collaborative purchasing of services
One Housing
• Accommodation based 24 hour service for people
experiencing enduring ill mental health
• Core functions and flexible support that can be banked
included
– recruitment of a pool of skilled staff on flexible contracts
– creation of a working agreement between the customer and their
Flexi Hours worker
– database for recording Flexi Hour support, a contingency fund to
pay for staff to undertake activities with customers
– need for a ‘matching database’ to support customers in making
choices about who they want to deliver their Flexi Hours
Midland Heart
• Piloted Individual budgets for older people, people
experiencing ill mental health and people with learning
disabilities
• On back of customer engagement – finding out what the
customer wants
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Customer focus groups
Customer Newsletter group
Mystery customer programme
Customer panel
Appointing contractors
Service steering group
Look Ahead
• Coventry Road
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Move from block contracts to flexible support
Baseline service – safety and security provided by Look Ahead
Choice based intensive support service provided by Look Ahead
Personal budget services or goods from open market
• Other initiatives
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Separating out types of support
Zero based contracts
Offer personal support assistants to those on personal budgets
Customer involvement including customer services committee
Dimensions
• Two journeys
• Making it personal - what changed for
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Customer offer (menu approach)
Finance (costings)
Marketing
IT
Personnel
Learning and measuring progress
• Making it personal for everyone
– Block contracts towards individual service funds
Customer Journey
• At each stage of their journey with you
how much choice and control do
customers have – be honest
• How do you find out
– Their strengths
– What is important to them
– What they want to achieve
• What do you tell potential customers
about your service vs what do they want
to know
• How do customers access your service
• How do customers get services that best
achieve their outcomes
Preparations
• What are commissioners planning in the locality
you are providing services?
• Local commissioning strategies
• Are you preparing for providing services that
people want?
• How do you explain Personalisation to your
clients
• Don’t wait to hear - Act now
Challenges
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Workforce transformation – frontline workers are key
Risk and safeguarding
Changes to staff roles and professional boundaries
Could you / do you deliver a personalised service
Changes to all elements of infrastructure
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Human resources
Finance
IT
Training and development
Governance
• Customers as commissioners
Websites
•Personalisation microsite for housing care and
support www.sitra.org
•Personalisation Toolkit
www.toolkit.personalisation.org.uk
•Department of Health (Putting People First document)
www.dh.gov.uk
•In Control - www.in-control.org.uk
Contact Sitra
• policy, representation,
membership
• advice, information,
publications, helpline
• consultancy: service
development, tendering
• training: public
programme and inhouse
• conferences, seminars,
events management
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London SW8 1SJ
Phone: 020 7793 4710
Fax: 020 7793 4715
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