Transcript Three major themes

An Introduction to
Personalisation and Services
for Vision Impaired People
Pamela Lacy
Project Manager with RNIB
Evidence and Service Impact
Learning Objectives
• To describe the concept of personalisation
• To describe the context of personalisation in
health and social care
• To gain knowledge of some of the
terminology associated with personalisation
• To consider what personalisation might mean
for the Social Care Sector and Vision
Impaired People
What is Personalisation?
Veronica Alalade/L&D/Docs/May 2009
Personalisation
Personalisation means thinking about
public services in a different way,
starting with the person not the service.
• This means thinking about adult social
care in a different way too, starting with
the person in need of a service rather
than the service itself
• It is part of the government’s vision to
empower citizens to shape their own lives
and the services they receive
• It is a major part of ‘Putting People First’ –
a government initiative to transform adult
social care
The
commitment:
10 December
2007
Putting People First set out:
• A “shared vision and commitment to the
transformation of Adult Social Care”.
• “People who use social care services and
their families will increasingly shape and
commission their own services”
• “The state and statutory agencies will
have a different not lesser role – more
active and enabling, less controlling”.
A Definition
“Personalisation means putting the
person’s needs first to give them more
control in their life.”
Personalisation: an Easy Read guide
Social Care Institute for Excellence 2009
Where has personalisation
come from?
Veronica Alalade/L&D/Docs/May 2009
Background -1
• The service user movement which
emerged in the 1970s and the social
model of disability
• Policy thinking and ideas of researchers,
policy analysts and think tanks e.g.
Charles Leadbeater (Personalisation
through participation 2004b)
• The practical work of in Control
Background - 2
• Social work values – human dignity and
worth; social justice; service to humanity;
integrity and competence (BASW, 2002)
• Public policy – personalisation is a
central feature of the government’s
agenda for public sector reform
• Direct payments – in practical terms a
driving force behind the agenda has been
the experience of direct payments
Public Policy
• Independence, Well-being and Choice
(2005)
• More explicit in the subsequent white
paper Our Health our Care our Say: a
new direction for community services
(2006)
• Putting People First - December 2007
Clear Central Government Agenda
• Local Authority Circular ‘Transforming
Social Care’ issued by Department of
Health (DH) January 2008
• Social Care Reform Grant makes £500m
available to all councils providing Adult
Social Care
• Local leadership and planning is crucial
• Delivery of personal budgets stated as
essential part of the overall agenda
Some Essential Terminology
used in Personalisation
Veronica Alalade/L&D/Docs/May 2009
A Direct Payment
• A cash payment paid directly to you, so
you can acquire your own support, rather
than having this delivered by the Local
Authority Adult Social Care dept.
• It can be used to contract with a private or
voluntary sector agency or by hiring your
own personal assistant for your social care
• It is one of a range of options for people
getting a personal or individual budget
A Personal Budget
• This is a clear, up-front allocation of
money made up solely of social care
funding that you can use to purchase
support from the public, private or
voluntary sector
• It is given to users after an assessment,
and the amount of money allocated should
be sufficient to meet their assessed needs
• Current policy uses the term "personal
budgets" for adult social care funds only
An Individual Budget (IB) -1
• This involves being clear with the person
from the outset how much money is
available to meet their needs and allowing
them maximum choice over how the
money is spent and on what
• An IB can combine several funding
sources that you can use to design and
purchase support from the public, private
or voluntary sector
An Individual Budget (IB) -2
• Initially, individual budgets (IBs) were for
social care funds only
• Subsequently, in some areas, especially
the 13 Department of Health IB pilot sites,
emphasis has been placed on merging
social care funding with other income
streams to produce an “individual budget”
• E.g. Supporting People and funds for
equipment
An IB Verses a Personal Budget
Individual Budgets (IBs) differ from
personal budgets because they cover a
multitude of funding streams and not
just adult social care e.g. Supporting
People, Disabled Facilities Grant,
Independent Living Funds, Access to
Work and community equipment
services.
Practicalities
• IB is good for buying difficult to fund items like
computer software
• You can fund a personal reader for about a
year and a half for the cost of a mid range
CCTV
• Communicator guide schemes provide a
good template
• Training/accreditation for personal assistants
Why do we need to change?
The present System is:
• Based on matching a limited range of
services to people’s assessed needs
• Costs are rising and services are under
increasing demographic pressures
• Many people assess the current situation
as being ‘in crisis’
• The current system of social care is not
sustainable
Local authorities' response:
• Looked to make efficiency savings
(including shifting large volumes of inhouse services to the private and voluntary
sectors)
• Changing eligibility criteria to restrict
access
• The current system of social care is not
sustainable
Beyond ‘Community Care’
“The time has now come to build on best
practice and replace paternalistic,
reactive care of variable quality with a
mainstream system focused on
prevention, early intervention, enablement,
and high quality personally tailored
services.”
HM Government (2007) Putting People First:
A shared vision and commitment to the
transformation of Adult Social Care.
Example:
Ambridge Adult Social Care spend £2m each
year on a block contract for domiciliary and
respite care delivered in the community.
This funding is paid under a service level
agreement to their local service provider. It
buys personal care, respite beds and
occupational therapy.
But what does it actually achieve for the
people using those services?
Commission for outcomes and outputs is:
Judging success by the tangible benefits
achieved by the people that the services are
designed to serve.
This involves moving away from counting
the services given e.g. the number of hours
of domiciliary care or respite beds available,
to counting the desired outcomes achieved
e.g. being able to maintain an independent
life or have a break from caring by going on
holiday.
How will Personalisation be Different
to the system we have now - 1?
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Person-centred
Choice and Control to the end user
Outcomes not Services
Independence
Prevention
Early intervention
Self - Assessment
How will Personalisation be Different
to the system we have now - 2?
• The tailoring of services to respond to
individual needs, instead of individuals
having to fit in with a service
• Finding new collaborative ways of working
and developing partnerships, which then
produce a range of services for people to
choose from
• Greater recognition and support for carers
What is personalisation
about in practice?
Veronica Alalade/L&D/Docs/May 2009
Fair Access To Care - FACS
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Eligibility Criteria
Low, Moderate, Substantial, Critical
Most set at Substantial and Critical
DH consultation on the revision of the Fair
Access to Care Services guidance to
support councils to determine eligibility for
social care services within the policy
context of personalisation and prevention.
Responses required by 6th October 2009
Self Assessment
• A key element in personalisation; an
individual assesses their own needs and
decides on what outcomes need to achieve
• You need to complete a self-assessment
form explaining what help you need. Adult
Social Care must make the form available
to you in an accessible format
• The form is used to decide what level of
need you have and how much money to
pay you based on a Resource Allocation
System (RAS)
Resource Allocation System
• Some areas have developed RAS from
experience gained from operating the In
Control scheme
• Some areas have developed RAS from
scratch. Still ongoing and evolving (Oldham
now on version 6)
• At present no national scheme but guidance
available through DH regional personalisation
teams
What is the aim of a Support Plan?
A Support plan has to answer these questions:
• What is important to you?
• What do you want to change?
• How will you arrange your support?
• How will you spend your money?
• How will you manage your support?
• How will you stay in control?
• What will you do next?
Self-directed Support
• A term used to describe how a support plan
is designed and led by the service user and
concentrates on outcomes rather than
services
• the level of support is agreed in a fair, open
and flexible way
• the individual should control the support and
financial resources for their support in a way
that they choose
What are the key issues for
the social care sector as a
whole?
Veronica Alalade/L&D/Docs/May 2009
The personalised social care system
will need to meet these objectives:
• A universal information, advice and advocacy
service for people needing services including
those funding their own care
• Self-directed support becoming mainstream
• Viewing Telecare as integral rather than
marginal
• A commissioning process that encourage
services offering high standards of care, dignity,
maximum choice and control
Veronica Alalade/L&D/Docs/May 2009
The personalised social care system
will need to meet these objectives:
• a fair and transparent system for allocating
resources
• personal budgets as an option for anyone
eligible for publicly funded support
• an increase in the uptake of direct payments
• supporting people to remain in their own homes
for as long as possible, while combating
potential isolation
• ensuring people, their carers and families have a
collective voice, influencing policy and provision
Veronica Alalade/L&D/Docs/May 2009
What does personalisation
actually mean for
Vision Impaired People?
Veronica Alalade/L&D/Docs/May 2009
Learn about and apply the Core
principles of Personal Budgets
• Choice and control
• Upfront allocation of funding/budget
Resource Allocation System (RAS)
• Choice of support for planning/brokerage
• Choice of delivery e.g. Direct payments or
Commissioned Service
• Potential mix of funding streams
Influence the Transformation Agenda
• Personalisation
• Information, advice and advocacy
• Closer working between health and social
care
• Joint Strategic Needs Assessments
• Emphasis on prevention and early intervention
• Outcome based assessment & commissioning
• Brokerage
Use the Successes
• … seeing people who’ve had very, very
traditional style support for a very long time,
living much more independent lives than they
had done. (IB lead officer)
• People are actually living, not existing and
they have stories that have changed the
hearts and minds of not only the care
managers but of the elected members. (IB
lead officer)
Overcome the Challenges
• I don’t think you will ever get a Resource
Allocation System that is accurate enough to
say this is an entitlement-based system … I
think it will only ever be indicative. (IB lead
officer)
• Managing the tension between the long-term
focus on outcomes of some individual budget
arrangements with the shorter-term risk focus
within the FACS approach was also noted as a
challenge.
Raise Awareness of:
• Resource Allocation System (RAS)
– Proper representation of sensory needs
• The FACS gateway
– Fully represents needs and risks
• Support for people with low level needs
– Care navigators
Help to engage with Local Involvement
Networks and Commissioners so that
we can:
– Improve care pathways
– Achieve the best mix for people of
health/social care/3rd sector input
– Shift choice and control from professionals
to users and carers
– Users and carers become partners in the
commissioning process
– Develop services people want to buy
Required LA Deliverables
• By March 2011 Local Authorities need to
have made significant moves towards
fundamental system wide change
• National Indicator (NI)130 is linked to
Personalisation and is mandatory. To
achieve this target, Local Authorities need
to have a minimum of a 30% take-up of
Individual Budgets by service users, by the
end of the 2010/11 financial year
Our Future?
“Over time, people who use social care
services and their families will increasingly
shape and commission their own services.
Personal Budgets will ensure people
receiving public funding use available
resources to choose their own support
services – a right previously available only
to self-funders.”
Putting People First – December 2007
• www.scie-socialcareonline.org.uk
• www.in-control.org.uk
• www.integratedcarenetwork.gov.uk/Per
sonalisation
• www.dh.gov.uk/en/SocialCare/Socialcar
ereform/Personalisation/index.htm
• www.dhcarenetworks.org.uk/personalis
ation
• www.supportplanning.org
Contact Information:
Patrick Haywood
RNIB
58-72 John Bright Street
Birmingham
B1 1BN
Email: [email protected]
Tel: 0121 665 4243
Pamela Lacy
Mobile: 07528 531909
Email: [email protected]
What do you think?
Veronica Alalade/L&D/Docs/May 2009