Welcome 13 th July 2015 Exploring opportunities for sustainability in a post Care Act world

SESSION OBJECTIVES Through this workshop attendees will: Be briefed about key legislative changes through the Care Act 2014 Explore challenges and opportunities for Care Providers arising from the changes Complete individual Action Plans

Setting the Scene

KEY LEGISLATIVE CHANGES BEFORE ACT: Confusing statute Focus on provision of services Delivery chiefly about crisis intervention Limited support for carers Variable Fair Access to Care Services Eligibility Open ended care costs and limited financial advice/options : Single, clear modern statute Focus on individual wellbeing Delivery emphasis on prevention including extra rights for carers National minimum eligibility threshold Capped care costs, plus deferred payments and enhanced access to financial advice

Key areas of change: Implementation from April 2015: Additional assessments and changes to eligibility Universal offer: Advice and information, Prevention Market shaping and commissioning Funding reform (deferred payments) For implementation in April 2016: Funding reform (cap on care costs) Appeals against local authority decisions made under Part 1 of the Act

The framework of the Act and its statutory guidance 6 Assessment and eligibility Charging and financial assessment Care and support planning Personal budgets and direct payments Review Key processes Prevention Integration, partnerships and transitions Information, advice and advocacy Diversity of provision and market oversight Safeguarding General responsibilities and key duties Wellbeing Underpinning principle

Care Act: Principles into Practice What is key to delivering the vision of the Care Act in practice: A system that promotes people's independence and wellbeing Based on the principle that people should have control of their care and support and be able to make the choices that are right for them Good care should mean care that is built around the whole person, their skills, aspirations and preferences as well as their needs Good care should also extend the opportunity for independence and help to build stronger community links, not just for the few, but for everybody

Theme 1: Wellbeing

The Wellbeing principle  Wellbeing broadly defined: 9 areas in particular  Local authorities should also have regard to other key principles when carrying out their activities, such as beginning with the assumption that the individual is best-placed to judge their well-being  “wellbeing” should be seen as the common theme around which care and support is built at local and national level.” 9 “The general duty of a local authority, … in the case of an individual, is to promote that individual’s wellbeing”.

Definition of Wellbeing Wellbeing is a broad concept, and the statutory guidance defines it as relating to the following nine areas in particular:  personal dignity (including treatment of the individual with respect)  physical and mental health and emotional wellbeing  protection from abuse and neglect  control by the individual over day-to-day life (including over care and support provided and the way it is provided)  participation in work, education, training or recreation  social and economic wellbeing  domestic, family and personal relationships  suitability of living accommodation  the individual’s contribution to society

Caring for our Future: Reforming care and support Maintaining independence: I am supported to maintain my independence for as long as possible Quality: I am happy with the quality of my care and support Dignity and respect: I know that the person giving me care and support will treat me with dignity and respect. Taking control: I am in control of my care and support How care and support works: I understand how care and support works, and what my entitlements and responsibilities are. 5 statements:

12 CQC operating model

What will be different: The PIR and questionnaires 14 Provider information return: Provider Questionnaires: People who use the service Family and friends Staff Community professionals Aligned to the 5 key questions

The Care Act and the new CQC inspection regime are aligned and define good care as: “..care that is built around the whole person, their skills, aspirations and preferences as well as their needs…” How does this descriptor fit with your current services? Where are you now? How far is personalisation currently embedded in your organisation? What opportunities does this definition provide to improve the quality of care and support services? Next steps?

Theme 2: Market Shaping & Commissioning

The Care Act: market shaping Local authority Market ALL LOCAL PEOPLE Market shaping and commissioning Duty on local authorities to promote a sustainable, diverse and vibrant market for care and support that delivers high quality services for all local people. – Focusing on outcomes and promoting wellbeing – Promoting choice to drive quality – Supporting sustainability – Working with partners and people who use care/carers – Approaches to market intelligence and facilitation – Importance of workforce development and pay – Securing quality and outcomes through contracting TLAP MARKETS PPT.

Key Definitions: Market Position Statement A Market Position Statement lays the foundations of relationships between the Local Authority and providers of social care services. It should cover all potential and actual users of services in the local area, not just those that the access state funds. An MPS should signal to Providers commissioners’ intentions to commission services now and in the future to enable them to respond effectively. They are likely to include summaries of the needs of the area, including the outcomes that people using services and the local population want to achieve and the activities the Local Authority will undertake to meet needs.

Market Shaping & Commissioning – How? Steps which local authorities should take to develop and implement local approaches to market shaping and commissioning:  Understanding the market  Designing strategies that assess and meet local needs, including likely trends that reflect people’s evolving needs and aspirations, and based on evidence  Engaging with providers and local communities  Facilitating the development of the market, including influencing the market to achieve the desired outcomes, for example, incentivising innovation by user-led or third sector providers, possibly through grant funding  Integrating their approach with local partners  Articulating an understanding of supply, demand and future intent through a market position statement  Securing supply in the market and assuring its quality and value for money through contracting.

What is the level of your engagement with your LA in relation to market shaping? Do you have access to local market intelligence? What do you know about the likely local trends in peoples needs and aspirations? What kinds of market/customer research and/or business development planning does your organisation undertake? What opportunities might the Care Act provide for your organisation? Action needed to move things on?

Theme 3: Innovation and Collaboration

The value of social care Every minute of every day people working in social care make a distinctive, valued and personal contribution to the lives of over a million people and their families/carers. They deserve to be trained, paid and valued in a way that is commensurate with the quality of service society rightly expects of them RAY JAMES, new President of ADASS

Market Shaping and Resourcing of Care & Support When commissioning services, local authorities should assure themselves and have evidence that contract terms, conditions and fee levels for care and support services are appropriate to provide the delivery of the agreed care packages with agreed quality of care. This should support and promote the wellbeing of people who receive care and support, and allow for the service provider ability to meet statutory obligations to pay at least the national minimum wage and provide effective training and development of staff. It should also allow retention of staff commensurate with delivering services to the agreed quality, and encourage innovation and improvement. Local authorities should have regard to guidance on minimum fee levels necessary to provide this assurance, taking account of the local economic environment.

The Reality on the ground “ …funding cuts had forced social services bosses to make a series of “invidious” decisions over care. As a result councils have tightened eligibility criteria for care and squeezed fees for providers – with the latter move having a knock-on impact on working conditions for staff and the financial stability of some care firms. Without extra funding those trends would likely continue… We are concerned given the backdrop it may well be that some social care services will become unsustainable by ”

What does “diversification” mean? What opportunities are there in diversification of services, market place or customers? Opportunities for working collaboratively with other Providers? - back office costs? - marketing costs? - sharing costs of posts, e.g. activity co- ordinators? How could this happen/be enabled? Next steps?