Sharing Good Practice when working with Domiciliary Care Providers 10th October 2013

Outcome Based Commissioning “The need for Personalisation and for Outcomes Based Commissioning has been the dominant narrative in Social Care delivery for the last decade at least. If we accept that it is not yet fully imbedded, we must ask why we have not progressed further. What questions must be answered before Outcome-Based Commissioning can be really put into practice” Outcomes Matter Effective Commissioning in Domiciliary Care – October 2012

How does Outcome-Based Commissioning work? Outcome-Based Commissioning – Does it work? – if not, why not? What are the barriers to Outcome-Based commissioning? Time / Task approach? Payment vs Care

Person Centred Approach “In care and support, quality starts from what matters most to enable people to live their lives in the way they want. By definition, there can be no “one size fits all” in personalised care and support. Getting the right balance for people can only be achieved through a person-centred approach which understands someone’s personal history, current circumstances, future aspirations and what is important to them. This may change over time – so it is important not to make assumptions.” Driving Up Quality in Adult Social Care (Think Local, Act Personal) – What is Quality? March 2013

What does Person Centred Approach mean? Who knows the person best? Themselves or family / advocate, commissioner, provider / carer? What does Person Centred Approach mean? Do commissioners respect the need for person centred care – is this evident in the contracting of hours? Support Plan vs Care Plan vs Commissioned time

Improving relationships between commissioners and providers “Many service providers still feel that they are given contracts based on the lowest cost of output per hour and not the results they can deliver. This can reduce the need for them to respond flexibly to individual demands and can actually work against the service user interests. Providers are given an active incentive to increase, rather than manage an individual’s need for care, as they will receive more hours of work as the package grows” Outcome-based commissioning in Domiciliary Care: overview of regional roundtables – LGiU, March 2013

Is this commonly the case? What can we do to improve? What are the barriers to being able to improve?

Private Providers, only in it for profit? “a recent engagement event with over 50 homecare providers, suggests that a sizeable number are already attempting to reduce the volume of business they undertake with councils in favour of private purchase. Providers’ ability to follow this course of action successfully will obviously depend on the relative affluence of the local population, but it raises questions about the availability of services to people receiving state-funded support in the future” Care is not a Commodity – UKHCA Commissioning Survey – July 2012

Are private providers only in it for profit?

Can you trust a Care Worker? “People’s experience of care and support depends heavily on the sensitivity and compassion of the care workers who work with them” Caring for our Future – reforming care and support – July 2012

Can you trust a Care Worker? Do you feel leadership and training are issues? Who is responsible for the workforce development of Registered Managers and Care staff? Are the LA / CCG’s providing adequate funding / training? Do Commissioners empower the care workforce? Is CQC’s action adequate that care workers training just needs to meet the essential standard?

Local Healthwatch

Do you have any current positive or negative experience regarding Healthwatch?

Overview Outcome Based Commissioning Person Centred Approach Improving relationships between commissioners and providers Private Providers – only in it for profit??? Can you trust a Care Worker? Local Healthwatch THANK YOU FOR YOUR TIME