A Review of Overnight Supports Lynne set the scene about the PSP working – 3 years, funded part finished, continue working, through course of PSP we already did original mapping exercise . Partnership working continues , we meet regularly, clear communication as we move forward with implementation. Heather and Mary will talk more about their experience of this.

The Project Plan Project Team Contractual information gathering Scoping the fact and figures TEC Timescales Project Plan – Lynne and Angie – identified costs of sleepover as is, new costs in relation tribunal case. Changed costs to an hourly rate and significantly increased cost from £850,000 to £1.3 million, now going up to £2.3m Project team – 2 from commissioning – 1 LD care manager and 1 team manager from different discipline – benefits – look at risk differently. Historically LD comes overprotective culture. Stage 1 contractual basis – to not raise concerns and just to scope out possibilities

Review of Overnight Supports Person Centred Risk Assessment Tools were used to gather information on our thinking about overnight support and risk enablement from everyone’s perspective. Information was gathered through overnight support recordings and discussion with the important people and a Just Enough Support Grid was developed to provide information on typical supported and unsupported activities and routines overnight An initial action plan was developed to inform how we will reduce overnight support where appropriate and the identified risks associated with our learning. 1. happy to talk about the content of this later.. f 2. Risk enablement tool – looked risk different perspectives – thinking tools 3 Stage 1 we asked Providers to share perspectives – Access to care first, nursing notes . Pick up on live information to be as robust as possible – Information form a paper on possibilities for savings to DMT.

Review of Overnight Supports Stage 1 – Options Review of Overnight Supports This gives an overview of possible outcomes 3 outcomes identified and we used person centred thinking tools to explore

Stage 2 Actions Move directly to implementation stage with consultation Risk Enablement Review to plan & implement TEC with responder service Continue with same overnight support and continue to review This is still progressing – we can talk about how this is looking = the challenges, the learning , the partnership working later

9 Providers supported people within a mix of individual and shared tenancies.

Individual Tenancies – 20 people and from these 20 Stage 1, 14 Nov– 21st Dec Total Numbers currently receiving overnight support as sleepovers- 67 people and from these 67 Individual Tenancies – 20 people and from these 20 No overnight presence required Need a Telecare responder service Continued overnight presence Residential service 17 28 21 1 No overnight presence required Need a Telecare responder service Continued overnight presence Residential service 5 4 10 1 67 people are funded to receive overnight support in the form of a sleepover. 21 of these resided within individual tenancies. Benefits to change – tenancies - pe

Shared tenancies - 47 people and from these 47 Location Number of shared tenancies Number of people sharing No overnight presence required Need a Telecare responder service Continued overnight presence Residential service Provider A 5 10 2 7 1 Provider B 8 Provider C Provider D 15 Provider E Provider F Provider G 4 6 Provider H Provider I Totals 22 47 9 27 11 Issue - for each home – this is an extra bedroom – funding – but may also be a way to look at future planning for people who have long been in the position of sharing with someone they are not compatible with. 3 in arnside, 7 in bridge , john william shareed laura wendy shared. Only 11 people required as is support. What does this say about our attitude to risk if others are benfitting from inappropriate support now and future. How do you unpick enforced risk adversness. To date one overnight gone – deceased £32,850 p/a And 3 other shared overnight removed £20,630 p/a

What we have learned The Public Social Partnership has provided us with the positive relationships with Providers and the culture of moving forward together The importance of buy in at a strategic level both within the PSP and with individual organisations. The process works best when there is a shared culture of risk enablement We think that putting TEC in as we began would support a smoother transition from Stage 1 to Stage 2 e.g. “Just checking” We learned that there are lots of examples of people who are not compatible who share a home We need look at housing availability as there may be a risk of financial burden for people who live in under occupied housing. Buy in at a strategic level Briefing for counsellors, briefing for GPs, tec just checking ,

Over Night Support Re-design Cosgrove Heather Gray Chief Executive

Principles Senior Officer buy-in with Trustee support Proactive approach with HSCP- solutions focused Strong messages about approach and intended outcomes. Developing solutions and innovative practice by working with staff, families and care managers. Aligning outcomes with HSCP partners and creating trust Research and evidence base for teams and creating champions Tests of change Steering group development with clear terms of reference Effective communication and project plans Trust and relationships

Steering Group- Over Night Support Redesign - Agree guiding principles around overnight support redesign and key messages about process for all- risk enablement. Research tests of change and approach for implementation. Identify, train and oversee Champions within services Agree evaluation methods and sign off risk assessments Ensure the voices of families are heard and taken into account in the design of the process Ensure reporting and communication with HSCP is in place and project plan is developed and updated Oversee development of and implementation of tests of change Agree communication plans across stakeholder groups and ensure these are up to date, relevant and working Problem solve and oversee any issues arising, ensuring effective communication with HSCP and other key partners.

Three Stage Approach Stage 1 Stage 2 Stage 3 Steering Group Development Mobile waking night team in place alongside sleepover Communication and key messages agreed and comms plan in place Champions Technology Evaluation and actions for first group agreed and review intervals in place Stage 2 Review process and transition support for group 1 Work progresses with second group Steering Group midpoint evaluation of impact and lessons learned Evaluation and actions agreed for second group and lessons learned Share practice and learning Stage 3 Evaluate impact/outcomes for group 1 Transition support for group 2 Evidence base and learning points presented Share practice and learning. Align with strategic priorities. Communicate impact and model.

Cosgrove Care – Work stream Next Stage Cosgrove Care responsible for pilot site – 2 buildings = 1 building (7 people for 1 one sleepover. Next building = 3 people for 1 overnight) . Proposal of one responder between the 2 buildings Current budget: £65,700. Replaced with one waking night for 4 houses@£57,378 Initial Saving of £8322 Future Staged Planning -The responder service taking on majority of remaining overnight supports . This equates to 2 people x one sleepover, 1 single tenancy x one sleepover, 2 people x one sleepover , 1 person with share of sleepover (different authority) = 3.5 sleepovers Current Budget of £114,975 Potential savings if Responder was 1 waking night = £123,297 Potential savings if Responder was 2 waking night = £ 57,597 TEC Costs to come from savings but not high

The Mungo Foundation – Work stream Next Stage The Mungo Foundation responsible for pilot site – which is 9 people supported by 4 sleepovers , 3 houses x 2 people and 1 house x 3 people . Current budget: £131,400 Replaced with one waking night for 4 houses: £56,575 Savings of £74,825 TEC Costs to come from savings but not high

Contact Details THANK YOU East Renfrewshire HSCP 12