Personalisation – what does it mean ? Levers for Change event 1 st May 2009

Clear central government agenda - 1. Putting People First (December 2007) 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”.

Clear central government agenda 2. Transforming Social Care (January 2008and 2009 ) provided further details on the significant resources being made available to councils to transform social care. The Social Care Reform Grant makes £500m available to all councils providing Adult Social Care There is room for local control in this agenda and so local leadership and planning is crucial The delivery of personal budgets is stated to be an essential part of the overall agenda.

Why do we need to change? The present system – 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 who are not eligible for services receive little help and support - Services respond to crises and high level needs only Local authorities' response to date – Looked to make efficiency savings (including shifting large volumes of in-house services to the private and voluntary sectors) – Changing eligibility criteria to restrict access. The current system of social care is not sustainable.

Elements of Putting People First Early intervention Re-ablement Joint working Personal budgets Personalised services Self directed support Neighbourhood networks Family and friends User led groups Vol. orgs. Information and advice Leisure services Transport

What are we trying to achieve? A new relationship between citizens and their public servants A single, coherent system able to respond to the differing needs of individual citizens A shift from crisis intervention towards enablement and early intervention to promote independence Support and services built around the specific needs and aspirations of individuals: to fit into their lives

Transformation – Challenges Scale and breadth of change required Culture change Involving users and carers Lack of capacity – in the market, within LAs Scarcity of skills ( personalised approaches) Leadership and sign up Uncertainty about the future shape of services – implications for workforce and commissioning Double running of systems Whole system approaches across health, social care and wider partnerships

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 DPs or commissioned service Potential mix of funding streams

Co-production Need to develop viable models of citizen commissioning because Many more users will become commissioners in their own right Inclusion means access to more universal services Need to develop services people want to buy Choice as well as needs should be reflected in Strategic Needs Assessments Users and carers should become partners in the commissioning process

Personalisation in practice Focuses on people rather than services Promotes self management and autonomy Real choice and control Focuses services on outcomes – little things can make a big difference Emphasises what people can do rather than what they can’t do Promotes inclusion and participation in the community Services and support fit in with everyday lives

Service user Lesley took part in the BANES Individual Budget Pilot Programme. Describing how she takes life one day at a time since being diagnosed with Rheumatoid Arthritis, she explained how she made use of her Individual Budget: to employ a family member to provide personal care to purchase help with laundry and transport Lesley said it's critical for services to work together on personalised care. A crisis in her housing meant her individual budget wasn't currently available, but she hopes to go back on it soon. "It's the first time I've been asked what I want... I can't leap around anymore but I can be effective".

Some of the things that people have done with their money Employing a neighbour Broadband access Purchase of a mobile phone Driving lessons Massage/ aromatherapy Buying an air conditioning unit Renting a workshop (two people together) Paying for travelling to stay with relative for a break

Pam Richards Personalisation Coordinator for the South West Region Tel