What is happening in Britain? Personalisation of Social Care

What happens in Britain? Four countries England, Scotland, Wales and N. Ireland Hospitals have closed NHS Campuses are closing Still lots of out of county placements Commissioning transferred to local authorities Mixed economy Voluntary Sector, Private sector, some public sector Mix of models Residential care, Supported Living, Self Directed Support

Valuing People 2001 “To improve the lives of people with a learning disability and their families and carers, based on their rights as citizens, social inclusion in local communities, choice in their daily lives and real opportunities to be independent.” Valuing People 2001

Valuing People Now2008 What Valuing People Now is about Improve the way we give services to people using them Making sure change happens

Improve the services offered to people Personalisation What people do Health Housing

in Control

Putting People First2007 A shared vision and commitment to the transformation of Adult Social Care /Publications/PublicationsPolicyAndguidance/DH_

Why Personalisation? The present system is not working well for several reasons It does not control costs well, especially when needs are perceived to be more complex. It limits creativity, innovation and community development. It discourages family and community support solutions It does not result in a good alignment between individual level of needs and level of service. But most fundamentally, by not telling people what level of funding they have available, it stops disabled people from deciding for themselves how they want to be supported

Personalisation - No longer if but how and when SDS is a new model of social care. SDS is about individuals receiving a personal budget that they control to meet their own care needs, rather than the current service led approach. It has the potential to improve the lives of vulnerable people by offering them more choice and control. SDS is planned to be rolled out nationally by 2012.

Social Care vs. SDS Social CareSelf Directed Support Vulnerable people need professional support Vulnerable people should control their own lives Existing services work wellSupport should be individually tailored Money is safest in the control of the state Money should be close to the individual Family and friends are unreliable Family and friends have a vital role to play

Lessons from other Sectors, Greater Consumerism Means Constantly innovating Constantly improving product Better quality Better price More individualised

Current resource allocation system

SDS resource allocation system

Options for receiving SDS with an individualised budget Direct Payment Direct Payment (agent) Direct Payment (trust) Broker Individual Service Fund Care Manager

What is Service Brokerage? Service Users + Financial Allocation Informal SupportProvider Organisation 1 Provider Organisation 2 Provider Organisation 3 Service Broker

In Control sees Brokerage as a set of functions Assisting the person to develop a vision of how he or she wants to live Reviewing, preparing and/or identifying indicative costs of creating and implementing a support plan Clarifying the person’s needs and expectations, including, in the light of the local authority’s assessment, eligibility criteria under Fair Access to Care Identifying and applying for funding from all government and non-government sources Supporting the Fair Access to Care appeals process if required Identifying and enabling the person to access community resources Assisting with funding negotiation with commissioners Liaising and negotiating with support providers Monitoring and evaluating support Modifying existing supports or develop new ones Mediating and resolving problems (as directed by the person ) A report on in Control’s Second Phase – Evaluation and Learning

Impact on the Market? Good quality, flexible, innovative providers will prosper Poor quality providers will fade Expectation that quality will go up and prices go down Potential for development of a lot of informal arrangements Marketing directed at consumers will be developed There will be opportunities for individual solutions

Seven steps to being 1. My money – finding out how much 2. Making my plan 3. Getting my plan agreed 4. Organising my money 5. Organising my support 6. Living life 7. Seeing how it worked

The Choice Support group at a glance Current turnover circa £32.5 million Support 750 people Employ 1300 staff Operates in …………………. Wakefield Nottinghamshire Stockport Oldham Leicestershire Bedfordshire Milton Keynes Buckinghamshire Hackney Haringey Greenwich Lewisham Southwark Lambeth Bromley Sutton Merton Hampshire Southampton Portsmouth

Preparation presentations by ‘in Control’, Paradigm managers (40+) 9 Managers attend Paradigm Brokerage for Change course CEO joins ‘in Control’ CEO group New bespoke individual accounting system developed and installed Management re-organisation

Formula for identifying support

Dealing with resistance “There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. Because the innovator has for enemies all those who have done well under the old conditions, and lukewarm defenders in those who may do well under the new”. Machiavelli

First steps in individualising services and reducing costs Lincolnshire – RAS 4 Individual services for people who present significant challenge

What’s happening now? Direct Payments Support Finance Personnel Free Service Brokerage Total transformation of a £7 million contract

Challenges Managing traditional services alongside new Ability to change organisational culture Ability to change systems and structures Ability to make desired savings Loss of control Loss of business Serving many masters - responsiveness Workforce transition Marketing – looking both ways Total transformation of funding of social care required To make better use of all of the available money in the system

Opportunities Those organisations that are able to respond positively can expand their business. Diversification – HR; Payroll; training; etc. Move away from contracting “culture” and reliance on “good relationships” with those in power. The credit crunch The opportunity to abandon the current failing social care system for one that is fairer, more responsive and delivers what the customer wants