Getting commissioned to deliver innovation and personalised outcomes Mike Wright, Development Director, KeyRing Living Support Networks 26 th November 2009

KeyRing Networks This is how a KeyRing Network might look Community Living Volunteer’s flat

Innovative & Personalised Use of a volunteer who lives round the corner Available when Members want it, in the form that Members want Support comes from: Other Members Community Living Volunteer Neighbourhood links Community Support Worker Supported Living Manager Team Manager

Outcome based Flexibility Co-production Responsive/preventative Prevents isolation Develops citizenship Increased choice Personalisation by design

Demand for Innovation? ‘Yes’ – KeyRing nearly 20 years old Now over 100 Living Support Networks across England & Wales Support some 900 people Work with over 50 Local Authorities

Future appetite for innovation? ‘Yes’ – Individualisation/SDS Need to improve value for money Valuing People Now etc., etc.

Future appetite for innovation? ‘No’ – Policy to reduce residential care yet spend is increasing Little bravery Time Bigger, less varied services

Outcomes - Prove it! Case studies/history –Written and specific –In person –The whole truth Monitoring plus Champions Service user involvement

Measure it! Measure what you can Use relevant indicators Measure a sample Discuss what and how Get someone else to measure it! Many of the things you can count, don't count. Many of the things you can't count, really count. Albert Einstein

Why? Consistent with several strands of CSED work, e.g.: –Individuals having suitable & supportive home environment –Reversal of current over reliance on expensive and inflexible residential types of support –Emphasises enablement (rather than dependence) –Allows support that is highly flexible and needs led –It is consistent with co-production, through mutual support –Support from a range of agencies is better co- ordinated and, therefore, more effective in terms of individual outcomes costs

What? – Cost Savings NetworkNumber of Current FTE Members Annual Cost of the Network Savings on alternative support Net Saving/ (Cost) Inner City9£30,630£47,590£16,960 Market Town9£38,090£55,430£17,340 Rural7.5£41,200£42,945£1,745 Total25.5£109,920£145,965£36,045 Ave per FTE Membern/a£4,310£5,724£1,414 Adjusted averagesn/a£4,233£5,724£1,491

What? – Cost Savings NetworkNumber of Current FTE Members Annual Cost of the Network Savings on alternative support Net Saving/ (Cost) Inner City9£30,630£47,590£16,960 Market Town9£38,090£55,430£17,340 Rural7.5£41,200£42,945£1,745 Total25.5£109,920£145,965£36,045 Ave per FTE Membern/a£4,310£5,724£1,414 Adjusted averagesn/a£4,233£5,724£1,491

What? – Cost Savings NetworkNumber of Current FTE Members Annual Cost of the Network Savings on alternative support Net Saving/ (Cost) Inner City9£30,630£47,590£16,960 Market Town9£38,090£55,430£17,340 Rural7.5£41,200£42,945£1,745 Total25.5£109,920£145,965£36,045 Ave per FTE Membern/a£4,310£5,724£1,414 Adjusted averagesn/a£4,233£5,724£1,491

What? – Cost Savings NetworkNumber of Current FTE Members Annual Cost of the Network Savings on alternative support Net Saving/ (Cost) Inner City9£30,630£47,590£16,960 Market Town9£38,090£55,430£17,340 Rural7.5£41,200£42,945£1,745 Total25.5£109,920£145,965£36,045 Ave per FTE Membern/a£4,310£5,724£1,414 Adjusted averagesn/a£4,233£5,724£1,491

What? – Outcomes Individual support plans showed good outcomes: “Before KeyRing I didn’t do nothing, never went out, had no social life. Now I do!” Move from high levels of support to living independently in the community None had lost their tenancy nor experienced homelessness during there time with KeyRing While some Members had experienced some abuse, KeyRing had effectively detected abuse at an early stage and acted to prevent it escalating

Conclusions Fully consistent with “Valuing People Now” & “Putting People First” Help adults with support needs to achieve more than traditional forms of support Are cost effective as costs are more than offset by reductions in other forms of support

Conclusions ‘We were keen to include Living Support Networks in our portfolio of case studies because, at present, relatively few exist while potentially many thousands of people could contribute to and benefit from being Members of them i.e. there is significant potential to expand the use of LSNs where commissioning processes identify they could be cost effective.’

Potential barriers to purchase Not delivered by the hour Not costed by the hour Low direct costs = higher central costs ratio Little passporting Invest to save (More) paid for support is ‘better’ Expectations of other people Identifying people before escalation Housing allocation policy

Tips to get better and wider outcomes Discuss what providers could offer to help achieve what commissioners want Before procurement process is planned Procurement processes to get quality without restricting innovation and choice Indicators when measuring is difficult Talk to and trust others Take the long-term view Change culture from where people are at

Thank you for listening