1. The FlexiCare Grant

2. Content Objectives for Flexicare Background and rationale How Flexicare will work FAQs

3. Flexicare Objectives A service model which: –can be consistently applied; –provides the right services; –offers appropriate choice and control; –is affordable for people living in Flexicare and the County Council; –is viable for providers; and –safeguards people.

4. Housing Management Housing Support Care Housing Contract Care Contract Care Contract Supporting People Contract

5. CARE SUPPORT

6. Strategic Review 2009 Block Contracts for Care: –Does not allow for client choice / personalisation –Bandings can be restrictive –Can residents without care needs access unplanned care? Should the County Council commission services separately?

7. Why provide choice / personalisation? Older adults generally report personal budgets as having a positive impact on their lives, where there is: –Self determination –An adequate budget –Help with support planning However, older adults more likely to have a ‘managed budget’ and miss out on some of the positive impacts.

8. Outcomes of personal budgets Centre for Disability Research Older people and personal budgets: A re-analysis of data from the National Personal Budget Survey 2011

9. Housing Management Housing Support Care Care & Support Care

10. The Flexicare Strategy Recognised benefits of an ‘Integrated Service’ –Better services for residents –Better value for money Impact 2020 –Flexicare housing will be seen as a positive, high quality, affordable, value for money option –People who live in flexicare housing will have choice and control

11. Housing Management Housing Support Care Care & Support Care Activities Catering

13. Housing Management Housing Support Care Old way

14. Housing Management Care & Support Care Activities Catering The Flexicare Way

15. Flexicare MENU

16. Main On Site Staff 24/7 Cover Emergency Alarm / Assistive Technology Emergency / Unplanned Support Housing Related Support Activities ?? Catering ?? £~?? per week

17. Extras Personalised Care & Support, e.g.: Home help Shopping Cleaning Washing Dressing Going out Leisure activities Computer lessons etc, etc, etc

18. That’s the theory….

19. Making it happen Turn to the internet…

20. Housing Management Housing Support Unplanned Care Care £Rent from Resident or Housing Benefit £SP funding or Resident £Fairer Charging £?????????? Must allow choice of planned care provider

21. Who pays for unplanned care? Social Care in full? –Can tender and have a contract –Unaffordable for the Council Residents in full? –No relationship with the Council –Expensive for residents? Social Care and Residents shared? –How?

22. Fairer Charging National Legislation on charging to meet assessed care needs Must leave a person with pension credit + 25% to live on Charge must be related to assessed care needs Can only have a flat charge in certain restricted circumstances

23. GRANT FUNDING

24. County Council Landlord (Community Anchor) Residents Provider Provider

25. Funding the Integrated Service Grant to be around £50k pa

26. Cost per unit per week (not rent) £50k grant for a typical 60 unit scheme is worth £16 per week per unit

27. Value for Money examples Ways to take advantage of integrated service delivery: –private arrangements with residents for shopping, preparation of meals, cleaning, etc.; –staff on call at night carrying out laundry and quiet cleaning; –some parts of housing support being delivered as floating support; –using care staff to provide housing support; –using assistive technology to check on residents; or –offering services to the wider community (e.g. day opportunities)

28. FLEXICARE 24/7 Care At least one person on site 24/7 who can provide ‘care’ Can have more, dependant upon –Care profile of residents; or –Residents willing to pay FLEXICARE

29. Grant Funding - benefits No contractual relationship, so Fairer Charging rules don’t apply Housing providers can get on with providing a full service in their scheme Share costs between Council & Residents Residents get a say on what is spent Maximise economies. Minimal procurement

30. Grant Funding – more benefits Grant conditions – can still monitor Bidding round for housing providers 3 year grants Potential for converting sheltered housing? Charge to residents may be partly covered by proposed changes to Housing Benefits?

31. FAQs Who can bid for the grant? –Only landlords of suitable accommodation So what is ‘suitable accommodation’? –Self contained units of accommodation (‘own front door’) –Generally for older people –Access to communal facilities –24/7 CQC registered care service on site

32. FAQs Where would the grant be funded from? –The existing SP and current waking nights funding What if I don’t bid for / secure grant funding? –Council would then only pay for assessed care needs (fairer charged)

33. FAQs How would flexibility in care needs be ensured –Direct payments include a 4 week ‘buffer’ which allows for week-by-week variations and short episodes of increased needs What if I’m a landlord who doesn’t provide care –Need to subcontract or arrange for CQC registered provider

34. FAQs Would this affect allocations? –No, would still want to see balanced communities. SCC would retain nomination rights where they exist. Need minimum number of residents with care needs (20-25) What about charges to residents? –For providers to decide in consultation with residents –Maximum linked to Pension Credit Guarantee –Unless residents agree otherwise

37. Extra Care Suitability at LSOA Seeking to encourage more development – Many providers told us that they will only build if they can provide services too

38. Core & Cluster Approach

39. The Flexicare Grant Giving providers the freedom to develop and deliver excellent services to meet the needs of their residents Giving residents excellent services, transparent cost structures and choice and control over the care they need Giving the County Council a consistent approach to commissioning, and a real alternative to residential care

40. The FlexiCare Grant