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Personalisation Self Directed Support & Supported Employment in Scotland
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Self-directed Support Self-directed support is a route to greater independence and citizenship for individuals with care and support needs.
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Self-directed Support Bill 1. Involvement 2. Informed Choice 3. Collaboration
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SUSE Capacity Building Exploring the connection between work, supported employment and self-directed support Clarifying how SDS systems can help people get work Exploring what supported employment service providers can do to take advantage of SDS to help disabled people get work
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SDS and Supported Employment The aims Build capacity Develop tools to help providers engage with commissioners and explore options The activity 1.Consultation exercise 2. Desk research
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SDS and Supported Employment Consultation exercise: A scoping exercise with SUSE, Capability Works & Renfrewshire Council. Focus group activity with commissioners, service users, carers and provider staff A review of the funding of supported employment in Renfrewshire. Desk research on current policy drivers, evidence base, data and research: The Scottish Supported Employment Framework, The SQA Personal Development Award in Scotland. The National Occupational Standards for supported employment in England. Early customer data on Work Choice published in June 2012. Previous exercises to cost supported employment. Valuing Employment Now demonstration sites in England. A summary of the discussions across the UK so far between providers and commissioners collated by BASE.
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SDS and Supported Employment The challenges for providers in a personalised marketplace: 1.Pricing 2.Marketing 3.Delivering
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SDS and Supported Employment The Commissioning Matrix The consultation and research suggest that the options for commissioners revolve around two central themes: 1.Control: the extent to which a local authority intends to manage the marketplace in which supported employment is traded, 2.Pricing: the way the market defines and prices the supported employment service which is traded in that marketplace.
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SDS and Supported Employment The Control Axis The control axis describes to what extent the commissioner intends to manage the marketplace. At one end of this continuum is a free market. At the other end of the continuum is the block contract Somewhere near the middle is the Preferred Provider scheme.
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SDS and Supported Employment Free Preferred Block market Providers Contract
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SDS and Supported Employment The Pricing Axis The pricing axis describes how a local authority defines what is being bought and sold. At one end of the continuum is payment by occupancy. At the other end of the continuum is payment by results. Along the continuum are the degrees to which what is being purchased is defined by milestones.
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SDS and Supported Employment Payment Milestone by results payments Occupancy payments
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Payment by results Payment by occupancy A Free market B Block contract C D
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Quadrant A Commissioners believe competition and payment by results (including paid job starts) will drive performance. Commissioners have a strong presumption of employability. Customers pay for a job outcome rather than hourly or daily rate payments. Supported Employment activity is not constrained by any performance or quality standards.
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SDS and Supported Employment Quadrant B Commissioners believe success is best driven by a clear set of performance and quality standards alongside a payment by results approach. Commissioners have a strong presumption of employability. A single agencies, or small number of competing agencies, are commissioned to provide the service. Customers receive a service that is defined and regulated by the commissioner.
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SDS and Supported Employment Quadrant C Individuals purchase work experience or employability training from a range of providers. There is open entry for providers into the marketplace. Commissioners have a weak presumption of employability. Individuals pay on an hourly or daily rate, as they would for any on-going day care provision.
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SDS and Supported Employment Quadrant D A single provider delivers the service in accordance with the specifications of the commissioner. Commissioners have a weak presumption of employability. Commissioners fund hourly or daily rate payments and receive an occupancy-based service which they define and regulate.
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SDS and Supported Employment
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The Key Questions Framework for commissioners (based on the Commissioning Matrix) 1.What presumption of employability do we hold for service users? 2.What strategic considerations do we have? 3.What is our approach to choice? 4.How do we want to manage or influence performance? 5.How, if at all, do we want to influence quality?
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SDS and Supported Employment The Five Key Questions Drilling down 1. The presumption of employability Do we believe that people with moderate and severe learning disabilities, and people with profound and enduring mental health conditions, can get and keep jobs? How much do we believe this? What is it that we want to pay for? Where do we want to draw the line in terms of paying providers to work hard and paying providers to find the right job? 2. Strategic considerations To what extent do we agree with the Scottish Supported Employment Framework which argues for `a partnership approach [through Community Planning Partners] to delivery, coupled with the dynamics of various funding sources, as this avoids duplication, reduces bureaucracy and provides a single approach to the individual's employment journey`. What role, if any, should we have in facilitating the transition of young people with a learning disability from education into employment? What transitions arrangements do we want in place? To what extent do we want a managed approach to employer engagement within the local authority area?
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SDS and Supported Employment 3. Choice How central to our approach to personalisation is a retail model of consumer choice? How do we reconcile the commissioners` responsibility to ensure effective service provision with service user choice? How effectively do we think that retail choices can be exercised in the arena of employment support? To what extent do we think customers will want to exercise provider choice? Should we have a role in managing entry to the marketplace? How should market entry be managed?
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SDS and Supported Employment 4. Performance How do we define `performance`? What outcomes do we want achieved? What balance of outcomes do we want to see achieved with and for service users? To what extent can performance be driven by choice? How can high performance be driven in the absence of a choice of provider or where choice is limited? To what extent do we think that payment incentivise performance? Should commissioned activity be time-limited? 5. Quality What do we think is the relationship between performance and quality? What should our role, if any, be in ensuring quality in relation to the five stage process of Supported Employment? How do we ensure that service users get the right job? To what extent should provision in Scotland be influenced by the Scottish Supported Employment Framework and the SQA`s Professional Development Award in Supported Employment Practice.
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SDS and Supported Employment Summary There are no easy answers The aim of the Commissioning Matrix and the Key Questions Framework is to provide members of SUSE with a set of tools to help them engage more confidently with commissioners as they consider together how employment outcomes for our service users can best be achieved in a world of Self Directed Support.
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SDS and Supported Employment Everyone should have an opportunity to work Looking at the strategies for including work within SDS developments and developing a SUSE position statement Influencing SDS systems to support opportunities for work Equip staff and services with skills and information My Life My Way training with personal assistants provided by VIAS Encouraging care managers to integrate employability into care plans Facilitating supported employment services to make action plans to be ready for SDS
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SDS and Supported Employment SUSE is working strategically with members to ensure SDS supports work We would welcome anyone interested in this contacting us We are collecting examples of people with personal budgets purchasing employability support – please contact us pippa.suse@btinternet.com www.susescotland.co.uk
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SDS and Supported Employment Questions & discussion
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