1. Doncaster's Story From seeds of ideas to redesigning processes

2. Changing the Personal Budgets process – why? A review following initial implementation identified improvement areas The developing policy agenda encourages it (Think Local Act Personal-TLAP) Service User and staff feedback identifies issues with the current process Work undertaken prior to Care Act and guidance implementation

3. Introducing the Re-Script Group Core Group Members: Social Workers Team Managers Specialist Services Business Improvement

4. Key Aims of the Group Assessment Paperwork and Processes: Leaner Supports social workers in recording their professional assessments Aligned to an asset based and outcome focussed approach to assessment Captures the ‘conversation’, the Service User’s ‘story’ and their aspirations

5. Creative Conversations exploring Asset Based Social Work Dr Celia Harbottle http://www.celiaharbottle.co.uk

6. Creative Conversation Aims To enable social workers to examine the evidence base and current policy context indicating a need for a cultural shift in social care provision underpinned by a re-defining of the social work role. Explore the need for change and what is meant by asset based social work, reflecting on pre-existing skills – under used in traditional care management approaches Facilitate social care workers to have had the opportunity to explore the need for a culture shift in social work whilst recognising that they have the core skills to make it successfully. To consider the wider evidence base for asset based social work and will be able to see its place in DMBC’s way of working

7. Our Journey Project Team established Work undertaken with staff, services users and advocacy agency Other Local Authorities documentation considered Decision for bespoke development

8. Key Aims Further Developed New Assessment and Process no longer in line with existing RAS Resource Allocation System (RAS) Driven by professional judgement of the Social Care Worker Non-complex, transparent and a total shift away from ‘tick boxes’ Approach to Development Work: Operational input throughout all development work From research to initial idea to prototyping to testing Ensure robust and fit for purpose at operational level Co-opt in additional expertise when required E.g. Finance, RAS Expert, OLM Consultancy

9. Our continued journey Prototyping and phased approach Specify RAS model Desktop sampling of 450 current random cases - statistically significant figure to give 90% accuracy Analyse, review and modify sampling results Make changes to model and calibrate Develop supporting tools Live test phase – 200 random cases Final calibration

10. New Assessment Form Current Form Manual form 30 pages – too long to complete ‘Deficit’ based. Not aligned to Asset Based and Outcome Focussed approach Doesn’t capture the Person’s ‘story’ Fixed tick box format due to driving the RAS New Form Lean: 10 pages, some pre- populated via CareFirst Aligned to Asset Based and Outcome Focussed approach Captures the Person’s ‘story’ and aspirations Free flowing, does not drive the RAS – no tick boxes

11. A Look Inside The New Form

15. New Resource Allocation System Current RAS A shift away from professional judgement Tick boxes and spread sheet drives complex and hidden calculations Inaccurate – uplifts and cases going to panel Bureaucratic and inefficient – delays payment to Service Users New RAS Professional judgement determines the budget Transparent with no hidden or complex algorithms or calculations More accurate – uplifts and panel on exception basis Lean and efficient enabling quicker payment to Service Users

16. A Look At The New RAS

17. Professional judgement driven 3 key professional judgements: Number of eligible unmet needs that remain outstanding (not met via Circle of Support, community or universal services etc) Risk Severity (level 1 to 4) Risk Likelihood (level 1 to 7) Multiply Risk Severity level by Risk Likelihood level to get an overall risk score to determine overall risk. Number of needs and overall risk score determines the cell on the RAS Grid (A to X) (Budget amounts available once development work is complete).

18. A Look At The New RAS Risk Severity Four levels: 1: Restricted independence 2: Moderate threats to independence 3: Serious threat to Independence 4: Immediate risk of harm/neglect/crisis Definitions and guidance information in packs – broad guidance not definitive. Aimed at informing judgements and enabling consistency.

19. A Look At The New RAS Risk Likelihood Seven Levels 1: Occasional incidents 2: An incident every month 3: Some incidents a month 4: An incident a week 5: Several incidents a week 6: An incident a day 7: Several incidents a day Definitions and guidance information in packs – broad guidance not definitive. Aimed at informing judgements and enabling consistency.

20. Support Planning Current Duplicate recording Deficits based & service led Prescriptive: ‘dictates’ how budget will be spent Budget sign-off after itemised break down Informal support not always captured Bureaucratic - tying needs to points to budget Delays payment of budget New Pull through of info on CF Evidence based practice Shift to outcomes focus Flexibility of spend – DP policy Higher level, not pinned down to itemised break down of spend Budget sign-off for agreed outcomes not services Incorporates informal care & community resources Leaner, person centred and Care Act compliant

21. Reviews Current Review = Re-SSAQ & Re- RAS for all cases Duplicate recording – manual paperwork & record on CF Fixed timeframe for all reviews Deficits and services focus Uplifts and panel New Record once in one place – pull through of information Proportionate: Re-assess & re-RAS only if change Budget: sufficiency principle Creative conversations and asset based approach Evidence based practise From service led to outcomes Individualised timeframe for reviews Less cases to panel and via CareFirst

22. Carers Current Manual - part 2 and part 4 Prescriptive - tick boxes Recorded against service user record on CF Impacts service user RAS £ Equipment / items led Bureaucratic process for flexible support fund release Not Care Act compliant New One assessment form Free flowing, no tick boxes Mirrors service user process and concept New carer RAS – detached from service user RAS Flexible spend - outcomes Budget: sufficiency principle Manager authorises budget Care Act compliant – eligibility criteria, entitlement in own right

23. Risk Severity Threat to Carers Well- being 1 – 2 Needs 3 – 4 Needs 5 – 6 Needs Moderate threat to wellbeingM1M2M3 Serious threat to wellbeingS1S2S3 Immediate risk of crisis / carer breakdownI1I2I3 Carers RAS Grid Replaces Flexible Support Fund One off DP to carer – flexibility and outcomes focussed Carer starter RAS amounts will replace numbers in grid Financial modelling will determine RAS £ and grid size Definitions and guidance information will be available – broad guidance not definitive

24. Next Steps …… Care Act training and resources CareFirst training Go live April 2015 Re-Script Group widened to support roll out & teams post go live Post implementation review Back Office Processes RAS recalibrations on a regular basis

25. Re-Script: ‘piecing’ it all together Creative conversations – Dr Celia Harbottle Shift from deficits and services Shift to assets, strengths and outcomes New RAS driven by professional judgement Budget available to spend earlier Care Act changes including new eligibility and Carers Compliance with the Care Act

26. Any Questions?