Personalisation – Moving forward

From Back Seat into the Driving Seat

What is personalisation?

Government View

• The ability to tailor a range of services to meet an individual’s specific needs

• Self directed support adds the principle that involving the individual in the planning process is a key way to increase personalisation

• Personal budgets are the key vehicle for self directed support in social care – they extend control as well as choice

Social care view

• “Personalisation means starting with the individual as a person with strengths and preferences who may have a network of support and resources, which can include family and friends”

• It means “starting with the person rather than the service”

SCIE (Oct 08) Personalisation: A rough guide

http://www.scie.org.uk/publications/reports/report20.asp

What is personalisation?

It’s not rocket science

• Personalisation: personalisation means taking something general and changing it so it suits you better.

Personalisation is a philosophy, not a set of rules and procedures

• Starts with what is important to the person and is outcome focused.

• Individually tailored support, building on the person’s strengths.

• The person is in control and takes decisions.

• It means being part of a community.

• It requires a shift in the balance of power.

People are experts in their own experiences

Personalisation umbrella

• Service user engagement• Person centred planning• Co-production• Self directed support• Individual budgets (IB)• Individual Service Fund • Personal budgets (PB)

Service user engagement

• Able to respond and be flexible to the group of individuals you are engaging with

• A fluid, dynamic and negotiated process

• “A way of doing things, and an end result”

(Novas Ouvertures 2001)• Requirements of

– Quality Assessment Framework– Homes and Community Agency– Care Quality Commission– Good practice

Person Centred Planning

• "Person Centred Planning discovers and acts on what is important to a person. It is a process for continual listening and learning, focussing on what is important to someone now and in the future, and acting on this in alliance with their family and their friends"

Thompson J. Kilbane J. Sanderson H. (2008) Person Centred Practice for Professionals. Open University Press

Defining Co-Production

“Co-production means designing and delivering services in an equal and

reciprocal relationship between professionals, people using services, their families and their neighbours.”

New Economics foundation

D. Mello’s Co-production equation

E + P = CExpertise Partnership Creation

Bring what we know and the best we have to offer

Working together as equals, celebrating each other’s expertise

With the objective of producing something

By Augusto D. Mello in partnership with Look Ahead Housing and Care

Centre for Welfare Reform – www.centreforwelfarereform.org

Self directed support

• Individuals having control over the support they need to live the life they choose

• Tailor support to meet needs, preferences and aspirations with appropriate assistance

• Use a framework of identified needs and outcomes agreed with those providing funding – Direct / Indirect payments– Individual budget– Personal budget

Individual Budgets• The individual receives an integrated budget which is

intended to purchase services to achieve the goals identified.

• May require housing related support and/or Social Care• There is no distinction between the various funding

streams • Enables people to purchase services from a single

provider, if they wish to do so.• Very effective in delivering joined-up services.

Individual Service Fund

• Money is held by a provider on individual’s behalf

• Provider is accountable to individual• Can be used in accom. based scheme• Person decides how to spend the

money and can change this• Person has reports of their account • Money only to be spent on that

individual service• Providers can respond to individual

contracts or transform block contracts

Personal Budget (PB)

• Personal Budget is when there is only ASC funding involved

• Not the same as direct payments• Some may decide to have it as direct payment• PB = how much £, what outcomes, how and when spent• Can be part direct/part indirect

Direct Payments

• A payment directly into a bank account controlled by the individual to the value of reasonably meeting assessed needs.

• Can be held by a third party on behalf of the individual

• DP’s can be used to secure any service or equipment in order to meet an assessed need.– Employing personal assistants - Employers responsibilities.– Socially inclusive activities.– Purchase of equipment e.g. computer to enable online shopping

• The individual has control

Indirect Payments

• A payment made on behalf of the individual - individual service fund or

• Money is retained by the Council: Council Managed Budget

• Provider is also the broker of services / goods on the individuals behalf

• Individual service agreement in place that forms the basis of the support plan.

• Control remains with the individual in that they may change provider if things don’t work out.

How it fits together

Personalisation

Self directed support

Personalbudgets

Direct payments

The process by which public services can be adapted to suit you

Support that is determined and controlled by you, based on an

assessment of need by the state. (Includes receiving cash, spending on services that meet your needs,

to choosing which service you would like to purchase )

An indicative amount of money that can combine

several funding sources that you can use to purchase services, from the public, private or voluntary sector

A cash payment paid directly to you so you can acquire your own services, rather than having

them delivered by the council

Individualbudgets

Like an IB but solely made up of social

care funding

Resource Allocation System

• Tool used by LAs to assess how much money to allocate to a personal or individual budget.

• The grounds for allocating resources must be transparent, and people must know the amount of available funding before they begin to plan how to use it.

• Need to define a clear and fair process for allocating cash to particular levels of need; this is called the resource allocation system (In Control, 2005).

Personalisation : Why Bother

• Right thing to do • Person planning their own support - greater

engagement/control/choice• Government direction of travel - past 15 years• Contractual changes - forcing change

23

Vision for Adult Social Care: DH Nov 2011

“Individuals not institutions take control of their care. Personal budgets, preferably as direct payments, are

provided to all eligible people.

“Information about care and support is available for all local people, regardless of whether or not they fund their own care”.

“Personal Budgets for all by April 2013”

Putting People First

‘Putting People First: A shared vision and commitment to the transformation of adult social care’ - through personalisation, prevention and early intervention

Systems wide transformation with significant progress expected by 2011

Signed by 6 government departments, the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS)

Putting People First Supporting people to live in their own

homes for longer

Universal information, advice and advocacy services

Common assessment processes – more self-assessment

Telecare as integral not marginal

Self directed support as the mainstream – personal budgets for all, direct payments for more people

Greater role for voluntary sector and user led organisations

Renewed concentration on safeguarding adults

Think Local Act Personal

• Concordat how sector will move forward with Government's vision for adult social care

• Builds on learning from Putting People First• Personalised community based approach for

all connected to preventative approaches• Framework for action• Provider blueprint

– People - learning and change– Money - back office– Support– Community

Reasons for continuing to commission/purchase services

• Continuity and security• Size of budget – smaller/limited amount

available for individuals to spend• Anxiety over new ways of spending/new

providers• Managed funded users more likely to opt for

mainstream services

Right to Control Trailblazers

• RtC included a number of funding streams– Access to Work – Work Choice (Jobcentre Plus specialist disability employment

programme late 2010) – Housing related-support (Supporting People) – Disabled Facilities Grants– Independent Living Fund. – Community Care Funding (e.g. Integrated Community

Equipment Service)

• Pilot authorities• Barnsley, Sheffield, Essex, Greater Manchester,

Leicester, Barnet, Newham and Surrey

DCLG work on personalisation

• Personalisation working group• Sub groups working on

resources for the sector– Provider transformation– Market management – Co-production

• Microsite• Festival of Ideas• Learning events

Ongoing Issues

• Commissioners approach• Quality assessment• How is support going to be planned• Risk management

– Protection from Abuse and Safeguarding

• Money –

– How to achieve an equitable allocation of resources?– Is there enough for people to achieve their outcomes?– Who pays for brokerage?

Challenges in Supported Housing

• How to personalise accommodation based services?

• How much flexibility is there in schemes where high levels of support are required 24 hours a day

• How much flexibility is there is schemes where levels of support required are low

• Possibilities

– Still have a choice of support worker,

activities, room, food, etc.

– Person centred support plan

– Independent living and purchase support services from different provider e.g. floating support

– Low support: scope for collaborative purchasing of services

One Housing

• Accommodation based 24 hour service for people experiencing enduring ill mental health

• Core functions and flexible support that can be banked included – recruitment of a pool of skilled staff on flexible contracts– creation of a working agreement between the customer and their

Flexi Hours worker– database for recording Flexi Hour support, a contingency fund to

pay for staff to undertake activities with customers– need for a ‘matching database’ to support customers in making

choices about who they want to deliver their Flexi Hours

Midland Heart

• Piloted Individual budgets for older people, people experiencing ill mental health and people with learning disabilities

• On back of customer engagement – finding out what the customer wants– Customer focus groups– Customer Newsletter group– Mystery customer programme– Customer panel– Appointing contractors– Service steering group

Look Ahead

• Coventry Road – Move from block contracts to flexible support– Baseline service – safety and security provided by Look Ahead– Choice based intensive support service provided by Look Ahead– Personal budget services or goods from open market

• Other initiatives– Separating out types of support– Zero based contracts– Offer personal support assistants to those on personal budgets– Customer involvement including customer services committee

Dimensions

• Two journeys • Making it personal - what changed for

– Customer offer (menu approach)– Finance (costings)– Marketing– IT– Personnel– Learning and measuring progress

• Making it personal for everyone– Block contracts towards individual service funds

Customer Journey

• At each stage of their journey with you how much choice and control do customers have – be honest

• How do you find out– Their strengths

– What is important to them

– What they want to achieve

• What do you tell potential customers about your service vs what do they want to know

• How do customers access your service• How do customers get services that best

achieve their outcomes

Preparations

• What are commissioners planning in the locality you are providing services?

• Local commissioning strategies• Are you preparing for providing services that

people want?• How do you explain Personalisation to your

clients• Don’t wait to hear - Act now

Challenges

• Workforce transformation – frontline workers are key• Risk and safeguarding• Changes to staff roles and professional boundaries• Could you / do you deliver a personalised service• Changes to all elements of infrastructure

– Human resources– Finance– IT– Training and development– Governance

• Customers as commissioners

Websites

•Personalisation microsite for housing care and support www.sitra.org•Personalisation Toolkit www.toolkit.personalisation.org.uk•Department of Health (Putting People First document) www.dh.gov.uk

•In Control - www.in-control.org.uk

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