Personalisation&

Support For Living Where I Choose

What is personalisation?Principles of Community Care

• Dignity and respect• Safeguarding / risk agenda• Cost effectiveness• Choice and control

Personalisation: A history to date and value base

A definition:Personalisation is the wholesale and radical change within the assessment and delivery process of social care and other publicly funded provision, notably health, which has at its heart the re-distribution of power and status between those who seek and receive services, commonly referred to as clients, users, patients and those who determine, assess, commission and deliver provision, professionals, such that the former have the right to choose and control WHO will deliver what they need/want together with HOW that will be delivered.

Choice and control are the DNA of PERSONALISATION

Cultural Changes• A shift from access to the uniform to access to the individualised• A shift from people as the passive recipients of professional expertise in

assessment and commissioning to active, collaborative work with professionals• A shift from reliance on professional expertise and knowledge to a mutual

respect and acknowledgement that the person is “expert” in their own life, by and large

• A shift from block commissioning, the available, to individualised/micro commissioning, innovation

• A shift from providing a service, excellent through to the abusive, to supporting people to improve/maintain the quality of lives and life chances, including aspirations

• A shift from paternalistic risk aversive management of people’s experience to risk enablement, collaborative approach to assist people to get the life they want

“I want a life Minister, not a service.” G Croft

From Professional Gift Model to Citizenship Model

Client/User/Patient as passive recipient of state benevolence

Person as active citizen/fully engaged

Professional and self-assessment (RAS)

Cash resource at start of process not a “service” at the end

Support planning, micro commissioning process

Cash resourceSupport

Plan• Improving quality of life/death• Improving life chances• Outcome focussed

What I want to achieve

How you can best support me to

achieve my goals

Do I want to manage my

budget (with or without support)

How I propose to spend my

personal budget

What outcomes will I

achieve

What is important to

me

NO

Direct Payment

Notional Budget

Managed Budget

Provider development in a social marketFrom tradition to transformation

Personalisation = radical change in commissioning for Local Authorities, Primary Care Trusts, Clinical Commissioning Groups and vastly reduced control

Block Public OrganisationsTraditional commissioning

£££££ Community Care/PCT Budget £££££

Private In-house Voluntary Organisations

Social Enterprises

Provision of service

Transformation

Self Directed SupportCitizen commissionersIndividualised

Splitting the atom of big budget beasts

4,000 personal budgets

4,000 potential micro commissioners / citizens

What does this mean for us?

How can I grow my business and reputation in a transformed

culture of person-centred micro commissioning?

Citizens of Walsall, Walsall Local Authority, Primary Care Trust and Clinical Commissioning Group need a high quality, cost effective, diverse and innovative collaborative marketThere is room for all good quality providers to serve 4,000 people with a personal budget plus people who fund their own service

How will I market my organisation / self to reach potential customers?How will transformed innovative information replace our current offer?What will my organisation look like based on what people want?What values and behaviours drive my daily work and how can this be evidenced?What can I offer to improve life chances?What can I offer to enable people to be valued, less dependent and contributing to their community?Can I research niche markets to provide person centred outcome focussed solutions e.g. enablement, re-ablement, recovery, job coaching younger students leaving college, maintaining older people with more complex needs at home, challenging behaviourCan I support and mentor fledgling providers to complement a developing transformed market?How can I most effectively help to co-produce a vibrant social care market alongside users, LA, PCT, CCG and develop a “Community of Practice”How can I ensure that I and all staff have a good understanding of the local Safeguarding Agenda?Am I cost effective? How will a potential customer know?

Risk in a personalised world• No evidence to date that the adoption of a citizenship rights model of personalisation has led

to any increase in reported incidents of abuse of vulnerable adults• Much the same pattern of abuse as indeed with children exists pre and post transformation -

most abusers are already known to the victim, family, professionals, friends, neighbours are significantly most likely source of abuse,

stranger abuse is comparatively rare

No grounds for complacency – we have a shared responsibility for keeping vulnerable people safePersonalisation does not absolve any Agency of the “Duty of Care”

Citizenship approach to risk

From risk aversion to risk enablement

• Crucial determinant is capacity• Compromised capacity – Mental Capacity Act 2005, / DOLS• The person is the “expert “in their own life• Person should be allowed to make decisions, even unwise decisions providing the decision

does not adversely impact upon any 3rd party causing them harm• Risk enablement panels to support decision making process

References• “Making it Personal” Leadbetter C, Gallagher N, Portlett J Demos 2008• “Making it Personal: A Providers Journey from Tradition to Transformation Scown S,

Sanderson H 2010• Personalisation: A rough guide” SCIE [2nd ED] 2010• Valuing People Series DH 2001 – 2012• Risk and Choice Framework DH 2007• Working Together for Change: Using person centred information for commissioning DH 2008• Commissioning for Health and Well Being: Glasby J, Policy Press 2012• Commissioning is an Era of Personalisation, chapter 11 Needham C, Duffy S

• Web sites• www.in-control.org.uk• www.scie.org.uk• www.dh.gov.uk

“Putting People First” Agenda DH 2007

• Looks to a model of lifelong personal growth, development, supporting people through collaborative engagement to maximise their skills, abilities, develop new skills or re-engage with old ones reducing dependency, to maintain or improve quality of life and well being and be afforded all the rights and valued roles of citizenship.

• The most successful providers, irrespective of size, will, through the outcomes they achieve with people, actively embed this model in the daily round and common task of what their staff do and achieve

THE END OF THE BEGINNING