© 2010 Peopletoo Limited and The Campaign Company

Transforming Adult Social

Care

Solutions that deliver measurablybetter customer experiences, improved performanceand cashable savings

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To create better models of care, people, systems and behaviour all have to shift from where they are now

A unique approach to transforming Adult Social CareWe believe simply cutting services to try to save money is not the answer. People who use care services deserve a better future. We can deliver this alongside substantial cash savings for health and social care partners and enabling the redirection of valuable resources.

We need to take staff and service users on a journey. People will need to think and act differently but everyone has to gain.

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Assessing transformation potential with:> Collaboration to integrate services> Engagement of the community and third sector> Supporting staff and service users to think and act differently

The challenges

> Reduction in resources from Central Government for social care - Transformation Grant ceases in 2011

> Integrated Care and Support Pathway Planning> White Paper on free care for those who have

critical needs> Ageing population and increase in those with long

term conditions > Self-directed support and personal budgets> DH push for Universal Offering – applying Fair

Access to Care Services (FACS) on exit of Reablement

> Existing staff needing to adopt new skills –commissioning, brokerage, outcome-focused

> Integrated health and social service provision

Transformation potential

> 15- 20% saving on current Homecare spend (in-sourced or out-sourced service) through introduction of Reablement

> Re-design of end to end customer journey to meet the requirements of the Transformation Agenda in ASC - including Self Directed Support, Individualised Budgets and Reablement

> Re-training of all staff including front-line care workers to be outcome focused > Development of front-end including contact centre/single point of access> Work with the LA, PCT and Third Sector to devise and implement integrated

services to support merging Prevention strategy > Reduction in admission to residential care through effective use of Assistive

Technology and Telecare > Develop Commissioning and Brokerage skills to support Personalisation and

Choice > Support in Transforming Community Equipment delivering savings of 10% on

existing budgets > Developing an efficient and effective transport infrastructure to support

personalisation

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Total Place for Adult Social CareAn integrated approach will deliver measurably better customer experiences along with improved performance and cashable savings.

1.Service StrategyService integration

2.Estate Management StrategyProperty rationalisation

3.Transport Strategy

Resource utilisation

> Focus on prevention> Single point of access

• Community Services

• Rapid Response

• Acute Homecare

• Step-Up / Step-Down Beds

• Reablement

• Signposting

• Brokerage & Commissioning

• Community Equipment &

Adaptations

Integrated Strategy Integrated Services

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A Typical ScenarioAnthony O’Neil is returning home after a long stay in hospital following a serious fall.

The hospital social work team are concerned that although he is recovering well, he currently can not undertake some tasks necessary for independent living such as cooking a hot meal.

Although Anthony has lived alone successfully for many years since the death of his wife, his family have disclosed that he had not been taking care of himself before his emergency admission.

> Effective Reablement reduces the whole life cost of careReducing the need for on-going high cost health and social care through intensive,

short-term intervention that focuses on an individual’s abilities rather than needs; supports their control and choice; focuses on sustainable outcomes and can be provided in conjunction with third sector and community organisations

The Traditional SolutionA range of high-cost services are provided for Anthony including daily meals-on-wheels.

He quickly becomes dependent on these services and starts to lose independence.

Increasing levels of support are provided, until, after several more admissions to hospital, he is unable to safely live at home and moves permanently into residential care.

The Reablement SolutionAnthony wants to continue to live as independently as possible in his own home.

Reablement provides him with the confidence and training to make this a truly sustainable objective.

One way this could happen is supporting him to regain his confidence in the kitchen. And, after some simple training and some simple adjustments to his kitchen such as providing a perching stool he can now cook safely.

When such services are integrated with NHS provided Intermediate Care services and local government partners, this dramatically reduces overall service costs whilst keeping people safe and well intheir own homes.

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Total place Reablement. Health and social care partners are recognising the potential of

Reablement. Total place Reablement takes this to the next phase ensuring maximum outcomes in terms of efficiency and quality of life by developing a supportive and sustainable environment.

We support you to create the systems, manage the people and change the behaviour that is needed to make Reablement a truly transformative and sustainable process for individuals and organisations

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A new way of workingOur approach recognises that for Reablement to be effective, active engagement of all stakeholders is vital– even if this is difficult.

Many of the people who would benefit from Reablement services fall into hard-to-reach or seldom-heard-from groups.

Our unique partnership enables the successful engagement of service users, including those with complex needs, as well as frontline staff in the process of change.

Outcomes for everyone will be dependent on effective conversations at a strategic level through to how individuals can tailor the Reablement service to meet their own needs.

The case for Reablement and engagement:> Effective Reablement reduces the whole life cost of careEffective Reablement requires engagement and a behavioural shift by

the people who provide and receive services. It is a significant change for individuals and organisations.

The benefits for users, families and their carers>Greater independence and increased confidence to live in their own home for longer

>Improved links with the community and a reduction in isolation

>Enhanced lifestyle and greater opportunities to engage in every day activities and learn new skills

>Reduced dependency on informal and formal carers and a return to lost behaviours

The benefits for councils>Figures published by CSED identify a nationalaverage of 58% of individuals no longer requiringa service following effective Reablement

>Over 15% savings on existing Homecare budgets

>Over 10% savings on Residential Care budgets

>Meets the financial challenge of an ageing population

>Focuses investment in universal offerings and prevention

The benefits for the NHS>Savings on existing service provision through integration and focuses investment in universal offerings and prevention

>Reduction in acute admissions and other medical interventions including those in primary care

>Reduction in medium-term health care demand

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Local SupportDave Jones (65) a just-retired PE teacher whose children are gown up. Like many retired people in Poole he wants to remain an active part of the community and give something back.

Dave runs a scheme which keeps men aged over 80 years old active through keep fit sessions.

As part of this, every month volunteer chefs from local restaurants come in to teach the class how to cook simple meals for themselves.

Dave also runs a special scheme for men who live alone or are carers who come out of hospital and need that extra support to get back to running their own home.

Illustrating engagement:

> Effective engagement of the community and third sectorSome great ways for the community and third sector to make a

valuable contribution to prevention

Third Sector Service SupportOften the cost of recycling community equipment is greater than its resale value, resulting in an overall budget deficit for the running of this service.

An option worth considering is working in partnership with the third sector to create a service where the third sector organisation is responsible for collection, recycling and redistribution of equipment to those individuals who are unknown to social services or deemed as having low or moderate needs.

Providing and fitting this equipment can sustain an individual’s independence far longer and reduce the risk of admission to hospital which is aligned with the overall prevention strategy.

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Mobilising the community1

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Transformation potential is substantial

>An integrated long-term strategy, commissioning and service provision across local government, NHS and third sector is critical to true transformation

>Community engagement and consultation is a key part of achieving and measuring successful outcomes

>Reablement is a core part of radical change and ensuring optimum financial savings, enhanced quality of life through independent living and changing demand trends

>Organisational culture, staff engagement and training alongside the transformation programme is essential to individual and collaborative success

>Governance and the financial model need to be considered including strategic and operational boards, arms-length partnership, pooled funding, legal entities and social enterprise.

Transforming Adult Social CareAn integrated approach will deliver

measurably better customer experiences,improved performance and cashable savings.

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Supporting your transformation:A true transformation approach across health and social partners that will deliver measurably better outcomes.

1.Assess baseline position

2.Develop transformation strategy for you and wider health and social partners

3.Support implementation

phase and move to long term

sustainability

> Service transformation> Staff and community transformation

• Focus on staff coaching and development

• Strong performance and financial management

• Create right culture and values

• Process re-engineering and smart technology

• Assess and change community behaviours

• Engage care service users

• Facilitate partnership working across health,

social and third sector including social

enterprise models

Key Stages Outcomes

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With growing pressure on the homecare budget and a rising demand for social services from an ageing population, Brent Council decided to implement a Reablement service for all community referrals.

Peopletoo CEO, Maggie Kenney, has been working alongside Brent’s Adult Social Care Transformation Team, creating the business case, service design and project managing the implementation of this new service.

Launched in April 2010, after just six months of preparation, rapid transformation was vital.

With all of the homecare outsourced in Brent the challenge was not simply to engage with the external providers but also to build the capacity and capability to deliver an effective Reablement service, requiring a change from the traditional mind-set of ‘doing’ to one of ‘supporting and guiding’.

Case study: Brent

Key aspects of delivery included:

>Creating an integrated service fromend-to-end with the focus on Reablement

>Working with the IT department to ensure existing software was fit-for-purpose

>Designing and delivering acomprehensive two-day training programme for trainers and carers

>Working with providers to design an effective incentive scheme based on monitoring key performance indicators, service levels and quality of care

>Forecasting >£450k savings in the first year, increasing to reach a target of£2.8m* p.a. ongoing savings by April 2011. (*Based on 75% of new and change of circumstances referrals commencing a Reablement service for up to six weeks, with 50% no longer requiring any form of service for a period of 12 months. National figures are even higher than this at 58%.)

> An effective Reablement service at Brent CouncilSix months to design and deliver better homecare services

for an ageing population and targeting to achieve ongoing savings of £2.8m* p.a. after only one year.

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A unique partnership – Connecting people, systems and behaviours

Peopletoo is a world class team of operational managers.Our customers are public sector organisations ranging from Local Authorities, NHS trusts, PCTs to Police, Fireand the voluntary sector, who all share a common goal:To deliver performance with an increasing set of financial challenges.

Peopletoo working with the client will develop a solution to not only drive performance but deliver real cashable savings and efficiencies. Where Peopletoo differs from its competitors is in its approach. Peopletoo offers flexible models that include in-source, outsourceor joint venture, or support of a separate legal entity such as a Social Enterprise.

The Campaign company has a 10 year track record of working with national and local government, NHS trusts and the voluntary sector partners to develop innovative processes that lead to sustainable behaviour change.

We believe that where people are not at the heart of the process such as Reablement cost savings will be transitory, staff motivation fragile, and the end user won’t get the services they need. TCC has a range of proven tools to involve people including hard to reach groups in the process of service change.

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