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A TASC Centred Summit
Delivering Putting People First
in the West Midlands
7 July 2010
Contents
Foreword........................................................................................................3
Introduction....................................................................................................4
Milestone 1.....................................................................................................5
Milestone 2....................................................................................................13
Milestone 3 ...................................................................................................23
Milestone 4....................................................................................................30
Milestone 5....................................................................................................35
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Foreword
On the 7 July 2010 over 115 delegates participated in the West Midlands Transforming Adult Social
Care Summit. The event showcased a range of practical activity underway in the region to achieve
the five Putting People First Milestones:
1) Effective partnerships with People using services, carers and other local citizens
2) Self Directed Support and Personal Budgets
3) Prevention and Cost Effective Services
4) Information and Advice
5) Local Commissioning
Each milestone was introduced by a local expert and follow up by a range of workshops evidencing
local approaches to achieving the milestones. Workshops and presentations were led by a mixture of
carers, people who use services and social care professionals from across the region.
We have created this prospectus as a record of the rich and diverse material presented on the day.
A DVD is also in production to ensure everyone working on this agenda in the West Midlands and
beyond can access the interesting approaches to this challenging agenda. The contact details for
each of the workshops are included so feel free to approach the experts directly.
Finally, many thanks to everyone who participated in the event – feedback to date has demonstrated
that it was valued highly by delegates and provided tangible insight into how transformation is
translating to practice.
Eric Robinson
ADASS Lead for Personalisation in the West Midlands
Corporate Director of Social Care and Health- Staffordshire County Council
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Introduction
Putting People First (PPF) is a unique, national programme whose ultimate goal is the transformation
of adult social care and to improve people’s experience of using it. Launched in 2007, PPF is a
commitment to make sure anyone who needs care and support can exercise choice and control to
live their lives as they want.
PPF puts people at the heart of the decision-making process. It enables them to identify their
needs and make choices about their support. It’s all about delivering high quality services tailored
to individuals’ wishes, and ensuring better health and well being for everyone, including families and
carers.
For more national and regional information on Transforming Adult Social Care, visit:
www.puttingpeoplefirst.org.uk
Transforming Adult Social Care in the West Midlands
The five milestones during the first phase of transformation (by April 2011) agreed between
the Department of Health (DH), Association for Directors for Adult Social Services (ADASS), and
Improvement and Efficiency West Midlands (IEWM) are:
That the transformation of adult social care has been developed in partnership with
existing service users (both public and private), their carers and other citizens who are
interested in these services.
That a process is in place to ensure that all those eligible for council funded adult social
care support will receive a personal budget via a suitable assessment process.
That partners are investing in cost effective preventative interventions, which reduce the
demand for social care and health services.
That citizens have access to information and advice regarding how to identify and access
options available in their communities to meet their care and support needs.
That service users are experiencing a broadening of choice and improvement in quality of
care and support service supply, built upon involvement of key stakeholders (Councils,
Primary Care Trusts, service users, providers, 3rd sector organisations etc), that can meet
the aspirations of all local people (whether council or self-funded) wanting to procure social
care services.
The TASC Centred Summit on 7 July 2010 was designed to showcase best practice in delivering
Personalisation in the West Midlands, based around the five TASC (Transforming Adult Social Care)
milestones – featuring local and regional initiatives.
1
2
3
4
5
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Milestone 1
Effective partnerships with people using services,
carers and other local citizens
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Milestone 1 Effective partnerships with people using services,
carers and other local citizens.
Key note: Nothing About Us Without Us
Key note presentation delivered by: Andrea Pope-Smith, Director for Adult Services and Health
Interim Executive Director of Children and Young People’s Services & Richard Johnston and Nigel
Smith, Changing Our Lives
Our approach
Sandwell is putting in place formal and informal structures to allow citizens and the full spectrum of
user and carer representatives to contribute to local design and delivery of social care. This goes
well beyond traditional “consultation” towards meaningful engagement. It is difficult to achieve and
cannot be done simply through tick box exercises or talking shops. It involves seeing people who
use services as experts and equals and treating people with respect.
Leadership requires listening to people who use services, leading by example and making actions
speak louder than words.
People in statutory services need to be prepared to change. A set of shared values and priorities
must be agreed and people who use services must be involved at all stages. This should be
followed by action on the important things and being prepared to accept the outcomes from
consultation and engagement
What difference has it made?
• Quality of Life standards have been embedded into provider contracts;
• The Quality of Life audit team made up of eight paid learning disability auditors;
• In the last two years Sandwell have led 115 audits of residential services, supported living,
mental health units, short breaks and acute hospital settings;
• The commissioning process has been influenced - homes have closed, staff have been
suspended, services have improved and people have achieved real social inclusion;
• The approach has been recognised as national best practice.
Further information
Andrea Pope-Smith
Executive Director
Sandwell Metropolitan Borough Council
andrea_popesmith@sandwell.gov.uk
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1. Sandwell: Engaging People Who Use Services and Carers
Presentation delivered by: Stuart Lackenby, Self Directed Support Manager
Our approach
Sandwell is made up of 6 towns and has a population of 282901. It supports around 12000
people who need social care services and around 2000 carers. There are a variety of User Led
Organisations in Sandwell who provide support to both people using services and carers
The Sandwell Ambassador scheme commenced through two large scale events in 2008 attended
by individuals and care providers. A monthly forum was developed as a consequence. The forum
promotes innovative new ways of engaging people who use services and carers and support. This
helps Sandwell ensure citizens are actively involved in the design and delivery of Putting People
First (PPF) in Sandwell.
Members of the forum have active membership across all of the PPF workstreams and
transformation board in Sandwell ensuring the engagement is at the heart of the transformation
agenda.
What difference has it made?
Ambassadors have been engaged throughout the PPF programme and have challenged and
influenced. Specifically this has impacted on the:
• Assessments approach;
• Information point;
• Safeguarding approach;
• Prevention strategy.
The scheme has received regional and national recognition. The challenges going forward include
ensuring sustainability, accessibility and a coordinated approach to delivering PPF. The next steps
involve an action plan including:
• Promotion of the Ambassadors;
• Formalising organisational involvement;
• Greater involvement with Health partners;
• Asserting the forum as a central point of engagement;
• Informal/wider engagement with harder to reach groups.
Further information
Stuart Lackenby
Self Directed Support Manager
Sandwell Metropolitan Borough Council
stuart_lackenby@sandwell.gov.uk
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2. Telford and Wrekin: Putting People First – Let’s Ask the Experts
Presentation delivered by: Katy Driver, Communications Officer for PPF & Rowland Brown,
Member of the User Consultation Group
Our approach
Our Goal: “If we are to win the hearts and minds of all stakeholders, especially front line staff, it
is essential that they are participants in the change programme from the design stage onwards. It
is hoped that every local authority will create forums, networks and task groups which will involve
staff across all sectors, people who use services and carers as active participants in the change
process” Putting People First: A Shared vision and commitment to the transformation of
Adult Social Care
Telford & Wrekin Council invited people to attend a group that meet monthly to discuss different
topics regarding their plans for the transformation of Adult social care. The group have contributed
to many different topics, including how people like to access information and advice and also how
different people would manage their personal budgets. Two members of the group sit on the PPF
transformation board and play a key role in future developments.
What difference has it made?
Rowland Brown, a member of the user consultation group said:
“I managed to resolve my issues with the help of others. My main problems were with the stigma
attached to going blind. In the end I was able to accept I had a problem with help from my wife
and GP. I had a visit from social services and tried to shut the door on him. I did not receive the
help very willingly. I eventually agreed to meet with someone and managed to gradually get my
life back together and accept retraining. I would like to see people who are newly registered blind
to have the opportunity to hear from another blind person and their family to understand what it
might mean. Their partners often need more help to come to terms with the situation. The costs
would be nominal but it keeps being turned down. I am frustrated with the current system and its
inefficiencies. Advocacy is needed. “
Further information
Katie Driver
Communications Officer for PPF
Telford and Wrekin Council
katy.driver@telford.gov.uk
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3. DH West Midlands: Developing User Led Organisations
in the West Midlands
Presentation delivered by: Anthony Walters, Former Department of Health West Midlands User
Led Organisation Project Manager and Christine Fortune, Development Manager - Mercian Ability
Partnership
Our approach
In its simplest form a User Led Organisation is an organisation that is managed by people drawn
from the membership. All local authorities with responsibility for Social Services should have a
ULO based on the Centres for Independent Living model in place by December 2010. This will
result in local people having more of a say in what services they receive and increase the uptake of
personal budgets.
Mercian Ability Partnership is a User Led Organisation, based on the Independent Living
Centre Model, run by disabled people for disabled people of all ages and their carers in South
Staffordshire and North Warwickshire. 100% of the directors, staff and volunteers involved with the
management of MAP have disabilities and live within South Staffordshire or North Warwickshire. By
use of the DH Action Learning Sites grant and with the support of their mentors and partners, they
have developed a sustainable organisation.
What difference has it made?
Mercian Ability Partnership is developing an Independent Living Centre in partnership with the
Staffordshire County Equipment Store, Tamworth Borough Council, Staffordshire Social Care and
Health and selected private equipment suppliers. There is a contract with County Equipment Store
to use bulk buying discounts to offer low cost equipment to disabled people and also a partnership
with Credit Union to provide loans & financial support
It is also working with Care First Limited with a group of seven adults with learning difficulties who,
following recognised training will deliver low cost gardening services to elderly & disabled people in
the area. It is hoped to develop this group into a social enterprise.
There is a contract to facilitate the Tamworth Adult Care Panel with the assistance of Social Care
and Health and another for preparation of Design and Access Statements for Jamie Oliver, Tesco,
Cote French Restaurant, West Herts College, and Eddie Stobart.
A Mobility Aid Repair Service is also planned as a social enterprise in association with
Shopmobility, where people with disabilities will offer a cleaning, repairing and maintenance service
to disabled people in the area at no cost to the Local Authority.
Further information
Anthony Walters
Former Department of Health West Midlands
User Led Organisation Project Manager
Department of Health
anthonygwalters@yahoo.co.uk
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4. Shropshire: The Five ‘I’s’ of Working with Carers
Presentation delivered by: Andrea Jones, Communications Officer, Shropshire Council
Our approach
Shropshire Council has been trail blazing work with family carers. It wants to recognise family
carers within the personalisation agenda as equal partner, not an add-on or after thought. It has
developed the five I’s:
1. Information;
2. Inclusion;
3. Influencing;
4. Involvement;
5. Inspiring.
What difference has it made?
Here are some views from carers and families:
“Mum is now doing the things that interest her…Because Mum is getting the help where she
needs it & her life is more varied, I feel less pressure to be with her all of the time. It is reassuring
for me that Mum is more independent & this has resulted in us both having more space. For the
first time in a long time I am able to spend more time with my peers.”
“I want Dave to achieve a normal life living in the same world as me, our family & friends. We
would like to spend our retirement as near as possible to how we planned it. With his new
personal budget along with the vital help of friends & family, Dave is having a better quality of life.
Ultimately, this has resulted in me also having a more full-filled life, being less stressed, less tired &
able to be a wife, mother, friend etc & not just ‘a carer’.”
The potential of personalisation will result in:
• Changing relationships and a shift in the balance of power;
• A focus on what is important to them – not what services they can fit into;
• A wider range of services;
• Increased accessibility and flexibility in services;
• Families becoming the employer;
• A need for transparency of services that demonstrate choice and dignity;
• Personal budgets for family carers.
Further information
Andrea Jones
Communications Officer
Shropshire Council
andreaj.jones@btinternet.com
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5. Shropshire: Communication Champions for Personalisation
Presentation delivered by: Gaynor Hadley, Communications Champion Coordinator
Our approach
Shropshire created a team of Communication Champions to deliver the Personalisation message
across the County to as many and as wide a group of people and organisations as possible.
This includes people who use services, their carers, social workers, care managers, voluntary
organisations, tenants associations, providers of services, senior citizens forums etc.
The eight (equivalent of three full time staff) Communication Champions come from a range
of backgrounds and different sectors in order to meet this challenge. The variety of skills and
knowledge is vital in order to deliver the message.
The team are all excellent communicators with a high level of interpersonal skills. This
transformation is a two way process and not just about delivering the message but to bring back
queries and comments that have informed the process and add to the FAQ (Frequently Asked
Questions) list.
They deliver the message in a variety of ways depending upon the audience, and at various
levels. This could take the form of a powerpoint presentation or an informal chat around a table.
What is vital is that the content and message is the same, but delivered in a way that people
will understand, in many instances communication champions make more than one visit as
once people start to assimilate the information this raises more questions and need for further
discussions.
Team members have different expertise which they can use with specific groups. For example one
team member has focussed on support for providers and developed a presentation tailored for
both in house and external providers.
What difference has it made?
The Personalisation message has been delivered in a consistent way. A large number of workers
and others have been given information in a short space of time and it has been possible to target
hard to reach groups and individuals. From the beginning of April to end of June, 1682 people
have received information on Personalisation delivered to them in a variety of ways.
Further information
Gaynor Hadley
Communication Champion Co-ordinator
Shropshire Council
gaynor.hadley@shropshire.gov.uk
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6. DH West Midlands: Building Structures for Engagement
in the West Midlands
Presentation delivered by: Simon Foster, Programme Lead, Carers and LINks, DH West
Midlands
Our approach
This workshop looked at two very different examples of structures to engage stakeholders in the
development of personalised services. The first was the work of Coventry LINk. The second was
the work of Telford and Wrekin Carers Partnership Board.
Personalisation was prioritised by Coventry LINk’s Steering Group in acknowledgement of its
significance for service users and because a number of questions had been raised. Coventry LINk
is about to publish report on personalisation in the city. The workshop looked at the process of
researching the content of the report through a community engagement exercise. It considered
how the report would be able to shape Personalisation policy and future LINk development.
Telford and Wrekin developed a 3-year Carer Strategy and Action Plan which was jointly owned,
response to National Carers Strategy. The Carer Partnership Board anchored the strategy,
embedded carer involvement and influenced commissioning. The Board has been carefully
developed to allow for strong carer involvement while being able to carry out its strategic role
effectively.
What difference has it made?
The Coventry LINk Personalisation Working Group has enabled:
• A LINk which is engaged with and able to support the further development of personalised
services.
• A set of recommendations on the development of personalised services, based on the
researched experience of around 50 stakeholders from a variety of user-groups.
The work of the Telford and Wrekin Carer Partnership Board resulted in:
• Appointment of ‘Moving and Handling Family Carer Adviser post: Joint working between PCT
Moving and Handling Team and Intermediate Care.
• Review of provision of publicly available information across the borough through Carer Contact
Centre contract
• All carer referrals now going through central Access Team.
• Improvement of Private taxi service for carers and people using mobility vehicles.
• Admiral nurse – developing and monitoring job role
Further information
Simon Foster
Programme Lead
Carers and LINks – DH West Midlands
simon.foster@dh.gsi.gov.uk
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Milestone 2
Self-directed support and personal budgets
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Milestone 2
Self Directed Support and Personal Budgets
Key note speech delivered by: Gill Vickers, Regional Personal Budgets Lead - DH West
Midlands
Our approach
Personal Budgets offer choice and control if:
• There are personalised services and support available to purchase;
• People with disabilities are empowered to play a more active part in their communities;
• Individuals are able to influence how services are commissioned.
Personal Budgets offer choice if:
• They have created a greater voice for disabled people through User Led Organisations ‐ which
now have a major role to play in the delivery of support;
• There is information, advice and guidance on support available (not just local authority provided
services) that is widely accessible to all citizens.
What difference has it made?
Examples of work supporting Personal Budgets around the region:
• Information & Advice and telephone assessment contact centre, open 8am – 8pm;
• (Alongside offering Personal Budgets to all new service users) a Personal Budget pilot with
approx 50 young people in transition, also mapping those coming through transitions and
linking them, where appropriate, to personal healthcare budgets;
• Advertising Personalisation and Personal Budgets in the local paper and also put similar
information in local supermarkets;
• Work with carers to co-produce a Carers Resource Allocation System;
• Work with Age Concern to identify and address delays in delivering Personal Budgets to older
people;
• Adult panel of Carers and service users and a Citizens ‘e panel’ to test understanding of
Putting People First communications;
• Piloting outcome based support planning with neighbourhood (domiciliary care) providers;
• Appointment of project officer to support micro-enterprises.
Further information
Gill Vickers
Regional Personal Budgets Lead
Department of Health West Midlands
gillv@btinternet.com
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1. Shropshire: My Life, My Choice
Presentation delivered by: Jenny Pitts, Transformation Lead, Shropshire Council
Our approach
Dave and Rene had led a full and active life and enjoyed holidays and travel. After Dave had a
stroke and was diagnosed with dementia they were determined not to lose their quality of life
together and the active and fun things they had enjoyed.
Rene was getting increasingly tired caring for Dave and in particular was suffering from a lack of
sleep. Dave was offered respite and day services but he didn’t enjoy the respite and Rene worried
about him when he was away from home and hence he didn’t use this service as often as he
could have.
When Shropshire Council invited people to take part in a pilot to test their system of self-directed
support, Rene felt this might work for them. Together with their daughter, Carol, they attended a
number of workshops and information events. They were offered a personal budget of the amount
that was currently being spent on Dave’s support. However, because they had declined some of
the respite on offer, there was a delay in doing a reassessment and getting the funding agreed.
What difference has it made?
With the support of Carol and the My Life My Choice team Rene developed a Support Plan that
focused on how they wanted to live their life to enable Dave to be well cared for and Rene to get
the support she needed.
Rather than respite, they have booked weekend breaks in a cottage and invite another couple
along – family or friends. The deal is that the husband of the other couple shares a twin bedded
room with Dave and this enables Rene to still spend quality time with him but to get a good nights
sleep as well.
They have recruited “Team Dave” Personal Assistants (PA) who support Dave to do the things he
enjoys, like going to the football, which his PAs etc share an interest in. He still uses the day service
for some of the time but has a much more varied week than previously.
It is early days but so far it is working well and Rene feels having a personal budget is the key to
them living their life in the way they want to – having fun as a family and doing the things that are
important to them.
Further information
Jenny Pitts
Transformation Lead
Shropshire Council
jenny.pitts@shropshire.gov.uk
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2. Warwickshire: Transforming Lives by Enriching Self-Directed Support
with Lessons Learnt from Direct Payments
Presentation delivered by: Lesley Kendall, Self Directed Funding Development Officer,
Warwickshire County Council
Our approach
Expertise, knowledge, tools and skills acquired from Direct Payments can be adapted to transfer
and encompass what works well into Personal Budgets.
• People in Warwickshire are making choices about what support they need to live their life.
• Direct Payments have increased threefold over the last two years exceeding to above 1500
people in March 2010.
• Building on this: Personal Budgets are no longer an idea - over 600 new Older People and
Physical Disability customers are now receiving their own budget.
• Plans to roll out Personal Budgets across the whole of the county to all customer groups are
progressing well in line with Putting People First milestone 2.
What difference has it made?
• There are benefits for customers, practitioners and the organisation as a whole.
• Transformational change has been promoted in the spirit of personalisation.
• Core delivery is mainstreamed and not an add on. This provides maximum options for choice,
control and mix and match.
• There is equity in the service which is both consistent and easy to use.
• NI130 measuring Direct Payment increased performance when offered through a Personal
Budget.
• Evaluation / review / sharing of good practice/ enthusiasm has been delivered via front line
champions meetings.
• Improved outcome for customers has been shown by fewer drop offs for Direct Payments.
There has also been an increase in quality referrals for support with Direct Payments.
• People are achieving outcomes with less money. A lighter touch back office monitoring has
resulted in more Direct Payment customers returning unspent funds.
The next steps will be to:
• Roll out self directed support to all customer group as core delivery. This will ensure all client
groups have choice and control by knowing how much they have to spend early on.
• People will be supported to choose Direct Payments as whole or part of their Personal Budget.
• Consult and co produce with customers a new model of support service and to ensure people
have easy access to advice and support tailored to them.
Further information
Lesley Kendall
Self Directed Funding Development Officer
Warwickshire County Council
lesleykendall@warwickshire.gov.uk
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3. Dudley: Moving Forward Together in Dudley
Presentation delivered by: Steve Jones, Interim Head of Transforming Social Care Team, & Julia
Wade, Unit Manager, Transforming Social Care Team & Lorna Reid, Micro-Services Coordinator,
Community Catalysts
Dudley’s vision is to work with citizens and partners to develop a community based support
system focussed on the care, health and well being of the population. Individual choice and control
will be the cornerstone of this approach.
Dudley made an early decision to have a single resource allocation system. The roll out of the
self directed support project began October 2009, phased within Older People and Physical
Disabilities services along with Learning Disability and Mental Health teams. Service users were
assessed through the Resource Allocation System and in Learning Disability services specific
support planners were identified.
What difference has it made?
• The importance of training and ongoing on-site support has been highlighted.
• There has been consultation with staff, users, parents and carers, BME groups and other key
stakeholders.
• Increased effectiveness and consistency.
• A single access point for adult social care.
• Information and advice – work with libraries including a community information directory and
implementation of a carer aware scheme.
Next steps will involve:
• Ongoing weekly management and staff support workshops.
• Measuring of outcomes at the review stage.
• Support planning.
• User/carer consultation evaluations.
• Market shaping development.
The Micro Services Project - Dudley
Micro Services are services that are providing support or care to people in their community,
delivered by 5 or fewer workers – paid or unpaid and they are independent of any larger
organisation.
• Barriers faced by micro providers both locally and nationally:
• Commissioning and procurement practice.
• Accessing relevant advice and information, including market information.
• Start up funding.
• Workforce training and development.
• Small amount of micro provision in Dudley.
• Not enough diverse and flexible services “out there” to meet the needs of the community.
• Geographical issues - too many services concentrated in one area.
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What difference did it make?
• There has been increased interaction with providers including signposting/networking, free
safeguarding training, guidance issued on the procurement process, the establishment of a
Provider Association and work undertaken with groups across all BME sectors.
• Feedback to so far has indicated that:
»» “the service was greatly needed, its been a lifeline as I didn’t know where to start”
»» “its nice for someone to provide friendly face to face contact and provide guidance, rather
than painstakingly looking on the internet”
»» “its great to know that there is someone who can give some comprehensive advice,
especially with all the changes with CQC regulation”
Dudley is now working towards:
• More flexible and diverse services;
• More community based/personalised services;
• More choice in the 3rd sector;
• Customers being able to purchase services tailor made to meet their needs;
• More people living independently with support.
Further information
Steve Jones
Interim Head of Transforming Social Care Team
Dudley Metropolitan Borough Council
steve.jones@dudley.gov.uk
Julia Wade
Unit Manager
Transforming Social Care Team
Dudley Metropolitan Borough Council
julia.wade@dudley.gov.uk
Lorna Reid
Micro-Services Co-ordinator
Community Catalysts
Dudley Metropolitan Borough Council
lorna.reid@dudley.gov.uk
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4. Telford and Wrekin: Personal Budgets - Developing Our Workforce
Presentation delivered by: Samantha Wells, Putting People First Project Officer, Kathy Jones,
Service Delivery Manager for Housing and Personalisation Commissioning
Our approach
We all know about personal budgets and RAS but what do we actually need to do to make these
a reality for our workforce? Telford and Wrekin have undertaken preparatory work to facilitate the
move to personal budgets.
The transformation, in line with our revised service delivery model, involves revising paperwork, and
undertaking interactive training followed by engagement and evaluation. The benefits will be an
improved joint understanding between managers and staff, improved outcomes for people using
services and better provider engagement.
What difference did it make?
Feedback from case manager: “Communication was much better, the person felt comfortable and
in control and was able to tell their story about their past, present and where they wanted to be in
the future. The worker felt that she wanted to listen, and the person felt that they were listened to”
Next steps will involve improved links to FACS, support planning and engagement with providers.
Further information
Kathy Jones
Service Delivery Manager
Housing and Personalisation Commissioning
Telford and Wrekin Council
kathy.jones@telford.gov.uk
Samantha Wells
Putting People First Project Officer
Telford and Wrekin Council
samantha.wells@telford.gov.uk
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5. Warwickshire: Warwickshire’s New Business Model for
Adult Social Care
Presentation delivered by: Diana King, Service Manager for Procurement and Quality
Our approach
This business model is an approach to benefits realisation - understanding the business, use of
resources and the impact of change initiatives. Warwickshire’s new business model for Adult Social
Care is being used to evidence and measure delivery of benefits. Warwickshire is also setting team
level targets for delivery of NI130. This approach:
• Shows how the organisation is currently spending it’s budget;
• Illustrates how demand is being managed;
• Provides a baseline position statement;
• Aids construction of ‘what if’ predictions;
• Tracks / illustrates impact of change.
The benefits are that it:
• Provides Directorates with essential information to manage change programmes;
• Identifies interdependencies;
• Measures performance against targets;
• Helps communicate the ‘Big Picture’;
Through better understanding of the impact of changes, longitudinal progress can be mapped;
analysed and used to inform future strategic plans.
This will be one component to help achieve buy-in to the transforming social care agenda.
Success will depend on effective and regular use of the model by directorate leadership teams and
business change leads and strategic planning based on evidence attained through evaluating the
impact of change. It will require better links between finance and activity information, performance
measures that focus on the business requirements rather than national indicators and new ways of
recording and classifying information that fits the new business model.
What difference did it make?
Next Steps:
• Use of the model to help manage the Adult Social Care Transformation programme.
• Update the baseline with 09/10 information and 10/11 predictors.
• Introduce the next level of sophistication to breakdown the headline numbers into a lower level
of detail.
• To understand expenditure across the range of different service / client / geographical areas.
Further information
Diana King
Service Manager for Performance and Quality
Warwickshire County Council
dianaking@warwickshire.gov.uk
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6. Sandwell: Personal Budgets - Delivering Personal
Budgets in Sandwell
Presentation delivered by: David Stevens, Transformation Programme Manager, Sandwell
Metropolitan Borough Council
Our approach
Personal budgets development in Sandwell commenced around learning disability pilots, before
moving to a default position in December 2009. The default position includes two phases:
»» Phase 1 where all new customers who meet the appropriate criteria receive a personal budget.
»» Phase 2 will expand to include people receiving mental health services or residential/nursing
care.
Associated with the default position tools have been developed around assessment, the Resource
Allocation System, support planning and reviews.
What difference did it make?
An evaluation of the approach to date has been undertaken and has identified the following
findings associated with the implementation of personal budgets in Sandwell
Benefits for the customer:
• The customer is in control and able to tell us what they want, not us telling them what they
need;
• People able to benefit from the outcomes associated with positive risk taking;
• There is much greater flexibility in the range of services a customer can have;
• Support is no longer only available from a traditional list;
• Being outcome focused means we focus on every customer individually and every customer is
different;
• Customers are more independent and are able to play a much more active role in the
community;
• Customers can employ personal assistants who can assist them with a much wider range of
support than what has been traditionally possible;
• Customer personal assistants are telling us how much more they are enjoying their roles and
how the greater flexibility of personal budgets is enabling them to do a lot more.
-22-
Benefits for Sandwell:
• We can make direct efficiencies in service delivery by listening to what customers want and
providing it as opposed to traditional care packages;
• There are efficiencies associated with claw back of unspent monies;
• Personal budgets support more effective commissioning having the services in place that
people want;
• Our staff are increasingly valued and respected by our customers who see that we are listening;
• We spend longer with each customer but deliver more effective services;
• We can develop tailored training to re-skill our workforce;
• Our approach to support planning means that have increased opportunity to identify potential
safeguarding concerns;
• Our providers are becoming more active in developing new services and assessing how they
will deliver a more person centred approach.
Lessons learned:
• Publicity is important both internally and externally;
• Training staff is a key factor in delivering success;
• Continuous evaluation of business processes is vital in ensuring bottlenecks do not occur at
critical points;
• Engagement with, and bringing external partners into the personal budget process as early as
possible is required to ensure they can manage increased work loads;
• The Personal Assistant market will grow steadily, but at a constant rather than there being a
sudden explosion;
• The culture of the organisation needs to change so that Personalisation is at the centre of every
thing we do.
Further information
David Stevens
Transformation Programme Manager
Sandwell Metropolitan Borough council
david_stevens@sandwell.gov.uk
-23-
Milestones 3
Prevention and cost effective services,
and information and advice
-24-
Milestone 3 Prevention and cost effective services
Early Intervention - Developing Cost-Effective Reablement Services
Key note presentation delivered by: Stephen Rea, Implementation Manager; Care Services
Efficiency Delivery Programme – DH West Midlands
The Government’s legislative intention is to accelerate the pace of Adult Social Care reform so
that older people and disabled people get the care they need - when they need it - for example,
ensuring that re-ablement support is given to people after discharge from hospital, to help them
re-gain the essential skills of daily living, and continue living independently, in their own homes.....”
The Coalition states “...the Government will be considering what more can be done on reablement
…”
Survey evidence gathered by CSED indicates that nationally 19 (12%) of councils have a full-scale
re-ablement service and that 130 (86%) of councils are in the process of either establishing a
service, or enhancing / extending an existing service.
Re-ablement works - the evidence is compelling, BUT, in order to work, a service has to be set up
properly, delivered large-scale, and performance must be measured. The policy intention is clear;
re-ablement will be a major feature of future Adult Social Care policy and practice. It’s more than a
new service – it’s both a new philosophy and culture.
What difference has it made?
In the West Midlands re-ablement is developing comparatively well – but there is still much to do.
CSED is currently supporting 10 WM councils with Re-ablement service development.
In a couple of these councils, the work is focused on starting up a Re-ablement service - in the
others, the work is focused on one or more of the following:
• expanding the scope (range of client groups and conditions supported) of the intake;
• growing the capacity of the service, to enable more service users to participate;
• improving the performance of the service, both in terms of its efficient delivery, and in terms of
the outcomes achieved.
The CSED support is coordinated, so that all the participating councils work to the same
methodology, and are encouraged to collaborate in developing good practice. The overall
objective of the programme is to achieve a step-change in both the scale and performance of
Social Care Re-ablement services across the West Midlands by March 2011.
Further information
Stephen Rea
Implementation Manager
Care Services Efficiency Delivery Programme, Department of Health West Midlands
Stephen.Rea@dh.gsi.gov.uk
-25-
1. Herefordshire: Using Technology to Support Personalisation
Presentation delivered by: Andrew Morris, Planning Officer – Planning Team, Integrated
Commissioning, Herefordshire Council
Our approach
Herefordshire is developing invest to save & low cost initiatives in Dementia services that support
personalisation, reduce costs, increase independence and unleash the strengths and potential of
people with memory difficulties.
Specialist intermediate care for people with memory difficulties features a partnership arrangement
with training at heart of all interventions and technology integrated into services rather than used in
isolation.
What difference has it made?
The service is provided in people’s own home to resolve crisis and has resulted in a 25% reduction
in funded placements over 2 year period (57 funded placements at £1.5 ‐ £1.7 million savings –
funding the mainstreaming of the service) . There has been a reduction in the use of emergency
respite / hospital admissions. The risk assessment is based upon objective rather than subjective
information – so people are given a real voice in the assessment process
In terms of meeting some of the challenge with low cost solutions - some will require major
investment or service re‐design but there are ways to develop improved services without major
cost implications by some creative thinking and partnership working –the more we can deliver via
this route the less pressure will be placed upon resources:
• Memory Cafes;
• Touch Screen Technology –iPad Memory Apps;
• One Life Alive! – meaningful activity based upon engaging and bringing people with memory
difficulties Alive!
Over the next twelve months Herefordshire will:
• Further develop the evidence base for technology solutions;
• Create alternative approaches to community based support involving caring communities and
partnership approaches;
• Support people with memory difficulties to make the most of their ‘One Life’ through engaging
staff and local communities to improve communication, activity and understanding of life
experience.
Further information
Andrew Morris
Planning Officer
Planning Team, Integrated Commissioning
Herefordshire Council
Andrew.Morris@herefordpct.nhs.uk
-26-
2. Staffordshire: Reablement Service Development
Presentation delivered by: Wendy Angus-Bovell, District Director – Staffordshire and East
Staffordshire County Council & Stephen Rea, Regional Implementation Manager, CSED
Our approach
A journey from Home Care to an Integrated Community Reablement Service began 4 years ago
with:
• A workforce of approximately 542 FTE;
• Traditional service centred model;
• Waste and inefficiencies in the system – down time;
• Inflexible;
• Costs of the service were £13.048 million.
The service required modernisation, moving to an integrated Reablement model and promoting
independence;
What difference has it made?
• Workforce reduced to 311.5 FTE;
• In-house service costs reduced to £8.892 million in 4 years;
• Our commissioning strategy – invest in the independent domiciliary care market;
• Working towards integration with the NHS.
The aim is to have a countywide integrated community Reablement model by mid 2011 across the
whole county.
Further information
Stephen Rea
Regional Implementation Manager
CSED
Stephen.Rea@dh.gsi.gov.uk
Wendy Angus-Bovell
District Director
Staffordshire and East Staffordshire County Council
wendy.angus-bovell@staffordshire.gov.uk
-27-
3. Stoke-on-Trent: Rehabilitation and Recovery
Presentation delivered by: Mark Palethorpe, Head of Adult Services and Partnerships, Jill
Broomhall, Strategic Manager for Reablement & Simon Pickford, CSED Implementation Consultant
Our approach
The development of a new model for the delivery of care and support designed based on wellness
and developing community focused solutions involves 3 stages:
• Access;
• Recovery;
• Longer-term support.
Key factors for success are:
• Access (co-located health and social care teams in 5 neighbourhoods, virtual teams and
pathways, customer facing links with internal and external partners and provision of low-level,
preventative and universal services in the customer’s locality.
• Rehabilitation and recovery (meeting a broad range of needs, an outcome focus and alignment
of assessment with specialised rehabilitation focus).
What difference has it made?
• Improved outcomes and lower costs - more efficient;
• ‘No wrong door’;
• Reduced waste;
• Improved access at a local level;
• Effective provision of preventative services;
• Outcome focussed support planning;
• Increased independence.
Further information
Mark Palethorpe
Head of Adult Services and Partnerships
Organisation
mark.palethorpe@stoke.gov.uk
Jill Broomhall
Strategic Manager for Reablement
Organisation
Jill.broomhall@stoke.gov.uk
Simon Pickford
CSED Implementation Consultant
Organisation
Simon.Pickford@dh.gsi.gov.uk
-28-
4. Solihull: Living with Reablement
Presentation delivered by: Christopher Siviter, Head of Integrated Commissioning &
Personalisation Fiona McGill, Deputy Director of Community Services
Our approach
Reablement helps people with poor physical or mental health maximise their independence by
learning the skills and confidence necessary for daily living. The main objective of the service in
Solihull is to help people regain skills so that they can remain independent “help people to do
rather than doing for”. Greater independence gives people greater choice and improved their
quality of life.
The outcome focussed, multi-disciplinary service is provided free for up to 6 weeks followed by a
user evaluation.
What difference did it make?
• Improvement in service user experience and outcomes
• Reduction in levels of care required
• Reduction in numbers of people admitted to residential care / hospital
• Independence, choice and quality of life maximised
• Reduction in levels of ongoing support
• Positive experience for both service users and staff.
The next step will be to develop the hospital re-ablement discharge service.
Further information
Christopher Siviter
Head of Integrated Commissioning and Personalisation
Solihull Care Trust
christopher.siviter@solihull-ct.nhs.uk
Fiona McGill
Deputy Director of Community Services
Solihull Care Trust
Fiona.McGill@solihull-ct.nhs.uk
-29-
5. Birmingham: Strategic Shift to Prevention
Presentation delivered by: Safina Mistry, Head of Project Development & Matt Evans, Business
and Data Analyst
Our approach
The aim is to reduce the numbers of people coming into high-cost services and moving into
substantial/critical and make a strategic shift to the ‘left’ of the funnel, away from Tertiary
Prevention using a predictive modelling process.
Birmingham is a unique and diverse population, so the needs (and future needs) of this population
need to be understood. An analysis was undertaken looking at 2 years activity for FACS bandings
within our Social Care system (Carefirst). We identified an annual average of 410 vulnerable adults
aged 65 and over who move from Low/Moderate to Critical/Substantial, and this group alone
costs the Directorate £2.6 million per year. Falls was identified as one of the major triggers for entry
into Social Care, whilst having a significant impact on Health.
The strategic shift to prevention involved building up joint working across a number of agencies
and sectors (Total Place).
What difference did it make?
• We have achieved a number of Quality of Life improvements for citizens, including:
»» Increased Health and Wellbeing
»» Ability to remain at home independently and for a longer period of time
»» Increased self confidence for citizens
• Links with the Benefit Service – citizens have increased benefits (via Take Up team)
• Reduced referrals for high cost care
• Robust cost-benefit analysis identified an estimated £15.3m Net savings over the next 8 years
(from 2010/11 through to 2017/18)
Further information
Safina Mistry
Head of Project Development
Birmingham City Council
safina.mistry@birmingham.gov.uk
Matt Evans
Business and Data Analyst
Birmingham City Council
Matt.Evans@Birmingham.gov.uk
-30-
Milestones 4
Information and Advice
-31-
Information and Advice Milestone 4
Information and Advice at the Heart of Self-Directed Services
Key note presentation delivered by: Linda Sanders, Director – Adult Community and Housing
Services – Dudley MBC
“The shoe that fits one person pinches another; there is no recipe for living that suits all cases!”
C J Jung
National support for best practice is available from I&DeA / ADASS“Transforming Social Care:
access to information, advice and advocacy” -
www.idea.gov.uk/idk/core/page.do?pageId=9454439
West Midlands support is available from: Impact Change Solutions “Information and Advice” Task
& Finish Group Report on Best Practice examples & Recommendations.
What difference has it made?
Dudley Council is working with Libraries to deliver Milestone 4 with:
• Information Professionals
• Well trained staff
• 13 service points across the Borough
• Carers information service launched December 2009
• Existing directory
Dudley community information directory is an easily searchable, up to date online directory which
as a community resource provides wide coverage. There is an adult information hub which is
improving access to virtual social care.
Next steps will involve:
• Volunteers in libraries – Information buddies
• Fully functioning adult information hub complementing single point of access for advice
Further information
Linda Sanders
Director
Adult Community and Housing Services
Dudley Metropolitan Borough Council
linda.sanders@dudley.gov.uk
-32-
Amanda Carr
Assistant Director, Adult Social Care
(Older People) Coventry City Council
Amanda.Carr@coventry.gov.uk
Rachel Upton
Older People’s Partnership Manager
Coventry City Council
Rachel.Upton@coventry.gov.uk
Karen Airlie
Contact and Connect Team Leader
Age Concern Coventry
karen.airlie@accov.org.uk
6. Coventry and Age UK Coventry: Contact and Connect
Presentation delivered by: Amanda Carr, Adult Social Care - Older People, Coventry City
Council, Rachel Upton, Older People’s Partnership Manager, Coventry City Council & Karen Airlie
Contact & Connect Team Leader, Age Concern Coventry
Our approach
Contact & Connect supports older people to remain living independent & safe in their own home
by providing a single point of access to a holistic range of services & information. The service
was set up in a unique funding and strategic partnership between Coventry City Council, NHS
Coventry, Age Concern, Coventry Carers Centre, West Midlands Fire Service, Coventry Local
Pensions Service and the NEA; this partnership is managed and coordinated through a voluntary
sector COMPACT agreement, and is accountable to the Older People’s Partnership. It is resourced
by all agencies, either through direct funding or resourcing-in-kind. Age Concern Coventry (soon to
be Age UK Coventry) acts as the host organisation, and works with all partner agencies to ensure
there are pathways of referral for all older people who would benefit from the service provided. The
service recently won a Special Commendation in Coventry’s Compact awards as an example of
excellent partnership working that achieves outcomes for people.
It features a holistic issue lead assessment, a single Point of access and an 85+ screening with
the Local Pension Service. There have been 6,924 clients, 15,247 referrals and 10,552 signposts.
People require access to solutions, advice & information, support to access services where
needed and choice & control.
What difference did it make?
There has been detailed client feedback and evaluations from both Warwick and Coventry
Universities showing:
• 58% - positive impact on their life
• 60% - improved health & wellbeing
• 58% - day to day life improved
• Over 10 Million in increased benefits
Next Steps will involve continuing to expand the referral network within the NHS, developing new
points for information e.g when leaving intermediate care and working with younger clients e.g.
those with early onset Dementia.
Further information
-33-
7. Worcestershire: Access to Services and Information in Worcestershire
Presentation delivered by: Andrew Morley, Access Manager – Adult and Community Services
Our approach
Developing a signposting resource for use by the Access Centre and other agencies and integrate
this into a revised contact screening/advice service.
‘Carewise’ introduces an element of co-ordination and quality to disparate advice services whilst
recognising and valuing multiple contact routes and the relationships built within the Council
and VCS. It also makes use of existing social capital to support broader well-being outcomes. It
involves an initial call screening by trained non professional staff resulting in high volume of call
resolution through advice or signposting and the obtaining of good quality referral information prior
to assessment using revised documentation/pathway options.
What difference has it made?
• Open access to high quality, consistent information and advice;
• More choice – information and access routes tailored to individual needs or preferences (eg
screen reader software);
• Enhanced opportunities for inter-agency work, to provide support to all levels of need;
• Economies of scale through centralisation;
• Consistency of quality/standards;
• Respond to contact promptly at the most appropriate point in the care pathway.
Carewise - Next Steps:
• Work with partners to establish Carewise as the information source of preference;
• Develop the “advice” options within the system to add value;
• Explore options to develop personal hubs within Carewise - to give direct access to care
records, self assessment forms and manage personal budgets;
• Develop Personal Assistant register and transactional tools;
• Use personal hubs as a means of sending direct referral from the Access Centre to key
external VCS partners.
-34-
Access Service - Next Steps:
• Review of placement within organisation structure;
• Ensure service more closely aligned to frontline services to provide support and ensure;
maximum use is made of presenting opportunities;
• Develop the added value activities within contact/referral pathway;
• Direct referrals to third party orgs, early start for benefits assessment, partnership working with
carer organisations;
• Explore partnership options with Health;
• Single point of access for intermediate care has been successful –we need to identify the
scope for further joint work.
Further information
Andrew Morley
Access Manager - Adult and Community Services
Worcestershire County Council
AMorley@worcestershire.gov.uk
-35-
Milestone 5
Local Commissioning - Developing the Market Place
-36-
Milestone 5
Local Commissioning - Developing the Market Place
Key note presentation delivered by: Mark Godfrey, Assistant Director – Adult Social Care –
Coventry City Council; and Vice Chair of WM Personalisation Leads Network
Back in 2007, Denise Platt, Chair of the Commission for Social Care inspection said:-
“Commissioning is at the heart of effective social care….it is the opportunity to transform people’s
lives and we should not allow ourselves to reduce the debate just to structures and processes…if
personalised care is to be made a reality, current ways of commissioning will have to change”.
Within the West Midlands, a wide range of work around commissioning has taken place, and this
year, work commenced on a market shaping programme, and through this a vision for the region
has emerged:
“A richer, more efficient market, shaped around customer needs with a mixed economy of
providers delivering real choice, better care and improved outcomes”.
Examples of regional work undertaken include the Personal Assistant project, provider
development work and micro market pilot sites that we have in Dudley and Telford and Wrekin.
The role of commissioning is key to the delivery of personalisation, This is the time to see the
changing landscape as an opportunity for innovation and improvement. Commissioners need
to work with providers to encourage and reward innovation in providing different opportunities,
stimulating and evolving the market - and this requires risk taking by both commissioners and
providers to do something different. As a region we supported an innovation exchange event
– a festival of ideas - in November 2009 for commissioners to meet and learn about the new
innovations that are taking place in the West Midlands in the Third Sector. There are also real
opportunities for us to work with individuals and carers to support them to demand and expect
something different.
The role of commissioners is important in organising the supply of services, delivering efficiency,
fairness and flexibility and improving the quality of services provided. More emphasis is now on
commissioning for outcomes, and measuring the impact that that has for individuals and reducing
dependency on adult social care, at the same time being mindful of issues of safeguarding. The
role of commissioning is also to identify and optimise the role of the third sector. In this changing
climate, working together with health partners and across authorities throughout the region, has
never been more important.
-37-
What difference has it made?
So what does this new landscape look like?
• it is continuing to change the way we commission, increasing the range of options
• it is about commissioning for outcomes that have a positive demonstrable impact on people’s
lives
• it is creating a sustainable, flexible, market that will be fit for purpose in the future.
• and with growing needs and rising aspirations, there will be even greater emphasis on adult
social care being efficient, affordable and doing things differently with less.
Further information
Mark Godfrey
Assistant Director - Adult Social Care
Coventry City Council
Vice Chair of West Midlands Personal Leads Network
Mark.Godfrey@coventry.gov.uk
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Shelley Davis
Health Development Officer
Health Development Team
shelley.davis@staffordshire.gov.uk
Angela Schulp
Service Delivery Lead
Cannock Chase District Council
angela.schulp@staffordshire.gov.uk
1. Staffordshire: Living My Life My Way
Presentation delivered by: Shelley Davis, Health Development Officer – Health Development
Team & Angela Schulp, Service Delivery Lead, Cannock Chase District Council
Our approach
Bigger Picture: Organisation, Development, Ideas:
• Shift from ‘doing to’ to real choice & control e.g. Personal Health Budgets;
• District, locality leadership –‘out there’;
• Joint Commissioning Unit – collaboration, 3rd Sector & Leadership;
• Place-Shaping toolkit to support practice:
http://www.staffordshire.gov.uk/NR/rdonlyres/3C1C3400-FA75-4DC9-86D6-
9ADEA1124148/135070/ForCommunitiesWithCommunitiesToolkit2010.pdf
• Training and Development – Cultural change;
• Performance – critical friend.
The Big Idea: Community Wellbeing Fund:
• Community Development / Capacity Building;
• Simple / Clear Process – Remove Bureaucracy;
• Prevention – Health, Independence and Wellbeing;
• £1million - 4 years;
• Improved Outcomes – Older People & Vulnerable Adults;
• Best Practice – Fully Commissioned Projects.
What difference has it made?
PACE 2000 is a community based project which received funding through the Community
Wellbeing Fund, to provide exercise groups, social interaction, information and support to older
people in the community.
“I would recommend anyone who is providing a local service to their community or who has a
new Idea of how they can help people in their area to apply for funding as it can make such a
difference. People who come along to our sessions have a real feeling of self esteem and it really
promotes the feel good factor.” (Dorothy Briggs, Founder of PACE 2000)
Bill Westwood is in his 70s and cares for his wife who has Parkinson’s disease and is a member
of PACE 2000: “I have always worked hard mentally and physically but nothing prepared me for
the strain of being a carer. Finding PACE has been my saviour – physical exercise, interesting
and friendly with excellent speakers. It has drained the stress from my mind and without PACE I
wouldn’t have been able to cope.”
Further information
-39-
2. Mobilising Community Capital
Presentation delivered by: Paul Johnston- Director of Impact Change Solutions working for the
West Midlands Joint Improvement Partnership
Our approach
Our vision for market shaping:
“A richer, more efficient care market, shaped around customer needs, with a mixed economy of
providers delivering real choice, better care and improved outcomes.”
The West Midlands PA Project was set up to deliver an evidence base, toolkit and
recommendations in order to increase the capacity (number) and quality (skills) of Personal
Assistants in the West Midlands.
What difference has it made?
The project has recommended local action (e.g. Employer’s Insurance, Direct Employment
Toolkit, Training for PAs and Employers), regional support (Process efficiency review, Information
& Advice workshop, PA Register pilots) and a new approach to Market Shaping (Market Analysis
& Engagement, Support for Innovation & Enterprise, Support for Providers, New Culture for
Commissioning).
Market Analysis & Engagement will collate the output from “Rich Conversations” between service
users, providers and commissioners with an analysis of market intelligence to produce a gap
analysis and market enrichment plan.
Support for enterprise & innovation will see the region host a number of Festival of Ideas-type
events, will develop an evaluation framework for innovative ideas and will look to encourage staff
enterprise. Support for Providers will look at the infrastructure and quality needs of micro-providers
and will look to support and evaluate a number of local pilots.
Work on the commissioning culture will consider the extent to which personalisation principles
are embedded in commissioning strategy and practices and the extent to which commissioning
behaviours reflect the strategic direction.
Collectively, this will result in a richer, more efficient market with more (and more sustainable)
providers, less reliance on the public sector and lower unit costs. Services will be shaped around
service user needs resulting in less unmet need and improved access to services. There will be
better care and improved outcomes and quality of life.
Further information
Paul Johnston
JIP Project Manager
Director of Impact Change Solutions
paul.johnston@impactchange.co.uk
-40-
3. Coventry: Commissioning for Personalisation - Changing
Supply and Demand
Presentation delivered by: Pete Fahy, Service Manager – Service Manager Adults
Commissioning - Coventry City Council
Our approach
We will directly support or influence others, to enable every adult and older person to have the
opportunity to live a fulfilling life based on their individual choices and aspirations.
What difference did it make?
Empowering users through involvement in all aspects of the commissioning process and primary
information access points. Consumer power and balancing safeguarding/ dignity and respect /
positive risk taking are integral to the approach as is challenging Coventry if people are not doing
their jobs properly.
Enabling choice including providing short term services for people to test out and make good
decisions, stimulating the market, cultivating and growing new ideas - supporting providers to try
something different. Also obtaining and organising information for e.g. through the 55+ Better Life
Survey. Finally improving workforce capability and skilling for outcomes.
Involving providers through forums, conferences, workshops, learning forums and developing
models which create opportunities to engage in different ways. Providers are key partners as they
know the people best. Risk is shared through COMPACT and involvement of Voluntary Action
Coventry.
Extending the offer:
• 2008/09 Home Support Pilot with Care UK Ltd
• Short Term Services models –Short Term Tenancies; then Promoting Independence Framework
• Housing with Care – currently testing Personal Budget = core hours + Direct Payment for
additional hours
• 2009 Day Opportunities pilots and Social Enterprise
• Carers – Conductive Education for stroke; carers direct payments; testing carer “entitlement”
• Provider engagement forums – Building Coventry’s Vision for Personalisation March 2010
Organising supply - increased offers are a measure of market strength and willingness to engage
as well as a level of competition to deliver end user outcomes.
Further information
Pete Fahy
Service Manager - Adults Commissioning
Coventry City Council
peter.fahy@coventry.gov.uk
-41-
4. Worcestershire: Establishing a Joint Commissioning Unit
Presentation delivered by: Peter Arch, Head of Joint Commissioning Unit
Our approach
Joint Commissioning between the NHS and Adult Care Services impacts upon Transforming Adult
Social Care. It involves supply side reform, a spectrum of responses and clarity of funding to create
a personalised offer for the local community. A programme/service specific approach was taken
with plurality and choice and local ownership.
What difference did it make?
A different approach to programme structure and budgets resulting in more and different
suppliers and a better understanding of the current state. It requires more sophisticated financial
management and models, marketing expertise (not selling) and a locality data base.
Joint Commissioners need clarity regarding the commissioning budgets they are directly
responsible for and in addition the wider resources that apply to any particular programme. This
may be regarded as a virtual budget for the whole system and the commissioner needs influence
over it to achieve whole systems change. E.g. Dementia, where resources are embedded in the
“budgets” of other commissioners
Next Steps:
• Agreed programmes/ direct and virtual budgets
• More helpful information for market segments/ greater diversity of supply and a more creative
offer
• Locality commissioning Infrastructure complementing Practice Based Commissioning
Further information
Peter Arch
Head of Joint Commissioning Unit
Organisation
PArch@worcestershire.gov.uk
-42-
5. Walsall: Joint Commissioning - Changing the way Health and Social
Care Commission for Personalisation
Presentation delivered by: Ian Staples, Joint Strategic Commissioning Manager, Disabilities
Our approach
In Walsall we have formed a Joint Commissioning Unit with a business plan which has led to more
effective commissioning for Personalisation. A Commissioning Matrix has been developed to gain
a panoramic overview of expenditure across the JCU – both NHS and Council. This is based
on 3 P’s - Programmes, Pathway Specifications (based on outcomes) and Procurement. The
commissioning intentions are:
• 20% reduction of £120 million over three years
• Reduce admissions to care homes with none out of borough
• Reduce admissions to hospital
• Prevention Prevention Prevention
What difference has it made?
The aim is to obtain:
• Value for money (VFM) from the Core services that do meet needs effectively (i.e. standard fee
levels instead of individually negotiated)
• Savings from keeping Service Users in high cost services for as long as they need to be (i.e.
emphasis on rehabilitation, recovery, intermediate care)
• Savings because citizens will be signposted/diverted to alternative services, rather than to the
core, costly services
• Savings because there will be a range of interventions to help people stay independent longer
• Further commissioned prevention services which the resultant savings will be reinvested in
further prevention services
The target operating model is for:
• Services purchased directly by consumers
• Individual budgets – self funding
• ‘Menu’ of services with clear tariffs/fees (RAS)
• Wider range of care and support – wider choice
• Independent brokerage, navigation, advice and advocacy – shifts focus from inputs to
outcomes
• Strategic procurement – framework agreements
• No special relationships
• Smarter Commissioning
“Everything we do will improve the experience of using the service, and value for money”
Further information
Ian Staples
Joint Strategic Commissioning Manager - Disabilities
staplesi@walsall.gov.uk
-43-
6. Wolverhampton: Local Commissioning and Engagement
of Universal Services
Presentation delivered by: Thanh-Giang Vo, Arts and Social Care Co-ordinator –
Wolverhampton Art Gallery
Our approach
Through a creative, people centred approach we can make a real difference to citizen’s lives: We
wanted to work with the sector to develop arts and heritage provision and input into the universal
offer, drawing in universal services to provide the community support allowing choice and control
where people can access services that are in their community. The service secured initial external
funding to pilot a series of action research projects. This collaborative approach will give social care
teams an opportunity to be entrepreneurial and develop a new way of working and new social care
commissioning models.
The council through PPF saw that it needed to be more of an enabling council rather than delivery
(operational) council and that the culture of traditional commissioning needed to change. The
commissioning cycle is about identifying needs, then designing a service profile with specification
focused around outcomes. It is about exploring new markets and looking at non traditional
providers delivering services where there is further reach and impact and working to a model that
is based around diversion and prevention.
What difference did it make?
Penn Hospital Dementia Project – a local history object was used for a group of over 65’s with
early onset of dementia and depression outpatients to do a reminiscence session to improve well
being.
‘Best day I’ve had in a long while. Enjoyed it immensely. Been a tonic’
Stadium Legends - elders learned how to use internet search engines, web design
processes, saving documents and images to the web, digital photography and development
of communication skills. The project provided benefits for both generations in terms of the
personalised learning agenda (an area of difficulty for schools to manage), a developed
understanding between the two generation reducing fear of crime and anti-social behaviour
and negative perceptions of young people amongst the elders and a respect for the wealth of
knowledge and experience of an older person from young people.
Further information
Thanh-Gian Vo
Arts and Social Care Co-ordinator
Wolverhampton City Council
Thanh-Giang.Vo@wolverhampton.gov.uk
-44-
Improvement and Efficiency West Midlands
Regional Partnership Centre
Albert House, Quay Place
Edward Street, Birmingham
B1 2RA
t: 0121 245 0220
e: info@westmidlandsiep.gov.uk
w: www.westmidlandsiep.gov.uk
_______________________________________________________________________
Please contact us if you would like this document in large print or in an
alternative format.
Wednesday, 15 September 2010
Tuesday, 14 September 2010
Final funds for personalisation
Councils have received the last and largest strand of funding for transforming and personalising adult social care.
The third and final year of the Social Care Reform Grant has seen
£237 million allocated for revenue funding, plus an additional £33.5 million capital funding for associated infrastructure costs, such as IT systems to help with accounting for personal budgets, or development of advice and information hubs.
Transformation and personalisation are based on the principle of involving service users and carers in designing, commissioning and delivering services. Details are set out in Putting People First: a shared vision and commitment to the transformation of Adult Social Care (2007).
Central to personalisation is provision of personal budgets for services users, so they can purchase care and support themselves.
Allocation of the Social Care Reform Grant has been pegged to key milestones to ensure progress of transformation.
Milestone requirements and achievement dates are:
•the move to personal budgets is well understood and local service users are contributing to the development of local practice (December 2009)
•every council has introduced personal budgets which are being used by existing or new service users/carers (April 2010)
•all new service users/carers with assessed need for ongoing support, and service users whose care plans are subject to review, are offered a personal budget (October 2010)
•at least 30% of eligible service users/carers have a personal budget (April 2011).
Read more
The third and final year of the Social Care Reform Grant has seen
£237 million allocated for revenue funding, plus an additional £33.5 million capital funding for associated infrastructure costs, such as IT systems to help with accounting for personal budgets, or development of advice and information hubs.
Transformation and personalisation are based on the principle of involving service users and carers in designing, commissioning and delivering services. Details are set out in Putting People First: a shared vision and commitment to the transformation of Adult Social Care (2007).
Central to personalisation is provision of personal budgets for services users, so they can purchase care and support themselves.
Allocation of the Social Care Reform Grant has been pegged to key milestones to ensure progress of transformation.
Milestone requirements and achievement dates are:
•the move to personal budgets is well understood and local service users are contributing to the development of local practice (December 2009)
•every council has introduced personal budgets which are being used by existing or new service users/carers (April 2010)
•all new service users/carers with assessed need for ongoing support, and service users whose care plans are subject to review, are offered a personal budget (October 2010)
•at least 30% of eligible service users/carers have a personal budget (April 2011).
Read more
BiLD annual conference
The British Institute of Learning Disabilities (BiLD) will be holding its annual conference and AGM on Monday 18 October 2010.
Delegate will:
• find out more about government health and social care policies
• consider what these policies might mean to people with a learning disability, their families and organisations that provide support
• identify how individuals and organisations might influence and respond to changing policies and priorities.
Read more
Delegate will:
• find out more about government health and social care policies
• consider what these policies might mean to people with a learning disability, their families and organisations that provide support
• identify how individuals and organisations might influence and respond to changing policies and priorities.
Read more
Transforming local government property asset management
A free conference hosted by Improvement and Efficiency West Midlands, will take place on Wednesday 3 November 2010.
Delegates will:
• learn about the collaborative work on asset management underway in the region
• gain insight to local implications of national developments such as the Government Property Unit and the Capital Asset Pathfinder Programme
• hear the views of key private sector partners on the future and alternative asset management models
• network with public and private sector colleagues
The event takes place in the Banqueting Suite, Birmingham Council House, B1 1BB
Read more
Delegates will:
• learn about the collaborative work on asset management underway in the region
• gain insight to local implications of national developments such as the Government Property Unit and the Capital Asset Pathfinder Programme
• hear the views of key private sector partners on the future and alternative asset management models
• network with public and private sector colleagues
The event takes place in the Banqueting Suite, Birmingham Council House, B1 1BB
Read more
Opportunity to help improve care services for adults
A consultation to help improve care services and healthcare results for adults with autism in England is underway.
This is the next stage of helping adults with autism live full and independent lives and follows the publication of the strategy – Fulfilling and rewarding lives.
Read more
This is the next stage of helping adults with autism live full and independent lives and follows the publication of the strategy – Fulfilling and rewarding lives.
Read more
Future of local care services, NHS and public health
The government is seeking views on the future of care and health services in two separate consultations.
‘Liberating the NHS: increasing democratic legitimacy in health’, builds on the White Paper proposing reforms to the NHS. It proposes bolstering democracy in local health services by giving local authorities a stronger role in supporting patient choice, and taking on local public health improvement functions.
Closing date: 11 October 2010.
Read more
‘Liberating the NHS: commissioning for patients’ - this consultation seeks views on a number of areas including how GP consortia and the NHS Commissioning Board can best involve patients in improving the quality of health services.
Closing date: 11 October 2010
Read more
‘Liberating the NHS: increasing democratic legitimacy in health’, builds on the White Paper proposing reforms to the NHS. It proposes bolstering democracy in local health services by giving local authorities a stronger role in supporting patient choice, and taking on local public health improvement functions.
Closing date: 11 October 2010.
Read more
‘Liberating the NHS: commissioning for patients’ - this consultation seeks views on a number of areas including how GP consortia and the NHS Commissioning Board can best involve patients in improving the quality of health services.
Closing date: 11 October 2010
Read more
Principles form basis of best approach
The organisations Skills for Health, and Skills for Care have developed a set of ‘Common Core Principles to Support Self Care’.
The principles capture best practice in transforming the service, promoting choice, control, independence and participation of people who use services.
Read more
The principles capture best practice in transforming the service, promoting choice, control, independence and participation of people who use services.
Read more
Equity and excellence: Liberating the NHS
The NHS White Paper currently going through Parliament sets out the Government’s long term vision for the future of the NHS.
The paper contains proposals for improving patient control and the information they need to make choices about their care, improving healthcare outcomes, and giving greater autonomy to health care professionals.
Read more
The paper contains proposals for improving patient control and the information they need to make choices about their care, improving healthcare outcomes, and giving greater autonomy to health care professionals.
Read more
SCIE’s web guide to develop ULOs
Online support is available to commissioners seeking to develop user led organisations (ULOs), in the form of an interactive guide.
Produced by Social Care Institute for Excellence, A commissioner’s guide to developing and sustaining local user led organisations includes video interviews with specialists, and useful tips.
ULOs are organisations run by and for people who need support to lead their day to day lives.
They offer a range of services including advocacy and support in using personal budgets.
Councils have to ensure they have carried out work to develop and sustain ULOs as part of transforming care, by December 2010.
Read more
Produced by Social Care Institute for Excellence, A commissioner’s guide to developing and sustaining local user led organisations includes video interviews with specialists, and useful tips.
ULOs are organisations run by and for people who need support to lead their day to day lives.
They offer a range of services including advocacy and support in using personal budgets.
Councils have to ensure they have carried out work to develop and sustain ULOs as part of transforming care, by December 2010.
Read more
Help needed with telecare questionnaire
A survey of information available on assistive technology and telecare on council websites is being carried out by the Community Gateway, and West Midlands Regional Improvement and Efficiency Partnership – Improvement and Efficiency West Midlands.
Please spare five minutes of your time to complete a questionnaire electronically – see link below.
The aim is to find out what’s on offer on the region’s council web sites, the quality of information displayed, and to identify missed opportunities for giving potential users access to the information they require.
Assistive technology and telecare products make it easier for people with a condition or disability affecting their physical or mental abilities, to support themselves without assistance.
It is an effective tool for personalising services, providing preventative care, and can be highly cost effective for councils.
Findings will be shared with all key stakeholders. Please return your completed questionnaire by 24 September 2010.
Thank you for participating, your input is valued.
Questionnaire link
Please spare five minutes of your time to complete a questionnaire electronically – see link below.
The aim is to find out what’s on offer on the region’s council web sites, the quality of information displayed, and to identify missed opportunities for giving potential users access to the information they require.
Assistive technology and telecare products make it easier for people with a condition or disability affecting their physical or mental abilities, to support themselves without assistance.
It is an effective tool for personalising services, providing preventative care, and can be highly cost effective for councils.
Findings will be shared with all key stakeholders. Please return your completed questionnaire by 24 September 2010.
Thank you for participating, your input is valued.
Questionnaire link
PA project progresses
Recommendations from the Personal Assistant (PA) Project will be implemented through the Mobilising Community Capital Programme.
The project was set up to help local authorities develop the PA sector and has produced analysis, guidance, and a toolkit on challenges and solutions to the employment, development and regulation of PAs.
Further development will take place as part of the Mobilising Community Capital Programme which seeks to create ‘a richer, more efficient community care market, shaped around customer needs with a mixed economy of providers delivering real choice, better care and improved outcomes.’
Contact: Paul Johnston, telephone: 07847 318 672,
email: paul.johnston@impactchange.co,uk
Read more
The project was set up to help local authorities develop the PA sector and has produced analysis, guidance, and a toolkit on challenges and solutions to the employment, development and regulation of PAs.
Further development will take place as part of the Mobilising Community Capital Programme which seeks to create ‘a richer, more efficient community care market, shaped around customer needs with a mixed economy of providers delivering real choice, better care and improved outcomes.’
Contact: Paul Johnston, telephone: 07847 318 672,
email: paul.johnston@impactchange.co,uk
Read more
Good practice resource on PPF site
Examples of good practice in PPF in the West Midlands can be found on the Putting People First website.
The site is aimed at social care practitioners. PPF examples include:
Birmingham City Council which set up a Citizen Engagement Project to identify how involvement of residents can be enhanced, and what this might mean for the council and how it works. The authority also involved service users in developing its Direct Payments User Guide, and is looking at how involvement of users can improve efficiency and the quality of services.
Stoke-on-Trent City Council has established two residential reablement centres to aid a speedy return to home from hospital, or even prevent admission to hospital. The centres provide integrated health and social care and have fitness and telecare suites on site.
Coventry City Council has put in place short term housing tenancies with the aim of reducing need for residential placements, and to smooth the transition between leaving hospital and returning home. The scheme has resulted in only 10% of people going on to long term residential care, compared to 30% of people using the short stay residential service during the same period. The tenancies demonstrate a viable value for money option for older people needing short term enablement support to get them on their feet again, in a home setting.
Coventry has also set up Contact and Connect, a service devised to help older people live safely and independently in their own homes, and improve their quality of life by connecting them – easily and efficiently – to appropriate services. Managed by Age Concern Coventry, it is delivered by a range of local agencies, such as the fire service, pensions service and the city’s carers' centre. Results include an uptake in benefits; more people maintaining their independence at home; a reduction of fire in the home by increasing the number of fire safety assessments and fitting of smoke alarms; plus increased access to home safety checks resulting in falls prevention.
Staffordshire County Council is developing the leadership skills of managers to aid delivery of its transformation programme. All managers in social services are required to attend the internal development programme for which accreditation is being sought. Senior managers have also attended ‘changing culture’ workshops run by consultancy Senn Delaney Leadership.
Read more
The site is aimed at social care practitioners. PPF examples include:
Birmingham City Council which set up a Citizen Engagement Project to identify how involvement of residents can be enhanced, and what this might mean for the council and how it works. The authority also involved service users in developing its Direct Payments User Guide, and is looking at how involvement of users can improve efficiency and the quality of services.
Stoke-on-Trent City Council has established two residential reablement centres to aid a speedy return to home from hospital, or even prevent admission to hospital. The centres provide integrated health and social care and have fitness and telecare suites on site.
Coventry City Council has put in place short term housing tenancies with the aim of reducing need for residential placements, and to smooth the transition between leaving hospital and returning home. The scheme has resulted in only 10% of people going on to long term residential care, compared to 30% of people using the short stay residential service during the same period. The tenancies demonstrate a viable value for money option for older people needing short term enablement support to get them on their feet again, in a home setting.
Coventry has also set up Contact and Connect, a service devised to help older people live safely and independently in their own homes, and improve their quality of life by connecting them – easily and efficiently – to appropriate services. Managed by Age Concern Coventry, it is delivered by a range of local agencies, such as the fire service, pensions service and the city’s carers' centre. Results include an uptake in benefits; more people maintaining their independence at home; a reduction of fire in the home by increasing the number of fire safety assessments and fitting of smoke alarms; plus increased access to home safety checks resulting in falls prevention.
Staffordshire County Council is developing the leadership skills of managers to aid delivery of its transformation programme. All managers in social services are required to attend the internal development programme for which accreditation is being sought. Senior managers have also attended ‘changing culture’ workshops run by consultancy Senn Delaney Leadership.
Read more
Your care, your say, your choice
The Choice Care on line directory has been designed by Herefordshire Council to provide residents with better information needed to help them plan their care.
The directory forms part of Herefordshire’s move towards personalising social care.
Read more
The directory forms part of Herefordshire’s move towards personalising social care.
Read more
Easy and straight to the point
Dudley’s new Access to Adult Social Care Service offers residents an easy and single point of contact for accessing services.
The contact point reflects Dudley’s moves towards working across boundaries and agencies in an effort to help people live independently for longer. It offers a full range of social and community activities including those not traditionally associated with social care.
The council has also set up a new section on its website for service providers, offering advice and best practice information on how they can transform their services to meet changing needs and demands.
Read more
The contact point reflects Dudley’s moves towards working across boundaries and agencies in an effort to help people live independently for longer. It offers a full range of social and community activities including those not traditionally associated with social care.
The council has also set up a new section on its website for service providers, offering advice and best practice information on how they can transform their services to meet changing needs and demands.
Read more
Transforming adult social care in the West Midlands
Details of local and regional activities to transform adult social care can be found in the publication ‘Delivering Putting People First in the West Midlands’, an account of what took place at the Transforming Adults Social Care (TASC) summit held in July this year.
The booklet, available free of charge, showcases best practice in the region and the work underway to reach five milestones during the first phase of transformation by April 2011.
Regional milestones agreed by the Department of Health (DH), the Association for Directors for Adult Social Services (ADASS) and Improvement and Efficiency West Midlands (IEWM) are that:
• transformation of adult social care has been developed in partnership with existing service users (both public and private), their carers and other citizens interested in these services
• a process is in place to ensure all those eligible for council funded social care support will receive a personal budget via a suitable assessment process
• partners are investing in cost effective preventative interventions which reduce the demand for social care and health services
• citizens have access to information and advice regarding how to identify and access options available in their communities to meet their care and support needs
• service users are experiencing broadening of choice and improvement in quality of care and support services built upon involvement of key stakeholders (councils, Primary Care Trusts, service users, providers, third sector organisations etc), that can meet the aspirations of all local people – whether council or self funded - wanting to procure social care services.
Download
Telephone: 0121 245 0220
Email: info@westmidlandsiep.gov.uk .
The booklet, available free of charge, showcases best practice in the region and the work underway to reach five milestones during the first phase of transformation by April 2011.
Regional milestones agreed by the Department of Health (DH), the Association for Directors for Adult Social Services (ADASS) and Improvement and Efficiency West Midlands (IEWM) are that:
• transformation of adult social care has been developed in partnership with existing service users (both public and private), their carers and other citizens interested in these services
• a process is in place to ensure all those eligible for council funded social care support will receive a personal budget via a suitable assessment process
• partners are investing in cost effective preventative interventions which reduce the demand for social care and health services
• citizens have access to information and advice regarding how to identify and access options available in their communities to meet their care and support needs
• service users are experiencing broadening of choice and improvement in quality of care and support services built upon involvement of key stakeholders (councils, Primary Care Trusts, service users, providers, third sector organisations etc), that can meet the aspirations of all local people – whether council or self funded - wanting to procure social care services.
Download
Telephone: 0121 245 0220
Email: info@westmidlandsiep.gov.uk .
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