Information service for prospective enterpreneurs

The Mutuals Information Service has been set up as a sign posting facility for public sector staff wanting to set up a social or mutual enterprise.

The service provides information on the range of business models available and their suitability for delivering services individuals may want to provide. It also puts staff in touch with organisations that offer help with business planning, HR and legal advice, finance and investment, marketing and market research.

The service is free and can be contacted on 020 7296 6705, or visit www.local.gov.uk/mutuals

GPs and county council working closer to improve healthcare in Staffordshire

Doctors and senior officials from the NHS met with Staffordshire Social Care managers recently, to forge ahead with plans to revolutionise the way people receive healthcare services in the future.
The event explored ways of delivering more effective and seamless services to people. It also focused on personalising services for individuals, including the use of emerging technology to allow individuals to manage their own health care better.

The county council already provides Telecare services to more than 1,000 residents, which are estimated to save the NHS £3,000 per user each year, as well as reducing demand on adult social care services.

County Councillor Matthew Ellis, Cabinet Member for Adults and Wellbeing, said:

"Staffordshire is at the forefront of truly integrated services with the opportunity to provide millions in cost savings, empowering people to take personal responsibility for their own health, and helping them to find the confidence to manage their own lifestyles in a way which will lead to healthier lives.

Bringing personal budgets, both for health and social care together, will mean a genuinely holistic approach to individual healthcare rather than the disaggregated 'part picture'.

Dr Ian Greaves, from Gnosall Surgery said: "It is essential for health and social care to work together to improve people's lives. We can overcome these traditional barriers by focusing on personalised care by informing individuals and their families of the services available and the associated costs. Such transparency allows everyone to become involved and plan for the future."

Forging firmer links in Lichfield

Plans to embed a multi agency referral system to support vulnerable adults are well underway in Lichfield and wider Staffordshire.

Under the banner of Let’s Work Together, a seminar attended by representatives from the fire service, police, health, housing organisations and the voluntary sector, was held in February this year to raise awareness of support available from other organisations to help people live healthy, safe and independent lives.

The event built on an existing arrangement between Staffordshire Fire and Rescue Service, and Social Care and Health, where workers from each organisation refer names of vulnerable people they come across, to each other.

The seminar resulted in a commitment to spread the practice throughout other public and voluntary sector organisations.

Since then funds have been secured to develop specific projects, and a project manager, Carmel Warren, has been seconded from the fire and rescue service for a 12 month period.

Carmen will oversee development of training and a referral process that will be embedded in all partner organisation infrastructures, and ensure all home visitors can work together.





Synopsis and case study

Let’s Work Together

Staffordshire Fire and Rescue Service (FARS) and Social Care and Health (SCH) have been working together since July 2007. This was following the death of an elderly lady, Olive Simcock, who died following a fatal house fire in her rural cottage in November 2006. Olive’s lifestyle put her at very high risk from fire and although she was known to SCH she was not known to the FARS therefore no fire safety measures were put in place. Following her death it was thought that more lives could be saved if the FARS and SCH worked together and the “Olive Branch Initiative” was born.

“Let’s Work Together” aims to build on the successes of the partnership working of the FARS and SCH. In February 2010 a multi agency awareness seminar was facilitated by the FARS and Lichfield District Community Voluntary Service Support (LDCVSS). The seminar was looking to raise awareness to Service Managers and all Home Visitors of the support that other organisations can offer to help support people to live healthy, safe and independent lives. It was attended by personnel from FARS, LDCVSS, SCH, Police, Lichfield District Council (LDC), Housing Providers, South Staffs Primary Care Trust (PCT) and organisations that are supported by LDCVSS.

The seminar was extremely successful and well received, feedback was very positive and there was a buzz in the air to move things forward. To help support the LWT project various funding applications were submitted which were successful, funders included Staffordshire One Place (IEWM), Trent Valley Basic Command Unit Fund, Safer and Stronger Communities Area Based Grant, and a contribution from the Locality Working Budget and LDC were made.

LWT now operates under the Staffordshire One Place/Lichfield One Place banner it is one of two projects developed by Staffordshire Chief Executives. The other project is Supporting Families both projects seeking to deliver better services with better outcomes for less money, demonstrating clearly how alternative ways of working can be achieved.

A LWT Project Manager, Carmel Warren has been seconded from Staffordshire Fire and Rescue Service for a 12 month period. During this time it is envisaged that a cohesive training and referral process will be introduced and embedded into all partners infrastructures. Ensuring that all Home Visitors can work together, never missing a chance to make a difference!

Case Study: Catharina Page

Since the initial seminar in February 2010 many referrals are now being made to partner organisations for assistance to help people they visit live healthier, safer and independent lives.

In March 2010 Carmel Warren met a lady called Catharina at Lichfield Library. Catharina is blind and the subsequent conversations that took place between Carmel and Catharina identified fire risks that Carmel thought should be addressed immediately.

Carmel returned to the station and arranged for a Home Fire Risk Check to take place immediately. When the crews returned to station they explained that Catharina felt lonely and isolated and the following risks were identified:

• She used the microwave by guessing the timings
• There was no door to the kitchen
• Only one fuse board for the whole property
• She had a faulty electric blanket
• Catharina also used a chip pan
• She used her hand to gauge the heat on her cooker
• She also used her finger to identify when she had reached the top of her cup when making a cup of tea
• There were no working smoke alarms in the property

Carmel immediately made a referral to SCH for an assessment of needs and also sent a referral to Bromford Floating Support .

The outcomes of these referrals were as follows:

• A stair rail fitted, tactile marks to kitchen appliances were introduced, Catharina was given a “talking pen” which is used to label items from shopping, to identifying the colour of her clothes
• weekly visits to shops, café for a coffee, confidence building, arrangements made for electrics and walk in shower to be installed.

Catharina made a recording and asked for it to be played to the fire fighters that made the initial visit:

“I have been sitting here thinking, my name is Catharina, I have been sitting here thinking how my life has changed since I had a visit from the firemen about safety in the home. Through those people I wasS put in touch with social services and since then my life has changed, for which I say a big, big thank you.”

LWT wants to support ALL people to live healthy, safe and independent lives. Ensuring that Home Visitors are aware of the services we all offer and knowing where to refer to will help us to achieve this goal.

My Care In Birmingham

A new website helping people to quickly and easily find out about adult social care services has been launched in Birmingham.

The site, known as MyCareinBirmingham, guides people through a short series of questions leading to a page of information and contact details about council services or organisations that can provide social care support and activities.

Cabinet member for Adults and Communities, Cllr Sue Anderson, said: “We are changing to a more personal approach to adult social care in Birmingham, and adults who have been assessed as needing support now have much greater choice and control over the type of care they get.

“This website helps adults get specific advice and information at their fingertips, and provides details of adult social care services and support, from helping people to remain independent at home for longer, to helping them get out and about.”

The new site will be delivered in three phases; the first being the ‘advice and information’ section, which is now live. The second, to be launched later this year, will guide people through an ‘adult social care assessment’ online. The third phase will see the addition of a ‘marketplace’ that will promote adult social care services available for people to buy.

Visit: www. birmingham.gov.uk

Birmingham chosen for social work practice pilot

Birmingham City Council has won its bid to test a different approach to delivering adult social care under the government’s Social Work Practices scheme, which seeks to devolve services from local authority control.

Birmingham plans to set up an arms length social enterprise, in partnership with user led organisations, with the purpose of testing a different approach to assessment and planning support.

This will involve:

• a period of rehabilitation/enablement overseen by occupational therapists and physiotherapists
• an ‘expert patient course’ under the direction of a GP to ensure self-management of medical conditions
• user led advice surgeries, and the creation of peer support networks
• advice on work or volunteering
• reviews of benefits and finances
• access to telecare and telehealth equipment and services
• a review of existing social care packages and exploring of alternatives

The pilot will create new opportunities for people with disabilities to become more active and independent.

Cabinet Member for Adults and communities, Cllr Sue Anderson, said:

“I am excited about the development of this pilot in Birmingham as it will provide a new landscape for promoting and building the networks needed to support people in their own communities.

“Social work teams will be attached to user-led organisations and enablement services, so that an enhanced offer can be made to people with disabilities. This will help social workers to work far more closely with individuals, in the heart of communities they live in.”


Visit: http://www.birmingham.gov.uk/

Introducing AskTara

Details of telecare products and other services provided by councils in the region can be found on a new website set up for individuals eligible for social services support.

AskTara carries users' views on products, and their tips on other useful gadgets available on the high street.  The site is customised to reflect the branding of local councils and sits on each of the region’s 14 local authority websites; allowing residents and practitioners to find information relevant to their area.

TARA stands for Technology and ReAblement. The site is regularly updated with new products and information on service developments. It was developed by the social enterprise, Community Gateway CIC, in partnership with the JIP and Improvement and Efficiency West Midlands.

You can view the progress on the site at: http://www.joined-up-software.com/index.php/every-day-living-needs.html


Fact sheet:

AskTARA - your local council’s answer to helping vulnerable people stay safe and independent at home using assistive technology and telecare.

1.  What is AskTARA?
AskTARA is a dedicated online resource for those eligible for social services support. It gives information on the assistive technology and telecare products your council provides, and other services offered, including how to be assessed. TARA stands for Technology and ReAblement.

2.  What about people who are not eligible for funding?
AskTARA has a sister site called TheCommunityGateway.com, which is for all potential users of assistive technology and telecare.  It works in the same way as AskTARA, but the catalogue has a more comprehensive list of products, including those not issued by your social services or health provider

3.  Where can I find it?    

You can find AskTARA on your local council website on the home page of the Adult Social Care Services. Users can visit as guests without the need to register, or create accounts to rgister, or create accounts to save searches.

4.  Is it easy to use?
Yes. It is similar to the popular Amazon site and was designed to be
simple to use. The menu and home page give clear instructions on how to use the site. Users can quickly navigate their way around and find telecare and assistive technology products to suit their particular needs. A special feature of the site is that users can write their own Tags for products, and share these easy to read descriptions with others.

5.  How will I know what products to choose?
As well as listing the products and equipment the council provides, AskTARA carries reviews by other users about what works well and what doesn’t; similar to TripAdvisor reviews of hotels. Some of the products have videos showing how they work, and others have downloadable instructions and information, helping to decide what might be best, but also handy if instructions get lost. Apart from finding out for themselves what products are available, users can make more informed choices. The site complements what your authority provides already, and is not intended to replace advice and expertise from a practitioner, nor a full assessment.

6.  How does it work?
When users have chosen products they think are suitable, these are added to a ‘wish list’ for consideration by social services who will assess their suitability with the user.

For councils operating the Retail Model, users can review products which have been prescribed for them, and make informed decisions based on reading other users’ reviews and feedback. Practitioners too can read reviews to learn how users use prescribed equipment.

7.  Who runs the website?
AskTARA and TheCommunityGateway.com have been developed by The Gateway Community CIC, a social enterprise in partnership with the West Midlands Joint Improvement Partnership, and Improvement and Efficiency West Midlands. We are professionals and practitioners from health and social care working extensively on personalised care.

TheCommunityGateway.com is a national online catalogue providing a more comprehensive range of telecare and assistive technology products. It carries products which social services and health authorities do not provide. Whilst aimed at users, it is useful to anyone involved in assessing and planning personalised care.

AskTARA is the bespoke catalogue for those councils or health authorities who subscribe to the site. As well containing your own catalogue, it has local information on how to be assessed, and can be branded with your own logo, and organisation’s name.

The Community Gateway CIC maintains the site; moderating comments and Tags proposed by visitors; deleting old products, and keeping it up to date with new products, images, videos and descriptions.

8.  How will users of equipment benefit from using AskTARA?
People who use telecare and assistive technology will know what equipment exists to help keep them safe and independent at home. It will also make local services more accessible to them.

9.  How will commissioners of equipment benefit from using AskTARA?
Commissioners will improve their knowledge of the telecare and assistive technology market to support their preventative and early intervention strategies. The Community Gateway CIC can also offer commissioners reports on product quality and usage; what people search for; what they are unable to find, and what equipment is issued by other commissioners.

10. What are the advantages of subscribing to AskTARA?
It is an ‘off the peg’ site which prevents unnecessary duplication and costs. Subscribers can adapt the site for their own use, but will also have access to a national pool of shared information on latest products and equipment, and how they are being used.

AskTARA will help councils achieve their obligations under the Putting People First agenda, to provide information for users, and support early intervention and prevention measures.

For further information contact us at info@thecommunitygateway.org.uk or 0844 736 5718.



11. How can I find out more?

Embracing a new approach to commissioning

A New Paradigm for Commissioners? outlines the policy direction emerging from the government’s vision for adult social care, and the likely legislative changes affecting commissioners.
The document (which follows) has been produced to support the West Midlands Market Shaping Project.

Contact: Paul Johnston, telephone: 07847 318 672, email: paul.johnston@impactchange.co.uk



A new paradigm for commissioners?
This paper looks at the policy direction emerging from central government’s vision for adult social care and the response of sector leaders (in the form of the new partnership agreement). Finally, it anticipates the likely legislative changes affecting commissioners of health & social care solutions to provide a summary of the challenges – and opportunities – facing commissioners. The paper concludes that the region’s Market Shaping programme provides an opportunity for commissioners in the West Midlands to embrace the new paradigm and to deliver lasting value for people who use care services.

Capable Communities, Active Citizens

A new vision for adult social care.
The new vision is built around the government’s core values of Freedom, Fairness and Responsibility. It sets out seven principles on which the new social care paradigm is intended to be built and provides a number of clear pointers for councils and commissioning teams.

On prevention & early intervention:
“Councils can play a vital role in leading change and stimulating action within their communities. Their broader role in promoting health and well-being will be enhanced by the new public health functions outlined in the White Paper Liberating the NHS, and by joint working with GP consortia on planning and commissioning services.”


“At its broadest level, prevention depends on promoting health and well-being at a grassroots level. The Coalition is committed to giving local authorities the power and influence they need to lead change within their communities. Following the NHS White Paper Liberating the NHS, local government will take on new health improvement responsibilities. Councils will also take the lead role in drawing up joint strategic needs assessments (JSNAs), which will shape the commissioning of health, social care and health improvement services. These developments offer councils a huge opportunity to shape local services to promote health and well-being and prevent dependency.”


“Councils should exploit the many opportunities to improve preventative services by:

• developing community capacity and promoting active citizenship, working with community organisations and others across all council services, establishing the conditions in which the Big Society can flourish; and
• commissioning a full range of appropriate preventative and early intervention services such as re-ablement and telecare, working in partnership with the NHS, housing authorities and others.”

On personalisation:
“Our vision starts with securing the best outcomes for people. People, not service providers or systems, should hold the choice and control about their care. Personal budgets and direct payments are a powerful way to give people control. Care is a uniquely personal service. It supports people at their most vulnerable, and often covers the most intimate and private aspects of their lives. With choice and control, people’s dignity and freedom is protected and their quality of life is enhanced. Our vision is to make sure everyone can get the personalised support they deserve.”
“To have real autonomy and choice people need information and advice. Lack of good, accessible information to help support their choices is a real concern for people. Councils’ role here is to ensure that everyone – whether using a personal budget or their own funds – can get the information and advice they need.”


“Councils should focus on improving the range, quality and accessibility of information, advice and advocacy available for all in their communities – regardless of how their care is paid for – to support their social care choices.”


On plurality & partnerships:
“There should be a fair playing field for providers, particularly for small providers who often struggle to engage with formal tendering processes but can offer very individualised solutions. Commissioners of services should work with suppliers in the independent and voluntary sectors to better understand market capacity and capability, and decide how innovation and best value can be incentivised effectively.”


“JSNAs will form the foundation of priority setting, encouraging greater involvement of local voluntary and community organisations. JSNAs will help local people to hold providers and commissioners to account, agree local priorities and inform a range of commissioning strategies and plans. This will be underpinned through new statutory duties for local councils and GP consortia to work together to promote the health and well-being of their local population.”


“Joint commissioning, pooled budgets and place-based budgets allow the focus to shift away from funding streams and onto people’s needs.”


“Simplifying the commissioning and contracting landscape by merging or sharing back office functions across councils and NHS commissioners can develop a more accessible, less costly process for suppliers.”


“Local councils should:

• exploit the opportunities of the NHS White Paper to play a lead role in their communities, ensuring local services are more coherent, responsive and integrated. Together with the NHS and other partners, councils should agree a shared view of local priorities and the outcomes to be achieved, and deliver commissioning strategies to meet the needs of their local populations – including the most vulnerable;
• work with the NHS and other partners to pool and align funding streams at the local level and alert the government if there are any barriers to this local flexibility; 
•  work with private providers, charities, voluntary organisations, mutuals, social enterprises and user-led organisations, and move away from traditional block contracts; and
• critically examine their arrangements for contracting service providers to ensure that the rules are fair, proportionate and enable micro and small social enterprises, user-led organisations and voluntary organisations to compete to deliver personalised services.”

On providing protection:
“Providers and commissioners of services are responsible for their quality and safety. They should ensure their staff provide safe, high quality care. This includes rigorous pre-employment checks and monitoring of their work. Equally, all staff need to see safeguarding and providing a high quality service as central to their role.”


On productivity, quality & innovation:
“There may be exceptional reasons for the council to retain services, but separating responsibility for commissioning and providing services should become the norm. It is crucial for providing choice for service users and carers, and increasing competition amongst providers. Evidence from a wide range of public services shows that choice and competition can be a powerful tool to drive up quality and reduce and control costs. Local councils with substantial in-house provision should look to the market, including social enterprises, mutual and voluntary organisations, to replace them as a local service provider. Benchmarking both quality and unit costs provides a useful reference point for councils as they grow a broader market of local care providers.”


“The current annual assessment of councils as commissioners of adult social care will be ended and replaced by a new sector ledapproach. Where concerns are raised about services, CQC will continue to be able to inspect councils. We envisage a robust system of triggers that can lead to inspection. For example, local HealthWatch organisations will be able to report concerns to HealthWatch England. It could request CQC to undertake inspections where it has grounds for concern about the quality or safety of social care or health services.”


On people:
“Local councils will play an important role, working with local employers in the independent sector and other partners, including healthcare workforce planners, to commission the workforce of the future and lead local changes for existing staff. Continuing training and skills development is a vital investment in the future. The Department will work with BIS and others to increase uptake of professional standards.”


“Local councils should take a leadership role in workforce commissioning in their area, including integrated local area workforce strategies linked to JSNAs. Central government will support and coordinate developments only where and when the sector demands this, with a particular focus on the smaller employers who predominate in this sector.”


Think Local, Act Personal


The New Partnership Agreement


Where the vision describes the desired ‘future state’ for adult social care, the new partnership agreement is intended to guide short-term focus and action aimed at making the vision a reality. It champions a new relationship between public, independent and community sectors, adding colour and texture to the “big society” rhetoric. At its heart is a “Framework for Action” that balances universal approaches with targeted support:

The agreement also makes clear the priorities for local action:

“Experience has shown that most progress in implementing personalisation is made where:

• Local leadership focuses on cultural change, just as much as systems change, encouraging concentration on outcomes determined by people and communities and engaging solutions beyond the narrow definitions of social care.
• People have real control over the resources used to secure care and support, with commissioning strongly guided by their decisions.

“Joint Strategic Needs Assessments (JSNAs) and Community Budgets can be used to identify the needs of local communities and utilise all available resources. Commissioners across all public services will increasingly focus on people within their ‘natural’ communities, rather than service and organisational boundaries. The financial and productivity challenge will require integrated working between councils, public health bodies and emerging GP consortia to identify and meet local health and social care needs efficiently, using existing mechanisms and the new public health structures.”

“In bringing together health, well-being and social care, councils and their partners will need to integrate health and social care commissioning around agreed outcomes to support independence and enable the joining of social and health personal budgets wherever possible.”

“Councils and their partners need to understand their local context regarding care and support needs, and the relative supply position, if they are to develop a diverse range of high quality provision that people want. ‘Market Position Statements’ (of the kind recommended by the National Market Development Forum) and market development strategies can be produced to assist this. Commissioning and supply partners should collaborate across public sector boundaries to achieve better efficiency and support innovation.”

“Co-production is integral to commissioning activity at all stages in the cycle, rather than an add-on or one-off process. This will mean the range of support commissioned meets both identified need and people’s aspirations for the future within available resources.”


“Personalisation implies less council purchasing overall and less block contracting. Some existing contracted services may become unviable and will need to be downsized or discontinued, in partnership with people affected and the relevant providers. Arrangements that enable the individual (or their representative) to agree directly with the provider the what, how, who and when of any support provided, are a good way to do this.”


“Local councils will...wish to consider...The potential for self-directed support to deliver efficiencies in the business process of councils. For example, by focusing social work time on key functions and thus freeing up care management resource; and by enabling councils to better understand costs at an individual level.”


“The care and support sector employs 1.7million people and will grow to meet the future needs of an ageing society. It is a key part of the national economy. Social care is primarily about ‘person-to-person’ support, requiring the right people in the right numbers in the right places. Planning and development must therefore be adequately focussed on the needs of this sector to ensure its sufficiency during the coming period, with the right dialogue between employers and commissioners.”


Modernising Commissioning

A Green Paper published in December 2010 poses questions around four issues:

• In which public service areas could Government create new opportunities for civil society organisations to deliver?
• How could Government make existing public service markets more accessible to civil society organisations?
• How could commissioners use assessment of full social, environmental and economic value to inform their commissioning decisions?
• How could civil society organisations support greater citizen and community involvement in all stages of commissioning?

It’s likely that the subsequent White Paper will acknowledge the significant value that ‘traditional’ commissioning actions have delivered (continue to deliver) but will conclude that these are insufficient in themselves to adequately facilitate civil society. Consultees will point to the disincentive effects on the market of commissioners seeking to deliver value by letting bigger, better value (price), longer contracts. Political and civil society interest increasingly lies in more innovation in commissioning processes, with the emphasis moving from “contract management” towards “relationship building, risk management, radicalism, citizen involvement and social value”. And with political leadership at the highest level committed to the transformation of commissioning, significant shifts can be expected.


Conclusion
It is clear that commissioning is central to the delivery of the new vision and its associated partnership agreement, and inevitable that the White Paper will seek to shake up the role and processes of commissioning. The region’s Market Shaping programme provides an opportunity for commissioners in the West Midlands to embrace the new paradigm and to deliver lasting value for people who use care services.