1. East Midlands Personalisation Programme Workforce Development Workshop
Joseph Silva Marie Lovell
(iMPOWER) Christine Collymore
(Skills for Care)
14/05/2009
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2. Agenda
Introduction and objective setting How big is this change? What shapes the future workforce? New types of working – how others have approached it Lunch Case studies from participating LAs Group exercise Practical next steps

3. Timetable Introduction and objective setting 1015 -1030
How big is this change?
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Next steps

4. Agenda
Introduction and objective setting How big is this change? What shapes the future workforce? New types of working – how others have approached it Lunch Case studies from participating LAs Group exercise Practical next steps

5. How big is this change? Workforce challenges emerging from SDS
The implications of SDS on the workforce are wide ranging and there will be few sections of the organisation which will remain unaffected by its implementation. Organisations previously considered external to councils will also be affected by these changes.
Scope of workforce affected:
Assessment and care management workforce.
In-house service provider workforce.
Private sector provider workforce.
Voluntary sector provider workforce, and volunteers.
Commissioning and contracting.
Procurement workforce.
The implementation of SDS provides authorities with the opportunity to now develop their workforce in order to respond to individual need and required outcomes and a process where there is a new emphasis on the citizen having real choice and control.

6. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

7. Organisation Structure: Challenges emerging from SDS
SDS implies a new organisation structure which delivers a new balance between control and delegation:
Enabling and supporting individuals to make their own choices and take control, while retaining safeguarding responsibilities.
Managing transparency – managing expectations of customers, a focus on equity, and clearly separating advice about choice, from delivery of care.
Market management techniques and encouraging innovative supply, and less on managing contracts and providers.
Financial and performance reporting based around outcomes and overall spending, and less on unit costs and input measures.

8. Organisation Structure: Recommended organisational change (SAMPLE)
Structural change
Rationale – why consider?
Separate out in-house provided services from assessment & care management.
Clear split between care navigation and care provision, greater impartiality.
Enables more focused operational management on performance improvement / commercial-style delivery of in house services.
Clearer budgeting approach with in house services are a cost and revenue centre under SDS.
Locate duty teams in expanded contact centre.
More consistency of assessment processes.
More efficient use of staff time, assumes phone and web based first contact.
Easier provision of self-assessment and mediated (phone) assessment.
Greater synergies with in touch team.
Create generic locality-based care management teams.
More of the assessment process taken by contact centre.
SDS model is equitable across different client groups (single SAQ & RAS).
Does not exclude potential for some specialist support for particularly complex / difficult cases.
Locate some commissioning staff in area offices.
Commissioning function will rely on local intelligence and knowledge of local solutions.
Can have a clearer focus on supporting local innovation / flexibility in supply.
will provide clear conduit of information through to centre where this informs strategic issues.

9. Organisational change: In house service split options (SAMPLE)
Structural change
No change
Incremental
Significant
Separate out in-house provided services from assessment & care management.
No change. Split not required / seen as beneficial.
Separate in-house services and make direct report to Director.
Create new ‘Head of’ role to run new division.
Pros
Reduces amount of change at a challenging time.
Provides separation without additional cost.
Provides absolute clarity and accountability.
Opportunity to bring in commercial skill set.
Cons
Does not recognise the potential conflict of interest issue.
May simply defer the problem.
Requires Director to take too operational a focus.
May cost more at a time of reducing management headcount.

10. Organisational change: Contact centre / duty teams (SAMPLE)
Structural change
No change
Incremental
Significant
Locate duty teams in expanded contact centre.
Keep separate duty teams.
Move some staff into contact centre, retaining some cover in area offices
Move all duty teams and most assessment processes into contact centre
Pros
Reduces amount of change at a challenging time.
Provides separation without additional cost.
Clear focus for teams moving and for teams remaining in area offices.
Larger efficiency opportunity.
Cons
Does not meet corporate direction of travel.
Reduces efficiency opportunity.
Muddies focus of respective teams
Could lead to process / accountability confusion
Will areas offices be viable in their reduced scale?

11. Organisational change: Generic locality teams (SAMPLE)
Structural change
No change
Incremental
Significant
Create generic locality-based care management teams.
Preserve existing specialist model
Retain reduced number of some specialists in areas
All area teams generic
Pros
Reduces amount of change at a challenging time.
Provides local cover for specialist / complex cases.
Consistency and clarity of role and process.
Flexibility / cover between area offices when capacity issues.
More efficient use of time.
Cons
Reinforces existing inequalities between different client groups.
Limited efficiency opportunity.
Small scale may prove difficult to justify a hybrid team
Risks losing specialist knowledge at local level.

12. Organisational change: Some commissioning based locally (SAMPLE)
Structural change
No change
Incremental
Significant
Locate some commissioning staff in area offices.
Commissioning staff all located centrally
Rotation / regular local visits for some commissioning staff
Permanent location of local commissioning staff in area offices
Pros
Concentrates skills at centre.
Not as disruptive as full scale change.
Opportunity to build real local knowledge and intelligence
Gets closer to communities and customers.
Cons
Lose local knowledge and opportunity for innovation.
Lack development of market management skills
Neither one nor the other; could be worse than no change.
Would not be easy to ensure a team feel to commissioning function.
Is there sufficient scale in the team?

13. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

14. Professional and administrative support: context (SAMPLE)
Included
Not included
The opportunity to streamline the assessment and care management process.
The opportunity to shift the ratio of qualified social workers to non- qualified care workers.
The opportunity to reduce how much support planning the council will pay for under the new model.
Assessment of opportunity to reduce size of strategic commissioning, performance, supporting people or business improvement. Strategic commissioning has recently been redesigned, and will need to change role again, but does retain a vital function in market management.
Assessment of opportunity to reduce costs of home care and day care services. These services are considered as costs of care and are both currently under review.

15. Drivers of efficiency in Professional and Administrative support
1. More efficient assessment process
Streamlined process involving contact centre
Some / all of assessment form completed by individual
Generic teams allowing greater flexibility
Mobile working enabling faster / accurate data entry
2. Shift ratio from qualified to non-qualified staff
More focus on initial contact (phone based)
Less focus on assessment process
More focus on support planning process (skilled but not necessarily QSW)
Less time on routine tasks, more time on complex cases and oversight, for QSWs
3. Reduce investment in support planning
Support planning requires more time under the new model
Does not all have to be done by the local authority
Could be externalised (funded) and or externalised (not funded)
Most clients will draw on some level of social capital in any case
Transition may require higher investment in process before savings can be realised
Likely to cost a lot in redundancy and pensions strain and will take time to transition
A possible area for longer term cost reduction but unproven and risky in the short term

16. The individual budgets process enables a more efficient use of staff time (SAMPLE)
Current process
Proposed process
High level of qualified time involved in verifying referral information, initial contact with client and data collection.
High level of paper based assessments by qualified staff.
High number of separate steps in customer journey, and a higher volume of decision points.
High percentage of qualified social worker time required to provide info/advice and guidance following Contact Assessment.
Qualified time in preparing care purchasing paperwork and transfer to Care Purchasing Coordinators.
Skilled Contact Centre staff provide initial screening of initial contact.
Direct input of non-qualified staff onto case management system.
Reduced number of steps within process.
Initial screening addresses the provision of advice and guidance prior to Contact Assessment by unqualified Contact Centre staff.
Only complex decisions requiring need for qualified input.
CPCs are non-qualified roles which would undertake the majority of these tasks.

17. More efficient processes will be reinforced by other important initiatives (SAMPLE)
Opportunity
Comments
Shift contact staff to contact centre
Assumes phone and web based first contact – requirement to encourage clients to use web-based self- assessment and mediated (phone) assessment
More efficient use of staff time. Greater synergies with ‘in- touch’ team
Create generic locality-based care management teams
More of the assessment process taken by contact centre
SDS model is equitable across different client groups (single SAQ & RAS)
Does not exclude potential for some specialist support for particularly complex / difficult cases
Implement Mobile working
Pilot demonstrated opportunity to reduce assessment process from 4.5hrs to 2hrs on average

18. Assessment and Care Management Workforce modelling: illustrative changes (SAMPLE)
Faster process
Qualified staff ratio
Less support planning
QSW
NQSW
10% reduction in process time = 10% reduction in staffing costs
Change in ratio from 1.5:1 to 0.75:1 = 6.4% reduction in staffing costs
10% reduction in NQSW = 4% reduction in staffing costs

19. Workforce modelling: scenario planning (SAMPLE)
Assumptions
Faster process (affects all staff)
Ratio
(Q) to (NQ)
Reduce support (affects NQ only)
No change
0.0%
1.5 : 1
Moderate
5.0%
1.25 : 1
Significant
10.0%
1 : 1
Radical
15.0%
0.75 : 1
20.0%
Staff implications
Qualified staff
Non-qualified staff
Total A&CM staff
Cost reduction* 96 64
160
0.0% 83 66
149
-8.6% 69
138
-17.2% 53 70
123
-28.0%
*iMPOWER analysis using sample council salary data only

20. What is the appetite for risk? (SAMPLE)
Moderate
Significant
Radical
Key points
7% reduction in ACM staff numbers
Process improvement of 5%
Small shift in ratio of Q staff to NQ staff
Reduction in 5% of staff doing support planning
14% reduction in ACM staff numbers
Process improvement of 10%
Shift in ratio of Q staff to NQ staff of 1:1
Reduction in 10% of staff doing support planning
23% reduction in staff numbers
Process improvement of 15%
Shift in ratio of Q staff to NQ staff of 0.75:1
Reduction in 20% of staff doing support planning
Risks
Could be achieved through natural wastage
May not focus enough attention on key changes required
May not allow opportunity to hire / relocate appropriate staff into new roles
Reduction in social workers (- 27)
Redundancy and pension costs may be prohibitive
Will be difficult to deliver combined changes in short term
Could place other goals (reduced care costs) at risk if delivered too quickly
Radical reduction in number of social workers (-43)
Unclear whether safeguarding responsibilities for vulnerable client groups will be covered
Could place other goals (reduced care costs) at risk
Long term direction of travel?

21. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

22. Workforce Challenges emerging from SDS
Change in Job Roles
Councils will need to carefully consider the competencies and role of care managers and other health and social care staff and also consider the change in culture and use an organisational development model of change management. There will need to be an extensive programme of consultation with staff alongside additional investment in training and development.
Some of the challenges which a change programme on this scale will need to address include:
Anxiety around new 'professions'.
Shift of care managers to a more enabling role.
Less control over packages of care.
Development of multi skilled teams.
Geographical location of teams currently (and possibly move to generic locality based teams).
Increased awareness and skills in risk management.
The abilty of the worker to 'let go'.
The ability to work within new structures, with new networks and partners.

23. Workforce Challenges emerging from SDS
Impact of Integrated Working
Staff working alongside colleagues from other professions.
Ensuring cohesion and consistency between teams in the new structure. Such a change will have implications for performance management, induction and training.
The need to support new ways of working by way of regular supervision and training.
Structuring performance management arrangements across a range of skills and services.
The development of pre and post qualification professional training programmes as they reflect national social care policy developments.
Physical staffing locations and accommodation.
How to manage the quality of services when they are chosen and controlled by individuals.

24. Workforce Challenges: Other
Corporate pressures
Changes to workforce roles and responsibilities will have an impact on staff remuneration and structures. Early union consultation will be crucial to help create acceptance and buy in to change.
Day Services reorganisation - links with commissioning/ roles and skills/ care model/ voluntary and independent sector.
Re-ablement – links with Roles/ Commissioning workstream/brokerage model/ interagency teams e.g. across Health and Social Care and existing interagency teams.
Modernised, new ways of working – Care Management/ Customer Journey/ Systems/skills and training.

25. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Role development exercise
Practical next steps

26. From Vision to Workforce Development utilising the Target Operating Model
Operational blueprint
Target Operational Model
Service breakdown
Adult
services
Community &
Customer Service
Systems infrastructure
CTS
Customer channels
Contact
centre
Physical sites
Building
1000
Other Sites
People
Roles
Processes
Specialist
Skills
Leisure system
Organisational structure
Services
Galaxy
LSC ’ s
Centre
Web
F2F Home
Generic
Semi -
Culture &
Tourism
CareFirst
Vision
for
Putting People
First
Workforce
Development
Strategy
The
Customer
Journey

27. Key recommendations (SAMPLE) 1
Area
Key decisions (summarised)
Customer channels
Move duty teams into contact centre
Move majority of the new customer journey into the contact centre
Enable self-assessment online
Push all first assessments through the contact centre
Processes
Adopt the new customer journey
Bring financial assessments forward in the process
Replace ‘charging’ with ‘contribution’ netted off at source
Services & Commission-ing /
Customers will have no choice about use of block contracts (until places are filled)
In-house services will be traded for 2 years – customers have choice
Commissioning function redesigned reflecting move to market management
Some commissioning staff to be based in localities
Develop / implement  a  strategic engagement strategy to ensure the effective participation of service users in SDS
People / workforce
Form non-specialist, generic teams in area offices
Shift ratio of social workers to care navigators
Ensure sufficient support and training is provided to drive the cultural changes required
Ensure robust and targeted corporate communication plan for delivery of workforce changes across  ASC

28. Key recommendations (SAMPLE) 2
Area
Key decisions (summarised)
Org structure
Separate in-house provided services from assessment & care management.
Locate duty teams in expanded contact centre.
Create generic locality-based care management teams.
Locate some commissioning staff in area offices.
Systems / IT
Non-technical solution for deployment of phase 1.
Synchronise any major changes in systems around the SWIFT refresh date of 2011.
Start planning now for requirements and re-procurement.
Examine potential for an additional customer-based solution (e.g. S4S).
Physical sites
Ensure ASC is fully appraised of the economic value of in-house properties.
Design a flexible workforce model capable of deployment regardless of corporate plan for physical sites.
Financial sustainability
Adopt FSM as core planning tool for programme benefits realisation.
Present FSM to COMT and corporate transformation team.
RAS
Adopt proposed RAS for phase 1.
Implement further refinement and monitoring .
Implementa-tion plan
Sign off implementation plan and provide mandate for Programme Manager to commit resources to deliver.
Enforce adoption of all ASC project work as part of the overall programme.

29. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

30. Good practice examples
Background
Skills for Care
New types of worker programme
Areas
Raising awareness
New roles
Practice development
Provider market
Strategic workforce planning

31. New Types of Working Local Authorities involvement Internal staff
Micro employers
Personal assistants
Private, voluntary and independent sector
Informal carers

32. Future development Personal Assistant - induction standards - training
National Minimum Data Set to capture micro employers and personal assistant data
InLAWS – Integrated local area workforce strategies

33. Key resources Common core principles Principles of workforce redesign
New types of working website –
Adult social care workforce strategy
Qualifications and Credit Framework

34. Key resources Leadership and management
National minimum data set – social care
National Occupational Standards
Knowledge Sets
Regional contact person

35. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

36. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

37. Discussion by LAs

38. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

39. Group exercise Break down into groups of 5 or 6.
Designate a reporter to feedback to the wider group.
Choose one of the five areas that have been discussed earlier (repeated below). Identify the issues and challenges in this area and provide one recommendation that you will need to undertake to ensure the successful delivery of this element.
Raising awareness amongst social care providers
Developing new roles
Practice development
Workforce changes within service providers
Strategic workforce planning

40. Agenda Introduction and objective setting How big is this change?
Organisational structure challenges
Potential for efficiency savings
Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps

41. Next steps Regional Improvement and Efficiency Partnership
Regional workshops
Support to each Local Authority