What are we trying to achieve? Its simple – for people to have more choice and control over their lives
PersonRepresentativeTrust Community Organisation Individual Service Fund Council Managed Creating more options for choice and control locally.
Providers Funders & Professionals Service Users Power Shift What Does Personalisation Mean for the market?
Providers Service Users Power Shift What Does Personalisation Mean for the market? Funders & Professionals
This is not about more of the same, but about doing something different. In most councils there are 35% of people using a personal budget by majority these are people taking the ‘cash PB offer’ of employing their own staff or hiring an agency (50/50) The other 65% are high volume, low cost, spot purchased OR are people in traditional services through block contracts or other similar arrangements inc: residential care for some people e.g. LD. This is about giving people real choice and control by enabling people to make an informed choice. It is about supporting people in a way which makes sense, self direction without over burdening people. Its about getting UNSTUCK!
Where are you, what does the local market look like, are you ready for the future what are the challenges?
What is an individual service fund? When someone wants to use their personal budget to buy support from a provider, we call it an Individual Service Fund (ISF).Individual Service Funds mean that:- The money is held by the provider on the individual’s behalf The person decides how to spend the money The provider is accountable to the person The provider commits to only spend the money on the individual’s service and the management and support necessary to provide that service (not into a general pooled budget). Individual Service Fund
= £ retail cost This could be an hourly/daily/flexible rate or a bespoke package. The cost must be open and transparent to the individual.
The Principles behind ISF’s “I can use my hours/budget flexibly and can choose what I am supported with” “I am supported where it makes sense for me; at home and out and about” “I choose who I want to support me. My support workers know me and I know them” What Where Who
When Co-production How Individual service funds “I choose how I am supported and my support workers know this is important to me” “I am fully involved in decisions about my own support and how the wider service develops” “I get support on the days and at the times that are right for me”
The 7 Steps of self directed support How does an Individual Service Fund Fit?
1.To proactively transform the block contracts into ISF’s. 2.To proactively encourage all providers to offer an ISF including homecare services. 3.To develop an ISF framework which makes it clear for providers in how you wish them to trade. 4.To get providers to respond to individual commissions from care managers, individuals or their family. 5.To simply go to the market and ask which providers would like to be ISF providers. 6.Do nothing and let the providers lead the way – why change? There are several ways that we can develop Individual Service Funds:
The ISF must be managed by the provider in accordance with the individuals support plan. The ISF monies can only be spent on the direct support of the individual. The ISF needs to be open and transparent to the council as to how each ISF is being spent. The provider will provide direct care in a flexible and person centred way to meet the individuals required outcomes. The provider will ensure maximum choice and control for the individual who requires support. If changes are made to the support plan the provider must keep within the objectives and outcomes of the support plan and refer back to the council as required. The personal budget will be managed in a way that clearly demonstrates strong financial governance and accountability and must be fully auditable and clearly recorded. The provider will supply the individual using the service with up to date accessible information on their ISF monies. Any surplus with a personal budget subject to requirement will be paid back to the council. Evidence of actual support provided must be accessible to the council. Ideas for a framework
Developing a local framework – what councils need to do is to decide what they want. The personalisation provider contract arrangement and how an ISF fits in with this OR not? Working with providers to develop ISF’s – what providers need to do. Ensuring people have choice and control and the ISF doesn’t just become the ‘default’ option. Requirements for an ISF Provider – tele-monitoring, support planning etc... or not? How the provider receives payments from the council – inc:net or gross How the provider will be audited and monitored The agreement between the council and the individual – two way or three way contracts?
The Council The Provider The Individual Specification of what is being provided and when and notice period. Details of ISF Payments and terms around financial contributions. Details of responsibilities and what to do if things go wrong. The Agreements
Developing the retail cost of your service. Describing what you do to for your customers and how to market your organisation. Being involved in the support planning process. Being flexible and responsive for people. Setting up an accessible agreement between the provider and the individual. Setting up internal systems to enable both the person to understand how their personal budget is being spent and the council to audit. Moving people from a block contract arrangement to an ISF. Changes in the need of the individual Providing support in different places. Opportunities for business development – top ups, self funders... Preparing for Personalisation – what providers need to do.
Using the Tool – Markers of Progress 1 or 2 - Starting to look at 3 – Making some progress 4 – Making good progress 5 - Delivering truly personalised services
The Person 1.We see the person as an individual with dignity and respect. 2.We understand and respect the persons life history. 3.We know and act on what matters to the person. 4.We know and act on what the person wants in the future (Outcomes). 5.We know and respond to how the person communicates 6.The person is supported to make choices and decisions every day 7.We know exactly how the person wants to be supported and how to support them to be fully part of everyday life. 8.We know what is working and not working for the person and we are changing what is not working. 9.We support people to initiate and maintain friendships and relationships and to be part of their community and civic life. 10.We support individuals to be in the best possible physical health and to remain as independent as possible.
Choice and Control Ensuring people have choice and control – giving people the right information at the right time. What do people want?
How do we ensure we keep people healthy, safe and well The review process What to do when the service is not working
Quality Assurance Making sure the ISF continues to work well. Ongoing review and learning Provider forums specific to ISF’s Personal Budget Survey Sit alongside people – ConsultACTION.
What we are looking for...... More people having a personal budget.... WHY? Providers -To ensure they are part of the future market for people who are managing their own personal budget and self funders who want to buy support from a provider in the future. Councils - to be sure that we are doing at a reasonable pace which allows us to use our money in the best way possible, but ultimately brings about better outcomes for people.
What does success look like for you and your organisation?