Presentation on theme: "Insert Local Authority Transformation Strategy Workshop Insert date This document is part of the personalisation toolkit www.dhcarenetworks.org.uk/personalisation."— Presentation transcript:
1Insert Local Authority Transformation Strategy Workshop Insert date This document is part of the personalisation toolkit
2Introductions Your name and role Your current level of knowledge of the transformation agenda and self directed support
3Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
4Objectives Gain a shared understanding of the transformation agenda Agree what transformation means for INSERT LOCAL AUTHORITYPlan what work needs to be done whenAgree how to approach a pilot
5Transformation agenda- What’s it all about? Universal services – Adult social care must provide support for all adults with social care needs and their carers, including signposting and help in accessing a range of services that are available to all including services outside of adult social care such as transport, leisure, health and education.Social capital – developing the community and encouraging individuals to make use of all resources available to them in the community, including personal networks (family and friends), community groups, the voluntary sector and other informal supportPrevention and early interventionHelping people maintain good health and independence with low level support.Identifying people at risk of losing independence and giving them support early.Helping people get back on their feet after illness, for example through “enablement”.Choice and control – ensuring people have greater choice and control over their lives, including through self-directed support.5
6Prevention and Intervention have a vital role There are activities at every stage which can improve quality of life and reduce demandCitizenshipInformationLifestylePractical supportEarly interventionEnablementCrisis / flexible responseInstitutional avoidanceTimely dischargeLow to moderate needsGeneral populationComplex needsSubstantial needs
7Benefits of transformation Benefits for users– Increased choice and control– A shift in power from the council to the individual– Greater flexibility– Prevention and early intervention improves quality of lifeBenefits for councils:– Increased transparency of resources and budgets– Greater flexibility and equity in provision across all adult groups– Greater awareness of support networks that exist in the community– More efficient process‘Putting People First isn’t just a vision for social care. It demands that all parts of local government ask some fundamental questions about the types of communities they want to build’Phil Hope, Minister for Care Services, 2009
8Co-production Co-production is a key part of this agenda Real change can only happen by engaging users and carers throughoutPersonalisation means empowering people to develop solutions that work for themPutting People First… “seeks to be the first public service reform programme which is co-produced, co-developed, co-evaluated and recognises that real change will only be achieved through the participation of users and carers at every stage. It recognises that sustainable and meaningful change depends significantly on our capacity to empower people who use services and to win the hearts and minds of all stakeholders’, especially front line staff”8
9No longer IF but HOW‘Transforming social care’ makes it clear that all local authorities have to change their social care model and that this will involve a significant amount of work.“We have a long way to go to give everyone more choice and control over the care and support they receive. Local councils are clearly working hard to transform their systems to do this. We need to work together with local communities to ensure this progress continues.”Phil Hope, Minister for Care Services, May 20099
10No longer WHEN but NOWCouncils and partners are working to deliver significant progress by 2011.“The information given to us from councils indicates very strong progress amongst a number of councils. We are confident that this will become widespread over the coming year”Jeff Jerome, National Director for social care transformation, May 200910
11IBSEN reportThe IBSEN review of the individual budgets pilots was published in November 2008, with a carers evaluation published later.The key findings included:More people felt in control of their livesMore people taking up direct paymentsMany people continued to use mainstream services- Need for better access to support planning and brokerageMixed evidence about the early outcomes for some peopleSome challenges about making it work for some groups (such as older people)- Mostly positive results for family carers11
12Transformation framework: summary Phase 1Switch OnFull PotentialInvestigationBlueprint(Enhance)InvestigationBlueprint(Review)Blueprint(Develop)ImplementationPlanningImplementationPlanningImplementationPlanningImplementationImplementationImplementationMonitor & SustainLimited LaunchExpanding the new approach to allOptimising the systems
14Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
15What counts as a success? Success is about service wide transformation - offering a personal budget or increasing direct payments is not enough, but is a key stepThe principle is to offer maximum control and choice while effectively managing riskThe development of universal services and social capital have an important role to playCo-production is a key tool in transformationReducing demand on services through a combination of prevention and early intervention.
16Defining success for INSERT LOCAL AUTHORITY What elements constitute successful implementation of transformation?Which of these can we measure?Can we define success in one sentence?When can we describe transformation as “mainstreamed”?
17You need to define what success means in your area Various perceptions of successGenuine choice and control?IncreasedSocialCapital?Maintain/ improve CQC rating?Improve-ment in outcomes?Greater control over limited finances?Efficiency?Inclusion of more funding streams?A new ‘agreement’ with citizens?Avoiding bad press?More Co-production?Evidence of new options in the market?Less reliance on local authority?Demon-strable culture change?Everyone acting as self-funders?You need to define what success means in your area
18Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
19The Customer Journey Early intervention Self-directed support Universalservices andearlyinterventioninitial contact assessment - advice and signpostingMeet immediate needs and enableAssessCalculateinitial personal budgetSupport planAuthorise&validateGo liveMonitor & reviewEarly interventionThis is the revised customer journey. It differs from the existing Customer Journey in the following ways:It includes Universal Services and Early InterventionInitial contact assessment is now ‘First Contact – advice and signposting’There is a new ‘Meet immediate needs and enable’ stepIt reflects the features of the existing customer journey but also reflect universal services and early intervention, the meeting of immediate needs and enablement.The lighter coloured segments of the journey show the activities that take place once an individual is in the realm of social care and moving toward a support plan, whilst the darker segments show the broader activities that do not necessarily lead to a support plan and may help prevent one being required.It is also important to note that whilst the diagram shows a linear process, successful early intervention, universal services and enablement mean that for many people their journey will be slowed or even halted, and in some cases enablement may take people out of the process altogether.Self-directed support19
20How can you help customers stay independent? Those not eligible for a package can get further informationReview may suggest enablementUniversalservices andearlyinterventionFirst contact - advice and signpostingMeet immediate needs and enableAssessCalculateinitial personal budgetSupport planAuthorise&validateGo liveMonitor & reviewThe first slide showed in a simple and straightforward manner the customer journey. This is a very useful way of helping people to understand the key elements and the order in which they fall.However anyone who has had exposure to this journey, whether they are staff, citizen or provider will acknowledge that the actual journey and the steps and actions around this are far more complex.This slide attempts to capture these complexities, and in particular emphasises that it is not a linear process but that people can move back up the journey or out of it altogether at various points.enablement prevents requirement for ongoing supportContinually look for opportunities to enable, signpost or give advice to increase independenceEncourage to the left, not inevitable drift to the right20
21Implementation planning Elements of transformationOn what is there already a INSERT LOCAL AUTHORITY consensus?At what stage should other decisions be made in?BlueprintImplementation planningImplementation
22Breakdown of activities for target operating model The following slides demonstrate how the transformation framework can be applied to the self-directed support element of the customer journeyThe principles and questions which are raised for each stage (e.g. blueprint, implementation) can be applied across the transformation agenda.
23Breakdown of activities for TOM BlueprintBreakdown of activities for TOMInitial contact assessmentProvision of information for individuals using or interested in socialcare services (including self-funders) is essential to allow genuinechoice and control. This covers information available via all channels(web, phone, face-to-face etc) at first enquiry stage and throughout the process.Develop new information resources – print & onlineDecide role of Council’s contact centre (e.g. will the council do initial telephone assessments?)Explore options for on-line contactReview appointment system with professional staffDevelop information for self-fundersTraining and development for ASC & customer contact staffImplement procedures to ensure information is consistent across all channelsAgree how to work with partners (public, provider and voluntary sector) in the provision of information and other support that people will be signposted toWork through and agree the interface with services providing low-level interventions, or enablement services and other ‘fast track-able’ or crisis supportReview triggers for assessments
24Breakdown of activities for TOM BlueprintBreakdown of activities for TOMAssessmentThe traditional care assessment and management process will needto be redesigned to enable transformation. Assessment includesdetermining eligibility and the personal budget amount which typically involvesdeveloping an operational Resource Allocation System (RAS) and defining the roleof self-assessment. This may have an impact on current role definition and teamstructure of social worker/care managers.Decide on approach to self-assessment & when to make citizens aware of their budgetDevelop assessment questionnaireDevelop Resource Allocation SystemRefine financial assessmentDecide how to validate and risk manage assessmentsPut appropriate risk management arrangements in placeEnsure integration with other assessments (CAF, other funding streams etc) - minimum signposting roleAdapt back office systems to support these functionsDefine the role of social workers & care managers and changes to role descriptions and team structureDevelop training plan
25Breakdown of activities for TOM BlueprintBreakdown of activities for TOMIndicative Personal Budget CalculatedAt this stage the person is informed about their personal budgetand about any appeals process.Decide how best to communicate this informationAgree processes for approving indicative personal budget allocationsDecide appeals processAgree policies for exceptional and transitional allocationsAdapt back office systems to support these functions
26Breakdown of activities for TOM BlueprintBreakdown of activities for TOMSupport planningThe traditional care assessment and management process will need to beredesigned to enable self-directed support. People can use any combination ofresource (third sector, friends, family, social workers, care managers) to developtheir support plan. The council will retain a role to risk assess and approvesupport plans.Decide maximum and minimum levels of assistance to be offered and by whomUtilise existing resources in the communityDevelp new support planning approaches to offer genuine choice and stimulate creativity while managing riskConsider boundaries for what personal budgets can be spent onDefine the role of social workers & care managers and changes to role descriptions and team structureDevelop training planAdapt back office systems to support these functions
27Breakdown of activities for TOM BlueprintBreakdown of activities for TOMAuthorisation & validationThe council will continue to retain a role in ensuring that support planswill meet the identified needs of individuals and that their legal responsibilitiesare met. To do this there needs to be an effective process to agree support plans.Agree a process for the authorisation of support plansDevelop guidance for social workers to negotiate changes to support plans, in line with support planning guidanceAgree an appeals process if people do not agree with social workers when determining the support plan
28Breakdown of activities for TOM Go Live/expansion/optimisation – service implemented and commencedIn a self-directed support system, citizens can choose to control theirpersonal budget in a variety of ways. There will also be the need to ensure peoplehave the assistance they need to secure the support specified in the support plan.Agree how to maximise the resource deployment options - direct payment; a representative, a legal trust, an independent support organisation or a provider manages the funds on their behalf; services provided or procured by the council; or a combination of these methodsAgree the control mechanisms over each methodDevelop processes for supporting these different types of personal budgetDesign structure and standard content of contract between the person and the local authorityDecide which aspects of organising support the council will support and which aspects it will rely on external providers for role of local authority under self-directed supportDecide what parts of the cost of organising support appear within the personal budgetIdentify and consult with current or potential organising support providersDecide if the cost of organising support should be included in a personal budgetCreation of resource directoryDefine the role of social workers & care managers and changes to role descriptions and team structureDevelop training planAdapt back office systems to support these functionsBlueprint
29Breakdown of activities for TOM BlueprintBreakdown of activities for TOMMonitor & reviewQuality assurance and review will be different under transformation.This includes the development of outcome based reviews, ensuring support plansare being delivered and also responsibility for understanding how personal budgetshave been spent. The relationship with monitoring suppliers’ quality will also bedifferent if this support was commissioned by individuals.Develop a process to monitor outcomes and a basis for agreeing individually how often support plans will be reviewedProduce review forms/templates/guidance documentsDevelop risk management framework to help ensure that the level of scrutiny undertaken on how individuals spend their budget is appropriate to riskDecide on level of quality assurance for providersDefine the role of social workers & care managers and changes to role descriptions and team structureDevelop training planAdapt back office systems to support these functionsCollate evaluation information to inform the next phase
30Breakdown of activities for TOM BlueprintBreakdown of activities for TOMUnderstanding needs and commissioningUnder a self-directed support system the council no longer has directcontrol over where a significant proportion of the adult social care budgetis spent. The market will be responding to individuals choosing what services theyreceive as well as any contracts that the council chooses to put in place. The roles ofstrategic commissioning, contracting and contract monitoring will fundamentally change.Find ways to learn about what people wantDevelop better information on needs and future demand including self-fundersExplore how and how much the council can influence the market and where it will get its intelligence about what people want to buy fromMap market in areaConsult with providersDecide what's in house & what's commissionedCharging policyStrategy for existing contractsAdapt financial, care management & back office systems to support these new functions
31Breakdown of activities for TOM BlueprintBreakdown of activities for TOMBack office servicesAllocating spend and procuring services on an individual basis will requirefundamentally different back office processes and systems. This will include ITfacilities as well as auditing, invoicing and payment processing. Assistingindividuals in managing their finances, including through third sector providers willalso require different processes. All these processes will need to be scalable i.e.some processes will work for small numbers of people but will be impractical forlarge numbers. In addition, different systems will be required to support both backoffice processes and delivery of care services..Decide back office processes for supporting different types of personal budget (e.g. direct payment, provider facilitated, nominal budget for procuring in-house services, combination)Refine and simplify direct payments processesUndertake analysis to better understand current spend, service user numbers and unit costsAdapt financial, care management & back office systems to support these new functionsDevelop risk management framework to help ensure that the level of scrutiny undertaken on how individuals spend their budget is appropriate to risk
32Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
33How do we define the success of the Transformation agenda? Does our definition of the success of transformation need updating?
34Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
35Getting started – defining a limited launch in Phase 1 Who will be involved in the pilot?– Client group?– Transition / new clients / annual review / all?– Other factor (e.g. locality / type of provision / team)?Size?– How many clients will be involved in the pilot?Speed?– How quickly will clients be brought into the pilot?What are the key issues for each of the elements of transformation when running a pilot?
36Contents Introduction What is success? What changes? Success revisited Getting startedNext steps
37Next stepsReport to DMTMove to Blueprint stageCommunications