The implications of Individual Budgets for Extra Care Housing London & SE Housing LIN 11th June 2008 Angela Nicholls, CSIP Consultant

personalisation agenda Individual Budgets - part of the ‘personalisation agenda’ Individual Budgets Pilot Programme The Self Directed Support Network

The Government is driving the shift to a personalised social care system …move from a system where people have to take what is offered to one where people have greater control over identifying the type of support or help they want and more choice about and influence over the services on offer Independence, Wellbeing and Choice 2005 …following the White Paper earlier this year, the development of social care policy is a crucial part of our programme. We have committed ourselves to a personalised social care service that fosters independence and dignity. In particular we want to see the further implementation of individual budgets and direct payments. Letter from Prime Minister to Sec of State for Health May 2006 “I don't think there is any doubt that a combination of individual budgets and personalisation of services is going to be the key component of a modern social care system. I don't want there being any ambiguity or doubt about that.” Ivan Lewis, MP, Minister for Community Services The Guardian, October 2006

Personal budgets for everyone eligible for publicly funded adult social care support Personal Budgets Personal budgets for everyone eligible for publicly funded adult social care support “Over time, people who use social care services and their families will increasingly shape and commission their own services. Personal Budgets will ensure people receiving public funding use available resources to choose their own support services – a right previously available only to self-funders.” Putting People First: A shared vision and commitment to the transformation of Adult Social Care (December 2007)

Individual budgets – Key Features A streamlined assessment and transparent allocation of resources Bringing together different income sources and funding into one package The individual deciding how best to use their combined budget to meet their needs A choice of mechanisms – cash or services Support from a broker or advocate

How did older people use their Individual Budgets? Not necessarily making great changes But feeling more in control Using family & friends Purchasing things Social Services didn’t provide Going for mix and match of services and providers

What worked for older people with Individual Budgets? Telling people how much services cost Simplifying the processes Enabling them to negotiate directly with the care provider Building in provision for changing needs Bringing in additional resources Using resources imaginatively e.g. pooling Individual Budgets

Extra Care Housing Brings together a range of services into one integrated scheme Care and support, and other services, can be tailored to the individual Can deliver very flexible care, responding daily to changing needs and wishes Promotes independence and dignity Cost effective

But also - Complicated funding streams Lack of integrated management Inflexible contracts Contracts which focus on inputs rather than outcomes Complex charging framework

Issues for Personal Budgets and Extra Care Housing PBs are portable – what if service users choose other providers? What if services users want a different mix of services from what is on offer? What if service users want to hold back some of their PB for other things? What about the impact on charging systems?

Some possible approaches Be clear about what the scheme is offering Build flexibility into contracts - while maintaining core stability Give more freedom to providers to arrange services directly with users Think about outcomes rather than services Train care staff and support workers to be imaginative and flexible

In conclusion: Personalised budgets are here to stay They are a positive development for service users They bring challenges for providers There are implications for commissioning and contracting ECH services But personalised budgets sit well with the principles of Extra Care Housing They have the power to transform services