Virginia McClane Commissioning Manager October 2014 Commissioners intentions for supporting people to live in their own homes Kent Housing Group 22 October 2014

“Life, not a service”

£330 million …new savings estimated between April 2014 and March 2017 Savings £18 million …Adult Social Care Savings for 2014/15

Phase 1 Phase 2 Phase 3 Current Operating Model Panel-focused care pathway Traditional system adjusted with independence- promoting services Time-consuming internal processes Time and task contracting relationships Large provider networks Wave 2: Increased breadth of services Broader suite of commissioned services throughout the FSC pathway Improved internal systems for efficient delivery of services Delivering the Future Vision Pathway working within the principles of care Integrated health and social care pathway, commissioning and provision Shaping the market through strategic engagement with key primary suppliers Wave 3: Integrated commissioning Integrated internal processes in the care pathway Work with partners to develop joint strategic commissioning arrangements Wave 1: Best use of existing systems Improved use of enablement-based services Improved internal systems Reshape provider markets (incl. rationalisation) to lay the foundations for future transformation c£30M savings Transformation Model (Phase 1)

Phase 1 – Better outcomes less cost

Accommodation and Homecare Strategies

Partnership with Housing Provider Commissioning, OT’s, Case Management & Care Provider Fully furnished Licence agreement issued by KCC Short term - up to 6 weeks stay Bookable in advance 55 + Eligibility Criteria Partnership with Housing Provider Commissioning, OT’s, Case Management & Care Provider Fully furnished Licence agreement issued by KCC Short term - up to 6 weeks stay Bookable in advance 55 + Eligibility Criteria Trial Tenancy Adjusting to a new condition or disability Assessment step up/down Respite Trial Tenancy Adjusting to a new condition or disability Assessment step up/down Respite Negotiations with providers for more flats Independence & wellbeing apartments

Affordability Rents 24 hour onsite care & support Meals Service Charge Review completed in Support the Accommodation Strategy -Does it act as a deterrent? -Comparisons with other LA’s -Develop consistent approach - 70% don’t pay - 27% pay full amount - 3% pay reduced amount - Kent expensive compared with other LA’s - Affordability can act as a deterrent Key decision taken September 2014 £15 for existing schemes effective April 2015 and immediately for new schemes. Wellbeing, lifestyle & peace of mind in Extra Care Still some work to do where Housing Providers are also care providers. Housing business models may be based on the assumption that they will also be the care provider and apply a “lifestyle” charge within tenancies £27.96

Phase 1 Phase 2 Phase 3 Current Operating Model Panel-focused care pathway Traditional system adjusted with independence- promoting services Time-consuming internal processes Time and task contracting relationships Large provider networks Wave 2: Increased breadth of services Broader suite of commissioned services throughout the FSC pathway Improved internal systems for efficient delivery of services Delivering the Future Vision Pathway working within the principles of care Integrated health and social care pathway, commissioning and provision Shaping the market through strategic engagement with key primary suppliers Wave 3: Integrated commissioning Integrated internal processes in the care pathway Work with partners to develop joint strategic commissioning arrangements Wave 1: Best use of existing systems Improved use of enablement-based services Improved internal systems Reshape provider markets (incl. rationalisation) to lay the foundations for future transformation Scope Demand management through community capacity (Vol. Sector) Integration with the NHS as a mechanism to improve outcomes and drive further efficiencies Increase breadth of commissioned services, focused on enabling a more holistic approach to care in the community Scope Demand management through community capacity (Vol. Sector) Integration with the NHS as a mechanism to improve outcomes and drive further efficiencies Increase breadth of commissioned services, focused on enabling a more holistic approach to care in the community Transformation (A Waved Approach) Phase 2

Integration – Whole System Transformation Whole System Transformation K CC’s Adult Social Care Transformation Plan The Better Care Fund – 2016 (£101m for Kent – not new money ) The Health and Wellbeing Strategy – 2017 Kent’s Pioneer Programme – 2018 CCG Strategic Plans – 2019

Our Model of Integrated Services Integrated Discharge Teams: Acute Hospital sites; 7 days a week working. “I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” Crisis Response Services: Access to shared anticipatory care plans by the ambulance service, enhanced rapid response, enablement services and voluntary sector based crisis response services. Integrated Care Home Support: Integrated teams including Consultant and GP support; Use of technology to Care Homes / Extra Care Housing providers. Integrated Equipment, DFGs, capital adaptations & assistive technologies at the front end of all services, video conferencing with clinicians and development of new pathways. Improved data sharing: Promotion of NHS number, better exchange of health information, use of the health and social care information centre, patients accessing own health records, GPs linked to hospital data. Operating model: Integrated skill mix, assessors accessing integrated care direct: i.e. nurses accessing social care and case managers nursing care, skills for mental health/dementia/LD. Non Acute Bed Provision: Consultant and GP support; Integrated Care Centres; Extra Care; Rehab Units; Community Hospital beds; Private Residential and Nursing bed provision. Integrated Enhanced Rapid Response: Rapid Response; active reablement; “Going Home Teams” Integrated Long Term Conditions/ Neighbourhood teams: 24/7 access to multi-disciplinary teams coordinated by the GP, inc mental health/dementia; risk stratifying patients; access to one shared care plan for patient & professionals. Integrated Access: Integrated Locality Referral Unit; 7 days a week direct access and 24/7 crisis response; Access to shared care plan on an integrated platform.

thank you Virginia McClane Commissioning Manager – October 2014