Nottinghamshire Working Together for Change Project Supported Living Services for People with Learning Disabilities

Sarah Craggs Person Centred Planning Perspective

What we did 54 Person Centred reviews across three supported living services- Choice Support, Mencap and Eden Housing.. We asked each facilitator to identify with the person or their circle of support the top three things that were working, not working, important for the future.

Supported staff to capture what people were saying at reviews in their own words as much as possible. What is workingWhat is not working Seeing Jane my girlfriend at my flat and spending the weekend with her and her family I would like to go on holiday abroad with Jane but staff are not sure if they can support her while we are away.

The Workshops We had representation from Commissioners, Providers, Service Users and Carers. We sorted each review statement into themed groups and voted on our priorities for action.

Top 5 themes I want to do new things I want to go on holiday I want to have my say I want a job I want to see the people who are important to me Whats important for the future

Whats working Top 5 themes Im supported well I like my own home I am supported to do what I want Relationships are important to me I have a good social life

Whats Not Working I cant make my own choices I am not seeing people I care about I dont get the right people to support me I am not happy with the people I live with My support is not right

Root Causes For each not working theme we thought about what caused the problem. For example - I dont get the right people to support me - because I do not choose the staff that support me.

Success Indicators We thought about what success would look like from an individual, provider and commissioners point of view Individual who uses the service ProvidersCommissioners I do not get the right people to support me I choose who I want to support me We have a person centred recruitment process We look for evidence of a person centred recruitment process and the staff matching tool being used.

Action Planning We thought about what we do already and other solutions. I do not get the right people to support me What do we do now RadicalTraditionalCommunity based Person centred reviews E-care - Ebay for social care Anonymous matching tool on back of job application form, with or without photo Using existing support networks – friends/family with personal budgets

ProviderWork focus ChoiceIndividual Service funds and better staff skills matching Eden HousingPerson Centred Recruitment Process MencapMatching housing vacancies to people looking for these. Focus for Ongoing work

Providers Perspective Dave Jackson Choice Support

It was really good to have the workshops as a focus point to actually sit and listen to what people we support were saying about their lives and then to commit to doing something with peoples comments. Working together on the project feels really important sometimes it is easy to feel that we do our thing and social services are just there to monitor us – but this feels like a real partnership, with sign up from all parties – I think it is helping to move the personalisation agenda forward. As a result of Working Together for Change we are focussing on developing Individual Service funds. This compliments work Notts have started which helps but it is not all easy – changing our internal systems and thinking differently – getting others on board like the finance department – takes time – but having clear time frames is helping us to move it forward. My top tip for other providers getting involved in the future would be that it really helped us to have the Chief Executive involved as he signed up to it and this is helping stop unnecessary barriers getting in the way. Providers View on Working Together for Change

Individual Views Eddie Morecroft/ Emma Shevlin We Can Do It C.I.C

What we liked Person Centred Reviews.

What we liked The things people said at their reviews – felt real. It was good everyone was working together and having an equal vote on what was most important

What could have been better More people with Learning Disabilities there. a workshop before the event just for us so we were more prepared. More carers of people with complex needs to be invited. Better communication after the workshops so that people who were not part of the ongoing action planning team know what has been achieved.

Commissioners perspective Giles Blower Suzanne Whitchurch

Some Background Supported Living Services have been actively promoted within Nottinghamshire LD services - since Over £10 million per annum committed to Supported Living for LD from ASCH and other funding partners – Supporting People – (5 million), ILF and Continuing Care. Across the County over 450 people are living in Supported Living schemes receiving support from 22 accredited providers.

WTfC Pilot Partners - Choice, Mencap and Eden Supported Housing provide support to nearly half of the 450. Commissioning process promotes Person Centred approaches as priority – Mini tenders – one page profiles – Service user led selection process. Current funding arrangements under a joint SP/ASCH contract for commissioned services reflect a degree of personalisation – each service user has an Individual Service Contract with their chosen provider. WTfC ideal opportunity to receive direct feedback around whether the delivery of services reflects person centred ethos.

Some feedback from the WTfC around What was working well - quite reassuring –

Themes from the WTfC reviews around Future Plans and What was not working help set a service user led agenda for change.

WTfC Pilot has is helping to re-focus the delivery of support via the promotion of Service user led outcomes. Current work with Pilot providers to facilitate this process. Develop Individual Service Contracts into Individual Service Funds – moving to ultimate goal of Personal Budgets. Empower Service users with greater awareness of support hours through – accessible service descriptions – co-production of support plans – inclusive staff selection and skills matching. Commissioners to actively encourage the flexible and creative use of funding streams to deliver agreed outcomes. Commissioners to encourage the adaptation of flexible staffing arrangements to enable providers to better match support personnel with service users interests, skills, personalities.

WTfC Pilot has is helping to re-focus the delivery of support via the promotion of Service user led outcomes cont…. Future work – To use WTfC themes in future procurement exercises to inform basic provider service requirements. To shift to outcome based monitoring system. To use regular Person Centred / outcome focussed Reviews as an opportunity to check on and determine actual service delivery as experienced by the service users. To help any service user who was part of the pilot move to a Personal Budget as part of the move to greater personalisation.

Using the WTfC Project to influence other support service areas What do we need to do Learn from the WTfC project What worked & what didnt Changing the culture for some providers and commissioners Market intelligence – find out what people want - to develop and stimulate the marketMarket intelligence – find out what people want - to develop and stimulate the market Market Information – know what services can be supplied, of what quality and at what costMarket Information – know what services can be supplied, of what quality and at what cost Changing the way we currently contract - offering more flexibility using outcome focussed models Involve service users and carers in the process

What Next We are currently working with a school to look at how information from Transition Reviews will feed into their school development plan. Using working together for change to help us make decisions within Learning Disability around our day service integration. Writing a proposal for senior managers on how working together for change can be used on an ongoing basis to help with strategic planning.

Finally our Top Tips Invest time in supporting staff to do reviews well – good quality data brought to the process makes all the difference. Get the right mix of people at the workshops think about your service users/carers/staff mix, Make sure there are senior managers who can drive change forward. Before you start decide how you will feedback action following the workshops to everyone who attended so people know what has happened.