Transforming Social Care Together Trust 14 th July 2008

The wider context Social care is a rationed service Demand will always outstrip supply Allocation of these resources increasingly open to scrutiny nationally and locally Historically this allocation was relatively local and informal This led to a ‘postcode lottery’ Increasing number of legal challenges around individual decisions

1998 White Paper ‘Modernising Social Services’ Established the notion of FACS – Councils should have ‘clear rules about who can get help’ so that ‘everyone in an area gets treated fairly’ Led to publication of eligibility criteria based on need and risk to independence – Critical – Substantial – Moderate – Low

What happened? Did achieve consistency within councils Achieved equity in terms of access to services such as intermediate care Some evidence that professionals tailored their assessment to make sure people met eligibility But if you rule people in you also rule people out especially – Self-funders – People with low level needs

Moved towards outcomes 2006 White Paper ‘Our Health Our Care Our Say’ identified seven outcomes: – Quality of life – Exercising choice and control – Making a positive contribution – Personal dignity and respect – Freedom from discrimination and harassment – Improved health and emotional well being – Economic well being Now used by CSCI as basis for assessment

Putting People First “Local Authority leadership accompanied by authentic partnership working to create a high quality care service which is fair accessible and responsive to individual needs”

Transformation Agenda Joint Strategic Needs Assessment Supporting a Community Strategy Commissioning that incentives quality provision Promotes innovation in the third sector (including social enterprises) Universal advice advocacy and information service (irrespective of eligibility) Greater emphasis on self assessments More individual budgets (including Health) Increased use of telecare

System Transformation Family members and carers as care partners Retail model for equipment Support for at least one local user led organisation to promote ‘voice’ LA to minimise risk of abuse or neglect Improved workforce planning Better integrated working with children’s services Championing the rights and needs of all vulnerable adults and older people

Quickheart Consultancy company under the umbrella of the Dept of Health Undertook a survey of how people get in touch with Adult Social Care Looked at the contact centre and website specifically Found a number of challenging issues

Chastening Findings Overall great confusion and conflicting points of view about what adult social care is and how it is delivered Use of web is limited and awareness of contact centre is also minimal Compounded by very real fear that social services represents – Loss of self respect and identity – Failure of ‘care’ and loss of control/choice – An emergency option – Loss of home/loss of dignity

And then People therefore are in denial that they ‘need care’ as they fear what ‘social care’ represents Only when a crisis occurs do they seek help – Reinforcing perception that social services represents a failure for the individual – embarrassing and undermining – Care becomes question of survival rather than choice (and something loathe to pay for) – Visible signs of care become symbols of that new position and status

FACS v Personalisation Professional assessment of need Categorisation Standardisation Consistency of treatment Explicit decision making Centralised purchasing Self assessment Self determination Choice Individual differentiation More arms length accountability for committing expenditure Commissioning for outcomes

Our Challenge To shift from: – A stigmatised and selective system – Based on criteria – Using difficult language that alienates many – That selects people out To: – A more universal system – Focusing on independence health and well being – Valued and used by a wider section of the community

In Control Personalised budgets is a key to this transformation We want to empower people to have more say over their care We want to make it more mainstreamed less marginalised We want to work with you on that That is what this day is about