Personalisation in Lambeth

Transcription

1 Personalisation in Lambeth (Monday 29 March pm) Extract from the Council s commissioning for personalisation: Direction of travel consultation document Introduction to Personalisation To better promote people s independence and well being, the Government has directed all Local Authorities to introduce Personalisation, a radical reform of adult social care services i. THE PERSONALISATION AGENDA Personalisation is concerned with: Putting People First so they can live their own lives as they wish, confident that services are of high quality, are safe and promote their own individual requirements for independence, well-being and dignity. ii Giving people more choice and control about the care and support they receive, through developing Personal Budgets and Self Directed Support Shifting the focus of services away from crisis intervention, towards prevention and early intervention. It is being introduced at a time when the growth in social care needs is giving rise to significant economic challenges: it is hoped, therefore, that personalisation will not only deliver better outcomes, but will do so in a more cost effective way. The Government is clear that the changes required are complex. To harness capacity across the whole system, it will be necessary to work closely with the voluntary, community and independent sectors and to develop partnerships with agencies such as housing, benefits, leisure, transport and health services. The Government has set a series of targets to shape the delivery of personalisation, including a requirement, by 2011, to Have in place a commissioning strategy, which includes incentives to stimulate development of high quality services that treat people with dignity and maximise choice and control, as well as balancing investment in prevention, early intervention/re-ablement and providing intensive care and support for those with high-level complex needs.

2 Have started a market development and stimulation strategy, either individually, or on a wider regional basis with others, with actions identified to deliver the necessary changes. Executive summary 1.1 Background Information The Government has directed all Local Authorities to transform the way adult social care is planned, commissioned and delivered, though the development of personalisation and Self-Directed Support. There is to be a greater focus on using preventative approaches to promote people s independence and wellbeing and on enablement and early intervention to promote independence rather than involvement at the point of crisis. Partnership working with the NHS, housing and other statutory agencies, as well as with partners from independent, voluntary and community organisations to ensure a strategic balance of investment in local services is needed to deliver the vision that people are able to live their own lives as they wish, confident that services are of high quality, are safe and promote their own individual requirements for independence, well-being and dignity. As part of the required transformation to enhance choice and control and to meet fundamental social and economic challenges, the Government has made a policy decision that Local Authorities must develop new ways of allocating resources: In the future, all individuals eligible for publicly-funded adult social care will have a personal budget (other than in circumstances where people require emergency access to provision); a clear, upfront allocation of funding to enable them to make informed choices about how best to meet their needs, including their broader health and well-being. Having an understanding of what is available will enable people to use resources flexibly and innovatively, no longer simply choosing from an existing menu, but shaping their own menu of support. A person will be able to take all or part of their personal budget as a direct payment, to pay for their own support either by employing individuals themselves or for purchasing support through an agency. Others may wish, once they have decided on their preferred care package, to have the council continue to pay for this directly. The approach, which may be a combination of both, will depend on what works best for them. The term personal budget will describe this transparent allocation of resources. The Government also recognises that a number of people will require support in managing this new way of working. The term brokerage is being used as a universal title for such supports, which may include: Assisting the person decide if Self-Directed Care and a Personal Budget is the right choice for them to make Helping the person to complete a Self-Assessment Questionnaire to determine the level of their Personal Budget

3 Planning their life-goals in a Support Plan and then designing and arranging the services and supports needed to achieve the agreed outcomes Longer term advice and support in managing a Self-Directed package, including practical help with payroll for Personal Assistants and general management of money To deliver this programme the Council must prepare the local community to respond appropriately through a series of jointly agreed actions to improve the support networks which will be needed. This means that some services which have traditionally been commissioned through formal contracting arrangements will change to provide a range of different, more localised services to meet the possible outcomes required of eligible individuals. Significant changes will be needed to the current operating systems and processes to make this transformation possible. The Council has therefore been developing the framework explained in this document to indicate the direction of travel it intends in collaboration with as many stakeholders as practicable, to ensure that all the main actions are related to a jointly agreed plan. This is to maintain an active commitment to co-production that allows the local community to actively participate in and influence the necessary changes that will be needed. Although the Personalisation programme is developing across the country, Lambeth is considering the outcomes of local and national pilots to help, through this collaborative approach, what might work best in this Borough. As there are different ways of delivering personalised support needs this document sets out our approach and explains what we intend to do and what is already happening. There is a lot of work needed to achieve a successful programme in support of Personalisation and this depends on full co-operation of our partners to help make the transition from the established ways of working to the expansion of the new way of arranging support to eligible individuals. 1.2 Our direction of travel and ambition To transform social care, the whole system must be focused on outcomes, driven by shared values and must work towards the following objectives: Making it easier for people to access and benefit from universal services, such as transport, leisure, education, employment, health services, housing, community safety, information and advice Making a strategic shift away from crisis management towards prevention, early intervention & enablement Increasing the choice and control people have about their care and support, through introducing Personal Budgets and Self Directed Support Strengthening communities, so that people can benefit from the friendships, sense of belonging, support and care that can come from families, friends, neighbours and communities.

4 To deliver these objectives, our commissioning priorities are to: Develop integrated prevention, early intervention and enablement systems and services Give service users and their carers more choice and control by engaging with them more and by devolving decisions to them about how money is spent Develop the market, in partnership with providers, to deliver more flexible, person-centred and innovative services Make sure all commissioned services are outcome-focused and deliver value for money Ensure we continue to safeguard vulnerable adults Expand of the scope of and integrate planning and commissioning across the council and its partners, so we increase the access people have to universal services and promote social inclusion. Further more detailed explanation will be found in Section 3 of this document Understanding the impact of personalisation Because there is so much uncertainty about how personalisation will unfold, we need to continue learning about how best to deliver it and the impacts it will have. To do this, we will continue to learn from work elsewhere and we will roll out work during a learning phase between October 2009 and March We will also run some additional pilot programmes such as the mental health personal budgets pilot and support brokerage. The uncertainties create particular problems for financial planning and financial management and these are exacerbated by the increasing pressure on public finances. Furthermore, the national pilots - as well as our local pilot - have highlighted that the process of transformation can be costly. To help address this, we are continuing to develop our Resource Allocation System [which guides the amount of money we allocate for an individual s care and support] and work is in hand to model the wider financial implications in greater depth Developing commissioning for personalisation Commissioning is at the heart of effective social care and as personalisation develops a new way of thinking about it is required. We are therefore adopting a multi-level approach to commissioning. This means commissioners will have a A wider role and broader focus, developing broader alliances with universal services, placing more emphasis on community development and on prevention, early intervention and reablement

5 A more connected role, working closely with service users and carers, providers, care managers and brokers A more enabling and creative role, with a significant shift from considering services for the user to promoting choice in the market A transitional role, helping people, including providers, to change their ways of working. This is explained further in Section Developing commissioning strategies Strategies that will help us to deliver the personalisation agenda have been established or are currently being developed. These will be underpinned by Lambeth s Joint Strategic Needs Analysis [JSNA] and include A Cultural Strategy that will address issues related to opening up access to universal services and community support Information, advice and communication strategies Strategies for each of our core client groups A prevention framework, which draws together work to develop community equipment services, assistive technologies, enabling home care services and extra care & supported housing A strategy to promote good mental health Developing and managing the market To make sure there is more choice about services and that services are more flexible and responsive, work has begun to develop the market of providers. This includes Working with providers to develop new contracting arrangements that promote choice, while also securing supply and promoting cost efficiency and cost effectiveness. As a part of this there will be a carefully managed move away from block contracts although some will remain. This work will include careful thought about funding models for extra care housing and building based housing and day services. Developing different approaches to the way we procure services Making sure there are robust arrangements to safeguard vulnerable adults. As a part of this we will consider developing local registers and accreditation systems for personal assistants. We are firmly committed to engaging with - and working closely with - providers to develop the market together. See Section 6.

6 1.7 Developing the personalisation pathways To deliver, we need a robust infrastructure. We will develop this through Engaging more with service users and carers Strengthening local user led organisations & developing a local model for a Centre For Independent Living Developing support brokerage and support advocacy Making sure there is good information and advice for service users and carers, including people who fund their own care Developing the local workforce to ensure there is sufficient supply of suitably trained staff.

7 i. LAC(DH)(2008)1: Transforming adult social care ii. LAC(DH)(2008)1: Transforming adult social care