Insert Local Authority Selfdirected Support Strategy Workshop Insert date This is a template present

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Insert Local AuthoritySelf-directed Support
Strategy WorkshopInsert dateThis is a
template presentation made available as part of
the Personalisation Toolkit, that can be adapted
and used locally. It has been produced by iMPOWER
for the Care Services Improvement Partnership.
Find out more from www.toolkit.personalisation.org
.ukGateway ref 9878
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• Introductions
• Your name and role
• Your current level of knowledge of SDS

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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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• Objectives
• Gain a shared understanding of self-directed
  support
• Agree what self-directed support means for INSERT
  LOCAL AUTHORITY
• Plan what work needs to be done when
• Agree how to approach a pilot

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• Whats it all about?

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• Benefits of Self-directed Support
• Benefits for recipients of self-directed support
• Increased choice and control
• A shift in power from the council to the
  individual
• Greater flexibility.
• Benefits for councils
• Increased transparency of resources and budgets
• Greater flexibility in provision
• Equity of provision across all adult groups
• More efficient process.
• Self directed support has the potential to be
  the most exciting development within public
  services in this generation.
• (Ivan Lewis, 19th November 2007)

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• The Central Balance
• Maximising choice and control, whilst effectively
  managing risk

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• No longer IF but HOW and WHEN
• Transforming social care makes it clear that
  all councils have to change their social care
  model and that this will involve a significant
  amount of work.
• Personalisation is about whole system change,
  not about change at the margins this is not a
  box ticking exercise, but a call to deliver
  significant change.
• Everyone eligible for statutory support,
  should have a personal budget, a clear and
  transparent allocation of resources
• This needs attention now Councils should
  consider setting clear benchmarks, timescales and
  designated delivery responsibilities to ensure
  tangible short-term progress. 

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• No longer IF but HOW and WHEN
• This will involve a significant amount of work.
• The timetable is tough The government is
  expecting significant progress in delivering
  personal budgets by 2011.
• Adult Social Services will be leading the
  personalisation charge the Social Care Reform
  Grant is likely to make up a significant
  proportion of the money spent delivering change
  across the public sector over the next three
  years. ASS will be a leading voice in the debate
  and player in the implementation of the
  Governments shared ambition . . . to put people
  first through a radical reform of public
  services.

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• Self-directed Support context
• The Department of Health has found that councils
  can
• Clearly articulate the concepts and benefits of
  self-directed support
• Relatively easily put processes in place to
  manage pilots
• For wider transformation however many
• Struggle to understand the scope of change
  entailed
• Struggle to communicate the scale of change
  required
• Find it difficult to plan the activities
  required
• Find it difficult to align transformation to
  self-directed support with existing change
  initiatives
• Dont have clarity re decisions when and by
  whom
• Dont have a clear picture of what the future
  organisation looks like
• What does self-directed support mean for INSERT
  LOCAL AUTHORITY ?

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Transformation framework summary
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Key elements of self-directed support
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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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• What counts as a success?
• There is no single definition of whether support
  is successfully being self-directed
• The principle is to offer maximum control and
  choice whilst effectively managing risk
• Offering a personal budget or increasing direct
  payments is not enough
• There may be a conflict between success of
  self-directed support and what we can measure.

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• Defining success for INSERT LOCAL
• AUTHORITY
• What elements constitute successful
  implementation of self-directed support?
• Which of these can we measure?
• Can we define success in one sentence?
• When can we describe self-directed support as
  mainstreamed?

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Various perceptions of success
Genuine choice and control?
Greater control over limited finances?
Improve-ment in outcomes?
Maintain/ improve CSCI rating?
Efficiency?
A new agreement with citizens?
Avoiding bad press?
Inclusion of more funding streams?
Less reliance on local authority?
Evidence of new options in the market?
Everyone acting as self-funders?
Demon-strable culture change?

• Just offering a personal budget is not enough

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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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Key elements of self directed support
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• Elements of self directed support
• On what is there already a INSERT LOCAL AUTHORITY
  consensus?
• At what stage should other decisions be made in?

Blueprint
Implementation planning
Pilot
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• Breakdown of activities for TOM
• Initial contact assessment
• Provision of information for individuals using or
  interested in social
• care services (including self-funders) is
  essential to allow genuine
• choice and control. This covers information
  available via all channels
• (web, phone, face-to-face etc) at first enquiry
  stage and throughout the process.
• Develop new information resources print
  online
• Decide role of Councils contact centre (e.g.
  will the council do initial telephone
  assessments?)
• Explore options for on-line contact
• Review appointment system with professional staff
• Develop information for self funders
• Training and development for ASC customer
  contact staffImplement procedures to ensure
  information is consistent across all channels
• Agree how to work with partners (public, provider
  and voluntary sector) in the provision of
  information and other support that people will be
  signposted to
• Work through and agree the interface with
  services providing low level interventions, or
  reablement services and other fast track-able
  or crisis support
• Review triggers for assessments

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• Breakdown of activities for TOM
• Assessment
• The traditional care assessment and management
  process will need
• to be redesigned to enable self-directed support.
  Assessment includes
• determining eligibility and the personal budget
  amount which typically involves
• developing an operational Resource Allocation
  System (RAS) and defining the role
• of self-assessment. This may have an impact on
  current role definition and team
• structure of social worker/care managers.
• Decide on approach to self assessment when to
  make citizens aware of their budget
• Develop assessment questionnaire
• Develop Resource Allocation System
• Refine financial assessment
• Decide how to validate and risk manage
  assessments
• Put appropriate risk management arrangements in
  place
• Ensure integration with other assessments (CAF,
  other funding streams etc) - minimum signposting
  role
• Adapt back office systems to support these
  functions
• Define the role of social workers care managers
  and changes to role descriptions and team
  structure

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• Breakdown of activities for TOM
• Indicative Personal Budget Calculated
• At this stage the person is informed about their
  personal budget
• and about any appeals process.
• Decide how best to communicate this information
• Agree processes for approving indicative personal
  budget allocations
• Decide appeals process
• Agree policies for exceptional and transitional
  allocations
• Adapt back office systems to support these
  functions

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• Breakdown of activities for TOM
• Support planning
• The traditional care assessment and management
  process will need to to be
• redesigned to enable self directed support.
  People can use any combination of
• resource (third sector, friends, family, social
  workers, care managers) to develop
• their support plan. The council will retain a
  role to risk assess and approve
• support plans.
• Decide maximum and minimum levels of assistance
  to be offered and by whom
• Design new support planning guidance/forms to
  offer genuine choice and stimulate creativity
  whilst managing risk
• Consider boundaries for what personal budgets can
  be spent on
• Define the role of social workers care managers
  and changes to role descriptions and team
  structure
• Develop training plan
• Adapt back office systems to support these
  functions

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• Breakdown of activities for TOM
• Authorisation validation
• The council will continue to retain a role in
  ensuring that support plans
• will meet the identified needs of individuals and
  that their legal responsibilities
• are met. To do this there needs to be an
  effective process to agree support plans.
• Agree a process for the authorisation of support
  plans
• Develop guidance for social workers to negotiate
  changes to support plans, in line with support
  planning guidance
• Agree an appeals process if people do not agree
  with social workers when determining the support
  plan

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• Breakdown of activities for TOM
• Go Live service implemented and commenced
• In a self-directed support system, citizens can
  choose to control their
• personal budget in a variety of ways. There will
  also be the need to ensure people
• have the assistance they need to secure the
  support specified in the support plan.
• You can find out more from this toolkits
  Managing the Money section and the
• Support Planning and Brokerage section.
• Agree how to maximise the resource deployment
  options - direct payment a representative, a
  legal trust, an independent support organisation
  or a provider manages the funds on their behalf
  services provided or procured by the council or
  a combination of these methods
• Agree the control mechanisms over each method
• Develop processes for supporting these different
  types of personal budget
• Design structure and standard content of contract
  between the person and the local authority
• Decide which aspects of organising support the
  council will support and which aspects it will
  rely on external providers for role of local
  authority under self-directed support
• Decide what parts of the cost of organising
  support appear within the personal budget
• Identify and consult with current or potential
  organising support providers
• Decide if the cost of organising support should
  be included in a personal budget
• Creation of resource directory
• Define the role of social workers care managers
  and changes to role descriptions and team
  structure

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• Breakdown of activities for TOM
• Monitor review
• Quality assurance and review will be different
  under self-directed support.
• This includes the development of outcome based
  reviews, ensuring support plans
• are being delivered and also responsibility for
  understanding how personal budgets
• have been spent. The relationship with monitoring
  suppliers quality will also be
• different if this support was commissioned by
  individuals.
• Develop a process to monitor outcomes and a basis
  for agreeing individually how often support plans
  will be reviewed
• Produce review forms/templates/guidance documents
• Develop risk management framework to help ensure
  that the level of scrutiny undertaken on how
  individuals spend their budget is appropriate to
  risk
• Decide on level of quality assurance for
  providers
• Define the role of social workers care managers
  and changes to role descriptions and team
  structure
• Develop training plan
• Adapt back office systems to support these
  functions

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• Breakdown of activities for TOM
• Commissioning
• Under a self-directed support system the council
  no longer has direct
• control over where a significant proportion of
  the adult social care budget
• is spent. The market will be responding to
  individuals choosing what services they
• receive as well as any contracts that the council
  chooses to put in place. The roles of
• strategic commissioning, contracting and contract
  monitoring will fundamentally change.
• Decide to what extent does the council still wish
  to be a commissioner
• Baseline existing commissioning activity
• Map market in area
• Consult with providers
• Decide what's in house what's commissioned
• Decide how you advertise
• Charging policy
• Impact of self funders
• Strategy for existing contracts
• Explore how and how much the council can
  influence the market and where it will get its
  intelligence about what people want to buy from

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• Breakdown of activities for TOM
• Back office services
• Allocating spend and procuring services on an
  individual basis will require
• fundamentally different back office processes and
  systems. This will include IT
• facilities as well as auditing, invoicing and
  payment processing. Assisting
• individuals in managing their finances, including
  through third sector providers will
• also require different processes. All these
  processes will need to be scalable i.e.
• some processes will work for small numbers of
  people but will be impractical for
• large numbers. In addition, different systems
  will be required to support both back
• office processes and delivery of care services..
• Decide back office processes for supporting
  different types of personal budget (e.g. direct
  payment, provider facilitated, nominal budget for
  procuring in-house services, combination)
• Refine and simplify direct payments processes
• Undertake analysis to better understand current
  spend, service user numbers and unit costs
• Adapt financial, care management back office
  systems to support these new functions
• Develop risk management framework to help ensure
  that the level of scrutiny undertaken on how
  individuals spend their budget is appropriate to
  risk

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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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• How do we define the success of
• self-directed support?
• Does our definition of the success of
  self-directed support need updating?

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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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• Getting started defining a pilot
• Who will be involved in the pilot?
• Client group?
• Transition / new clients / annual review / all?
• Other factor (e.g. locality / type of provision
  / team)?
• Size?
• How many clients will be involved in the pilot?
• Speed?
• How quickly will clients be brought into the
  pilot?
• What are the key issues for each of the elements
  of self-directed support when running a pilot?

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• Contents
• Introduction
• What is success?
• What changes?
• Success revisited
• Getting started
• Next steps

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• Next steps
• Report to DMT
• Move to Blueprint stage
• Communications