making it personal: a provider’s experience steve scown
TRANSCRIPT
Making it Personal: A provider’s experienceSteve Scown
Dimensions
Support adults, young people and children with learning disabilities and who experience autismSupport just over 2500 peopleWe offer support via RCH / GLS / SLS / Day Services / Short Breaks and employment training and preparation Work in 71 Local Authority areasEmploy approximately 3800 staffBudgeted turnover in 12/13 of £125m
“We must not let our past, no matter how glorious, to get in the way of our future”
Charles Handy
The Immediate Challenges
• Traditional services currently offer more secure income streams
• Traditional services are less and less in demand• Personalised services will be what people want to buy
and have funding for• Personalised services will have very small and fixed
margins
The Provider Conundrum
Managing yesterday’s services today whilst developing new ways of listening and responding
to tomorrow’s customer – and accepting less money for doing it.
The LA commissioned service
Paul lives in a home with 4 other peopleLocal Authority pays Dimensions £50k per annumHome has a team of 5 staff – there is 1 staff there all the time during the day and sleeps in at nightThere are 40 hours per week shared amongst the groupPaul wanted to go abroad for a holiday and a group of 8 people decided if that was OKPaul spends 2 days a week at the local learning disability day centre and the rest at leisure.
What Paul wants
Paul has an Individual Budget of £34k.
Paul pays Dimensions £22k a year for: Support in the mornings whilst his Mum is at work Support 2 days a week whilst he works in a garage keeping the
floor clean and the place generally tidy Support every 4th weekend whilst he goes away for short
breaks – either camping or on a city breakOne of his support workers is his cousin at his family’s insistence.Paul is offering a one-off £3k payment if Dimensions can find him a job which he can keep for 6 months.
“So basically you’re moving from wholesale to bespoke retail”
Market Dynamics
Now B2B B2C
Future B2B B2C
Public Sector Austerity
“It is not the strongest of the species that survive, nor the most intelligent, but the one that is most
responsive to change”
Charles Darwin
“We cannot solve our problems from the same level of thinking that created
them”Albert Einstein
The key questions we considered
How will you ensure Paul and his family/circle of support knows about you?
What do you want Paul and his family to think of you and your company?
What does brand mean to you?
“What people say about you when you leave the room”
Jeff Bezos - Amazon
In your groups please spend 5 minutes considering the following:
How can you find out what they really think about when you’ve left the room?
Who would meet Paul and his family/ circle of support?
In your groups please spend 5 minutes considering the following:
In your organisations which of your current roles would you send to meet Paul and his family?
How will you help Paul decide what he wants?
“One who cares, listens”
Paul Tillick
So how about the money?
Overhead activityABC/ Insurance Model/ Variable Input
PremiumsClient Group/ Postcode
SpecialsRefunds/ discounts / free offers
In your groups please spend 5 minutes considering the following:
What specific factors might you also need to consider when defining your cost model?
What will you offer Paul and his family/ circle of support?
One-off Offers
Something a family may purchase which may or may not lead on to further business
Facilitation of a PCP Support Design Behaviour Analysis
Review AT Assessment Holidays
Service Design Benefit Review H&S Environment
Review Housing Brokerage
Defined Term OffersSomething a family may buy for a fixed period of time with a pre-determined out-come• Life skills training• Community integration• Active support• Job skills training• Facilitation of PC Review
On-going OffersSomething a family would purchase without an end timeframe
Personal care & support
Sleep-in Live-in Support Short Breaks Training of PAs Quality Assurance
Waking night Housing related support Recruitment of PAs Management of team of
PAs On-call & out-of-hours
support
In your groups please spend 5 minutes considering the following:
How would your organisation’s menu differ from Dimensions?
How are you going to cost your offer?
What’s your overhead percentage?
Overhead activityABC/ Insurance Model/ Variable Input
PremiumsClient Group/ Postcode
SpecialsRefunds/ discounts / free offers
How will you help Paul recruit the right people?
What makes a good support worker good?
You Decide – We Employ
Bespoke - Person Specification- Job Description- Employment Contract- Rate of Pay
“I am always doing what I cannot do in order that I may learn
how to do it.”Pablo Picasso
So what about the people we’re already supporting in traditional services...
What did we hope to achieve from Anne Marie’s perspective?
What did we hope to achieve from the staff team’s perspective?
Individual allocationIdentify each person’s share of the funding we receive based upon their individual need
Core support and shared costsIdentify what support and costs are necessary as a result of the service being shared
In my personal controlIdentify ways of enabling each person to maximise their control over what resource they have once they’ve paid their share of the core support and shared costs
The current model
A 6 bed home with a budget of £300k
Each placement is charged at £50k per person
Occasionally extra costs on an individual basis can be negotiated
The ISF model (1)
A 6 bed home with a budget of £300,000
Person A: individual allocation of £50kPerson B: individual allocation of £42kPerson C: individual allocation of £45kPerson D: individual allocation of £53kPerson E: individual allocation of £65kPerson F: individual allocation of £45k
The ISF model (2)
From the budget of £300k
Core support costs are determined to be: £30k x 6
Shared costs are determined to be: £10k x 6
Total budget for core support and shared costs is £240k
The ISF model (3)
Leaving In My Personal Control money as:
Person A: £10,000 (£50k – £40k) Person B: £2,000 (£42k – £40k)Person C: £5,000 (£45k - £40k)Person D: £13k (£53k - £40k) Person E: £25k (£65k - £40k) Person F: £5K (£45k - £40k)
Choosing staff
What do you have to do to get dismissed in your organisation?
So what changed for Anne Marie?
• New people in her relationship map• Voluntary work• Unpaid support• New places• Reconnected with old friends• Busier and happier• Better relationship with estranged sister
Some thoughts about change
Preparing your organisation
• Ensure your leaders are all actively engaged and prepared for the change.
• Establish your criteria for success at the outset, based on what you want to achieve for the people you support and for your organisation.
Preparing your organisation
• Be realistic about what you’re aiming to achieve. Major change to working practices takes courage, determination - and time.
• Recognise and feel comfortable with accepting you will discover some things that must change. You’ll learn much more and achieve positive change more quickly by clarifying your expectations and engaging in honest and open dialogue and avoiding the ‘blame game’.
Preparing your organisation
• Develop your own views very early as to how you would allocate Individual Service Funds, what should constitute core services and what people can have under their own personal control.
• Develop your organisational response to dealing with a member of staff whom nobody wants to support them.
Preparing your staff
• Provide people with clear information about the principles of personalisation, individual budgets and Individual Service Funds at the outset.
• Everyone, including business support, but particularly every member of operations should be familiar with person-centred thinking tools and should work towards becoming ‘fluent’ in them.
Preparing your staff
• Help your staff understand they must have their own personal offer for the people they are supporting. If they haven’t got one, help them to develop one.
• Find anchor points that are real and use stories and journeys to connect people to change.
Managing through the tough times
• Use person-centred supervision on a regular basis. Having the feedback of people being supported as an explicit component of individual staff supervision and appraisal is very beneficial.
• Be prepared to provide higher levels of support, training, independent challenge and coaching than you think necessary.
Managing through the tough times
• Don’t under-estimate the impact of broader organisational change upon local services and their attempts to improve how they provide support.
• Accept it will never be right and just keep on going.
“If you want something different to happen, you have to do something different”
Sharon Di Santo