val event workshop 2

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1 Choice & Control Richard Wilson Project Manager, Personalisation Leicestershire County Council Adult Social Care Service

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Page 1: Val Event   Workshop 2

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Choice & Control

Richard WilsonProject Manager, Personalisation

Leicestershire County CouncilAdult Social Care Service

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Customer Journey

Advice & Information Provision

Prevention

Referral/Contact Assessment

(CSC)Re- ablement Assessment & Eligibility

RASSupport Planning Review

Outcomes MetOutcomes Met

Authorisation and Validation

Adult Safeguarding, Protection and Risk Management

CUSTOMER JOURNEYSupport Pathway

Brokerage

Advice & Information Provision

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Prevention & Early Intervention

• More problems will be solved before Adult Social Care needs to be involved

• For example: Information to help you get a grab rail installed before you fall, or services to help people stay healthy and independent

• ‘Nipping it in the bud’

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• More information and advice available in the community

• Easier to find out what services are available, and easier to access them

• Advice on how to stay healthy and active, and maintain independence

Advice & Information

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• Getting people back on their feet

• Supporting people to do things for themselves to maintain their independence

• Re-skill e.g. cooking, dressing

Re-ablement

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• RAS (Resource Allocation System) – A set of questions to work out the person’s needs

• Support plan – Lays out what the person wants to achieve with their life, and what support needs to be in place to do this

• Personal Budget – Money is allocated to the person to buy the support in their plan

Support Plan

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Live your life• Leicestershire County Council need

to authorise your plan

• Decide who will manage your Personal Budget – You, family, organisations, the Council etc.

• Advocacy and support – people who can help you

• Brokerage – help to find the best services for you

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• The move towards Personalisation of services and Self-Directed Support, although a positive step in improving choice and control for service users, does not replace, or reduce the local authority’s duty of care towards the people it serves.

• Currently, there is no evidence that the increasing number of service users choosing to have the support they need provided through SDS has led to a disproportionate increase in safeguarding referrals.

• What it can mean, particularly for people choosing to receive Direct Payments, is that there may not be the same safeguards in place of checking and monitoring mechanisms such as those in current contracting arrangements within local authorities. Therefore robust risk assessments need to be undertaken by assessing workers.

Safeguarding and Personalisation

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• Wherever possible service users and their carers, where appropriate, should be involved in identifying risks to themselves, and potential risk management strategies (see Independence, Choice and Risk: A guide to best practice in supported decision making ,DoH 2007).

• Workers should ensure that the service user is aware of 3rd party support available for Direct Payments, which can be an additional monitoring mechanism in identifying any risks.

• Service users should also be aware that often the Local Authority with pay for CRB checks on prospective employee where a service user wishes to use a PA.

Safeguarding and Personalisation

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Checklist for working with Personal Budgets

• What is the Mental Capacity of the person? Remember this has to be established in respect of each decision for which consent is required.

• Where the person lacks capacity, has a ‘suitable person’ been identified who has agreed to manage direct payments for the person

• Are there existing Safeguarding concerns?• Does the person wish to receive Direct Payments as part/all

of their Individual Budget?• Does the person wish to use direct payments to employ a

personal assistant? If so who do they wish to employ?

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• Is the proposed employee within the group of persons who may be employed under direct payments or does the close relative restriction apply?

• Are there known risks around the proposed employee?• Will the service user agree to CRB checks for employees?• Does the service users have any other monitoring

mechanisms around their support package, e.g. family, friends, college tutors?

• If there are any risks identified regarding the above issues, or in any other areas, the worker should discuss with their line manager before proceeding any further.

Checklist for working with Personal Budgets

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• What are your anxieties / opportunities?

• How can we ensure quality services and balance positive risk?

• What will need to change?

• What will we / you have to do to achieve those changes?

What does it mean for you?

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Brokerage

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What is Brokerage?

Dictionary definition:“an agent who functions as an intermediary between two or more parties in negotiation agreements, bargains, or the like”

The In Control definition of a support broker is:An individual who:

• Has the role of helping people plan and organise and support they need

• Does not have the job of rationing resources

• Does not have the job of providing services

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Where is Leicestershire?

• Co-event held on the 4th Feb `10

• Facilitated by iMPOWER

• Attended by service users

• Looked at different options and models

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Different levels of brokerageWould we need a different range of options to suit different service user needs?

SU broker

SU acts as own broker using

the web

Generic support broker

Specialist support broker

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Who could deliver brokerage?

PUBLIC SECTOR

PRIVATE SECTOR

3RD SECTOR

INDIVIDUALS

Front line staff Private sector commercial organisations

Centres For Independent Living

Service user

Commissioners Private sector – independent / Self employed

VCS organisations

Carers / Support network / Family

Arms length service delivery body

Social Enterprise

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Which models for Leicestershire?

PUBLIC SECTOR

PRIVATE SECTOR

3RD SECTOR

INDIVIDUALS

Front line staff Private sector commercial organisations

Centres For Independent Living

Service user

Commissioners Private sector – independent / Self employed

VCS organisations

Carers / Support network / Family

Arms length service delivery body

Social Enterprise

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Advantages and Disadvantages

Type of model Advantage Disadvantage

Provided by the council

• Able to use existing contractual arrangements

• Already have an existing relationship with service user

• Allows changes to he existing system to be made in a more controlled and cost effective manner

• Likely to be a subjective advisor

• May not be commercially aware

• Seen as an “old” way of working

• Support planning maybe less creative and innovative than external partners

• May be less able to negotiate “creative” or cost effective services

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Advantages and Disadvantages Type of model Advantage Disadvantage

Provided by the 3rd sector

• Uses community services in the local area

• May encourage innovation

• Likely to already have a good understanding of needs and possible solutions

• Influenced by own particular cause

• Services offered are likely to be for one user group only

• If offers services in the same market, likely to be a subjective advisor

• Brokerage market is currently under-developed

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• What do you think is the most appropriate model for delivering brokerage – who should deliver?

• How can we minimise conflict of interest and maximise the market?

• What resources do you have available to do this?

What does brokerage mean for you?

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We need your help!Aim • To build as detailed knowledge base; of Private

and Voluntary Providers• Including as much detail on services available as

possible

How you can help• Keep in contact• Think about different services you can offer• Send us details of your service including areas

covered, services offered etc.

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Contact details:• Richard Wilson

Service Manager - Market Shaping [email protected]

• Chhaya McDonald Engagement Officer – Personalisation [email protected]

• Claire Payne Team Support Officer

[email protected]

• Edd Tillen Communication Officer- Personalisation [email protected]