PERSONALISATION Challenges and opportunities for supported employment Personalisation Kathy Melling and Paul Wilson
Introduction • Our six themes for today: • What do we mean by personalisation? • The personalisation journey in UK • The challenges for service users, providers and commissioners of supported employment • How BASE has been responding to those challenges? • What we`ve learned - BASE`s current position • The key issues for Irish stakeholders in the context of New Directions
Personalisation means thinking about public services and social care in an entirely different way – starting with the person rather than the service. It will require transformation of the way we deliver public services. • Julie Jones, Chief Executive, SCIE
Personalisation • Where did the idea come from • Social work values • Government agenda of choice and control • Disabled people peoples’ movements
What is personalisation? • Begins with the person, not the service • Recognises a person’s strengths, preferences, networks or support, friendship etc. • The individual is best place to make decisions about their life • Access to information and advice • Irrespective of whether self-funded or publicly funded • About giving people choice and control over their lives • Making sure that individuals live life as they want
What personalisation is not • A completely new idea • Just about giving people individual budgets • Only for people eligible for Government funding or those needing traditional services only
What it does mean • Finding new collaborative ways of working and developing local partnerships, which produce a range of services for people to choose from and opportunities for social inclusion • Tailoring support to people’s individual needs • Recognising and supporting carers in their role, while enabling them to maintain a life beyond their caring responsibilities • Access to universal community services and resources – a total system response • Early intervention and prevention so that people are supported early on an in a way that’s right for them
Personalisation – 4 elements Community facilities and services that we all use, e.g. transport, leisure, health, education, housing and access to information and advice Support that’s available for people to stay independent for as long as possible People choosing who provides their support and what form that support takes, and controlling when and where those services are provided, rather than being expected to fit in with what’s already on offer People as participants in their communities, friendships and family relationships - individuals with lives and relationships
What’s it all about? The process by which state provided services can be adapted to suit you Personalisation Support that is determined and controlled by you, based on an assessment of need by the state. (Includes receiving cash, spending on services that meet your needs, to choosing which hospital you wish to attend) Self directed support Individual budgets Personal budgets Like an IB but solely made up of social care funding Direct payments An indicative amount of money that can combine several funding sources that you can use to purchase services, from the public, private or voluntary sector A cash payment paid directly to you so you can acquire your own services, rather than having them delivered by the council
Personalisation journey in the UK • Key themes: • Clear policy intent across Government, but intent is only benefitting some people • Concentration of activity has been on PBs and RAS methodology • Inadequate attention to other system changes • Inability to “braid” funding • Varied life and satisfaction outcomes across service-user groups • Employment often not considered during assessment • Impact of austerity measures
Personalisation journey in the UK • In Control • Think Local Act Personal (TLAP) • Department of Health – Direct Payments, Jobs First, personal health budgets • Office for Disability Issues – Right to Control • Liz Sayce review of specialist disability programmes • Department of Education – Special Educational Needs and Disability reforms • How personalisation is being interpreted locally
The challenges to providers & service users • Good supported employment is: • A genuine partnership • Independence, choice and control • The six stage process • Personal budgets mean: • No change for customers • Significant change for providers & commissioners
The challenges to providers & service users • The three challenges posed by the marketplace: • Pricing challenges • Marketing challenges • Delivery challenges
The challenges to providers & service users • Pricing Challenges • What do commissioners want to buy and how do they want to buy it? • The challenge of the hourly rate • ‘Working hard’ to find ‘the right job’ • The service user`s `end to end` journey • Predicting progress • Fire-fighting
The challenges to providers & service users • Marketing challenges • Selling directly to customers • Differentiation (M&S or Poundshop) • Price differentials • Selling more than job starts
The challenges to providers & service users • 3a. Delivery challenges • The context: • A professionalising sector • Inspection, QI, payment by results • The art of balancing risk, independence, learning & progression
The challenges to providers & service users • 3b. Delivery challenges • A retail model • Managing fluctuation in cases • Managing work flow & overcapacity • Economies of scale • The risks and rewards of an agency model
How BASE is responding to the agenda • Discussion workshops for members • BILD guide – Personalisation and Supported Employment • Mapping through member intelligence • Engagement with Think Local Act Personal (TLAP) • Right to Control in Stockport – My job, My choice • Work with SUSE • Support to members
The challenges for commissioners • The need to work proactively with commissioners • Capacity-building work with the Scottish Union of Supported Employment (SUSE) …..
The challenges for commissioners • The Commissioning Matrix developed for SUSE • The consultation and research suggest that the options for commissioners revolve around two central themes: • Control: the extent to which a local authority intends to manage the marketplace in which supported employment is traded; • Pricing: the way the market defines and prices the supported employment service which is traded in that marketplace.
The challenges for commissioners • The Control Axis • The control axis describes to what extent the commissioner intends to manage the marketplace. • At one end of this continuum is a free market. • At the other end of the continuum is the block contract • Somewhere near the middle is the Preferred Provider scheme.
The challenges for commissioners • The Pricing Axis • The pricing axis describes how a local authority defines what is being bought and sold. • At one end of the continuum is payment by occupancy. • At the other end of the continuum is payment by results. • Along the continuum are the degrees to which what is being purchased is defined by milestones.
The challenges for commissioners • The Key Questions Framework • 1. What presumption of employability do we hold for • service users? • 2. What are our strategic considerations? • 3. What is our approach to choice? • 4. How do we want to manage or influence • performance? • 5. How, if at all, do we want to influence quality?
Draft position statement on personalisation and personal budgets • Fully support the move to personalisation • Supported employment has always been a fully personalised model of employment support • Not simply about giving people a personal budget • Professionalisation of the sector is at risk in a wholly individualised retail model • Need a different approach to how it is applied to employment support • Either an up-front fee to get a job, and lower fee for on-going support – a one-off process or transaction that delivers longer term savings; or a strategic approach to commissioning the service. • There is a need for commissioners to understand what evidence-based best practice is to get those furthest away from the labour market jobs. • There is a need for disabled people to understand what good employment support looks like if they are using their personal budget to purchase employment support. • There is a need for an evidence-base of the genuine costs to deliver supported employment using personal budgets. • There will always be infra-structure costs as not all activities of supported employment can be attributed to one particular person using a service. There is a need for an evidence-base of the percentages of what that this will be.
Key issues for Irish stakeholders • Personal budgets do not guarantee personalisation • Personal budgets need to be powerful enough to achieve multi-service integration • Understand the barriers to achieving personalisation through New Directions • Collective purchasing & Value for Money issues • Supported employment infrastructure costs • Transition arrangements
Summary • Our six themes covered today: • What do we mean by personalisation? • The personalisation journey in UK • The challenges for service users, providers and commissioners of supported employment • How BASE has been responding to those challenges? • What we`ve learned - BASE`s current position • The key issues for Irish stakeholders in the context of New Directions
Personalisation & Supported Employment • Questions & discussion points