Adult Placement and Personalisation Donald Macleod

1. Adult Placement and PersonalisationDonald Macleod

2. Path of innovations Established 1919 1926 organisation now known as Age Concern 1936 Marriage Guidance 1938 Citizens Advice Bureau 1948 Legal Aid 1978 Adult Placement 2000 PSS Scotland 2003 Alzheimer�s caf� 2007 NHS Health Trainers PSS was established as a charity in 1919, to address the social needs affecting Liverpool in the slump that followed the First World War. PSS recently celebrated 30 years of providing Adult Placement and it�s 90th Birthday. PSS is a dynamic social enterprise providing community social and health care services across England, Central Scotland and�North Wales.Our 174 services enable people of all ages and needs to live independent and healthy lives and are delivered at neighbourhood level using innovative models and practice. Roots in the community. PSS was established as a charity in 1919, to address the social needs affecting Liverpool in the slump that followed the First World War. PSS recently celebrated 30 years of providing Adult Placement and it�s 90th Birthday. PSS is a dynamic social enterprise providing community social and health care services across England, Central Scotland and�North Wales.

3. PSS Adult Placement Process: Carers/Service Users Diversity & flexibility Geographical spread Process Carers � assessment, pre-approval training, home safety checks, approval by an independent panel, post approval training, ongoing monitoring. Service users � Needs assessment, support planning, matching process Diversity � Diverse user groups and flexibility of the model Geographical spread � Scotland, Merseyside, North West England, Wales, Staffordshire.Process Carers � assessment, pre-approval training, home safety checks, approval by an independent panel, post approval training, ongoing monitoring. Service users � Needs assessment, support planning, matching process Diversity � Diverse user groups and flexibility of the model Geographical spread � Scotland, Merseyside, North West England, Wales, Staffordshire.

4. Changing Lives report sets out the personalisation of social services as a key theme for modernisation. Quotation � Personalisation, A Shared Understanding, Changing Lives Service Development Group, The Scottish Government, Edinburgh 2009. Changing Lives report sets out the personalisation of social services as a key theme for modernisation. Quotation � Personalisation, A Shared Understanding, Changing Lives Service Development Group, The Scottish Government, Edinburgh 2009.

5. Personalisation Definition Care Standards - dignity, privacy, choice, safety, realising potential, equality and diversity Personalisation means that people become more involved in how services are designed and they receive support that is most suited to them. This can range from engaging with a community resource, which could mean that referral to a social work department isn�t necessary, right through to provision of an intensive support package. Personalisation is about prevention, maintenance or intensive support � whatever is needed. Care Standards - dignity, privacy, choice, safety, realising potential, equality and diversity. Personalisation means that people become more involved in how services are designed and they receive support that is most suited to them. This can range from engaging with a community resource, which could mean that referral to a social work department isn�t necessary, right through to provision of an intensive support package. Personalisation is about prevention, maintenance or intensive support � whatever is needed. Care Standards - dignity, privacy, choice, safety, realising potential, equality and diversity.

6. How is it achieved? Assessment tools and information Finance Workforce Economy Quality How is it achieved? Assessment tools and information about the services available and how to access them. Finance � RAS, SAQs and provider systems which can accommodate individual financial statements/individual budgets. Current resource allocation doesn�t tell people what funds they have available. Glasgow CC has developed one which does. Workforce � self employed carers support people in every aspect of community life as part of their lives. They provide advocacy, risk assessment, brokerage. Support to unpaid carers maintains informal support and prevents greater dependency. Economy � by increasing the range of options. Adult Placement�s flexibility can meet the demands of several models of provision. Quality provision � through involvement and feedback How is it achieved? Assessment tools and information about the services available and how to access them. Finance � RAS, SAQs and provider systems which can accommodate individual financial statements/individual budgets. Current resource allocation doesn�t tell people what funds they have available. Glasgow CC has developed one which does. Workforce � self employed carers support people in every aspect of community life as part of their lives. They provide advocacy, risk assessment, brokerage. Support to unpaid carers maintains informal support and prevents greater dependency. Economy � by increasing the range of options. Adult Placement�s flexibility can meet the demands of several models of provision. Quality provision � through involvement and feedback

7. The provider�s role Considerations for providers: how to personalise existing services what is its organisational mission and role what is its future organisational size, shape and culture how will it recruit, retain train and manage a workforce how will it communicate with the public and potential service users how will it account for individual budgets, income and expenditure how will it continue to meet the requirements of regulators Role of providers Front-line practitioners play a crucial role in actively engaging with individuals, carers and others to develop the right sort of support at the right time.Role of providers Front-line practitioners play a crucial role in actively engaging with individuals, carers and others to develop the right sort of support at the right time.

8. Personalised service specifications Service Specifications The principles of personalisation need to be translated into elements within service specifications and would include: meeting expectations, offering choice, providing flexibility and innovation, promoting independent living and improving care standards.Service Specifications The principles of personalisation need to be translated into elements within service specifications and would include: meeting expectations, offering choice, providing flexibility and innovation, promoting independent living and improving care standards.

9. Role of commissioners Stakeholder involvement Strategic planning Financial planning Partnership Procurement vs Self Directed Support Role of Commissioners Involving Service Users and Carers Strategic Planning: establishing a commissioning for personalisation approach, allowing for cultural and organisational implications Financial Planning, Individual Budgets and Resource Distribution Market Management and Partnership with Providers: working with others effectively to develop the social care market. The implications for change will depend to some extent on how far people decide to commission their own services, use brokers, support agencies or other third parties or to use services provided or purchased by local authorities. Procurement and Contracting vs self assessment and self directed supportRole of Commissioners Involving Service Users and Carers Strategic Planning: establishing a commissioning for personalisation approach, allowing for cultural and organisational implications Financial Planning, Individual Budgets and Resource Distribution Market Management and Partnership with Providers: working with others effectively to develop the social care market. The implications for change will depend to some extent on how far people decide to commission their own services, use brokers, support agencies or other third parties or to use services provided or purchased by local authorities. Procurement and Contracting vs self assessment and self directed support

10. Benefits Empowerment Strong communities Removal of barriers Flexibility, choice and control Confidence and wellbeing Benefits empowering people and putting the principles of independent living into practice and enabling people to be active citizens in their communities; creating a healthier nation with stronger and safer communities, which is key to achieving a fairer and wealthier Scotland reducing or removing the physical, organisational or attitudinal barriers that people may experience in the world around them; providing flexibility, choice and control and a decent quality of life promoting confidence and wellbeing for those with an assessed need.Benefits empowering people and putting the principles of independent living into practice and enabling people to be active citizens in their communities; creating a healthier nation with stronger and safer communities, which is key to achieving a fairer and wealthier Scotland reducing or removing the physical, organisational or attitudinal barriers that people may experience in the world around them; providing flexibility, choice and control and a decent quality of life promoting confidence and wellbeing for those with an assessed need.

11. Key stages Information Individual support Self assessment Individual budgets Support planning Choice and control Key stages Good Information � to people who currently or may use services Individual Support � through advocacy, brokerage, assessors and care managers Self-assessment � of needs and desired outcomes (with help as necessary) Individual Budgets � indicative allocation of Individual Budgets Support Planning - people developing their own support plans (with help as necessary), the funding agency checking and agreeing support plans Support Choice and Control - people having choice and control over what services they receive (within their individual budget), who should provide them, when and how they should be delivered. People having the right to choose between options � direct provision by local authorities; provision by a specified voluntary or private provider (service purchased by the Council); purchasing by a third party (relative, broker, support agency) chosen by the service user; purchasing through direct payments; provision through a mixture of options; people reviewing their own needs, services and outcomes and revising their own support plans (with help as necessary) and taking account of managing risk.Key stages Good Information � to people who currently or may use services Individual Support � through advocacy, brokerage, assessors and care managers Self-assessment � of needs and desired outcomes (with help as necessary) Individual Budgets � indicative allocation of Individual Budgets Support Planning - people developing their own support plans (with help as necessary), the funding agency checking and agreeing support plans Support Choice and Control - people having choice and control over what services they receive (within their individual budget), who should provide them, when and how they should be delivered. People having the right to choose between options � direct provision by local authorities; provision by a specified voluntary or private provider (service purchased by the Council); purchasing by a third party (relative, broker, support agency) chosen by the service user; purchasing through direct payments; provision through a mixture of options; people reviewing their own needs, services and outcomes and revising their own support plans (with help as necessary) and taking account of managing risk.

12. Pilot sites Highlands Dumfries and Galloway Glasgow Glasgow Self Assessment Questionnaire measures disability/illness against social care resources, using a points system. Resource Allocation System will result in an allocation of funds which will top up and sustain the natural support already in place. The means by which this will be used will be identified through a support plan. Restrictions: no gambling, investment or illegal activities. Bridging finance Cutting red tape Leadership and trainingGlasgow Self Assessment Questionnaire measures disability/illness against social care resources, using a points system. Resource Allocation System will result in an allocation of funds which will top up and sustain the natural support already in place. The means by which this will be used will be identified through a support plan. Restrictions: no gambling, investment or illegal activities. Bridging finance Cutting red tape Leadership and training

13. What can providers offer? Brokerage Financial services Management Back office function services Training PCP/support planning Information services What can providers offer? Brokerage, financial services, management, back office functions, training, PCP, information. Individual Budgets PSS is currently piloting a scheme which it can offer to those wishing to move towards a full individual budget. The pilot recognises the need for the individual to be in control of how their funding is spent to provide care and support for their needs. Whilst recognising this, PSS also understands that managing finances can be difficult and we can offer the support needed to put together an individual budget and monitor spending. Our simple budget plan consists of �This is my individual budget� and will list the funding the individual receives and importantly whether the funding will be paid as direct payments or paid to the individual. Alongside this is �This is how I will spend my individual budgets�, which will list the areas of spending under the four broad headings of Housing, Support Work, Learning and Living and Leisure. It is indicated alongside the individual items of spending whether they are paid by direct funding or by the individual. What can providers offer? Brokerage, financial services, management, back office functions, training, PCP, information. Individual Budgets PSS is currently piloting a scheme which it can offer to those wishing to move towards a full individual budget. The pilot recognises the need for the individual to be in control of how their funding is spent to provide care and support for their needs. Whilst recognising this, PSS also understands that managing finances can be difficult and we can offer the support needed to put together an individual budget and monitor spending. Our simple budget plan consists of �This is my individual budget� and will list the funding the individual receives and importantly whether the funding will be paid as direct payments or paid to the individual. Alongside this is �This is how I will spend my individual budgets�, which will list the areas of spending under the four broad headings of Housing, Support Work, Learning and Living and Leisure. It is indicated alongside the individual items of spending whether they are paid by direct funding or by the individual.

14. What can Adult Placement/Shared Lives offer Short breaks Supported holidays Flexible day support Intermediate care Transition Diverse user groups What can Adult Placement/ Shared Lives offer? Short breaks Supported holidays Flexible day support Intermediate care Transition Diverse user groups: learning disability, older people, mental wellbeing, offenders, dementia, homelessness, addiction, mothers and children, couples. In the case of offenders, even though the delivery of a community penalty is a compulsory state intervention, that�s not to say we shouldn�t try and get as much out of this as we can, for the individual and the wider community. So, for example, tailoring the approach taken and offering the intervention most likely to prevent the individual from offending in the future; recognising and working with offenders on addressing some of the wider needs that some may have to make it more likely they will move on; involving the community in consideration of work that could be carried out as a part of community service would contribute to a more preventative, personalised approach. Swedish model In Sweden, offenders can spend half of their sentence in an Adult Placement. This was established in the 70s, as part of a major reform of the penal system. Prisoners are resettled into new communities, with new networks of support and employment.What can Adult Placement/ Shared Lives offer? Short breaks Supported holidays Flexible day support Intermediate care Transition Diverse user groups: learning disability, older people, mental wellbeing, offenders, dementia, homelessness, addiction, mothers and children, couples. In the case of offenders, even though the delivery of a community penalty is a compulsory state intervention, that�s not to say we shouldn�t try and get as much out of this as we can, for the individual and the wider community. So, for example, tailoring the approach taken and offering the intervention most likely to prevent the individual from offending in the future; recognising and working with offenders on addressing some of the wider needs that some may have to make it more likely they will move on; involving the community in consideration of work that could be carried out as a part of community service would contribute to a more preventative, personalised approach. Swedish model In Sweden, offenders can spend half of their sentence in an Adult Placement. This was established in the 70s, as part of a major reform of the penal system. Prisoners are resettled into new communities, with new networks of support and employment.