Putting People First

1
Putting People First
Carey Bamber Personalisation Programme
Manager carey.bamber_at_northwestjip.nhs.uk
2
JIPs are partnerships with multiple investment
sources and multiple lines of accountability.

• Dept of Communities and Local Government
• Department of Health
• Member Organisations/Networks
• Regionally developed and managed
• Linked to RIEPs

3
Putting People First 10 December 2007

• Concordat outlining national multi department,
  multi agency commitment to transformation of
  Adult Social Care
• person centred planning and self directed
  support to become mainstream and define
  individually tailored support packages Personal
  budgets for everyone eligible for publicly funded
  Adult social care support

4
How did we get here?

• Disabled peoples campaigns
• Direct Payments
• In Control
• Individual Budgets pilots
• Putting People First (TASC)
• Darzi Report
• Staying in Control
• Personal health Budgets pilots 2009
• Right to Control DWP 2009
• Children's Pilots 2009

5
Putting People First
Early intervention

• Information, advice
• and advocacy
• for all

Low level services
Volunteers
Self-assessment
Neighbours User Led Organisations

• Self-directed support

Personal budgets
6
Direct Payments

• Since 1997 -able to offer DP
• Cash in place of social care services for those
  meeting the Local Authority eligibility criteria
• Willing and able to manage (with support)
• Some exclusions relating to Mental Health Act
  status

• Since 2003 - duty to make DP
• Take up consistently low in mental health and OP
• Lots of research
• Lots of solutions Training, leadership, systems
  and processes, information for people, support to
  manage.

7
Direct Payments let people choose what works for
them

• Buying a mobile phone
• Driving lessons
• Joining a violin group
• Joining a fishing club
• Taxi to a mainstream drama group
• Renting a workshop (two people together)
• Hiring an art teacher (four people together)
• Employing someone to manage a small enterprise
  (six people together)
• Travelling to stay with relative for a break
• Employing a PA

8
Focusing on outcome rather than activity

• As a general principle, local councils should
  aim to leave choice in the hands of the
  individual by allowing people to address their
  own needs as they consider best, whilst
  satisfying themselves that the agreed outcomes
  are being achieved.
• Direct Payments Guidance Community Care,
  Services for Carers and Childrens Services
  (Direct Payments) Guidance England 2003
  Department of Health

9
Local Authority Circular Jan 2008, Jan 09
The direction is clear to make personalisation,
including a strategic shift towards early
intervention and prevention, the cornerstone of
public services LAC (DH)(2008) 1 Significant
Movesby 2011 National Indicator set - NI 130
10
What is self-directed support?
11
(No Transcript)
12
What are people buying?

• Changes depending on age, expectation, need etc
• Some traditional services
• PA support
• bike, dog, camera, art materials, car, hair
  extensions, reflexology
• Skills -driving lessons, art group, college
  course, tai chi, gym membership, job coaching /
  seeking
• Support -life coaching, managing bills and money,
  pooled money for group support, ironing, cleaning
• Respite - short breaks, holidays
• Assistive technology - telecare, home safety
• www.personalisation.org.uk for streamed stories
• Using a range of deployment options

13
Its different

• I also bought a kite, a bike and other clothing
  for outdoor activities. Im on my bike nearly
  every day.
• My paranoia and suspiciousness is considerably
  better. This is because I feel more confident
  which is mainly down to me being a lot fitter.
• My mental health has improved. I am doing much
  more.
• Without individual budgets I would have probably
  have just struggled on as I was doing last year.
• It has given me a kick start.
• I am feeling alive.

14
What did the evaluation say?

• Complexity in integrated services
• Whats Health and whats social care
• Significantly higher self reported quality of
  life for IB recipients than those in the control
  group.
• Mental health outcomes most significant

15
Risk and Audit

• Small number of people not at liberty to organise
  own care
• Get the timing right
• Fluctuating conditions
• Risk Enablement Approach developed by LAs
• Independence, Choice and Risk (DH 2006)
• Signing off Support Plans
• Range of options include agent, direct service,
  Trust, Individual Service Fund too
• Support through care manager, Support planners,
  brokers, user led organisations
• Light touch audit
• Monitoring through review
• Anecdotal evidence from sites

16
North West activity

• In Control total sites Lancs, Oldham Cumbria
• 16/23 LA NI 130, all aiming for 30 minimum
• Generally good progress overall
• Personal Health Budget provisional pilots
• Ashton Leigh and Wigan          Continuing
  Healthcare
• Blackburn with Darwen             CHC and mental
  health
• Cumbria                                 
  Continuing Healthcare, mental health and
  LTC            
• East Lancs tPCT                     Mental
  health
• Heywood, Middleton Rochdale  Learning Disability
• Merseyside                             Mental
  Health (joint project)
• West Cheshire                        LTC
• Manchester, Oldham and possibly Halton too.

17
What is the right to control?

• Regulations under this bill will empower disabled
  adults to take greater choice and control over
  support and services. This means being able to
• require authorities to tell them how much money
  is available
• require the authority to plan with them how best
  to use this money to meet their needs
• being able to choose the degree of control over
  the support they receive.
• The individual will be able to receive a direct
  payment, continue to allow the public authority
  to arrange their support, or use a mixed approach

The right to control recognises that disabled
adults are the experts in their own lives
18
Which funding streams will the right to control
cover?

• Access to Work
• Independent Living Funds
• Specialist disability employment programmes
• Other funding streams for inclusion will be
  determined through a national consultation
  exercise with disabled adults, providers and
  user-led organisations. They will be considering
• Funding for equipment and adaptations
• Funding that enables disabled adults to access
  education and training

Adult Social Care is excluded from the right to
control as legislation already exists to enable
direct payments. We will align the right to
control with Adult Social Care.
19
How will right to control be implemented?

• From 2010 the right to control will be piloted in
  a small number of trailblazing public authority
  areas
• We want to test both if the right to control
  should be implemented nationally, and also how
  this should be done
• We will be asking local authorities, Jobcentre
  Plus and other agencies to develop proposals
  together and in co-production with disabled
  people, setting out how they propose to implement
  the right to control
• Neither social care, nor any other service should
  be the sole gateway to choice and control
• The trailblazers will join up different services
  and funding streams to avoid the fragmentation of
  support too often experienced by disabled people

The trailblazers are expected to run for two
years. Funding will be made available to support
trailblazing areas.
20
Next steps

• If you are interested in applying to become a
  trailblazer or want further information on the
  right to control, please contact Caroline
  Throssel
• caroline.throssel_at_dwp.gsi.gov.uk
• 0207 4495091

21
Implications for Supported Employment schemes

• Local plans
• Right to Control trailblazers
• Unit costs
• Critical mass approaching
• Talk to local commissioners
• Menu of services
• Map the pathways develop new projects
• User led organisations / brokerage services
• Marketing your services
• Shop 4 Support?
• Stories

22
For more information..

• www.in-control.org.uk
• www.personalisation.org.uk
• www.supportplanning.org