LETS GET PERSONAL AND PRACTICAL: EFFECTIVE SELF-MANAGED CARE FOR - - PowerPoint PPT Presentation

LET’S GET PERSONAL AND PRACTICAL: EFFECTIVE SELF-MANAGED CARE FOR TODAY AND THE FUTURE

INTRODUCING

Tony Pilkington Managing Director Jamie Eaton Director

The ADASS report & Survey The Challenge Meaningful Information & Advice Prevention & Proactive Intervention Demand Management Ease, Fairness & Choice Empowerment, Control & Transparency Market Management & Supporting Providers What next?

TOPICS

ADASS / YOUNIFI REPORT

INTERVIEWED

Colin Angel Director of Policy and Campaigns, UK Home Care Association Alex Fox Chief Executive, Shared Lives Plus Tim Gollins Lead for Self-directed Support and Personal Budgets, Think Local Act Personal Richard Humphries Assistant Director of Policy, The King’s Fund Richard Pantlin Programme Manager for Engaging Citizens Online for Care for ADASS Denise Porter Head of Adult Social Care, South Gloucestershire Council Alison Rogan External Affairs Director, Tunstall Healthcare

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Focus groups/interviews On-line research Undertaken in February and March

171

Responses

Care and support profile Age profile

30% 38% 32% Currently receiving care and support Provide care and support to a friend / family member Do not receive care and support nor provide it to others 13% 16% 45% 21% 5% 18 - 25 years 26 - 40 years 41 - 60 years 61 - 80 years 80 + years

Barometer research slide

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Currently receiving funded care and support

Highest priorities

3. Reassurance that the care provided to me is safe 2. Choice over how my care and support works 1. To remain at home for as long as possible

Not receiving care and support but provide it to others

4. Freedom to spend money on care and support in ways and at times that make sense to me 3. Choice over how my care and support works 2. To remain at home for as long as possible 1. Reassurance that the care provided to me is safe

Not receiving care and support nor provide to others

3. Control over my daily life 2. To remain at home for as long as possible 1. Reassurance that the care provided to me is safe 4. Freedom to spend money on care and support in ways and at times that make sense to me

73.3% 76.7% 80.0% 73.3% 69.2% 77.5% 82.0% 69.2% 60.5% 65.1% 67.4%

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Information and advice

Straw poll

THE CHALLENGE

Increasing Demand Safeguarding Complex Processes Fragile Provider Market Changing Legislation Financial Pressures Accountable Care Traditional Technologies Statutory Obligation Stretched Staffing Growing Roles Integration Pressures

Prevention and proactive intervention Meaningful information & advice Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers

MEANINGFUL INFORMATION & ADVICE

“We need much stronger information and advice for people. This is not just about giving people a list of home care agencies and telling them to get on with

• it. The advice given should be as important as helping somebody investing in a

pension or buying a house.”

Richard Humphries, The Kings Fund

MEANINGFUL INFORMATION & ADVICE

Access to as much information and advice as possible Currently receiving funded care and support Not receiving care and support but provide it to others Not receiving care and support nor provide to others

48.2% 64.1% 41.9%

MEANINGFUL INFORMATION & ADVICE

Survey respondents saw good Information & Advice as being highly important, secondary only to having control of care funds

“I would want information and advice to support me to make the right decision about my care and support. I do want the freedom to spend money on the right care” “Need to know what is out there first and for people to understand what help I need” “most people don't understand the system until they are thrown in the middle of it” “have been awarded £50 per week but not able to talk to my social worker so I still have not used any of my allowance”

MEANINGFUL INFORMATION & ADVICE

Information & Advice, what do I need from it? § To be advised of what I don’t know § To inform me of my options and give me direction § To help me to help myself Need to be: § Personal § Meaningful to the enquiry being made § Tailorable to support and retrieve information § Clear and understandable Achieving: § Helping people make informed choices § Promotion of low cost alternative solutions to aid outcomes and cost control § Keeping people informed of things that may help them § Giving Council insight into where to best intervene and support Technologies: § That meet the expectations of citizens - built around the person for the person § Giving good information and advice enabling good decisions § That target resolution more than merely redirection § Proactive in information sharing

Prevention and proactive intervention Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers Meaningful information & advice

PREVENTION & PROACTIVE INTERVENTION

“We need a system that focuses on promoting independence and prevention rather than reacting to crisis.”

Richard Humphries, The Kings Fund

“Actually social work needs to be about professional intervention that helps people self-manage and service provision as a last

• resort. Money needs to be spent
• n prevention and intervention

rather than on fixing people.”

Tim Gollins, Think Local Act Personal

“Technology, such as Telecare, has helped achieve significant financial savings, increased the number of residents not requiring further services and reduced long-term residential placements.”

Ali Rogan, Tunstall Healthcare

PREVENTION & PROACTIVE INTERVENTION

To remain at home for as long as possible Currently receiving funded care and support Not receiving care and support but provide it to others Not receiving care and support nor provide to others

80.0% 77.5% 65.1%

PREVENTION & PROACTIVE INTERVENTION

“We would all hope to be able to do much of the organisation

• urselves; but I recognise that some of us won't be able to do so

when it matters. So flexibility of approach for different user groups seems critical to me”

Consumer Views

PREVENTION & PROACTIVE INTERVENTION

Need to have: § Rich information to highlight

• pportunities

§ Preventative and low cost offers to divert people to § Workforce that promote prevention & needs led intervention Need ability to : § Identify opportunities for proactive intervention § Understand persons preferences

• f Council role

§ Know intervention is wanted § Know prevention is appropriate Achieving: § Helping People stay out of the system § Helping people maximise lower cost means of meeting needs § Helping more people through lower cost means § Targeted resource and effort to where most effective Technologies: § To monitor behaviours and activity where it is wanted § That automate the identification of

• pportunity and trigger response

§ Proactively share new preventative offers

Prevention and proactive intervention Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers Meaningful information & advice

DEMAND MANAGEMENT

“More and more people are finding themselves self-funding their own care. Over half of care home income comes from private individuals

• themselves. The system has not kept pace with

that.”

Richard Humphries, The Kings Fund

“Actually social work needs to be about professional intervention that helps people self- manage and service provision as a last resort. Money needs to be spent on prevention and intervention rather than on fixing people.”

Tim Gollins, Think Local Act Personal

DEMAND MANAGEMENT

Need ability to see and plan for future demand: § Where is it coming from? § How do we change its trajectory/ § What services do we need? § Demand on what funds? Need to have: § Rich information gathered from that emerging demand § Ability to quantify where best to put our resources and skills § Workforce that promote self help and help people help themselves Achieving: § Helping People stay out of the system § Helping people maximise lower cost means of meeting needs § Helping more people through lower cost means § BI to inform planning § Targeted resource and effort to where most effective Technologies: § Meeting todays expectations § Built around the person § That target resolution more than merely redirection § Promoting of preferred options § Providing insight at the person level

Prevention and proactive intervention Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers Meaningful information & advice

EASE, FAIRNESS & CHOICE

“At the moment if someone is eligible for public money they tend to get pushed into council managed services and a very restrictive offer. Someone who has their own money is not so restricted but we don’t tell them what’s available. We need to change both of these things we need to provide people who get state funding they need to have more choice and we need to inform people who pay for services themselves about the range of services available.”

Tim Gollins, Think Local Act Personal

“The system is going to need to make direct payments much more accessible and easier to navigate so that those people who are in most need are able to manage it in a way that gives them the least hassle.”

Denise Porter, South Gloucester Council

“What we need, and many people are content with the idea but not the delivery, is to allow people to use their personal budgets much more flexibly.”

Colin Angel, UK Homecare Association

EASE, FAIRNESS & CHOICE

• 1. Freedom to spend money on care and support in ways and at times that make sense to me &
• 2. Choice over how my care and support works

Currently receiving funded care and support Not receiving care and support but provide it to others Not receiving care and support nor provide to others

73.3%1 80.0%2 69.2%1 69.2%2 41.7%1 48.4%2

EASE, FAIRNESS & CHOICE

“Council's should listen to what service users want to do e.g. health & well being by going to the gym and swimming. I do not require a babysitter or child minder”

Consumer Views

“I look after my grandmother who receives care, I find it a struggle to keep the paperwork in hand and on top of all the day to day chores that are not covered as part of the package” “If it gets to a point where my care is consistent, then I'd rather the council pay for it on an on-going basis. I don't want the hassle”

EASE, FAIRNESS & CHOICE

Need: § Clear options explaining § To share experiences § To be consistent § Need to be clear § Need to not be prohibitive § To let consumers shape the market too Need to have: § Rich information that helps people make their own choices § Flexibility to meet needs as they wish including through self developed services § Evidence the meeting of those needs § Ability to seek assistance when needed Achieving: § A solution as an enabler to all § One experience irrespective of funding but with management options § Citizen empowerment § Consumer driven market forces § Evidence based development of Community Assets Technologies: § That are inclusive of many ways of meeting needs § Easy management of care and support § Giving the person autonomy and the Council and providers their necessary controls § Giving opportunities to collaborate

Prevention and proactive intervention Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers Meaningful information & advice

EMPOWERMENT & EASY CONTROL

”ISFs are a way for individuals to use a direct payment without having the hassle of managing the money. I think that is one of the reasons why direct payments haven’t always taken off as well as they might. Either the council will arrange care for you or you can have the money, but then you are on your own.”

Colin Angel, UK Homecare Association

“The model needs to be based on

• utcomes. We shouldn’t

prescribe the activity or the service, rather it should be based

• n achieving the outcomes that

have been agreed with the individual.”

Richard Humphries, The King’s Fund

“There is not enough support for people to come together and shape the care system that suits their needs”.

Alex Fox, Shared Lives Plus

EMPOWERMENT & EASY CONTROL

Council Managed Direct Payment in a nominated bank account Payment to pre-paid card or other similar A combination of any of the above,

23.3% 63.3% 3.3% 10%

Flexibility Receiving Care Managing care for others

17.5% 27.5% 15% 40%

Multiple options and multiple combinations required

EMPOWERMENT & EASY CONTROL

Consumer Views

“Because I am self funding I have had little advice or support from SS they just told me to get on with it” “We would all hope to be able to do much of the organisation

• urselves; but I recognise that some of us won't be able to do

so when it matters. So flexibility of approach for different user groups seems critical to me” “It is often very difficult to arrange one's own care providers - my council does not offer to do that for me. It is not easy to get the right care at the right time of day. Paying carer invoices is difficult if you are not mobile and don't have or use the internet” “I'd want to retain as much control and independence as possible” “We can not choose when to spend, budgets although supposed to be for service users to choose care and support in reality is still very much controlled by local authorities and social services, therefore not much room for out the box support or saving hours for extra support i.e. to cover extra needs i.e. holiday, long respite care”

EMPOWERMENT & EASY CONTROL

Need: § Ability to see what is happening across a persons care § Transparency of spend and expected costs § Flexibility § Choice Need to have: § A mechanism by which to access non-council contracted services § A means of people negotiating care with providers § A way of simple approval and payments of services received § An audit of spend that meets all parties needs Achieving: § Visibility of availability of services § A single view of a persons services and support § Visibility of cost changes § Collaboration around service optimisation § Transparency of costs accruing, due and paid Technologies: § Flexibility to allow council, person or jointly managed support § A collaborative environment for holistic managed support § Ownership and control in the hands of the person § Transparency of accounting for person, Council, providers

Prevention and proactive intervention Demand management Ease, fairness and choice Empowerment, control and transparency Market management & supporting providers Meaningful information & advice

MARKET MANAGEMENT & SUPPORTING PROVIDERS

“We need a rebalancing of responsibilities. What we need to create is a better, more individual relationship with the service provider and the customer and councils are the mediator of that relationship.”

Tim Gollins, Think Local Act Personal

“There will need to be more reliant informal networks of care in the community. Partly because the funding won’t be there but because it will help alleviate the problems with isolation that so many

• lder people with care needs suffer”.

Richard Pantlin, ADASS

MARKET MANAGEMENT & SUPPORTING PROVIDERS

Consumer Views

“I have just put my mother in law in a home - 95 with dementia, I had so much trouble finding one that suited her. Very, very to hard”

MARKET MANAGEMENT & SUPPORTING PROVIDERS

Need: § An agile market § The right services § The right capacity of services § Market resilience § Viable providers § Less dependency on council managed care Need to have: § Lower barriers to market entry § Easy trading environment § Lower costs for providers § Visibility of the demand for their services § Community based low/zero cost alternatives § Support around compliance and managements Achieving: § Visibility of capacity § Deficit analysis to inform strategic commissioning § Auditability § Micro provider opportunities § Lower operating costs for providers Technologies: § Streamlined administration to support cashflow § Simplified business tools § Flexibility to support outcomes over service schedules § A single platform for all sectors of the market to promote their services and support § Flexibility to deliver ‘out of the box’ services that better meet the requirements of the individuals § A shift from provider driven to consumer driven

WHAT NEXT?

People

Managing and in Control

Increase autonomy Support for people with needs Targeted intervention Support for carers Informed choice Support to providers Enabling technologies Support for communities Financial transparency Alternative market offers Safety Market diversity & Capacity Prevention

Council enables, facilitates and responds

Providers

To be personal and practical