Personalisation in practice
This major one day event took place on 25 November 2009 at the Westminster Thistle Hotel in London. The event aimed to promote the personalisation agenda in the housing, support and care sector and considered:
- Personalisation in practice
Morning plenary: Personalisation in housing, support and care - what’s happening now?
The morning plenary session, was chaired by David Wolverson, Chief Executive of Dimensions UK.
The speakers were:
Geoffrey Ferres, Head of Policy and Public Affairs, Sitra - Download presentation (pdf)
Lorraine Regan, Head of Northern Regional Resource Team, CLG - Download presentation (pdf)
Martin Cattermole, National Programme Manager, Personalisation, DH -
Download slides 1 to 5 of presentation (pdf)
Download slides 6 to 7 of presentation (pdf)
Amanda Johnson, Head of Supporting People, Royal Borough of Kensington & Chelsea – Download presentation (pdf)
Planning for the future: Roundtable discussions
This roundtable discussion provided an opportunity for participants to explore issues around brokerage, risk and safeguarding and quality assurance.
Chair: Jenny Pitts, Regional Facilitator, In Control
Summary of rountable discussions (pdf)
Workshops
Workshop 1: Making personalisation work in accommodation based services
Workshop 2: Making personalisation work with the most vulnerable
Workshop 3: Making personalisation work with socially excluded groups: outreach services
Workshop 4: The Importance of training within Personal Budgets
Workshop 1: Making personalisation work in accommodation based services
The experience of a personalisation trial at Look Ahead’s Coventry Road mental health service.
Speaker: Irmani Darlington, Head of New Business, Look Ahead, and Jean Gibb, Contract Manager, Service User, Coventry Road Mental Health Service - Download presentation (pdf)
Summary
Look Ahead’s Coventry Road personalisation trial provided a solid focus for considering the reality of personalisation in practice. The mental health scheme provides a home for 20 tenants, many of whom are assessed as being high risk either to themselves or the community, or both. It has been running for some time and has achieved a QAF ‘A’ score for years.
The tenants, or customers, when asked before the pilot began, didn’t feel they had enough control of their day to day lives; they wanted more flexible support, they valued companionship, and they wanted to do more ‘normal’ things. In contrast, staff at the scheme felt that customers did have control and feared that if they were offered more flexibility they might choose the ‘wrong’ things. These conflicting responses were a shock to the Look Ahead managers.
The pilot started with a full consultation with customers and staff, introduced a change programme from week one and then moved into the new model. Person centred planning focused on ‘live planning’ events which led to individual personalised plans; these asked and answered questions such as how I want my life to change, and how I am going to use my personalisation fund to make those changes.
Each customer received 3.5 hours of one to one flexible support from the scheme staff plus £40 per week to spend on support. This left the organisation with two thirds of the contract value to manage the core service provision; an amount they had calculated was the minimum necessary to offer a viable service.
The result on customer’s lives has been significant and has led to surprisingly different purchases as reflected in the different personalities and life experience of the customers. An unexpected and disappointing result has been the limited take up of the flexible support. At the beginning of the pilot in March 2009 customers scored the control they perceived they had in their lives as an average of 2.5 out of 5, with 1 being not in control and 5 being totally in control. That score has now risen to 3.5 with the majority now saying they do have control in their lives. The pilot has thus been considered a success.
Challenges have included the cultural changes needed from staff, practical systems for handling cash, administrative and financial systems, and the difficult to quantify internal transaction costs.
Questions from conference participants focused on: the operation of the steering group and their ability / flexibility to allocate funds for non-SP tasks (Answer: mostly flexible, some lengthy debates, sometimes said no); the decision to pay cash to customers and not transfer into bank accounts (Answer: wanted to discuss and debate use of money with customers); the flexibility of support hours (Answer: only to be used within scheme at present); and evidence of hard outcomes (Answer: not yet quantified but evaluation report due out after March 2010).
Workshop 2: Making personalisation work with the most vulnerable
Exploring the skills required to make personalisation work and the lessons learnt from pilot for older people’s services.
Neil Tryner, Head of Business Development, Midland Heart - Download presentation (pdf)
Summary
Midland Heart is a large association with 32,000 properties, 11,000 of which involve care and support. The properties are spread from Stoke to Hereford, and from Wales to Lincoln.
Midland Heart began its discussions about personalisation two years ago. From the outset, the organisation adopted a positive and pragmatic approach to personalisation; but also kept in mind the possible challenges.
Midland Heart have three individual budget currently taking place. These will be evaluated by In Control. These pilots are based in Northampton, Coventry and Hereford.
Northampton
In Northampton Midland Heart received an extra £20,000 from Northamptonshire Supporting People on top of their £70,000 block gross Supporting People contract. This £20,000 has been allocated to the 10 mental health service users who wanted to take part in the personalisation pilot.
Some of these service users have chosen to spend their money on:
- Download presentation (pdf)
The challenge for Midland Heart will be when the extra £20,000 ends. At present, they aim to operate with less than the current contract sum (of £70,000) to counteract this.
Coventry
In Coventry the pilot takes place at an extra care site. The site has 48 beds and is funded by health care services, social services and Supporting People. The pilot targeted 10 of the 48 people.
The extra care services had been divided between “core” and “fluff”. The core services include the cost of round-the-clock cover and represent about 70 percent of the funding.
Service users chose to spend their money on:
- Download presentation (pdf)
Midland Heart Personalisation work
In addition to the pilots, Midland Heart have been working with Box of Frogs to deliver a project, focused around delivering services in the future. This participatory research project found for example that:
- Download presentation (pdf)
To cement their work on personalisation, Midland Heart have implemented a new, internal quality framework. However, Neil pointed out that they still need to resolve Code of Conduct issues regarding professional boundaries between staff and services users.
Midland Heart are currently discussing what to do when the pilots finish and what their approach should be for 2010-2011. It is possible they will undertake a pilot in relation to homeless people with Birmingham City Council.
Questions and comments from participants focused on: discussing the feedback from older people presented in the IBSEN report. The delegate highlighted that a follow-up study to this report demonstrated some of the biggest benefits of individual budgets were reaped by older people; whether Midland Heart’s income was likely to reduce as a result of offering personalised services (Answer: no); staff retention in light of service user desire to see staff continuity (Answer: as yet there are no changes to staff terms and conditions: Midland Heart personalisation projects are still in a pilot stage and are fully aware of maintaining a stable and good quality workforce); Resource Allocation System (Answer: Midland Heart does not have a RAS of its own).
Workshop 3: Making personalisation work with socially excluded groups: outreach services
How can partnerships promote personalisation? A rough sleepers’ personalisation pilot, and how other outreach services can be personalised.
Fran Rodgers, Head of Housing Needs and Support, Northampton Borough Council and Carole Jones, Service Director, Council on Addiction Northampton - Download presentation (pdf)
Summary
Northampton is the largest Borough/District Council in England (Population 200,000+). Rough Sleeping Counts are regular and find between two and five (although 11 at last count including five migrants). Northampton is Rough Sleeping Champion and pilot. The key partners are CAN, NCC-Adult Social Care, Supporting People.
Priorities for the pilot are Prevention, Choice, Independence, that it is a close fit with “Putting people first” agenda and “the way people are supported should make sense to them and suit their own lifestyle”.
There are certain critical factors which include that people should know how much they had, that they are able to spend the money in ways that make sense to them and that clients know what outcomes are to be achieved. Seven steps are applied:
- Download presentation (pdf)
Anything goes as long as it is legal, safe and meets action plan priorities.CAN work with individual rough sleepers. NBC do joint gateway assessments with CAN and budget approvals. NCC Adult care do the administration of the scheme and supporting people match fund the CLG funding.
There are three levels of payment:
- Download presentation (pdf)
The project devolves decision making, has complex proposals and high costs agreed jointly by all partners, is transparent and as users are involved in the process they can challenge decisions.
Case studies
Vince is 58 and has been rough sleeping for three years. He has started to engage with the support provided by CAN. He has paid for a haircut, new clothes, shopping for food and books. He is considering making links with estranged family. He did not want to go to a hostel so is now living bed and breakfast accommodation.
Brian has been rough sleeping for 20 years and has been difficult to engage. CAN plan to engage him by meeting him at a café he regularly attend and buying him a meal.
Success will be measured by customer and stakeholder consultation and feedback, personalisation in action and by asking if the life chances of the customer have improved. Personalisation here means tailoring support to people’s individual needs enabling them to live full independent lives.
Where was Vince’s voice? Vince was clear that he did not want to go to a hostel. He was given options and started with meeting his basic needs. Personal budgets gave people more options in toolkit.
The feedback the have had so far includes:
“Small changes make a big difference”
“Being in control”
“What is right for me”
A more successful approach than zero tolerance and moving rough sleepers on!
Workshop 4: The Importance of training within Personal Budgets
An example of how we can meet the needs of users and how learning disability services can be more personalised in the future.
Chris Jordan, Managing Director, Spokes CIC - Download presentation (pdf)
Chris spoke about his experiences as a father of a son with moderate leaning difficulties and the types of achievements he has made including cycling from Lands End to John O’Groats raising £12,000 for Chris’s Foundation and climbed mount Kenya to raise £16,000 for Mencap. He contrasted this with the nature of Alex’s autism where whilst he is very able he has a way of doing things that sometimes create difficulties for him. Chris talked about the Personal Budget Alex receives from Worcester CC and how it has helped him towards more independence. Chris then focused on the need to include training within Personal Budgets which is not happening in many cases often because ASC are saying it’s not an eligible activity for their money. However it’s vital if people are to access training and then employment.
Chris then talked about the community interest company he and a colleague set up in <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />Kidderminster called Spokes which trains people with learning disabilities. One of the main problems for people with learning disabilities is the kind of work they can get is often very seasonal, for example, working in garden centres and being laid off little to do in the winter.
Spokes repairs and rebuilds dilapidated bicycles. The rebuilt cycles are sold but they also offer a repairs service for a number of clients including the police. Staff are paid but on minimum wages and funding is always tight for them although they aim to earn at least 50 percent of their income. They try to work with local colleges but it is sometimes difficult as the funding for the individuals will sometimes keep them inappropriately in college for years when it would be better if they took up training and employment opportunities with organisations like Spokes. Personal Budgets are important for social enterprises if they allow individuals to spend their money on training therefore Chris’ plea that Personal Budgets contain a training element. Chris felt that PBs were the best way forward giving the taxpayer a better deal as well as helping the individuals in receipt of them.
Questions and answers
Q: Do you have links with employers?
A: Tried to by its difficult. Most LD people are taken on with Remploy who will not get involved with us.
A discussion then took place about challenging Remploy’s contract with job centre plus and that if they are not achieving their outcome targets they may loose their contract.
Q: Are you offering careers advice or skills
A: Depends on which pot of money comes from the Council. The Learning and Skills Council did not want to get involved.
Some of the audience thought Spoke should be more active in promoting their work.
Chris pointed out that they use the local college and press. There was some criticism from the audience of colleges not doing personal assessments.
