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Explore a revolutionary model for adult social care delivery focusing on strengths, investment advisors, and co-production to enhance well-being. Learn the golden rules and bubbles of innovation driving this change.
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A new way of delivering adult social care Tandra Forster
Challenges • Austerity • Ageing population • Burden of disease • Integration • Care Act
Pressures! ‘Fiscal austerity’ is now expected to extend to at least 2018
‘If I had asked people what they wanted, they would have said a faster horse’ Henry Ford
Two Choices: • Centralisation, making it harder, savings targets. • or • Stop assessing people for services, focus on what they really want, focus on strengths not deficits, carers, social work as investment advisors.
One Model: Safeguarding Right Skills, Right People
Golden Rules • Always offer tiers 1 and 2 before offering tier 3. • Never plan long term with people in crisis – stick to people like glue. Always think hard about what will help carers continue caring. • In tier three – we’re not experts, but ‘investment advisors.’ • 100% of people and families plan their own support. • Learn as we go using data we trust. • Benchmark – is the response good enough if it was you, or someone you love?
Bubbles • Co-produce a precise set of rules about doing things differently. Let the world carry on. • Be really clear about what you are going to do – and for how long. • Go with the grain – where there is the greatest likelihood of success. • Know how you are going to collect data – everyday – from day one. • Make everything transparent and visible. • Learn as you go – weekly meetings. • Work to a plan – stop – reflect and learn. • Go again.
First Phase • Two innovation bubbles • 5th January start, reviewing initial results but so far very positive • First Contact – focus on people new to the Council • Ongoing needs – people already in receipt of services • All 3 conversations • Stick to people like glue • No hand offs until the right time • Second phase – scaling up • Second evaluation – August 15
You know what I want! I know what I want! Does it matter who pays for it? Joint Care Provider – Tier 2 conversation
The task: To simplify the route to independence • Develop a shared understanding with every ‘Sam’, and do it quickly! • Challenge our own bureaucracy • Target the right experts • Pool resources
Who wins? • ‘Sam’ gets home and gets on with his life. • Hospital beds freed more quickly. • Costs for long term care do not escalate through the disorienting and de-skilling effects of excessive stays in hospital. • Less duplication = improved capacity
What makes the change hard? • Comfort of current working methods. • Conversion of managers into Change Managers. • Pressure to maintain high performance levels during change.
How we are achieving change: • Step changes closely monitored to allow adjustment and refinement learning from the effects of first steps. • Testing new route on Hospital Discharge patients first, and then extending to all. • Seeking ‘licence’ from the Partner organisations to test new permissions.
Development Framework for: • 7 Day working – testing all pathway steps for ability to match ‘Sam’s needs, and to respond to and match other system activity. • Trusted assessors – allowing partner staff to commission across organisations. • Generic Care Worker – developing/testing role with BHFT Therapy assistants and WBC Care Workers.
