Putting People First

1. Putting People First • Carey Bamber • Personalisation Programme Manager • carey.bamber@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 people’s 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. 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. Direct Payments

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 Children’s 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 Moves”by 2011 National Indicator set - NI 130

10. What is self-directed support?

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. It’s different … I also bought a kite, a bike and other clothing for outdoor activities. I’m 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 • What’s Health and what’s 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 LA’s • 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 provisionalpilots • 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? The right to control recognises that disabled adults are the experts in their own lives • 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

18. Which funding streams will the right to control cover? 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. • 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

19. How will right to control be implemented? The trailblazers are expected to run for two years. Funding will be made available to support trailblazing areas. • 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

20. Next steps iMPOWER 14 Clerkenwell Close London EC1R 0AN T 020 7017 8030 F 020 7017 8040 jcooper@impower.co.ukwww.impower.co.uk Jeremy Cooper, Director • 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@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. www.in-control.org.uk www.personalisation.org.uk www.supportplanning.org For more information..