Outcome Based Domiciliary Care Commissioning A West Sussex Approach

1. Outcome Based Domiciliary Care Commissioning A West Sussex Approach South East ADASS Regional Symposium Translating a Contractual Framework to meet the PPF Agenda

2. Objectives of the Presentation • Look at the West Sussex experience and compare with other authorities. • To develop a shared understanding of Self-Directed Support • To look at how “Outcome Based Commissioning” is starting to work in practice • Explore challenges and opportunities for domiciliary providers

3. Principles of SDS

4. What is an outcome? “The aim of an outcome based approach is to shift the focus from activities to results, from how a programme operates to the good it accomplishes” “The impact, effect or consequence of help received”

5. Individual Outcome in Social Care • Maintenance • Change • Process

6. The West Sussex Approach • Background information • Demographics and domiciliary care provision • Contractual arrangements • Pilots and approaches to progressing personalisation • Domiciliary care; moving to meet the changing culture of Self-Directed Support.

7. December 2007 Consultation Process Commenced • Three month consultation period • Letters to all contracted providers • Presentations to West Sussex Domiciliary Care Provider groups. • Local independent discussion groups • Feedback to WSCC early March 2008 Decision then made to progress to a new form of contract for Domiciliary Care.

8. Through consultation with customers, commissioners and providers it became clear: • New contractual arrangements would be required, to enable people to have more control over how their services are to be delivered. • People need simple systems to assist with making choices. • Providers wanted support to develop personalised services and track spend for customers under contract.

9. Developing the new contract • Outcome based specification • Publishable rates in a simple comparable format • Sharing customers stories and provider feedback through workshops • Promoting social inclusion through collaborative working.

10. Managing the money • Direct Payments • Indirect Payments • Council Managed Budgets (Managed Individual Accounts) And for the future: • Individual Service Funds

11. (Provider quote from the IBSEN evaluation report for the individual Budgets pilot) ‘We have spent year after year after year brainwashing our carers. “Stick to the Care Plan, don’t do this, don’t go outside this, do this,”… …this is a totally different, almost alien way of working’ West Sussex Independent Domiciliary Care Provider

12. How is WSCC supporting providers in the delivery of SDS? • Provider/Customer workshops to share good practice and challenges • Free training throughout 2009 on outcome based practice • Web-based information about local community services • A shared Excel spreadsheet to track spend and accruals of personal budgets • Care Commissioning Teams to work as brokers and intermediaries supporting both customers and providers.

13. Challenges ahead • To move from fitting people around services to fitting support around people • Being outcome focused – “it’s about getting a life not a service” • Supporting self-determination – choice must be real even if the budget remains notional

14. Questions & Answers Thank you – and did this meet your outcomes?