The Future Direction of Adult Services Welcome Samih Kalakeche – Director of Adult Services

1. The Future Direction of Adult Services Welcome Samih Kalakeche – Director of Adult Services

2. Welcome from the Director

3. The Future Direction of Adult Services Natalie Markham Divisional Manager – Governance, Quality, Safeguarding and commissioning

4. Purpose of the sessions • Session 1: Demand and Supply • To present the latest policy requirements & commissioning priorities • To set out the budgetary position and implications • To set out the long term supply and demand trends • To explore what is required to support organisations to develop and transform service models • To launch the Innovation Network • Key outcome: Market position statement

5. Purpose of the sessions • Session 2 (September): Supporting innovation in service delivery • Complex needs intelligence, trends and analysis • A chance to explore new approaches and enabling programmes: • - Asset based community development • - Social enterprises and mutuals • - Workforce development • - Personalisation • - Early feedback from Innovation Network • Key outcome: Market Facilitation Approaches

6. Purpose of the sessions Session 3 (December): Review and Next Steps

7. Financial Challenges Andrew Buck Head of Finance Childrens, Adult Social Care & Health

8. Britain faces spending cuts “almost without historical or international precedent” over the next few years and, painful as the squeeze has been so far, it amounts to less than a 10th of what is planned by the 2016/17 fiscal year. (Institute for Fiscal Studies, February 2012)

9. Savings proposals for 2012-13 The Budget Gap 2011-12 £91.4m (delivered) 2012-13 £50.0m 2013-14 £20.0m 2014-15 £30.0m 2015-17 £30.0m TOTAL £221.4m

13. 2013-17 Mayoral Budget Strategy • Open & transparent process • Priority led • A longer term view • Take decisions early • Challenge the financial assumptions • Consider all budgets and all spending and income • Consult on the difficult decisions • Ensure equality • Look to do things differently • Recognise growth/ demand pressures • Consider cost v performance

14. Timescales Develop budget savings options - July 2012 to September 2012 Stakeholder Consultation - October 2012 to January 2013 Mayoral Select Committee - February 2013 Cabinet - February 2013 City Council - March 2013

15. Demand Challenges Jonny Keville- Performance Improvement Manager

16. POPPI / PANSI Population Projections

17. SU age at point of entry in ASC compared to the projected length of service requirement

18. SU age at point of entry in ASC trend by year (2007 – 2012)

19. SU service duration in ASC trend by year (2007 – 2012)

20. SU Population July 2007 Age as of July 2007 Age as point of entry

21. SU Population July 2012 Age as of July 2012 Age as point of entry

22. Commissioning Natalie Markham Divisional Manager – Governance, Quality, Safeguarding and commissioning

23. Policy Priorities – Care & Support White Paper/Bill • Core vision: promoting people’s well being and independence to avoid crisis • Improving information • Eligibility and assessment • Commissioning for outcomes • Supporting carers • Quality of care and support/safeguarding • Care audits – dementia care • Healthwatch

24. Commissioning Implications • Stimulate development of time banking schemes • New ways of investing in services (social impact bonds) • Development of specialised housing for older and disabled people • Dignity and respect • Improve joined up working between NHS and care and support • Testing scope of extending direct payments into residential care • Developing user led organisations • Social action in deprived neighbourhoods

25. 3 Key Shifts • Managing demand – shift resources to prevention & community based solutions • Personalisation & Outcomes • Reablement/short term interventions to maximise independence

26. Managing Demand

27. Family, Friends, NaturalSupport Building Community Universal, Information Early Intervention & Prevention Short Term Interventions Crisis Response, Resettlement / Outreach Equipment, Re-ablement, IntermediateCare Long Term Care andSupport Access, Pathways, Assessment, Support Planning and Review Shifting Priorities - Prevention

28. Embedding Personalisation • Culture shift – consumer as purchaser • Adapting systems and processes to deal with personal budgets and direct payments • Workforce development and leadership are key • Know your unique selling points and strengths to give you market edge • Develop whole family services • Focus on outcomes • Supporting community capacity • Flexible integrated care and support service models

29. Shift resources to short term interventions • Innovative approaches to reablement and post discharge care and support • Develop crisis and rapid response services • LA working in partnership with independent sector to maximise value of community hubs • Effective resettlement and rough sleeper services

30. Care & support • Increasing shift away from residential care to community support, housing & care solutions • Dementia services – day & community support, joint working to improve pathways • Increased use of assistive technology to maximise independence and resources • Complex needs – short term step up and step down residential services, short breaks

32. Procurement Timetable

33. Key messages The Council: • needs your innovation and creativity to find more effective solutions for local people • wants to work with organisations that can show the outcomes they deliver for people • needs organisations that can maximise resources outside of the public purse – including volunteers • wants partnership approaches to connect up the various systems – Health, Welfare, Benefits, Housing, Community • wants services that actively engage with citizens and communities

34. The iNnovation Network (iN): ‘no old roads to new directions’ Phil Rigby Transformation Manager

35. iNnovation Network (iN) ‘Innovation is anything, but business as usual…’ 1. iNnovation Roundtables [monthly] 2. Adult Services Hack Days [one off sessions] 3. a) Collaboration Forum (Matching) [quarterly] 3. b) Collaboration Forum (Hatching) [by project] 4. Alternative Assets[ongoing]

36. iNnovation Matrix

37. iNnovation Toolkit

38. Next Steps • Circulate iN Matrix with guidance • Submissions should be mindful of the analysis identified today, commissioning intentions etc. • Expressions of interest by noon, Weds August 15th

39. Phil Rigby phil.rigby@liverpool.gov.uk Ray Dixon ray.dixon@liverpool.gov.uk 0151 233 4199

40. Group Workshop

41. Workshop Purpose: • To explore the information and intelligence that will enable your organisation to make intelligent decisions about investment and development

42. Discussion Questions • What opportunities do you see to respond to the changing requirements for meeting future care needs? • What factors can help or hinder your ability to transform your services to meet the challenges? • How can we as an authority help create the right conditions for innovation and sustainability? • How can you as a sector better inform our commissioning intelligence?