Where next for personalisation?

1. Where next for personalisation?

2. Some background • Personalisation is central to the coalition’s Vision for social care – the 1st of its 7 principles • Putting People First became Think Local Act Personal to reflect a more collegiate and sector-led personalisation agenda • Personalisation is defined in the Vision as: • ”individuals not institutions take control of their care. Personal budgets, preferably as direct payments, are provided to all eligible people. Information about care and support is available for all local people, regardless of whether or not they fund their own care” • Making it Real (TLAP)

3. Is personalisation all about direct payments? A personal budget alone does not in itself mean that services are automatically personalised. This requires a wholesale change - a change of attitude by councils and staff, reform of financialand management and information systems, and reduction of inflexible block contracts. People should get personal choice and control over their services - from supported housing through to personal care.Even those with the most complex needs can benefit from personalised services.

4. Personal budgets – challenges on the horizon • Clear target – all care users will have a PB by 2013. Direct Payments to be the default type • Personal health budgets – entitlement to request by 2015 • Personal budgets in Supporting People – pilot in 2012 • Currently 30% of users have a PB - 23% are LD, 10% are older people, 5% have mental health needs • Recognised challenge around older people and those with mental health needs or lacking capacity – local authorities more cautious and awareness is lower • Two thirds of PBs are managed budgets – just one third are direct payments. A tick box exercise? • Funding – dampners placed on PBs. 48% of social workers believe PB amounts are insufficient to meet need • Widespread restrictions on what PBs can be used for – holidays, sports, PCs

5. Thinking about personalisation more widely Some groups and care settings are not conducive to direct payments: • Mental health needs • Complex needs • Palliative care • Residential care • Supported housing?

6. Obstacles to “person centred care” – what people have told us • Personal budgets being used as a silver bullet – a source of staff complacency? • Small issues falling below the care planning radar • Lack of funding for “extra curricular” activities • Lack of universal services for providers to tie in to (training, employment, leisure) • Lack of information and bureaucratic burden • Ageing and physical needs overlapping with mental health or LD – complexity of multiple systems • Service user push-back – “a home for life” and “routine within a routine”

7. Obstacles to “person centred care” – what people have told us • Lack of housing stock and engagement from housing providers – a block to supported living and fully integrated care • The importance of democratic processes in collective settings – choice and voice • The natural constraints of communal living versus institutional regulations • NHS and care at different places on the personalisation spectrum - NHS staff seeking clinical solutions • Increasing complexity with NHS/local commissioning plans – greater chance of slipping through the net?

8. Delivering personalisation • Don’t give up on PBs! – mix and match approaches and ISFs for a more inclusive PB agenda • Democracy and co-production • Health, care and housing – a holy trinity • True integration around outcomes – Health and Wellbeing Boards, Community Budgets • Rehabilitation pathways • Social networks and ‘just enough’ support • Staff culture – risk, attitude and consistency