Supporting Yorkshire and HumberIndividual Service Funds

Workshop 24th April 2013

Making it Real in Yorkshire and Humber

Busy times for TLAP

What is Making it Real?

A set of 26 “I” statements developed by people who use services, carers and citizens supporting organisations to move towards more personalised and community based support

Agenda for the day

• 10.00 Introductions, overview and plan for the day • 10.30 An introduction to Individual Service Funds• 11.30 Break • 11.45 ISFs in different settings exercise• 12.45 Lunch • 1.30 ISF Journeys so far• 2.30 Break• 2.45 Action planning• 3.30 Next steps • 3.45 Close

Why are ISFs important?

• They build on provider expertise in delivering personalised support

• They focus on outcomes for the individual and move away from clock watching

• They embed person-centred practice into the fabric of a service

• They make managed personal budgets more meaningful

• They ensure personalisation doesn’t stop at the care home door and works for people with the most complex needs

• They enable organisations to make progress with Making it Real!

What are they?

ISFs address the issue that traditional methods of service costing can inhibit choice and control for people, they mean that:– The person supported has a clear idea of how much resource (£/hours)

is available for their care and support– £/hours are held by the provider on the person’s behalf on their

support and other costs necessary to provide it (not as a pooled fund)– The person is supported to develop a plan for how to use the £/hours

in their individual control– There is more flexibility in the usage and banking of £/hours, which can

sometimes be used outside the service– They can be an option for personal budget holders but are not

dependent on personal budgets

How they work

1. The Individual allocation:Identify each person’s share of the funding based on their individual needs

2. Core support and shared costs:Identify what support and shared costs are necessary

3. In my control:Maximise people’s choice and control of the remaining money

How are they being used?

Most work to develop ISFs has been provider led and three different approaches have emerged:

1.Identifying core, shared and individual control hours within an existing contract (Partial disaggregation)

2. Doing the above to a greater degree and identifying a pot of money the person controls (Full disaggregation)

3. Setting up a new service that builds support around the individual (Micro commissioning)

Choice and control in commissioned services

Partial disaggregation example:

• Riverview is a residential care home for older people• Created an internal resource allocation system to work out the hours

each person was entitled to• Divided into “background hours” (that everyone shares) and “individual

hours” (the dedicated hours for each person) by working backwards from the current contract price

• 78 year old Sam had 4 individual hours a month – staff worked with him to develop a support plan

• The manager put these hours into an “agreement” to review with Sam in 6 months time

• Sam used his hours to reconnect with friends he has lost – matched with a staff member to take him bowling

Full disaggregation example:

• Down Street was a group home for 4 people run by IAS in Greater Manchester commissioned through a block contract

• IAS negotiated with the Local Authority to redistribute resources to deconstruct the contract and provide individually designed services

• There were sufficient resources allocated to enable one man to move into his own place with 24/7 support, another to get his own tenancy with several hours support a day and the remaining two men to pool their resources and rent somewhere together

• For all 4 men, resources were identified and ring fenced to implement their support plan

• Each individual has been able to use the resource flexibly – saving up hours, converting “standard hours” to “enhanced hours” or converting hours into money

Micro commissioning example:

• Jennie is a young woman with autism who lives in her own flat in Stockport and uses her personal budget to purchase care and support from a provider, Independent Options

• Jennie has a circle of support made up of family, friends and professionals who know her well

• Jennie and her circle developed a support plan and then interviewed providers about how they would deliver what was in the plan and recruit staff for her within the indicative allocation

• Jennie asked the council to commission the service for her using her personal budget – this is treated as her money and as a restricted fund

• Independent Options report clearly and transparently on spend against the budget to the council and Jennie’s circle

Contractual and financial implications

• An ISF is not a contract: accountability/liability remains between the council and the provider unless the person has a direct payment

• ISFs do not necessarily require different forms of contract, though there may be a need for contractual variations

• E.g. Nottinghamshire have negotiated changes to their contractual specification to enable piloting of ISFs in light of issues that arose around subcontracting, banking of hours and “cash conversion”

• ISFs mean moving towards budgets structured around individuals rather than services – this is a big shift

• They often require a decision about how to break down an existing contract to reflect individual needs: CFC, RAS etc?

• They should ideally involve a way of showing people what they have used or spent and what they have left

• They can mean new or different training for staff in how to support people to manage their money

Practice implications

ISFs mean using the best tools you can to enable people to say how they want their support to look, including…

how I want my life to change

My perfect week

Decision making

agreements

Working/not workingAspirationsGifts

Relationship Map

Community Map

Important to/forWhat best support looks like

1 page profiles

What does success look like?

Top tips

• Start from a clear view of what success looks like• Keep it as simple as possible but involve the right expertise• Give yourself enough time – you will uncover historical anomalies

in how funding works and some income streams arte less flexible than others

• Concentrate on people not just money• Use whichever tool makes sense to calculate hours/£• Start small and share stories of success• Build partnerships – while you can achieve a lot alone, the best

outcomes require commissioners and providers working together

Stay connected with Think Local Act Personal:

• Twitter: @TLAP1, @samhbenn• Tel: 0208 6789 536• Email enquiries: sam@groundswellpartnership.co.uk or

sam.bennett@scie.org.uk