Community Life Choices

A strategy for day and respite care

Provider Engagement Network

January 2012

SCOPE

• Day services and Respite services

• All adults (OP,OPMH,LD,MH,PD

• Up to 2016

• The strategy documents will be launched for consultation in the coming days

• We are finalising the details of how the consultation process will be managed with various stakeholders

• We want to create opportunities for providers to contribute to the consultation and would welcome any suggestions you might have on the best way to achieve this.

• For example we will be engaging in more detailed discussions with the PEN subgroup particularly around the opportunities and challenges the proposed strategic approach has for providers.

• The consultation is likely to last until March 2012

• We would look to consider the outcomes of the consultation and develop more detailed proposals in the weeks following the completion of the consultation.

The strategy describes

• the aims and individual outcomes we wish to achieve

• the principles that underwrite the vision• the policy and research that informs the vision• what people tell us about these services and

what they expect to receive• an analysis of demand, supply and costs• a proposed strategic direction• the possible impact on the market.

Some key messages

• Policy thrust toward personal budgets as the key way of delivering personalisation and importance of prevention and early intervention to manage future demand.

• Policy around employment as a key enabler • Significant demographic pressures including the

importance of carer support• Declining usage of day centre and care home respite • Significant increases in the use of personal budgets and

in the use of community services• Challenging financial circumstances • Significant investment in directly provided DCC services• Client group areas are in different places in terms of

reliance on day centre and care home respite

Changing expectations of services• People are demanding personalised support that

• fits in with personal circumstances, interests cultural and religious beliefs,

• That enables them to access greater flexibility variety and choice in terms of activities.

• Are of a good quality, safe, and affordable etc.

• Whilst some people will choose group based activities more and more are wanting individualised support to attend a range of activities within community settings

• Services have to respond to these inevitable shifts in demand for community based support and activities.

In order to ensure that people have the greatest opportunity for independence and to participate in community life and to manage the pressure on demand arising from demographic growth DCC proposes to develop a 4 tier model

4 tier model

Level 1

Universal services

Level 2

Community Enabling

Level 3

Community providers

Level 4

Buildings based

services

Level 1 offer – Universal Services

Advice information and signposting

Services and activities open to all including Leisure, cultural, Adult & Community learning, employment,

volunteering etc

Level 2 offer – Time limited - Community Enabling

No charge

Outcome focussed & personalised

Access into universal services, community and voluntary services

Support into employment & employment schemes

Support independent living skills

Build services and support in local communities

Level 3 offer – Longer term support - Community Providers

Funded by Personal Budgets (PB’s)

Support to use activities/facilities in local communities accessible to all

Outcome focussed & personalised

Supporting PB holders to come together with similar interests

Level 4 offer – Longer term support - Buildings/place based services

Funded by PB

Integrated intimate care or supervision

Outcome focussed & personalised

Could be an overnight, all day or part day offer

Link to community providers

Possible market related issues • Possible opportunity to develop time limited

community enabling offer

• Need to ensure a broad range of affordable community based services and support that personal budget holders will wish to buy

• Opportunities that might arise for independent support planning

• We want to engage with providers and understand what support they may need to deliver personalised services.

Possible market related issues• Providers may have roll in facilitating individual budget

holders coming together to more effectively buy services.

• We want to create a flexible market that enables providers to choose to offer services that address as many of a person’s outcomes as they feel appropriate and/or work in partnership with other providers

• Providers of buildings based services will need to

respond to the changing needs and circumstances of their clients as well as falling demand from state funded clients.

• Which services are commissioned in the future will be primarily driven by people utilising their personal budgets. We would want to talk with providers about the most flexible contractual arrangement to reflect that reality.

Possible market related issues• Market development is crucial. Personal budgets are of little use if a

range of services offering choice are not accessible or available. We would like to engage with providers to consider for example;

– How new entrants into the market particularly in underdeveloped areas of service provision or in underdeveloped geographic areas can be supported.

– How we can support other organisational forms that allow service users, carers and communities to exercise greater control or run their own services i.e. mutual organisations, co-operatives, charities, community and social enterprises and micro providers.

– How we can support voluntary and community groups with the impact of a shift to personal budgets and

– How we can support all providers given the planning uncertainty about the take up of services when personal budgets predominate.