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Making it Real Islington “We said, we did” Final Evaluation Report August 2016
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Making it Real Evaluation – Executive Summary
The Making it Real Programme commenced in September 2013 and was completed in March
2016. We are extremely proud of our progress towards achieving the Making it Real vision for
people in Islington.
The Making it Real programme has been a shared effort across social care and health. Voluntary
sector partners have been well represented on our Board and with our Experts by Experience at
the heart of the programme. Our approach was based on genuine co-production and power
sharing at the most senior level.
The Making it Real Islington Action Plan was the centrepiece of the programme and it set out our
commitment to make services more personalised in Islington. The Action Plan was developed
through co-production. The evaluation provides detailed progress on each action in the Action
Plan. This is set out in the ‘We said, we did’ table, which demonstrates our commitment to co-
production in the development and delivery of the actions. We made clear progress toward most
of our agreed actions. Most of the actions for the three priority themes were in place by the end of
the programme. For the actions that need more work and monitoring and review we have agreed
to a lead person or service.
As part of this evaluation report, we also took the opportunity to review our approach to Making it
Real and to assess the wider impact of the programme. Co-production as an approach has been
widely adopted among Making it Real Board members and partner organisations. Islington’s
corporate plan includes a clear commitment to co-production as a way of working across the
council. The Experts by Experience are having an impact on changing organisational culture, in
particular in how staff relate to the people who use services. Plus the Experts by Experience have
benefitted in knowledge, skills, confidence and increased capacity and motivation to be part of
and lead change.
Making it Real’s achievements represent the start of a journey towards a new way of working for
Islington. We look forward to continuing to work together and maintaining the connections from
our Making it Real journey. This will be achieved through the launch and development of our new
Islington Centre for Inclusive Living (CIL) in 2016. The CIL aligns directly with the legacy of the
Making it Real Board and it will build on the local and existing peer support carried out by the
Islington Personal Budgets Network to help people tackle challenges they face across health and
social care.
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Section Contents
Page
1 Working together
4
2 Supporting statements
5
3 Forward from co-chairs 6 Our vision
7
4 Introduction
8
5 Summary of outcomes and achievements
9
Structure chart 10
Action plan 10
Key highlights and achievements 11
Coproduction cordat 13
Wider impact 13
Department of Health survey results 14
Peer Research 15
POET Survey
16
6 Detailed progress update 16 Action plan progress
16
7 Wider impact 25 Peer Research 25
POET Survey findings
26
8 Recommendations and next steps
29
9 Conclusion and closing statement
30
10 Board membership
31
11 Appendixes
32
12 Contact information
32
13 Partners 33
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1. Working together
Being part of Making it Real has made me evolve into a better person. I’ve learnt so much for myself and other people with learning disabilities. Nick Avlonitis, Expert by Experience
As an expert by experience, the MIR project has given me the opportunity to experience working with professionals in social care. I have witnessed social workers embracing personalisation to make it work in their practice. However, this is on-going as social care and housing providers need to be more engaged with personalisation in how they deliver services. George Topping, Expert by Experience
MIR has really shown me the true value of co-production and working together with service users and carers. I found it quite inspirational working with people who really understand what it is like to be on the receiving end of services. I think it’s really made a difference. Neil Chick, Head of Learning & Development
I have enjoyed being involved and seeing the end results. I’ve made it real for others and myself. Being an expert by an experience and overseeing the co-production of the action plan has helped me get back the self- respect I left in the bottom of a glass a few years ago. Mick Havens, Expert by Experience
I am proud to have been a member of Making it Real for the last 2 or 3 years. Via all the meetings held we have talked, been listened to and made lots of useful connections. Fiammetta Schofield, Expert by Experience
Whilst on the whole I still feel that personalisation and personal budgets in mental health still have a long way to go I have valued the Making It Real Board immensely. Having a place where, collaboratively, issues have been raised, points made and knotty problems acknowledged has the real potential for a longer term positive impact. It has been helpful to see a bigger picture too. I have been impressed with the dedication and skill of the Experts by Experience and the genuine dedication to partnership working throughout. Ginny Sell, Hillside ClubHouse
Islington is a progressive borough and there has been a real willingness to make a difference. Making it Real has really worked hard on co-production and ensuring all stakeholders have been able to have an equal input at looking at solutions to difficult issues. The development of the co-production concordat was very important as it made sure we were all on the same page. We have worked hard to make services more joined up. The separate Complaints’ Feedback Focus Group in particular learned extensively from reviewing case studies, customer satisfaction and feedback forms over an extended period. Rose McDonald, Healthwatch
Before Making it Real I was just a carer in a bubble - I didn’t know how to make a difference. Two years on I have learnt so much about how social services, safeguarding and the complaints system, in particular, works. It’s had a massive impact on me and I have gained so much. I feel Islington council are listening to carers and that we now have an equal partnership. We can’t stop now just because the MIR Board has ended, we need to continue to work together to deliver services in the best interests of our sons and daughters. Niroo Patel, Expert by Experience
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2. Supporting Statements
The Making It Real project has been a fascinating one. I have watched the
experts by experience grow in stature and self-confidence to the extent that they
were able to give talks and presentations to groups of staff members both locally
and nationally. This has been a project which, from my perspective, has been a
genuine attempt at co-production between the Council and service users. In
some ways it may be easier for officers to come up with changes to services
behind closed doors, but that is a sterile way of working and if the changes they
come up with are unpopular and don’t work, then that exercise has been
unsuccessful. Service users are in a much better position to explain what they
want and, perhaps counter-intuitively, the services they want are often cheaper
to deliver. Rightly, our Making It Real project has attracted national recognition;
from my perspective, I have very much enjoyed being a (peripheral) part of it and
would like to thank everyone involved.
Councillor Janet Burgess MBE Deputy Leader and Executive Member for Health and Wellbeing
Over the past year Islington Clinical Commissioning Group (CCG), Islington Council and the wider NHS have all made significant progress in delivering personalised services whilst facing the challenges of rising demand. Personalisation has been key in allowing Islington CCG and the Council to tackle the difficulties posed by issues such as an ageing population and a significant increase in people living with long term conditions. Early work to develop Personal Health Budgets has found that given this responsibility, people are often not only able to find more clinically effective solutions for their needs, but also more cost effective ones too.
Without the project’s Experts by Experience who are at the center of the
Making it Real programme, this would not have been possible. Making it Real
in Islington has also prompted a new kind of working with providers, the third
sector, carers, clinicians, and service users. It is only through such
collaboration that policies, procedures and services have all been reshaped to
deliver what is a personalised and integrated offering for Islington.
Dr Katie Coleman
Vice Chair of Islington Clinical Commissioning Group
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3. Foreword from the co-chairs
Our Making it Real Programme started in September 2013 and closed in March 2016. We
are pleased to present this final evaluation report. We are proud of our progress towards
achieving our Making it Real vision for people in Islington. It is the outcome of a lot of work
and represents an effort to bring together a wide range of people and views.
Our Making it Real programme has been a shared effort across social care and health, with
voluntary sector partners well represented on our Board and with Experts by Experience at
the heart of the programme. We are proud that a third of Board members were Experts by
Experience. These are people with lived experience who helped to make sure that our
Programme was meaningful to people who use our services. Our approach was based on
genuine co-production and power sharing at the most senior level. This started with us as
the Board Co-Chairs, an expert by experience and Islington council’s Service Director for
Adult Social Care.
We would like to thank all our Board members and our Experts by Experience in particular
whose commitment and participation has been inspiring. There are many benefits of
working in this way with our Experts by Experience, tapping into their knowledge, skills and
creativity to develop our Action Plan that was both ambitious and realistic.
Making it Real’s achievements represents the start of a journey and a new way of working
for Islington. We are proud of what has been achieved. We look forward to continue working
together and keeping the connections from our Making it Real journey through the launch
and development of our new Islington Centre for Inclusive Living (CIL) in Spring 2016. The
CIL aligns directly with the legacy of the Making it Real Board and will build on the local
existing peer support carried out by the Islington Personal Budgets Network CIC, to help
people tackle challenges they face across health and social care.
Sandy Marks Chair
Islington Personal Budgets Network CIC
Simon Galczynski Service Director
Adult Social Care Islington Council
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4. Introduction
Early in the process, the Islington Making it Real Board agreed that we would work on all six
Making it Real themes to develop our action plan. We used the Making it Real ‘I statements’
as a basis for discussion with people who use our services. We also encouraged staff to
think about the statements and what they might mean for people who use our services. The
Making it Real Action Plan focused on the three priority themes was published on the Think
Local Act Personal website in April 2014. In July 2015 we had an agreed action plan for all
six themes. See appendix 1 for details.
The Making it Real Islington Action Plan was the centerpiece of our programme and it
set out our commitment to make services more personalised in Islington. The Action Plan
was developed through co-production. We held many small working groups to develop the
actions for each theme. The small working groups included representatives from the local
authority, Experts by Experience, the NHS and voluntary sector organisations. The Action
Plan was then approved by the Making it Real Board.
The evaluation gives detailed progress on each action in the Action Plan. This is set out in a
‘We said, we did’ table, it reflects our commitment to co-production in the development and
delivery of the actions.
As part of this evaluation report we also took the opportunity to review our approach to
Making it Real and to assess the wider impact of the programme. We trained peer
researchers to help us to gather feedback from people that use services. We received over
100 responses using a postal survey called POET (Personal Outcomes Evaluation Tool). The
survey responses help to understand local people’s experiences of personalisation and
personal budgets and how this compares nationally.
We also considered responses from a larger Department of Health postal survey which is
sent to all local service users and carers .These results make up our local account of adult
social care and helps us understand what we have achieved and how our services are
performing.
This report highlights our progress and achievements to date and makes recommendations
for the next 12 months.
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5. Summary of outcomes & achievements
Our approach
To prepare for the Board meetings a co-chairs meeting was held before each meeting
The project managers supported the co-chairs to plan each meeting agenda and agree
proposed meeting outcomes and invite guest speakers
A co-chairs meeting was held after each Board meeting so the co-chairs could reflect on
discussions and lessons learnt in order to improve the next meeting
Meeting accessibility and support requirements to facilitate participation was valued by
people involved in the Making it Real programme
We developed guidance and procedures on when the Experts by Experience would
qualify for acknowledgement and expenses payments, in line with HMRC, DWP
legislation and the London Living Wage. These payments are known as ‘Reward and
Recognition’
All Board meetings were well attended and engagement and participation was strong
throughout the programme
To help the experts by experience prepare a week before each board meeting they met
with the project managers to go through the agenda, provide feedback on table
discussion ideas and agree how they wanted to participate in the meeting
The board members sat at small tables at the Board meeting to support small working
group discussions
The tables were rotated at every meeting to encourage networking and getting to know
each other
Staff and Experts by Experience valued the opportunity to work alongside each other as
equals in pursuit of common goals
As a result the Board members came together and developed the co-production
agreement or concordat which outlines our approach and commitment to co-production
All partner organisations on the Making it Real Board adopted the Making it Real
Islington co-production concordat. We asked all partner organisations to demonstrate in
a practical way how the concordat is being implemented and how it will continue
Some board members were concerned that as Housing and local home care providers were
not represented on the Board, that they would not adopt co-production or embrace
personalisation to the same extent as Board members
Board members remained hopeful and optimistic that the Making it Real programme
legacy will achieve positive change. There were concerns about the scale and pace of
change and the difficult financial context in which we are working
Making it Real had a dedicated programme team of two project managers and a project
support officer
These staff members set up the programme and monitored the progress alongside the
co-chairs
Key roles included facilitating the small working groups and experts by experience
preparation meetings, keeping records, monitoring the action plan, and evaluating the
programme
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Making it Real structure and links
Action Plan
Our Action Plan was co-produced and monitored by the Making it Real Board
We developed the skills and confidence of a diverse range of Experts by
Experience who increasingly lead on the delivery of our Making it Real
programme
We developed a separate Making it Happen meeting, co-chaired by
Islington’s personalisation lead and an expert by experience
The lead for each action attended this 6 weekly meeting to update on progress
and feedback on how the action was being co-produced
The meeting highlighted which actions were on track and where more work was needed
We made good progress on most of our agreed actions. Most actions for the 3
priority themes were in place by the end of the programme
For the actions that needed more work and monitoring and review we agreed a
lead person or service
Fiammeta Schofiled & Niroo Patel at the Mayor’s Civic Awards 2015
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Key highlights and achievements
Theme 1: Flexible integrated care & support
We are making progress towards more joined up, integrated health and social care
We achieved integration ‘pioneer’ status
We co-produced a personalisation policy, a Direct Payments Agreement and Direct
Payments factsheets that work across health and social care
We are embedding personalisation and co-production across our frontline services. We
introduced a new approach to assessment which is based on assets and strengths
We made direct payments easier to manage with pre-paid cards
Theme 2: Information and Advice
We trained staff in plain English so that communication is easier to understand
We introduced a new online service directory that improves staff and the public’s access
to information about local care and support services
A new point of contact to adult social services was set up so there is now one way to
access social care services
People now have access to an independent advocate as outlined in the Care Act. We
will co-produce a single statutory service in the next twelve months
Theme 3: Workforce / My support staff
We developed our co-production concordat and it has been adopted more widely than
Making it Real
We established a new forum to learn from complaints, compliments and suggestions
based on principles of co-production
We co-produced engaging personalisation training programmes for staff. This was co-
facilitated by Experts by Experience and council officers. The Centre for Inclusive Living
(CIL) will be involved in a review of the learning needs of people involved in
personalisation
We co-produced and co-facilitated staff training sessions on strength or asset based
assessments to reflect the changes brought in by the Care Act 2014
The Islington Personal Budgets Network (IPBN) is a well-established peer support
network for people who receive a personal budget or personal health budget, carers and
people who manage a personal budget on behalf of someone. We are supporting the
IPBN to grow and reach more people as part of the new Centre for Inclusive Living
In the last year, over 400 people attended peer support and training events
We are supporting direct payments employers to pay their staff the London Living Wage
We developed a simple Personal Assistant register for direct payments employers and
self-funders
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Theme 4: Active & supportive communities
We did focused work on what support carers need in order to continue in their role
We raised awareness about Making it Real and peer support through events and
regular meetings
We contributed to the work of the local Employment Commission to support more
disabled people and carers into paid or voluntary work.
For more information see http://www.islington.gov.uk/advice/employment/employment-commission
We are working in partnership with home care services to hold regular service user
feedback forums. This will help us to recognise and share good practice and to
improve home care services based on feedback
Theme 5: Personal Budgets
The IPBN is co-producing training for direct payments employers and personal
assistants. This will help increase the take up of direct payments and provide more local
employment opportunities
We co-produced new information on personal budgets and direct payments
More work is needed to ensure support plans and personal budgets are more flexible
and focused on the personal goals of service users and carers
The CIL will build upon the work of the IPBN and deliver support groups to help people
increase their confidence
Theme 6: Risk enablement – feeling in control and safe
We want to make sure all staff have access to training on positive risk taking. This
will be included in a new learning organisation
We reviewed our current end of life training for staff and put all our linked resources
online so all stakeholders can access them
The Islington Carers Hub are progressing actions to support carers to continue caring
and when their caring role ends
Together we are Making it Real
http://www.islington.gov.uk/advice/employment/employment-commission
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The wider impact
Co-production as an approach has been widely adopted by the Making it Real Board
members and partner organisations. Islington’s corporate plan includes a clear commitment
to co-production as a way of working across the council
We are promoting co-production in Islington and changing how people interact with
services
Approximately 50 staff attended co-produced training on asset based assessments during 2015.
Staff spoke about how helpful and inspirational it was to have service users and carers
experiences at the center of this training
A Making Safeguarding Personal approach has now been adopted by Islington. This is an
example of a co-produced process that involves the service user and carer from the beginning
and on agreeing on the outcomes
Islington’s Making it Real programme is viewed as best practice and is inspiring people and
organisations around the country to embrace co-production. Several London boroughs,
Hackney, Camden, Barking & Dagenham and Greenwich, attended Board meetings to learn
from our co-production approach
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Experts by Experience acted as ambassadors for personalisation and co-production in
Islington and at a national level. A presentation from the Experts by Experience was highly
valued by staff at the Housing & Adult Social Services staff conferences
The Making it Real Islington programme presented at the Think Local Act Personal
(TLAP) 2014 conference in Liverpool
Islington MIR ran their own conference in partnership with TLAP in September 2015, called
Making it Real, Making it Happen – Come Together, Share the Learning. Islington MIR wanted
to showcase their achievements and share the approach with others
The Experts by Experience are having an impact on changing organisational cultures, in
particular on how staff relate to people who use services
Experts by Experience have benefitted in knowledge, skills, confidence and increased
capacity and motivation to be part of and lead change
John Thomas & Mick Havens at the Mayors Civic Awards March 2015
Department of Health survey results
We continue to be one of the highest proportions of service users and carers using direct
payments in London and are committed to doing more to encourage the take up of direct
payments
Our annual Department of Health survey indicates a number of improvements in the year
2014-15 including more people with learning disabilities living in the community to 78.3%
We achieved our target in 2014/15 to get 5.8% of social care service users with mental illness
into paid employment
In 2014/15 we also asked service users specifically to tell us about feeling safe. Most people
who responded told us that their home care workers, personal assistants and staff in supported
accommodation or residential care helped to make them feel safe. As well as the help with
personal care, around the home, and in helping people to get out and about in their local
communities, the skills and attitudes of staff and the way they supported service users were
particularly important in terms of feeling safe and quality of life
Some people also talked about housing and local services as influences on having a good
quality of life. We are continuing to work closely with health and housing partners and services
to deliver more joined up services via our Health and Housing programme
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Local peer research findings
Local Peer Research indicates that some people do feel they have choice and control to
lead an independent life, feel safe and feel included in the community. More work is
needed to ensure personalisation works well for everyone
The research also highlighted that the impact of Making it Real needs to be wider. More
work is needed to ensure that people with sight and hearing loss and people living in
residential care can access personal budgets See Appendix 2 for more details
Rosemary Lamport presents the Peer Research results at the TLAP Islington conference September 2015
Personal Outcomes Evaluation Tool (POET) survey results
Our POET survey results indicated that a high proportion of service users have positive
experiences of support planning. See Appendix 3 for the full report
The quality of support is good or very good for most people
The survey results tell us that we need to improve the overall quality of information
provided to service users receiving personal budgets
The results also show that we need to do more to improve access to the wider
community, work, training and leisure
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6. Detailed progress update
Action plan progress
Theme 1 - Flexible integrated care & support
We said We did Cultivate good ideas for improving our services by working together with our Experts by Experience and staff
We recruited 10 Experts by Experience to the Making it
Real Board. We provided support to the Experts by Experience to prepare for and participate in Board meetings and other work groups. We agreed what co- production means locally and by a process of co- production we developed a co-production concordat. All Making it Real Board partner organisations have adopted the concordat at a Board level. Our Making it Real Action plan was developed through co-production and it is regarded as a national example of best practice.
Progress
We will visit other places to get good ideas and arrange guest speakers for the Board
We made several visits to other places and attended a number of
conferences. Experts by Experience were always involved in
these activities.
We arranged guest speakers who have shared their knowledge and experience with us, including Sherone Phillips from the National Co-Production Advisory Committee, Professor Peter Beresford and John Waters from In-Control.
Progress
Develop a personalisation policy based on choice and control that works for health and social care
We co-produced a single Personalisation policy across
health and social care. We commissioned the Design Council to help us. They held several workshops with key stakeholders, including NHS staff, Experts by Experience, patients with personal health budgets and Islington Council staff. More work is underway on a joint personal budgets and direct payments policy.
Progress
Ongoing monitoring & review lead Heidi Rossetter & Joint Commissioning
Oct 2016
Ensure that people know if there are charges for their services up-front and that people can get help to complete financial assessment forms
We co-produced new template letters in plain English for use by the Finance Department. We developed an Easy Read guide about financial assessments. We are committed to providing personalised support options for service users and carers in relation to financial assessments. This includes home visits, when required, to meet access needs.
Progress
Join up the work across the council and the NHS. We will have a shared vision and share our learning and work plans
We have shared visions and programme plans.
We achieved Integration Pioneer Status. Representatives were on both the Making it Real Board and the Integration Board. We re-organised our services to achieve care coordination and co-location of health and social care staff. Simon Galczynski continues to champion integration across Adult Social Care and the Clinical Commissioning Group.
Progress
Agree a set of ‘I’ statements that work across health & social care
We agreed usage of standard 'I' statements across physical health, mental health and social care.
Progress
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Develop options for setting up and managing a direct payment using pre-paid cards
We developed the pre-paid card option and it is now available to
all new people taking up direct payments and to existing direct
payments users who would like to take up this option.
We are committed to on-going feedback to help further develop and improve how the card works for people.
Progress
Review and simplify how we support people across health and social care. Make it simpler and quicker for service users and carers
Our co-production approach to developing policies and services
is helping us to stay focused on what is important and what
matters to service users and carers. We reviewed how our health and social care staff work together and introduced a more coordinated way of working. We trialed a new approach to assessment and support planning that is person centered and focused on people’s assets and strengths. The pre-paid card now makes financial monitoring of direct payments more simple for service users and carers. We need better understanding of how people experience services across health and social care.
Progress
Ongoing monitoring & review lead Claudia Thompson March 2017
Support people to get together and pool their direct payments. Explore how we can encourage creative pooling arrangements.
We supported the development of stronger peer support
among service users and carers by funding the Islington
Personal Budgets Network.
We are keen to explore new ways personal budget holders can
use their personal budgets –how groups of service users can
be supported to come together to purchase support collectively
and to increase the variety of support available to purchase by
personal budget holders.
The Islington Centre for Inclusive Living (CIL) will support
pooling by encouraging peer support among service users.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
Develop options for setting
up and managing a direct payment with Individual Service Funds
We are reviewing how ISFs currently work in Islington. A best practice model of direct payments support needs to be co-produced.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
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Theme 2 - Information and Advice
We said We did
Develop Easy Read and plain English guidance documents about personal budgets
We co-produced a set of simple direct payments factsheets, to support service users and carers to understand their options and responsibilities.
Progress
Develop a training programme for staff about communicating in plain English
A group of staff in Adult Social Care received accredited training in
plain English. These staff are now acting as ‘Plain English
Champions’ in their teams and supporting the development of more
accessible documents for the benefit of service users and carers.
Plain English training is included in our core training offer for staff and managers.
Progress
Develop a useful and
accessible web directory that will help people to get information about care and support locally
We developed and launched a new online service called Links for Living www.linksforliving.islington.gov.uk Experts by Experience helped to design and test the new directory. We are committed to continuous improvement and updating of Links for Living.
Progress
Review and strengthen independent support and advocacy options for service users and carers
People now have access to an independent advocate to help them
make decisions about their health treatment or social care support as
outlined in the Care Act. The Council has commissioned separate
advocacy services for IMCA (Independent Mental Capacity Advocacy)
and IMHA (Independent Mental Health Advocacy).
We will co-produce a single statutory advocacy service to support everyone entitled to statutory advocacy.
.
Progress
Ongoing monitoring & review lead: Joint Commissioning & CIL March 2017
Develop a clear advice and guidance plan about personal budgets and community based support across the council and health partner organisations
The plan pulls together other pieces of communications work within
the action plan which are already underway. This includes work
around the review of the Islington Council website and information
leaflets.
We produced a resources toolkit for local voluntary sector organisations so that they can give better advice and information about local services and social care to people they work with.
Progress
Ongoing monitoring & review lead: Joint Commissioning & CIL March 2017
Ensure that we have useful and accessible web pages about personal budgets and community based support across health and social care
An initial review of the Council’s web pages was completed with
our Experts by Experience.
We will align our work with a wider review of the website that will
happen in the next year.
We have agreed with colleagues in the Communication Department
that this work will be co-produced with Experts by
Experience.
Progress
Develop a Single Point of Contact service for information and advice about health and social care
The new Access and Advice service was set up in April 2015.
It is the first point of contact for all initial enquiries including safeguarding concerns, community physiotherapy services, speech and language therapy and the Community Rehabilitation Team. The service provides information, advice and care support for people with physical disabilities, sensory disabilities, older people, their friends and family. We are committed to ongoing feedback to develop and improve services for people.
Progress
http://www.linksforliving.islington.gov.uk/
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Theme 3 - Workforce / My support staff
We said We did
Agree what co- production, working together, means in practice, what our priorities are and how we will do it locally
We held a number of workshops with Making it Real Board members
to work on this action. We discussed this at board meetings and
proposed a draft co-production concordat. Our agreement sets out
what co-production means in Islington and our commitment to working
in this way.
Our co-production concordat has been adopted more widely than the Making it Real Islington Board. Partner organisations are actively working to implement it. The corporate plan now includes a clear commitment to co-production as a way of working across the council.
Progress
Communicate our vision to staff and service users using plain English, videos, team briefings and presentations at events
We co-produced a strong and clear Making it Real programme
mission. It is featured in our Action Plan.
We communicated our vision widely in a number of ways, including in newsletters, events and conferences. We created a short film about Making it Real in Islington.
Staff engagement was strong and knowledge of the Making it Real
programme was shared across the department.
Progress
Develop the skills and confidence of the Experts by Experience who are supporting the Making it Real programme
We provided individual and group support to develop the skills and
confidence of the Experts by Experience who are supporting the
Making it Real Islington programme.
The Experts by Experience participated in a bespoke Community
Leadership Programme that was developed and delivered by the
Head of Learning and Development, Islington Council.
Our Experts by Experience presented at local and national
conferences and are ambassadors for co-production and
personalisation. They co-facilitated staff training on asset and
strength based assessments and Whose Shoes sessions sharing
their experiences of being service users and carers.
We provided training in peer research (participatory appraisal) for the
Experts by Experience, service users and carers. We identified
opportunities for experts by experience to be involved in the Centre for
Inclusive Living and further policy and service development work once
the Making it Real programmes closes. The lessons learnt from the
experts by experience will help shape Islington’s co-production policy.
Progress
Explore ways that we can learn from complaints, compliments and suggestions
We established a new forum to learn from complaints, compliments
and suggestions. Experts by Experience were involved in co-
producing the scope, purpose and terms of reference for the new
group. They chaired the group on a rota basis. The group reviewed
and learnt from anonymous complaints. Very positive feedback was
consistently received from participants about the approach taken.
This resulted in members feeling empowered to express their
feedback.
The group co-produced a report summarising their learning.
Recommendations were made to improve the complaints and
feedback system across the department and to help secure service
improvements by learning from complaints.
Progress
https://www.youtube.com/watch?v=LVButGU5Stk&feature=youtu.be
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Look at all the learning needs of people involved in personalisation in Islington. Develop a plan that will meet any gaps in skills and knowledge
Direct Payments e-learning has been co-produced.
The Embedding Personalisation and Co-production in Practice (EPCIP) project helped to develop a learning needs analysis to support a change in ways of working for staff. Service user feedback from the EPCIP project was very positive. We need to do more work in order to apply an asset based approach to assessment and support planning, informed by the values of personalisation and co-production. More work is needed to ensure that all staff have the required skills and knowledge to ensure service users and carers receive personalised support.
Progress
Ongoing monitoring & review lead Claudia Thompson March 2017
Develop personalisation training for staff, including using Whose Shoes electronic board game
To date over 50 staff and service users have participated in Whose
Shoes workshops. These workshops are co-facilitated by a
member of staff from Islington Council and an Expert by
Experience.
Feedback from the workshops was overwhelmingly positive with
participants valuing the opportunity to discuss and reflect on issues
and challenges alongside Experts by Experience in a nonjudgmental
and supportive environment. We have now made this training
available to more people on an on-going basis by including it in our
core training programme.
Progress
Support the Islington Personal Budgets Network to develop peer support for people using personal budgets
We supported the Islington Personal Budgets Network to grow and
develop. The network held a number of events including learning and
training sessions and informal coffee mornings. The IPBN hosted the
International Day of Disabled People. 298 people attended the event
in 2015, the largest number yet!
On a small budget we supported over 20 people to apply for Skills
for Care funding and ran assertiveness, confidence building and
supervision training sessions. We had peer support sessions
throughout the year introducing people to new training and learning
as well as meeting new people. We encouraged people to share
their resources and knowledge, learning from each other. The IPBN
will now focus on establishing the CIL that will continue the legacy of
Making it Real in Islington.
Progress
Support direct payments
employers to recruit and keep good quality Personal Assistants by paying the London Living Wage
We got a commitment that Direct Payments employers will get
enough money in their personal budgets to pay their staff the London Living Wage
The direct payments team have supported Direct Payment employers
to update their support plans and staff pay rates and will continue to
do so.
Progress
Link with the Islington Employment Commission and work together to help disabled people and service users get support to access job opportunities
We held a workshop and co-produced a submission from the
Making it Real Board to the Islington Employment Commission. Future Ambition – a new employment support offer for young disabled adults has started. We are developing a trial of health-led employment support provided in primary care in partnership with the NHS. Employer engagement is focused on increasing job opportunities for disabled people.
The Centre for Inclusive Living will work with experts by experience to
help lead and shape a new Health and Work programme for Islington.
Progress
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Improve access to and availability of Personal Assistants for people with direct payments by developing a PA sharing service and a PA register
We co-produced a simple, low cost, local PA register. Opting
for a much lower cost solution is a direct result of solutions proposed by Experts by Experience and it highlights the financial case for co-production www.islington.gov.uk/pafinder The CIL will help further develop informal PA sharing arrangements. We will continue to work to improve and develop our PA finder service and increase the number of available PA’s. We will include self-funders in the work we do in this area.
Progress
Ongoing monitoring & review lead Nicola Martinez-Herrero & CIL March 2017
Theme 4 - Active & supportive communities
We said We did
Hold events to promote
peer support, Making it Real, and to raise awareness about support that is available from the council and community organisations
IPBN hosted weekly peer support meetings for three months. A joint TLAP and Islington Making it Real – Making it Happen conference was held on 22 September 2015. We supported the IPBN to host International Day for Disabled People 2015, with a record number of people in attendance.
Progress
Explore role of job
brokers to support people to job share and work flexible hours
This was completed as part of the employment commission work. The
recommendations and aspirations of the commission have been
included in the work of the Learning, Skills and Employment service.
Progress
Do some focused work on Making it Real for Carers – Check out how things are working and develop a separate action plan for carers
A small working group did some focused work in this area.
Rather than co-producing a separate action plan for carers two specific on-going actions were agreed 1. Co-produce and monitor a comprehensive carer communication plan for the carers hub, care professionals and providers and 2. Co- produce learning opportunities for carers hub, care professionals and provider.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
Promote and host
community learning and
training workshops on
Dementia, Epilepsy,
Mental Health First Aid and
expert patients programme
We hosted a meeting for the Expert Patients Programme and encouraged people to join. We linked with Dementia friends. We invited all of these groups to be part of International Day for Disabled People. We shared information about current training events for the expert patient’s programmes.
Progress
Support people to become volunteers so they can share their interests, skills and abilities, to include Timebanks
This is an action that needs more work. There is the potential for the Centre for Inclusive Living to help support this work through promoting peer support.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
http://www.islington.gov.uk/pafinder
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Inform home care organisations about personalisation and explore what this means for how they work with service users and carers
Organisations attended our co-produced Whose Shoes sessions.
We are working in partnership with home care services to hold regular service user feedback forums, to recognise and share good practice, and also to improve home care services based on service user feedback. Our personalised home care model for providers is planned to start after March 2016. We will co-produce our Local Account which will tell us how well we are doing in social care and inform future developments.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
Develop a
commissioning strategy to promote and develop peer support
Islington is committed to achieving this. There are already good examples of peer support in Islington and the Centre for Inclusive Living will support the development of the strategy.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
Theme 5: Personal Budgets
We said We did Make the Direct Payments set up process quicker and easier
We reviewed the steps in the process. Charge assessments are
now completed earlier on in the process.
We co-produced the PA Finder to help speed up the recruitment
process. We co-produced a Plain English DP
agreement to make it easier to understand the Direct Payments rules and responsibilities. We know that more work is needed to make the process quicker and easier so more service users and carers can benefit from direct payments.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017 Make sure that people know what their Direct Payments can be used for
A support planning guide was co-produced to help people plan and
organise the support that makes sense to them, based on their
strengths and goals. A plain English Direct Payments Agreement and
a series of Direct Payments factsheets have been coproduced to
outline how direct payments work. More work is needed to ensure that
support plans are focused on goals rather than specific services and
that these payments are spent more flexibly.
Progress
Ongoing monitoring & review lead Commissioning & CIL March 2017
Develop a timeline of the actions involved in setting up a Direct Payment
We co-produced a simple road map of the set up process so that everyone can understand what to expect. It focused on the key steps rather than the time taken to set up as this will be different for each person.
.
Progress
People paying for their own care will have access to advice and support
Our services have been redesigned under the Care Act. The
Information and Advice service and Direct Payments Team provides information, support and signposting for people who fund their own support. Links for Living is available to all residents. www.linksforliving.islington.gov.uk
Progress
Get feedback on people’s experiences using direct payments
We signed up to POET and completed the survey in December 2015. We received a summary report from In Control which benchmarked us against other authorities.
Progress
http://www.linksforliving.islington.gov.uk/
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Develop peer to peer
buddies to help people work through the process
The Centre for Inclusive Living will build upon the work of the IPBN. They will deliver support groups to help people to increase or regain their confidence.
Progress
Ongoing monitoring & review lead CIL March 2017 Make sure service users and personal assistants can access training
Adult Community Learning are co-producing training for potential
PA’s and Direct Payments employers.
We are co-producing a one day induction course for new and
existing personal assistants and Direct Payments employers, to
include signposting on to other training opportunities. We co-
produced a flyer outlining all local training opportunities available.
Progress
Ongoing monitoring & review lead Neil Chick March 2017 Join up and improve how we review support plans and financial monitoring
The pre-paid card supports a lighter touch approach with financial
monitoring. More work is needed to ensure that support plans are
focused on goals rather than services and that those payments are
spent more flexibly.
We will do this in co-production with Finance and the IPBN.
Progress
Ongoing monitoring & review lead Simon Galczynski March 2017
Theme 6 - Risk enablement – feeling in control and safe
We said We did
Enable staff to have
difficult conversations around crisis prevention with service users and carers. This will ensure that contingency planning is included at the assessment and support planning stages
No one training course will achieve this but it is being incorporated into all other relevant training for staff so they have the necessary skills.
We want to continue to offer a range of training for all staff and this
offer will be brought together as part of the future learning
organisation.
Progress
Co-produce training for
staff to support people with positive risk taking and making decisions
This has not been completed but will be part of the future learning organisation.
Progress
Ongoing monitoring & review lead Rene Corrie & Neil Chick March 2017 Reduce social isolation by promoting voluntary organisations and services
This is being driven by Islington’s prevention strategy and is a priority
for council corporate departments. A key priority is to encourage
people to use services that help reduce social isolation. The work is in
its early stages and will be co- produced.
Progress
Ongoing monitoring & review lead Jess McGregor March 2017
Co-develop a pathway of support to prevent carer breakdown
A small working group, including Experts by Experience, met.
Each of the members shared in initial discussions about the wider carers pathway group at Centre 404 and Islington Carers Hub. All the actions will be taken forward by Islington Carers Hub.
Progress
Ongoing monitoring & review lead Andy Murphy & Islington Carers Hub March 2017
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Co-develop a pathway of support to promote a life after caring when the caring role ends
A small working group met including experts by experience and each of the members fed-back the discussions to the wider carers pathway group at Centre 404 and Islington Carers Hub. All the feedback will be taken forward by Islington Carers Hub.
Progress
Ongoing monitoring & review lead Andy Murphy & Islington Carers Hub March 2017
222012017 Co-produce tools and resources for staff to have conversations with service users and carers around dying
Our experts by experience attended commissioned end of life
training and shared their experiences and ideas to inform future
training.
Useful written resources were collated from various teams and added to OLLIE, our online learning portal so that staff, service users, carers and personal assistants can access them.
Progress
Making it Real with the Leader of the Council, the Mayor & Mayoress, Pearly King & Prince of Finsbury & Elizabeth Jones BME at International Day for Disabled People December
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7. Wider impact
Peer Research
Four of the Making it Real experts by experience became peer researchers, together
with six other Islington service users and carers. They were supported by two Making it
Real staff team members who also participated in the training
The researchers were trained in participatory appraisal (PA) techniques. PA is a
community based approach to research and engagement that gives priority to the views
of local people, on the basis they are the experts, and are best placed to come up with a
programme of collective action. In this way, it is in keeping with the philosophy of the
Making it Real programme. Through PA, people can explore and share their knowledge
of life and local conditions, as well make decisions, and plan and carry out actions to
effect change for service users
The training was facilitated by Susie Hay www.shortwork.org.uk . It comprised 30
classroom hours learning the principles and techniques of PA, five hours of fieldwork in a
variety of settings in Islington, as chosen by the researchers, and presentation of the
findings. The training is accredited by the Open College, and all of the peer researchers
passed the course and received their accreditation in February 2016
The peer researchers completed some face to face research into the impact of the
Making it Real programme at International Day for Disabled People event on 3
December 2015
The peer researchers spoke to around 50 people in total, asking a couple of overarching
questions early in the day; later on testing out a couple of the Making it Real ‘I
statements’ they felt would be relevant to this particular audience
The full report is available in Appendix 2. A summary of the findings is below
“I have choice and control to lead an independent life”
Most of the 19 responses were positive
A range of issues were cited as evidence that things were working well, including specific services, barriers being broken down and people leading active, independent, social lives
Lengthy timescales, delays, limited accessibility of support, Personal Budgets for those with sight and hearing loss and in residential care and more general concerns including getting into employment and potential future cuts to services were all cited areas for improvement
Personalisation – what does it mean to you?
24 people responded with a range of comments
Those for who it was working well, it gave them and other disabled people independence, choice, doing things differently and having a say
For others it was too complicated, not always working in practice and not available to everyone
For a few people, the term ‘personalisation’ didn’t mean anything
“I feel safe and can live the life I want”
Nine out of the ten people who responded agreed with this ‘I statement’
Comments were positive about the local area and support services
https://protect-eu.mimecast.com/s/LKJ6BtgpAvT3
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Nick Avlonitis & Cllr Janet Burgess MBE at the MJ Awards ceremony in June 2015
“I feel included and welcome in my community”
Ten people responded, with only two stating they did not feel included in
their communities, the other eight responded positively
Comments included some people seeing services as controlling, and some people not
having equitable access to their communities
What can Islington learn from the Peer Research?
The Peer Research indicates that some people do feel they have choice and control to lead
an independent life, that they feel safe and included in the community but that more work is
needed to ensure personalisation works well for everyone.
The research also highlighted that the impact of Making it Real needs to be wider. More
work is needed to ensure that people with sight and hearing loss and people living in
residential care can access personal budgets and personalised services.
It is clear that this one-off research has only scratched the surface as a small number of
people responded. It does tell us about some of the issues that are currently important to
disabled people in Islington and it gives us some insight into their views of personalisation
at the end of the Making it Real programme. It indicates that we need to keep monitoring
progress towards achieving the Making it Real Vision.
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Poet Survey Findings
Alongside the peer research, in December 2015, 110 personal budget holders in Islington
completed the POET (Personal Outcomes Evaluation Tool) survey. The survey asked
people about their experiences of personal budgets.
The survey was sent to 600 randomly chosen Islington residents, which represents about
one fifth of the total personal budget users in Islington.
In Control, a national charity compared the Islington data against responses from 2,144
personal budget holders in other parts of England and have used the most recent version
of the POET tool.
Islington respondents were more likely to be male, over 65 and more likely to report mental
health needs compared to respondents from other parts of England.
The results of the survey reveal the following key points about services in Islington.
See appendix 3 for full details.
What’s good about receiving personal budgets in Islington?
A greater proportion of service users receive direct payments compared to respondents
from other parts of England
A high proportion of service users have positive experiences of support planning, with
84% considering their views to be taken fully or mostly into account, 81% feeling that
their support plan includes the outcomes they wish to achieve, and 80% feeling that they
have fully or mostly achieved the outcome described. However, this was lower
compared to respondents from other parts of England
The quality of support is good or very good for almost 80% of respondents. This was
slightly lower compared to respondents from other parts of England
Personal budgets have a positive impact on the health of the service user for around
69% of people and this is similar to respondents from other parts of England
What can Islington learn from the POET survey?
Not everyone realises they are receiving a personal budget (18%) although this is higher
compared to respondents from other parts of England.
Only 36% know how much money is in their personal budget compared to 61% of
respondents from other parts of England. However we would not expect people to always
know the value of their personal budget if it’s a service organised or commissioned by the
council. 53% said they have good or very good access to information about different support
options and this is similar to respondents from other parts of England.
15% employ a personal assistant, which is lower compared to respondents from other parts
of England. Is this because a personal assistant wasn’t needed for many of the people
surveyed? Or is it because people don’t have enough information and support about how to
employ a personal assistant? We know that more good information about support options is
crucial.
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These points indicate that lessons could be learned about the overall quality of information
provided to service users receiving personal budgets. We will continue to promote direct
payments take up by reviewing local direct payments information, providing on-going staff
training and ensuring service users and carers have access to peer support as highlighted
in the action plan.
65% believe they have very good or good levels of choice and control in their support, a
slightly lower proportion than people in other parts of England (71%). More than half of the
respondents didn’t feel that the personal budget was helping improve access to
relationships, friends and family, to work training and leisure and to their ability to engage
with the wider community. The results show that we need to do more to improve access to
the wider community, work, training and leisure.
The survey is worth building on over the coming years, to see how the picture might change.
It gives people an opportunity to share details of their experience with personal budgets more
than any of the other surveys.
Making it Real Experts by Experience complete the Community Leadership Programme August 2014
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8. Recommendations and next steps
Keep co-production at the heart of everything we do
We will embed the learning about co-production in the development of the Centre for
Inclusive Living (CIL).Our aim is for there to be meaningful service user involvement
and co-production in all levels of the service from overall design, specific delivery, to
individual users and the organisations governance. The aim is for the CIL to be regarded
as an important local service in Adult Social Care and a national best practice example
of a co-production approach in commissioning, service development and delivery
We will explore how all funded and commissioned services can sign up to the MIR
concordat and principles of personalisation as more work is needed
We will include co-production and personalisation into staff appraisal objectives for
2016-2017
We will co-produce our Local Account in 2016-2017 in line with the co-production
concordat principles
Monitor and Review progress towards the Making it Real vision
We will continue to check the list of outstanding actions with the named leads for
progress and to check each action is being co-produced
We plan to hold an annual ‘recall conference’ and reconvene the Making it Real Board to
review further progress towards personalisation and Making it Real in Islington. We will
ensure housing and home providers are represented
We will set up arrangements to support the trained peer researchers to be able to
undertake more peer research in Islington. They will be housed within and supported by
the IPBN
We will explore the option of participating in future POET surveys so we can check
progress on the experience of personal budgets
We will work with Healthwatch to conduct ‘mystery shopping’ events to check how
services are working in personalised ways
Continue to support the workforce to change
We will establish a learning organisation. This will support organisational cultural change
and will help to ensure the workforce has the knowledge and skills needed to deliver
personalisation and more joined up health and social care
We will use the tools we have co-produced to help with the induction of new staff and
development of existing staff, such as the Making it Real Video
We will develop a plan to embed a strengths based approach into our service delivery
model in Adult Social Care. This is to support a focus on what people can do and to
build on people’s skills, knowledge and strengths
We will embed ‘Whose Shoes’ training into the Learning and Development programme,
so that Whose Shoes workshops will be a fixed offer in the Learning and Development
calendar. Whose Shoes board games have been purchased and Experts by
Experience have registered interest in being co-facilitators
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Further encourage peer support and community inclusion
The Islington Personal Budgets Network is a well-established peer support network for
people who have a personal budget or personal health budget, carers and people who
manage a personal budget on behalf of someone
Islington will support the IPBN to develop and begin providing services under the Centre
for Inclusive Living. The Centre will remain independent from the Council
The Centre for Inclusive Living will have a strong emphasis on community inclusion and
citizenship and will provide a range of information and services related to peer support,
personal budgets and direct payments
We will encourage and embed peer support and on-going engagement opportunities for
the Experts by Experience from Islington Council. The Experts by Experience have
developed their own peer network post March 2016 and the council will provide updates
on Learning and Development and engagement opportunities
9. Conclusion and closing statement
We said we would make it real and we are, together. It is still early days in what developed
into a significant change management programme. The Making it Real programme has
made significant progress towards meeting the commitments outlined in the Making it Real
Islington Action Plan and vision.
The key legacy of Making it Real is co-production. The Board and namely the Experts by
Experience have ensured that working together is now both valued and prominent across
Islington council and its partner organisations.
The CIL will now continue the work and vision of Making it Real. The CIL will be based on
the principles of independent living and co-production and include a range of services
related to peer support, personal budgets and direct payments.
It is only fitting for an expert by experience to have the final say.
I was initially skeptical about the role of the Making It Real Board. What did 'Making It Real' really mean?
Were 'personalisation', 'co-production' and 'Think local, act personal' anything more than fashionable buzz
words and aspirational slogans?
But after more than a year and a half on the MIR Board I am convinced that it represents a genuine attempt
to kick start and reinforce fundamental changes in the culture of adult social care and health services in
Islington. It has raised awareness of the essential role of the service user in shaping policy and practice. It
has illustrated in practical ways how co-production can enhance the personalisation agenda. And it has
begun to show how adult social services, the local health service and the voluntary sector can work together
to design and deliver more effective user-centered services.
But this is just the beginning. These changes need to be accepted, absorbed and embedded within the
health and social care services. Hopefully this will be one of the legacies of the Making it Real Board.
Certainly it will be a major challenge for the future. John Thomas, Expert by experience
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10. The Board Alison Greenhalgh Head of Social Work & Social Care, Camden & Islington NHS
Andy Greene Disability Action in Islington
Andy Murphy Chief Executive, Age UK Islington
Barry Garnham Expert by Experience
Bola Gboyelade Expert by Experience
Chika Wogu Case Manager South Social Care & Rehabilitation Team
Clare Henderson Programme Director Integrated Care, Islington CCG/LBI
Claudia Thompson Assistant Director of Assessment and Personalisation, LBI
Cllr Janet Burgess MBE Deputy Leader and Executive Member for Health & Wellbeing
Deborah Wright Head of Social Work and Social Care, Camden & Islington NHS
Dr Katie Coleman Vice Chair, Islington CCG
Fiammetta Schofield Expert by Experience
George Howard Associate Director, Joint Commissioning, Islington CCG/LBI
George Topping Expert by Experience
Ginny Sell Programme Manager, Hillside Club House
Jenny Mackley Deputy Team Manager, Islington Learning Disabilities Partnership
Jess McGregor Assistant Director, Strategic Commissioning
Jim Beale Service Lead, Islington Learning Disabilities Partnership
Jo Mackie Centre 404
John Thomas Expert by Experience
Laura Gordon Service Lead, Islington Learning Disabilities Partnership
Linda Wan Commissioner Islington Council
Liz Mercer Islington Carers’ Hub Manager
Maisie Heather Expert by Experience
Mandy Woods Mental Health Social Worker
Marilyn Nikkie Bello Expert by Experience
Mick Havens Expert by Experience
Neil Chick Learning and Development Manager, LBI
Nick Avlonitis Expert by Experience
Niroo Patel Expert by Experience
Pat O’Driscoll Mind
Paul Davies Expert by Experience
Ramesh Logeswaran Senior Commissioning Manager- Older People, LBI
Robbie Rainbird Head of Processing Services, LBI
Rose McDonald Healthwatch
Rosemary Lamport User & Carer Initiatives Manager, LBI
Sandy Marks Co-chair
Sara Little Commissioning Lead and Project Manager for NHS CHC
Simon Galczynski Co-chair
Sita Chitambo District Nurse
Sophie Partridge Expert by Experience
Stephanie Earnshaw Centre 404
Steven Pruner Commissioning Manager, Continuing Healthcare
Theresa Rattigan Case Manager North Social Care and Rehabilitation team
Theri Thompson Service Lead, Social Care & Rehab Service
Tony Bamforth Chief Executive Elfrida
Valerie Garnham Expert by Experience
Victoria Gedge Social Worker, Islington Learning Disabilities Partnership
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Programme Team
Andrew Richardson Project Manager
Mary Keats Project Manager
Jayne Moran Programme Support
Thank you to all board members, partner organisations, staff, volunteers and supporters who helped to Make it Real in Islington.
11. Appendices
Note: Appendices embedded as attachments are not available in the PDF version of this document.
Appendix 1 Islington’s Making it Real Action Plan Available at www.islington.gov.uk/makingitreal
Making it Real Islington Action Plan
Appendix 2 Peer Research summary report
Peer Research findings.pdf
Appendix 3 The POET Survey Data Report February 2016
POET local report
2016 - Islington.pdf
12. Contact information
www.islington.gov.uk/makingitreal www.ipbn.co.uk
http://www.islington.gov.uk/makingitrealhttp://www.islington.gov.uk/makingitrealhttp://www.ipbn.co.uk/
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13. Partners