the welsh government’s vision for markets in wales

8/12/2019 The Welsh Governments Vision for Markets in Wales

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The Way Forward

Session 3

Chris Edmunds


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The Welsh Governments vision formarkets in Wales

We recognise that private and independent providers

play a crucial role in social care but do not believe thatthe market should determine priorities. We believe that,collectively, we should drive the market, not allowmarket choices to drive us.

Social care must be delivered within a public serviceethos and we will expect those who wish to be serviceproviders to embrace this value base.

All providers must have a place at the partnership table

and we will ensure that the independent sector is able toplay its full part.

Sustainable Social Services for Wales: A Framework for Action,

WAG March 2011


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Promoting Independence Focus on outcomes Planning for move to greater

independence

Establishing a pathway home for life philosophy no more Normal lives, within the community Telecare


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Transparent Expectations Clear process for making placements

Clear specifications + contracts +

compliance

Clear costs


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Dependency Levels 1 2 3

4 5

6


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Triangle of Need


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High Level Support ServicesChallenges

This is a small cohort of individuals and there is currently little joint commissioning between social care and health, or acrossauthorities. This results in high cost solo placements beingmade, and sometimes out of area.

There can be a lack of clarity between purchaser and provideras to the package being delivered resulting in confusion overthe responsibility for additional services such as behaviouralspecialists, day services and 1:1 support.

There is not always a step down plan in place meaning thatindividuals can remain in high level service for longer thanthey require

There is not always a shared acceptance and tolerance ofrisk. Individuals need to be able to take appropriate risks inorder to develop independence.


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High Level Support Services Access Routes

Currently Proposed way forwardIndividual placements are purchased by statutory service staff.Placements are sourced via the SEWIC brokerage hub .

Providers advertise vacancies in a variety of ways.

Placements will be sourced via the SEWIC brokerage hub,

or via the Special Procurement Vehicle.


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High Level Support ServicesPriorities

Ensure that there is sufficient good quality provision locally tomeet current need and the needs of those coming throughtransitions.

Ensure that services are seeking to maximise independenceand that individuals have outcome based support plans thatseek to promote independence and, if possible, support theindividual to move to a supported living environment

Ensure good quality 24 hour provision that is clearly specifiedand not reliant on additional services (such as local healthspecialists, or additional day services) by improvingcontractual expectation and performance management.

Develop Incentives for providers to safely and appropriatelymove individuals to lower level support services.


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Medium Level Support ServicesChallenges

Some buildings are no longer suitable for use There is an aging cohort of individuals who were rehoused as

part of hospital closures. Vacancies within these schemes areincreasingly difficult to fill. (Standard Residential Care Model)

Commissioning has evolved organically and there is notalways a clear understanding of the amount or cost of service

being provided. There is not always a clear divide between landlord andsupport provider which reduces choice for individuals

Specific housing needs (specially adapted accommodation)are not routinely captured and dont inform buildingdevelopments.

Services are not always focused on delivering outcomes forindividuals.


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Medium Level Support Services Access Routes

Currently Proposed way forwardPlacements are sourced via the SEWIC brokerage hub. Theseare currently for provision that includes both accommodation

AND support.

Accommodation with support will be accessed via the SEWICbrokerage hub.

Accommodation without support will be accessed via theCommon Housing and the Support will be sourced via SEWIC.


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Medium Level Support ServicesPriorities

Ensure that services are seeking to maximise independence and thatindividuals have outcome based support plans that seek to promoteindependence.

Ensure that services are well specified and delivering services to a highstandard by improving contractual expectation and management.

Develop, in partnership, a market position statement that details the qualityand location of accommodation currently being utilised.

Ensure a pathway for young people leaving residential schools or the familyhome to access appropriate support service that will actively promoteindependence.

Increase the use of Adult Placements as a pathway to move independentliving.

Ensure a pathway for individuals living in lower level support services to

access higher levels of support as they get older. Ensure that providers are able to utilise the Common Housing Register toensure vacancies have a greater chance of being filled.

Ensure that services actively promote community engagement andencourage individuals to live as full a life as possible.


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Low Level Support ServicesChallenges

Individuals looking to live independently typically haveto rely on the provision of social housing.

The location of some designated accommodation canincrease the risk of individuals being targeted.

Families who are supporting people to remain at homeand not require higher level support services requirerespite. There is not always sufficient choice of respiteavailable.

There are a limited number of providers offeringoutreach support which disincentives providers tomove current service users into independent living.

Individuals cannot currently always pick who they livewith. Accommodation tends to be thought of in eithersolo or group living terms.


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Low Level Support Services Access Routes

Currently Proposed way forwardSome placements are sourced via the SEWIC brokerage hub.These are currently for provision that includes bothaccommodation AND support.

Accommodation can be sourced via Common Housing Register,or through private lets.

Support (if social services eligibility is met) may be sourced viaSEWIC or through normal Council standing orders.

Current medium support provider may continue to provideoutreach support after enabling individuals to find suitableaccommodation


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Low Level Support ServicesPriorities

Ensure that there is timely access to accommodation of agood quality and in a good location by using the commonhousing register and links with private landlords.

Ensure that support is outcome focused and seeks to improvelevels of independence by accurately specifying requirementsand improving contract management.

Encourage medium support providers to actively seek suitablealternative accommodation for individuals who are able to livein a more independent setting (may be private lets, CHR orhub and cluster model).

Incentivise medium support providers to actively seek

suitable alternative accommodation for individuals who areable to live in a more independent setting Explore options for extending the range of options for respite

facilities


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Next Have lunch Write comments on post it notes and stick

upstairs

Look at your coloured dot to identify yourgroup Group work 1.30 2.30

the welsh government’s vision for markets in wales

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