Blueprint For Personalised Care & Support
Innovative practices in Personalisation
Provider: Outlook Care
Project: Remodeling services
Outlook Care is a not-for-profit organisation that is committed to providing a range of services that enable increased independence and choice for vulnerable adults. By working in partnership with people with a learning disability, mental health needs and older people, we deliver personalised support, care and nursing services.
Outlook Care have become specialists in remodeling traditional residential care services to better meet the needs of service users, and to increase independence at every stage of people's lives, and by January 2011 they will have transformed nine services with a further seven to follow.
Our flagship service, Raydons Road in Dagenham, has been remodeled from traditional registered care to a supported living service which has made marked efficiency savings. We have employed a Project Development Manager to identify and help to roll-out necessary changes within our services to enable people to live in a more personalised way.
In addition to our range of support options, we have launched a Personal Assistant matching service 'People4People', further strengthening our ability to provide choice and control to vulnerable people.
Outlook Care worked closely and in partnership with the Local Authority to communicate the Transformation process and answer specific questions about the proposed changes. Initially, some relatives raised concerns; questioning the need for change, and expressing concern about how their relatives would manage living more independently and taking on more control over their support.
The people who we support showed less concern and were keen to see how things would change:
- having worked with people in a person-centred way within the registered care setting, and provided ongoing support to help people to prepare for the changes, to become more independent (e.g. holding their own medication, purchasing their own safes to store their money).
- take on more control, the people who we support were ready for the next steps towards independence.
Throughout the consultation process, we checked understanding and reviewed how each person was feeling at each stage; working closely with their advocate, Care Manager and supported by the staff team, regular consultation meetings were held, involving relatives, with follow-up 'house meetings' to go over the key points, and to respond to specific questions and concerns.
Outlook Care decided to remodel the service in Raydons Road, Dagenham to provide more choice and control to the people who live there. The intended improvements were:
- to give people more choice and control.
- to provide more personalised services.
- to offer more flexible support.
- to reflect 'Valuing People Now' and Local Authority initiatives.
- to prepare staff for a fundamental shift in the way in which social care is delivered.
- To train them to work more flexibly to help meet the personalisation agenda.
Outcomes were measured via:
- Service User Satisfaction Survey - comparison now and then.
- Person-Centred Plan reviews - comparison now and then.
- Measuring the amount of outcomes achieved.
- Measuring the amount of new outcomes identified which relate to increased independence and personalization.
- Measuring the number of Positive risk assessments indicating that people are trying new activities.
- Measuring the level of risk - now and then - has there been a decrease in risk as people gain more skills and increase their independence.
- Feedback from staff.
- The people who use the service are going out more as a result of a more flexible approach to support e.g. One person is able to visit the local pub on Christmas Day which he has always wanted to do. He is able to use part of his personal budget to pay for a member of staff to accompany him. This was not possible before the changes took place.
- The people who use the service are more involved in staff selection and recruitment process.
Outlook Care began the transformation process in October 2009 and worked in partnership with the commissioners - the London Borough of Barking and Dagenham:
- to provide accessible information to the people who use our services and their relatives to help them to understand the changes and decide if this is something they wish to do.
- to explain the concept of Personalisation and how it can transform lives.
- to support the people who use our services through the Self Assessment Questionnaire and Resource Allocation process.
- to work with the people who use our services with their individual support plans.
- to support people to manage their Individual Budgets.
- Staff presentations and workshop sessions with managers and support staff to ensure that they understood the changes and were in favour.
For the people who live at Raydons Road, the transformation of their support, and their increased rights and responsibilities as tenants has already had a significant and very positive impact on their lives.
- Exploring alternatives to paid support; being more creative in using the Individual Budget to achieve outcomes.
- Planning supported holidays to achieve wellbeing outcomes.
- Increasing community participation through trying new activities in the community and accessing community-based support (e.g. at the gym, at the swimming pool, at church).
- Developing networks and greater community links to resources (e.g. signposting to CAB, Housing, Benefits).
- Increasing natural support through formalising links with family and friends, and recruiting volunteers.
- Exploring education and employment opportunities.
- Accessing therapies for self development and wellbeing.
- Working with one person to achieve his goal to move on and live more independently.
- Moving from Individual Service Fund Agreement to increased control over the money as people gain confidence.
- Moving towards people employing their own Personal Assistants for individual support.
By working in partnership with the local authority, staff and people who use the service, the process has been changed for the better, and has and introduced marked efficiency savings, whilst also helping to meet local authority targets for personal budgets. The remodeling process enables people to live their lives more independently and be more flexible with their support and care. It means that they can choose when and how their support is delivered, and only pay for the support they require. In addition, it represents cost savings for local authorities at a time of economic difficulty.
As a provider, this project has enabled us to change our systems and processes in line with the demand of the emerging personalised market place. Our financial management systems of invoicing, collecting payments together with our operational staff deployment processes have all required significant change. Such changes are future proofing our organization to meet the markets demands, ensuring our ongoing sustainability.
Raydons Road was funded directly by the Local Authority Social Care department, with a contribution from service users' DWP benefit payments. The cost to the Local Authority Social Care department included the housing and property costs of the building and for staffing at the levels required by the Care Quality Commission. The cost to the Local Authority for Raydons Road as a registered care home was around £250,000 per year (net cost after service user contribution to care).
Following transformation the Local Authority Social Care department now only funds the Social Care provision through the Individual Budgets allocated to each person. As there are 7 people living at Raydons Road there is a shared / 'core' support component: the total of the Resources Allocation for all 7 people living at Raydons Road, funded by the Social Care department is currently £181,000 per year.
Rent, Housing and Property costs are now paid directly by the tenants; as they are all eligible for Housing Benefit and Council Tax benefit they only pay a service charge to the Landlord to cover communal maintenance.
With everyone who lives at Raydons Road now in receipt of all of their DWP benefits entitlements, they now have more money in their pocket.