Homecare and personalisation

Context

• Personalisation is central to the social care policy of successive governments and is at the core of the Care Act 2014

• Major implications for homecare. Practical challenges to commissioners and providers but also real opportunities to develop and improve support

• Homecare perhaps not received same attention as some other areas in personalisation

• But high level of political and public attention• Some developing approaches with potential for

homecare

Our work

• Emerged from discussions about practical approaches to personalising homecare with UKHCA

• Explored changes that both commissioners and providers can make within the constraints they face to personalise home-care

• Developed products available on an open source basis for commissioners and providers to use (with sponsorship from Mears)

Products

The products of the project are:

•An outline approach to ISFs in homecare that can then be developed and used by interested commissioners and providers. A short paper outlining the approach•A home care version of the Progress for Providers tool available for use by providers – making a contribution to the wider development of personalisation in homecare, including delivery of the Think Local Act Personal Making it Real markers of progress

Personal budgets

• The Care Bill says all people eligible for community based social care will receive a PB

• And actually, many older people are getting benefits from personal budgets

• But there is still a lot to do to make sure that PBs make a good contribution to personalisation for older people

Think Local Act Personal Review

• ADASS in The Case for Tomorrow pointed to some challenges and called for a review

• Age UK and the Alzheimer’s Society pointed out older people, isolated people lacking capacity, people with dementia not benefitting equally

Questions

Been asking:

•What does the research tell us?

•What are the numbers of older people using PBs?

•What are councils finding to be the main challenges?

•What solutions are people finding/trying?

First Report

www.thinklocalactpersonal.org.uk or http://bit.ly/13HC9Hw

Numbers

• 2012/3 for 65+ increase from 36.6% to 46% (NHSIC) to 412,000

• Percentage of personal budgets that are managed budgets only: 18-64 = 58%, 65+ = 86% (NHSIC)

• Very significant regional and local variations

Are personal budgets making a difference for older people?

• 2nd National Personal Budgets Survey (NPBS 2013) reported that:

• While personal budgets had less impact for older people than others in some areas of life and support, they still had a generally positive reported impact:

• A majority of older people reported a positive impact of their budget on 9 out of 13 areas of their lives

• Less than 6% of older personal budget holders reported a negative impact on any of the 13 areas of their lives

• Older people were similar to other groups in reporting their budget making their lives better in seven areas and less likely to so report in six areas

• Getting help to plan the budget• Feeling their views were included in the support plan• The council making all aspects of the personal budget

process easier across all groups

To produce the best results for people the processes should be:

• User friendly• Transparent • Controlled by the person • Engaging

What makes a difference?

Promising practice – not just about personal budgets

Oliver, Foot and Humphries 2014

For example:oMaking it easier for older people and families to find out about, get and use personal budgetsoSupport to planoInformation advice and guidanceoHelping staff offer and support PB useoFit with prevention, re-ablement and crisisoDeveloping the choices availableoFit with safeguardingoSupporting people lacking capacity and without supportive local familyoSupporting provider development

Promising practice

Why ISFs and Provider self-assessment?

• Personal budgets mandatory, many older people likely to opt for managed PBs. Managed PBs not currently offering sufficient choice and control – ISFs a way forward

• Providers want to continue to improve and show commissioners and PB holders/self-funders what they can do