Individual Service Funds

Colin Angel, Policy Director

@colintwangel@ukhca

United Kingdom Homecare Association

Member-led professional association Represent 33% of UK’s independent and

voluntary sector homecare agencies Promote high quality, sustainable care services so

that people can continue to live at home and in their local community

Provide campaigning, leadership and support

@colintwangel@ukhca

What is an Individual Service Fund (ISF)?

The management of a service users’ personal budget to achieve agreed outcomes

Council pays budget directly to the provider Provider arranges care according to the users’

wishes

@colintwangel@ukhca

Individual Service Funds for Homecare from In Control

Authors: Caroline Tomlinson (In Control) Michelle Livesley

(Helen Sanderson Associates) Sponsors:

UKHCA Mears Care Limited

Contributors: People who use services Wirral and Lancashire councils

Get the publication from In Control [Link]

@colintwangel@ukhca

Where ISFs fit with Government policy

White paper “Caring for our future”: Services close to home Greater choice and control

The Care Bill: Commissioning for wellbeing Personal budgets as an entitlement Direct payment as the preferred delivery method

@colintwangel@ukhca

ISFs and degree of control(for illustration purposes)

Council commissione

d service

Council or3rd party managed personal budget

Direct paymentto buy

services

Individual ServiceFund

Direct payment to

employ personal

assistant(s)

Less individual control More individual control

@colintwangel@ukhca

Why is UKHCA supporting ISFs?

Benefits for users, providers and commissioners

Traditional purchase models don’t make best use of scarce resources Prescriptive planning Pressure on price & visit times

@colintwangel@ukhca

The impact of current funding on homecare visit duration

<= 15 minutes

16-30 minutes

31-45 minutes

46-60 minutes

Over 1 hour

10%

63%

11% 10%6%

Source: Angel, C (2012) Care is not a commodity

@colintwangel@ukhca

How and ISF works(A simplified overview)

1. User receives personal budget allocationfrom council to meet outcomes

2. User designs their support plan with the provider

3. Budget is paid to provider on a regular basis User can buy additional services, if desired

4. Provider delivers the service including buying services from elsewhere, if necessary

5. Provider able to account for how the budget is spent in “near real time”

6. Council that desired outcomes are achieved

@colintwangel@ukhca

The relationships within an ISF

Specifies compliancerequirements and obligations

1. Agreement & funds

What is provided

and when

3. Support Plan

State

men

t of a

mount p

aid

and u

ser c

ontrib

ution

2. ISF d

etai

ls

Council Provider

Serviceuser

@colintwangel@ukhca

The benefits for…

People who use services

Can increase chance to remain at home Reduces implications for the individual of:

Managing a direct payment Becoming the direct employer of a PA

Greater control over service Individual can prioritise what's most important for them Reduces "time and task” / inflexible commissioning

Similar control as enjoyed by private purchasers Potential to be used by people who lack capacity

With appropriate support and advocacy

@colintwangel@ukhca

The benefits for…

Homecare providers

Offers greater flexibility: User and provider can negotiate care plan

to find ‘best fit’ between choice and resources Avoids prescriptive or inflexible plans, with unnecessary

authorisation procedures for minor changes

Greater assurance of payment: Avoids credit control costs, reduces write-offs Better cash-flow, with predictable income

Higher satisfaction for customers and staff Similar processes to private-purchase work

@colintwangel@ukhca

The benefits for…Local authority commissioners

Can create a fast-track process to get people onto personal budgets

Has the assurance that outcomes are defined Agrees the outcomes with the person using the service But leaves the detail how and when to the experts

Reduces contracting effort But savings need to be passed to providers, who take on

this role

@colintwangel@ukhca

People with an ISF should be able to say…

“I am fully involved in decisions about my own support and how the wider service develops”

Co-production

“I choose how I am supported and my support workers know this is important to me”How?

“I get support on the days and at the times that are right for me”When?

“I choose who I want to support me. My support workers know me and I know them”Who?

“I am supported where it makes sense for me; at home and out and about”Where?

“I can use my hours/budget flexibly and can choose what I am supported with”What?

@colintwangel@ukhca

Some practical considerations

How the payment made? In advance or arrears?

Is users’ contribution paid to council or provider? Provider-collection is higher risk, but may increase QA

Need a system for dispute resolution Eg. missed visits, or user not at home when expected

What is the price? Management costs different to high-volume contracts

Develop experience in responsive plans Especially if not already supporting self-funders

@colintwangel@ukhca

Making ISFs work in practice

ISFs need to be an available option to all Willing providers must be identified and

able to deliver Effective contracts need to be in place

All parties must understand their responsibilities A specimen from Lancashire included in paper

Monitoring to ensure that outcomes are achieved Reviews 6-weeks to check bedded-down, then annually,

or when needs change

Trust is required between councils and providers

@colintwangel@ukhca

How to contact me

Website:

www.ukhca.co.uk

E-mail:

colin.angel@ukhca.co.uk

Telephone:

020 8661 8152

Twitter:

@colintwangel