The impact of personalisation on social care providers•Personalisation equated with being more...
17
The impact of personalisation on social care providers Martin Stevens Jill Manthorpe Jess Harris Jo Moriarty Shereen Hussein
Transcript of The impact of personalisation on social care providers•Personalisation equated with being more...
The impact of personalisation on social care providers
Martin StevensJill Manthorpe
Jess HarrisJo Moriarty
Shereen Hussein
2
Acknowledgments and disclaimer
The research team is grateful for the funding from the Department of Health. And very grateful to all participants in the study.
The views expressed in this presentation are those of the authors, not necessarily those of the Department of Health
Introduction
• Recapping emergence of personalisation
• Impact on providers
• Longitudinal Care Workforce Study
• Findings
• Implications
Direction of travel
Empowerment and
citizenship.
Ability to able to choose the best services
Lymberry (2012).
Social care providers
• 17300 organisations providing and organising
• 39,000 ‘establishments’ (individual care homes/home care branches)
• Half residential, half home care
• Two thirds CQC regulated
Marketisation of social care
36%
5%
94%89%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Care Home Home Care
1979
2012
Fotaki, Ruane and Leys (2013)
Marketisation of Social Care
• UK has gone further than many European countries in privatising social care provision (Daly and Lewis, 2000)
• Commercial priorities, at timesof austerity can affect quality (Greener, 2015),
• Increased demand at a time of reduced public spending makes it harder to provide emotional aspect of care (Lynch, 2007)
Personalisation and social care providers
Early messages from IBSEN:• Providers mainly positive about the idea of
personalisation • Some were able to offer more flexible services• Fears about invoicing and loss of staff (not found in a
later study - Rodrigues et al, 2015)• Hopes that service users would continue to use
services, even with greater choice
Contracting
• Block contracts to framework agreements
• Individualised purchasing
• Preferred and approved lists
– indication of quality
– reduces choice?Boyle, 2013
The Longitudinal Care Workforce Study
• Aims to increase understanding of the factors that facilitate or constrain recruitment and retention in the social care workforce in England
• Methods at two time points (Time 3 is underway)– 300 interviews care home and home care managers
(n=112) and staff (n=117) and service users (n=71)– Online survey of social care staff – Time 1 = 2009-2011; Time 2 = 2010-2014
• Presentation draws on interviews with care home and home care managers and staff
• Data coded at ‘personalisation’ node recoded for this presentation
Findings
• Four themes:
– Awareness of personalisation and understanding its potential impact
– Adapting services
– Contracting
– Impact on the business.
Awareness of personalisation and understanding its potential impact
• Increasing understanding of importance of personalisation
• Care homes – Personalisation = Person-centred– ‘We are trying to personalise it as much as possible
within the four walls’. Care Home Manager 9 2009 T1
• Home care – Personalisation = flexibility– I don’t think there will be many places
would be able to say, well, actually we take washing away to wash for individuals. It’s about personalising it. Home Care Manager 76 2009 T1
Adapting services
• Care Homes for people with learning disabilities: Moves to supported living?– we’re used to a residential regime and now
obviously we’re adapting to working with [Support worker agency supervisor] and the team Care home manager 171 2011 T2
• Home Care: micro changes in provision– No, not really. I mean, erm, care is sort of
allocated in regards to the amount of time they have got. From social services it’s task orientated: Home Care Manager 78 2012 T2
• Day services and centres: changing patterns of provision to ‘follow the market’. Concerns about continued availability of specialist services
Contracting• Block contracts to Individualised purchasing
– More uncertainty: ‘But that left us in a position that we could have been wiped out in a day’.Home Care Manager 75 2009 T1
– Creates drive for increased competition:‘What we’ve found now is because the block contracts have ended, a lot of clients can choose where they go, so they’re asking to come to us because they weren’t happy where theywere, which is good. ‘
Home Care Manager 172 2011 T2
Impact on the social care market• Personalisation, simply a thinly veiled attempt to save money?
– It’s cost driven as well, I think, if I’m being honest, the perception is that it’s cheaper to do it that way and I don’t think it is.” (Care Home Manager 10 2009 T1)
• More marketing required– The last resort now is a sandwich board down town
Care Home Manager 118 2011 T2
• Changes in local placement policy – It's all down to [local authority’s] contracts, for whatever reason,
they're not referring anybody anywhere. So it's a struggle, it's a struggle. And I expect if we don't pick up, there's possibilities of closure. Care Home Manager 118 2011 T2
• No ‘shopping around’– But it doesn’t happen, because they are not
shopping around. Basically, their budget is organized by their care manager or social worker and they are told what there is. Home Care Manager 75 2010 T2
Discussion and conclusion
• Personal budgets has more impact on social care providers than direct payments
• Personalisation equated with being more person-centred and flexible care
• Hard to distinguish impact of personalisation from austerity, though the two are linked
• Changes in contracting and increased uncertainty potentially limits the market and choice and quality
Thanks for listening
Research team:Martin Stevens [email protected] Manthorpe [email protected] Harris: [email protected] Moriarty: [email protected] Hussein: [email protected]
The Longitudinal Care Workforce Study:http://www.kcl.ac.uk/sspp/policy-institute/scwru/res/capacity/locs.aspx
