SELF DIRECTED SUPPORT IN HARTLEPOOL

Hartlepool decided in 2006 to go for total transformation around personalisation as part of the inControl programme. Led by Nicola Bailey Director of Adult Social Care at the time (now Director of Child & Adult Services) engagement was entered into with users of services, carers, Members, the Chief Executive, staff and colleagues in the wider council.

A vision was set out to create a social care system that was equitable, gave people information at the front end of the process both around what options were available to them outside of the social care system and should they need social care support then what resources would be available to them from the outset. This whole approach was kick started in one year at no extra cost (other than blood, sweat and tears).

In order to implement this vision it was necessary to invest in a good universal information system – this is a web based system called Hartlepool Now which holds up to date information about communities and is for all not just those with a disability or elderly. Acknowledging that not all individuals would want to use web based systems a lot of effort was put into making sure that the wider council ‘got on the bandwagon’ and therefore information was key in areas such as libraries, community centres, recreation centres, housing support offices etc.

To allow individuals to know what their resources would be up front a 2 parted Resource Allocation System (RAS) was created – this was in the form of a Self Directed Assessment Questionnaire (SDAQ) and a Resource Allocation method. The questionnaire ensured needs were assessed in the same way for everybody and ensured that details of available social support were assessed and recorded (this was more than just unpaid carers). The new process started for all user groups in December 2007 and individuals completed the SDAQ process and were then told up front what their ‘indicative allocation of resources’ was. With this information they were able to plan with family, friends and professionals dependent on what suited them to create a Support Plan that met their needs not those of workers or organisations. Shortly after the process began the department also implemented a new Contribution Policy – this swept away charging for specific items of service and acknowledged that if the individual had a total resource allocated to them the contribution should be spread across the whole plan. The current policy states that the individual will pay 75% of the value of a support plan up to their ability to pay following a means test. This approach has ensured the principles of contribution/sharing resources.

There are approximately 1500 people currently using Personal Budgets but due to demographic changes probably double that have been through the system since inception.

The new system has enabled individuals to be in the driving seat of the services they want; they can commission directly through Direct Payments or engage the dept to commission on their behalf. They have through their choice and control generated new providers and the ‘old’ providers have stepped up their game and are providing much more person centred and value for money services.

System inherently measures the value of social capital and allows intelligence to enable investment and sustain informal networks be they direct carers or groups of supportive individuals. Although the system takes into account the contribution of the caring role it does it in such a way that the basic needs of individuals are never discounted.

This approach is now embedded in Hartlepool and because of that people stay at home longer, better value for money, they spend their resources on what they choose. Even individuals who choose to allow care managers to commission on their behalf know the costs and know they can make different choices. Agencies/providers are aware that individuals can change provision very simply which has increased qualities and outcomes for people and avoids the ‘we’ve got the monopoly mentality.

In this system we have shifted from a gift model to recognise the real wealth that people have within themselves and around them – our system aims to compliment the lives of people with disabilities rather than trying to shape them into services. Linkages with the community are intended to broaden the experiences and opportunities rather than to isolate as set services often do.

CONNECTED CARE

Connected Care (CC) is a model which seeks to address fragmented service provision and provide local services that are co-designed and produced by local people and rooted in their local communities. .

CC went live in 2008 with a small team of navigators who work with people using low-level interventions and linking them to more specialist services when required. The focus is on early intervention and prevention.

In 2010 a Community Interest Company (CIC) was set up to develop and commission services to support the people in Owton ward to live independently and achieve a better quality of live. The CIC is the business arm of Connected Care and trades/commissions services and has a Board of Directors drawn from local organisations that have a wealth of experience in developing local community services. CC is embedded in Manor Residents Association, a thriving local social enterprise with over 20 years experience of developing local services. It has deep roots and strong networks into the community and an understanding of what is needed. A significant number of people who come to CC for support end up volunteering to put something back into the community which they see as having been there for them when they needed support.

CC is funded by the PCT, Hartlepool Borough Council, Housing Hartlepool and a range of funding drawn in by the CIC. The services offered by CC and the CIC include:

  • Navigators working with people on a range of issues including debt, poverty, family welfare, volunteering, employment, health and social care, housing, volunteering, mediation, home safety and bereavement. (Well over 2000 people have used navigators and low level support)
  • Handyman repair service and the Supporting Access to Independent Living Service (SAILS) which supports people in their homes – gardening, meals, call-back/ service.
  • Outreach sessions at the local primary care centre. A significant number of people have been supported to register with a GP.
  • Time Bank where people share their skills which affirms their self-worth and confidence.
  • Future Jobs Fund helping people into training and jobs.
  • Benefits and Welfare Advice service with £200,000 secured in 2009/10 for residents
  • Partnership with Accent Foundation Housing Association to supportyoung vulnerable tenants. CC is due to be rolled out to the rest of the borough over the next 3 years. Whilst CC grows in the other areas of town the LA and PCT will continue to fund the core navigator service. The CIC will generate 100% income /support to run all low level support/early intervention projects. These low-level services are clearly keeping people out of hospital or delaying their move into residential care. These services are new to the community and have not therefore affected other local businesses but may reduce the need for LA-arranged home care following assessment. This income will be generated from a range of sources such as grants, personal budgets and charging where appropriate when people are self-funding. Some CIC services are new and limited to Owton such as the Time Bank while others are town wide and all can benefit.

The CC model meets the objectives of localism, the Big Society and empowering local communities. The services are close to the community, often run by local volunteers and accessible. Navigators provide a one stop shop in terms of information and drawing the services as needed, linking people together into circles of support. Time bank is a good example of this model as well as the breakfast and after school clubs which are run by local volunteers.

Outcomes from these services include securing housing for homeless people, providing hot meals and daily call-back to vulnerable people, maintaining gardens. CC supported a family, following Mum’s stay in prison to get her 5 children out of foster care which resulted in a cost saving to the LA of about £5,000 a week. Also support for older woman who had become reclusive and was in dire health and was resisting help from LA services. Navigator is able to build relationship (both local women) and link her to local networks. Housing issues resolved and health much improved. The model is based on local volunteering and good neighbour ethos.

It costs CC £20 to provide 7 meals a week to a person. This includes the administration of the service. It would cost the LA £37.80 to put a home-care worker in for half an hour each day to prepare a meal and to this must be added social work/admin costs.

The CC model maintains the person’s links with their communities, friends and neighbours who often also volunteer.