Adult Social Services
Programme Initiation Document
22
Contents
1 / Introduction and Background / 52 / Programme Definition / 7
3 / Programme Governance Structures / 18
4 / Programme Approach and Controls / 23
5 / Appendix 1: Referenced Documents / 25
6 / Document Information / 26
Summary: Changes to the Programme Initiation Document (for v8)
Version 7.2 of the Programme Initiation Document was approved at the programme board meeting in September 2007. It has been used as the basis of the programme’s governance since that time.
Version 8 of the Programme Initiation Document has been developed to formalise the changes to the programme agreed by Adult Social Services’ senior management team on 4th September 2008. It is being presented for approval at the programme board meeting of 26th September 2008.
The key changes between version 7.2 and version 8 are as follows:
· Exclusion of commissioning work from the programme’s scope – instead sitting it as the responsibility of the new Strategic Commissioning Team. This reflects the direction given by Adult Social Services’ SMT in later 2007.
· Update the project definitions and timescales to reflect both the learning and also the slippage that has happened in the last year.
· Build links with the Future Shape of the Council programme. This is both as a general dependency, but also specifically through closer links on customer engagement, policy development, and the development of a market for external support planning.
· Revision of the programme’s governance structures. These changes are complex, and it is recommended that section 3 of this document is read in full.
Questions for programme board attention:
It is noted that the redevelopment of this PID would be a good opportunity to create a set of outcome measures for the programme (linked to new national, outcome-focussed, PIs). The board’s advice and approval for this are requested.
The views of the programme board are also sought as to whether Cllr Hillan should be a member of the programme board, under the new arrangements outlined in section 3 of this document.
The table below provides a detailed summary of the changes that have been made to the Programme Initiation Document between v7.2 and v8. All reference numbers are taken from v7.2.
Section / Change1.1 Document Purpose / Removal of paragraph 1.1.4, which stated that the Project Definition and the Programme Resource Summary would normally be updated before each programme board meeting.
1.3 Methodology / Rewording of paragraph 1.3.1 so that it reflects the decision that commissioning work should be done by commissioning teams, not directly delivered by the programme.
2.2 Programme Products and Success Criteria / Re-grouping of the list of products to separate work being delivered by the programme and work being delivered by commissioning staff.
Note: the development of independent brokers is being regarded as a programme activity, rather than a piece of commissioning work. This reflects the need to tie the work of independent brokers seamlessly to our internal processes.
2.3 Product Dependencies / Update the diagram of product dependencies.
2.3.1 Programme Dependencies / Updated to reflect links to Future Shape of the Council programme.
2.4 Project Definition / Updated to reflect progress since September 2007 and current forecast timescales. The diagram was also updated to reflect this.
Removed reference to activity now defined as Commissioning Work.
Removed reference to analysis of links between projects and Medium Term Financial Strategy, which was done in late 2007.
Addition of a paragraph noting that the EDRMS and Independent Brokerage projects will form elements of the corporate Wisdom roll out and Future Shape of the Council work, respectively.
2.5 Change Management Activity / Added a paragraph explaining that the engagement with the wider community will be linked to the work of the Council’s new strategic core.
3. Programme Governance Structures / Completely re-written to reflect the new structures.
4. Programme Controls / Minor changes to reflect new governance structure.
Removal of references to the Risk Management group, reflecting dissipation of the Council’s programme office and the advice of Manjeet Bhania that this group was not adding significant value.
Appendices 2 & 3 (programme comms and resourcing) / Removed as these are recorded and being managed in other documents.
1. Introduction and Background
1.1 Document Purpose
1.1.1 This is the Programme Initiation Document (PID) for the London Borough of Barnet’s ‘Delivering Choice and Independence’ programme. This PID defines:
· what the programme will deliver;
· how the programme will be governed;
· how the programme’s progress will be monitored and controlled.
1.1.2 This PID acts as the ‘contract’ between the Programme Manager and the Programme Board. The PID provides both parties with a framework that supports the successful attainment of the programme’s objectives within a controlled environment.
1.1.3 This PID is a ‘living’ document. It will be updated to reflect significant changes to the programme or pertinent changes in the wider local or national context. The Programme Board will review and approve any changes to this document.
1.2 Background
1.2.1 Cabinet approved an initial 3-year Vision for Adult Social Services on 15 January 2007. This established a strategic direction for Adult Social Services based on increasing customer choice and control over services through large scale implementation of individualised budgets and development of self directed support. Cabinet agreed that if choice and control are to be meaningful, a radically different landscape of services will be required where providers will increasingly need to respond to individual service users as commissioners and purchasers of services.
1.2.2 As a consequence, the Council, and Adult Social Services in particular,[1] will need to develop the capability and capacity to provide support and assistance via brokerage and advocacy functions to help service users identify, purchase and manage their own care choices, as well as having more developed market management capabilities exercised on behalf of the whole community where increasing numbers of people will wish to find self care solutions to their needs. This is a fundamental shift from the current arrangements where care packages are, in the main, determined by care managers and other local authority employed professional staff. The programme of change will fundamentally shift the decision-making power from the Council to individual service users.
1.2.3 Subsequent to the Cabinet decision on 15 January, a more detailed plan of action for the attainment of the vision was developed (the Vision Action Plan). This provided a comprehensive definition of the outputs that needed to be delivered. These outputs will impact on every service user and every member of staff in Adult Social Services. They will revise:
· ways of working;
· ways of commissioning and procuring services;
· relationships between care professionals and service users, their families or advocates;
· requirements of information systems.
1.2.4 The Vision Action Plan was adopted as the formal policy of the Council on 18 June 2007.
1.3 Methodology
1.3.1 A large proportion of the work defined in the Vision Action Plan will be directly delivered through the ‘Delivering Choice and Independence’ programme. The exception to this is commissioning work defined in the action plan, which will be delivered by the service’s commissioners. Work delivered directly through the programme will be managed in a way that ensures that its constituent projects are operating within a controlled environment. To do this, the following principles will be adhered to:
· all activity should take place within a clearly defined governance structure;
· all activity should contribute to the delivery of formally defined ‘products’;
· all activity should be preceded by strong planning;
· all activity should be subject to formal monitoring and control mechanisms.
1.3.2 The programme’s constituent projects will be managed following the London Borough of Barnet’s Corporate Project Management Toolkit, which is derived from PRINCE2.
1.3.3 Where a project includes commissioning, contracting or procurement activity, that activity will be managed using the Council’s regulations for those activities.
1.3.4 The Programme Board incorporates Adult Social Services’ senior management team (SMT). This Programme Board, rather than SMT, will be the main decision-making body in relation to the programme. It should be noted, however, that the programme will report into other senior bodies, such as Council Directors Group, Cabinet, and the Future Shape of the Council board. The Programme Sponsor (the Director of Adult Social Services) will lead on such reporting.
2. Programme Definition
2.1 Programme Aim and Objectives
2.1.1 The Vision provides an analysis of the relationship between Adult Social Services’ vision and corporate and national drivers. In turn, the Vision Action Plan describes how the implementation of the vision would have wide ranging impacts on the Council’s staff, our partners and service users. This PID builds on those documents by providing a concise description of the programme’s aim and objectives. This is given in sections 2.1.2 and 2.1.3, below.
2.1.2 The aim of the programme is to create an environment that:
· empowers vulnerable adults and their carers to direct their support; and
· enables vulnerable adults and their carers to choose support that reflects their desires and needs and is affordable.
2.1.3 The programme will do this by achieving the following objectives:
· delivering a consumer driven Adult Social Services directorate; and
· developing a consumer driven care market.
2.1.4 In addition to the above, the programme has two ‘internal’ objectives. These are to deliver a consumer driven Adult Social Services directorate and care market in a way that:
· delivers the budget reductions defined in the Medium Term Financial Strategy; and
· effectively supports all stakeholders through the changes generated by the programme.
2.2 Programme Products and Success Criteria
2.2.1 The Vision Action Plan provides a comprehensive description of the outputs that needed to be delivered to achieve the Service’s vision.[2] For the purposes of this programme, those outputs have been divided into three categories, namely:
· Products: tangible changes to Adult Social Services that will be delivered by the programme;
· Change Management Activities: outputs that will facilitate the successful delivery of the programme’s products;
· Commissioning Work: changes to the local care market, which will be delivered by the council’s commissioning staff.
2.2.2 The table below lists the products and the commissioning work defined in the Vision Action Plan.[3] It also defines the criteria that will be used to judge the success with which each product was delivered.[4]
Output / Success Criteria /Programme Products
Resource allocation system / · The RAS tool is applicable to all client groups
· The RAS tool delivers savings by decreasing the proportion of younger adult clients who have high-cost placements
Supply management team / · The team includes brokers who work directly with service users but do not set budgets
· The team more effectively manages contracts than its predecessors
· The team more effectively controls expenditure than its predecessors
· The team’s activity supports market diversity and the take up of individual budgets
· Improved domiciliary care monitoring enables a £450k budget decrease
· Decreased use of spot purchases enables a £20k budget decrease
· Renegotiated residential contracts enables £600k budget decrease
· Improved procurement of spot contracts enables £125k decrease
Revised care management teams / · The teams include brokers who work directly with service users but do not set budgets
· The teams include care managers who support service users with complex needs and / or individual budgets
· The teams produce outcome-based assessments
Single access point / · The team includes staff who can assess people with simple needs and apply the RAS tool to their case
· The team can directly progress simple cases to brokers
· The team can act as a ‘signpost’ for those not meeting FACE eligibility criteria
· The team can directly progress complex cases to care managers
· Model is developed with input from NHS partners
Revised business processes / · The business processes support the RAS
· The business processes support brokerage
· The business processes support outcomes-based assessment
Upgraded CM2000 / · The Council pays domiciliary care providers for the actual amount of care provided, rather than the amount commissioned.
· Payment for actual care provision enables a £400k budget decrease
Improved Swift / · Use of Swift’s financial management modules rationalised / unified
· Improvements enable devolved budget management
· Improvements enable improved income and debt management
· Improvements enable business intelligence reporting
EDRM / · Wisdom provides electronic document management for service user and carer files
· Wisdom enables electronic file sharing between teams
· Wisdom provides potential for file-sharing with non-LBB staff
eSAP / · Protocol provides improved assessment recording tool
· Protocol links with other systems (Swift and Wisdom)
· Protocol provides the potential to integrate with other organisations’ care management systems
Social care portal / · Portal provides information on demand for staff, consumers, suppliers, partners and the wider community
· Portal facilitates self-assessment
· Portal possibly supports individual budget management tool
Information systems requirements analysis / · The Service’s future information systems needs are identified.
Long term conditions teams / · Teams provide intensive support for people with long term conditions
· Integrated teams (with NHS trusts) are created to support people with learning disabilities, physical and sensory impairments and mental health issues (for both older and younger adults)
· A team is created for older adults (a model that reflects our relationship with health needs to be developed, but this may not be full-fledged integration)
Increased strategic commissioning capacity / · This capacity reflects the Council’s commissioning relationships with NHS trusts and other partners.
· This capacity is organised to work closely with the Supply Management Team
Independent brokers[5] / · Independent brokers will work directly with service users but do not set budgets
Commissioning Work
Remodelled day care services / · Day care is targeted for people complex and specialist needs
· Remodelling of services enables a £100k budget decrease
Market development strategy / · Strategy covers:
o use of pre-procured services
o remodelling of existing services
o decommissioning of existing services
· Strategy paces change to avoid destabilisation of the market
Rehabilitation service for people with neurological conditions / · This includes community-based rehabilitation
· This is commissioned in partnership with the NHS
Recommissioned intermediate care service / · This aligns with the Enablement service provided for domiciliary care
Recommissioned Enablement service / · This includes a specialist Enablement service for people with mental health issues
Remodelled NHS intensive response service / · This should be a multi-disciplinary team
· The team incorporates specialists in supporting people with behaviours that challenge
Remodelled Supporting People-funded services / · This provides an increased level of housing-related floating support for disabled people living at home
Telecare services / · This is included in the Barnet ICES contract[6]
Reprovision of 2 new homes for people with dementia / supported living accommodation / · This is delivered in partnership with the Tamarisk Trust
· Each home has 22 beds
Sanctuary Housing / Wood Court / · This provides 90 units of Extra Care housing
Reprovision of 2 residential homes as Supported Living flats / · This is delivered in partnership with Adepta and Norwood
Transition service for Young People / · This is delivered in partnership with Notting Hill Housing
· This provides 7 self-contained flats
· This provides 24 hour support for residents
Supported living service for the Asian Community / · This provides 8 flats
Paid employment for people with learning disabilities / · 100 people with learning disabilities are in paid employment
Formal separation of the Council’s commissioning and in-house provision of services for people with learning disabilities / · The Fairer Pricing Tool is utilised when care packages including in-house provision are generated
· The relationship between the commissioning and provision functions is managed through a service level agreement
· The use of the Fairer Pricing Tool enables a budget decrease of £176k
Remodelled Flightways / · Flightways provision is focussed on enablement
· Flightways provision is focussed on community-based day activities and opportunities
· Remodelling Flightways enables a budget decrease of £325k
Reduced respite services / · Remaining services are targeted on people with complex and / or specialist support needs
· Reduction in services enables a £200k budget decrease
Resettlement of people with learning disabilities from residential care to supported living / · Resettlement enables a £1.419m budget reduction
Remodel nursing home block-procurement and domiciliary care procurement / · This aligns with the introduction of individual budgets for older people
· Remodelling enables a £100k budget reduction
Information and advocacy services / · Advocacy services provided for older people
· Advocacy services provided for people with physical or sensory impairments
· Barnet User Group delivers advocacy services for people with learning disabilities
2.2.2 The output-focussed success criteria listed above should be complemented by a set of outcome-focussed ones. In 2008/9, CSCI will utilise a suite of outcome-focussed performance indicators to monitor the performance of the Service. This programme’s outcome-focussed success criteria shall be defined once these new PIs are available. This will link the programme’s success to nationally recognised and comparable figures. It will also help control the Service’s performance management workload.