25 November: Workshop 3

The third of the four workshops took place on Friday 25 November and brought together the seven discussion leaders and their reference group members.

The session was a valuable opportunity for attendees to share views and the insight collected to date.

Watch the films below to see what Sian Lockwood (Chief Executive, Community Catalysts), and Miranda Wixon (Managing Director, Home Care Partnership) had to say about the workshop.

Key points

Sian Lockwood

  • Sian brings her knowledge of the complications of making personalisation work in practice
  • Sian understands the barriers that prevent personalisation
  • During the workshop they agreed the top 5 priorities for action in the personalisation workstream and how these fit into the Governments wider priorities for social care.

Miranda Wixon

  • Believes that service users want to be cared for at home and in a personalised way
  • A wide range of groups have been able to have their say on the future of care and support including service user groups, staff, informal carers, and people working directly with people with disabilities
  • It’s clear that people think personalisation is a good idea. The challenge is how do we deliver?

Tell us what you think using the comments field below.

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9 Responses to 25 November: Workshop 3

  1. Elmira says:

    That hits the target pfercelty. Thanks!

    • Byron says:

      user-involvement, support krwtoens, a system that is unburocratic and decent funding are the key aspects for a personalised service. As a disabled person I have been using Direct Payments since the mid-nineties I employ Personal Assistants rather than having agency carers or living in residential care. I work in the field as a personal budget co-ordinator in a user-led disabled persons charity but the majority of peopl on my books use traditional methods of meeting their needs especially agency care.So why aren’t more people trying some of the more innovative ways of meeting needs well there is a real lack of meaningful service user input we are not consulted from the start but after strategies and policies have already gone through several draft stages and a final draft is reached,. There is not much training provided to help people change their mindset we are taliking Social services and users themselves professionals are still paternalistic, and users still think professionals know best. People don’t have a clear idea of what is possible, and more importantly, exactly what their responsibilities are before I recieved my direct payment I went through a 6-weeks course to help me understand possibilities and responsibilities! There is so much burocracy we are now told that we have to use specific support planning documents so much for someone being able to do a support plan in the way that suits the user and there are now restictions on what is an appropriate use of a PB, essentially limiting people to care (agency or private) or certain bits of equipment regardless of whether the more innovative uses put forward are meeting the need in the best way for the individual!As for funding, we have seen tightening elegibility criteria around the country and resource allocation systems that are designed to give the impression that they are taking account of social needs, whereas the only categories that translate into funding are personal and practical care resulting in people only being able to afford survival care . As one of the other respondee has pointed out it is very difficult to get good quality care when you can only offer a pittance in wages!And do I need to point out the decision to replace night assistance to use the toilet with the provision of incontinence pads? How can this possibly be seen as personalisation?These are all trouble spots that need to be addressed in order to really provide the opportunity for service users to design assistance that is really is personalised!The role of current, sucessful users of personalised care services is vital. Provision of peer support groups, service user champions and trainers (for both services users and professional) and service user input at the begining of any strategic decision will inevitably steer the service in the way that users choose and will highlight user issues that might be missed by professions who are on the other end of social care provision. (of course many of the members of my PB user groupl would love to be involved but their care packages aren’t generous enough as accessing the community / education / work score practically nothing on the RAS!)Independent support service are essential a support sevice provided by the same organisation that has to deal with funding restriction, tightening of elegibility criteria and paternalistic practice represent a conflict of interests we have already seen that council-funded support services told that they cannot advocate for the service user!There are no user groups that wouldn’t benefit from personalisation, however there are challenges. People can’t be set up to fail, which often happens where people don’t fully understand the system, and where the system is set up with no flexibility or where everyone has to fit the system, rather than the system fitting the individual. Additionally, development of marketplace needs additional investment, and thought concerning the support that can be given to smakk organisation providing a service and moving off a bllock contract, particularly charities who don’t necessarily have the business acumen of commercial providers.

      • Yuneli says:

        Personalisation is a good idea, however I haven’t seen the dsreviity of services developing that enables people to choose between options (the choice is to go or not go), and the development of a resource of people willing to be personal assistants seems to be struggling, possibly becuase when potential PAs are looking for work they need a decent number of hours a week to make ends meet, but possibly the PA work builds up initially as a few hours here and there. Transport and accessible activities in the community are also an issue, not merely mobility access but access for people who may say or do unsual things due to the nature of their mental health condition, memory loss etc. At present we seem to have asystem where we can pay through personalisation or Direct Payments, but the activities, transport and and social acceptance isn’t there at the level it is needed. Tehre has eben talk of stimulating the market for a long time, but it doesn’t really seem to be happening yet.

        • Evelyn says:

          Personalisation is a good idea, however I haven’t seen the dviiserty of services developing that enables people to choose between options (the choice is to go or not go), and the development of a resource of people willing to be personal assistants seems to be struggling, possibly becuase when potential PAs are looking for work they need a decent number of hours a week to make ends meet, but possibly the PA work builds up initially as a few hours here and there. Transport and accessible activities in the community are also an issue, not merely mobility access but access for people who may say or do unsual things due to the nature of their mental health condition, memory loss etc. At present we seem to have asystem where we can pay through personalisation or Direct Payments, but the activities, transport and and social acceptance isn’t there at the level it is needed. Tehre has eben talk of stimulating the market for a long time, but it doesn’t really seem to be happening yet.

      • Kory says:

        My first instinct when I saw the evicende of how sadistically LD customers were being treated was to hold the provider and its management to account. This was a complete scandal and I really do wonder how a provider in this position could survive the reputational damage this must have caused them.If it is a provider’s management issue, expecting government’, CQC or whoever, to root out this type of malpractice locally when it could re-start the moment their back is turned is not likely to be a successful. The priority is that whosoever is commissioning these services in large amounts should be ensuring that their customers are getting what the commissioner is paying for. In a ‘personal budgets world’ this requires a little more thinking through as the commissioner appears to be just one person, but the principle can be still made to apply to good effect.

    • Matglee says:

      The road to hell is paved with good intentions . We creetad a system designed to help, support and protect, but which has ended up disempowering people and safeguarding the professional over and above the disabled person (please forgive the catch-all phrase). It’s left us with easy, safe and one-size-fits-all solutions being doled out by care managers and local authorities (LA’s). It’s also creetad a complete absence of customer service for disabled people (except through being lucky enough to be placed in a good’ service) which no-one would accept in any other area of their lives. And often, it’s made people believe that they are incapable of choosing what support they want, when they wouldn’t bat an eyelid at choosing a builder or a hairdresser. In order to make these changes happen we must remind professionals that not all disabled people are vulnerable’, that most people can be trusted to make choices and take decisions and that SDS is not an either or’, but a sliding scale of change. In other words, people can choose how much they want to do for themselves to keep control, and how much they want someone else to do and then we plan for that. Personalisation is not about ignoring those that are especially vulnerable and those that need a great deal of support. But as it stands, the system forces us to assume that everyone is like that before we’ve even met them and disempowers more than it empowers. So We need to stop thinking that services’ are the answer to everything and take a more holistic view of peopleWe need to remind the system’ that it is not and should not be in control of most people’s lives. The system must not focus only on solutions’ that have measurable results. The small stuff matters and good forward planning pre-empts many crises. But because you cannot measure a negative (i.e. how many crises were avoided), such services’ are rarely commissioned. It’s a false economy to wait for a crisis to happen before the system contributes.We need to acknowledge that some professionals will resist these changes because it takes away their power, because they are scared of being directly accountable to service users and because they fear their jobs might be at risk. It is perhaps unfortunate that in many LA’s, it is the commissioner who is the lead on Personalisation a person who often has no social care background and a person whose job is perhaps most at risk from the changes if disabled people will become self-commissioners. Turkeys and Christmas, anyone ?We must make sure that traditional provider services are aware that their customers are just that customers. Nothing actually changes if disabled people don’t have an individual contract with those services and if they cannot actually take their money elsewhere. Yet this principle is too often forgotten as the council target is met when a support plan is approved, NOT when it is actually implemented. But it is only in the implementation that real change actually happens.We must remember that there is more to life than the Dept of Health. Disabled people are first and foremost citizens in their own right and not everything they do is related to or ruled by their impairments. And finally real choice must be offered on a level playing field. This means independent advice, guidance and support brokerage being a genuine offer and the LA accepting that they are not always the best person for the job. As it stands, LA’s are reacting to The Cuts by withdrawing funding and pulling everything in-house, the precise opposite of what they are supposed to be doing and what their customers would like them to do. The system persists in putting its own existence as a priority above and beyond the people it is supposed to serve. This must be turned around, with legislation if necessary.

      • Subrata says:

        There are many aspects of plraonseisation and co production which would be useful tools for helping vunerable people or people with limited finance or both; to function on an equal level. As with most things the controlling aspect is finances with respects to the council’s involvement in releasing a direct payment or personal budget. There are also overlooked choices as a person becomes more vunerable and requires NHS involvement and assesments. Somerset PCT release a personal budget while N Somerset does not which means one group of people are controlled by the budget and via a succession of people from the ones who hold the purse strings at government level to the nurse or carer who come to look after a sick person who’s time slot’ can run out leaving someone more vunerable than before. This can and does occur with domicilliary and home care from the PCT and social services provisions.On the other hand, or perhaps level would be a more appropriate word ..the other group of people have finances in the bank after care and consideration is given to assess the requirements. A certain amount of control of finances and the direction of them is required as this is a world where, sadly, even the vunerable are capable of cheating the system using valuable money that could make life easier for the genuine needy.

      • Innocent says:

        The concept of srntrgeas entering the home is the flaw at the heart of most traditional domiciliary care. As was highlighted by the IPPR Report, consistency of care, matching of carers to the elderly and introductions prior to the first visit are all ways of ensuring that the carer should be a friend rather than a stranger. In order for personalisation to be truly effective the elderly need to be at the centre of the thought process around care provision. Many approach care with the financial implications at the fore, others see the elderly as units which have to be dealt with logistically. A true person-centred approach should mean that the individual needs of the cared for come first. How can anyone approach the funding or logistics of care unless they first understand what care is needed? To personalise care we need to stop assuming that we know what the elderly need and start asking.

    • dani is my name says:

      what next

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