self directed approaches lessons from a uk provider
TRANSCRIPT
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Self Directed Approaches Lessons from a UK provider
Steve Scown CEO Dimensions
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The UK context
• Number of Local Authorities (LAs): 152
• LA adult social budgets: £19b (34.2B AUD)
• Number of provider organisations: 12,700
(86% have less than 50 employees)
• Number of people employed in social care: 1.63m
• Number of adults receiving social care support with a personal budget: 605,000
(over 100,000 employ their own care staff)
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Dimensions
• Support adults, young people and children with learning disabilities and who experience autism
• Support and accommodate over 3500 people
• We offer support via residential homes, supported living, short breaks, day services and supported employment
• Work in 70 Local Authority areas
• Employ approximately 5000 staff
• Budgeted turnover in 14/15 of £110m
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Our Challenges
• Traditional services have offered secure income
• Traditional services are less and less in demand by people who exercise choice
• People want personalised services
• Personalised services have small and fixed margins
• Local authorities have less money to fund increased need
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The Provider Conundrum
Managing yesterday’s services today whilst developing new ways of listening and responding to tomorrow’s customer –
and accepting less money for doing it.
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The LA commissioned service
Paul lives in a home with 4 other people
Local Authority pays Dimensions £50k per annum
Home has a team of 5 staff – there is 1 staff member there all the time during the day and 1 sleeps in at night
There are 40 hours of shared support per week
Paul wanted to go abroad for a holiday and a group of 8 people decided if that was OK
Paul spends 2 days a week at the local learning disability day centre and the rest at leisure.
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What Paul wants
Paul has an Individual Budget of £34k.
Paul pays Dimensions £22k a year for:
Support in the mornings whilst his Mum is at work
Support 2 days a week whilst he works in a garage keeping the floor clean and the place generally tidy
Support every 4th weekend whilst he goes away for short breaks – either camping or on a city break
One of his support workers is his cousin at his family’s insistence.
Paul is offering a one-off £3k payment if Dimensions can find him a job which he can keep for 6 months.
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“So basically you’re moving from wholesale to bespoke
retail!”
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Our initial market prediction
Now B2B B2C
Future B2B B2C
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Our current experience
£ Local Authority Customer
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“It is not the strongest of the species that survive, nor the most intelligent, but the one that is most responsive to
change”
Charles Darwin
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Our first journey
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The key questions we posed ourselves
• How will Paul and his Circle of Support know about Dimensions?
• What do we want Paul and his Circle of Support to think of us?
• Can we provide what Paul and his Circle of Support will want to buy?
• How do we cost and then price very different models of support / products?
• How different will Dimensions and our staff have to be?
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Your offer - one-off products
Something a family may purchase which may or may not lead on to further business:
Facilitation of a PCP
Support Design
Behaviour Analysis
Review
AT Assessment
Holidays
Service Design
Benefit Review
H&S Environment
Review
Housing Brokerage
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Your offer - defined term products
Something a family may buy for a fixed period of time with a pre-determined outcome:
• Life skills training
• Community integration
• Active support
• Job skills training
• Facilitation of PC Review
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Your offer - ongoing products
Something a family would purchase without an end timeframe:
Personal care & support
Sleep-in
Live-in Support
Short Breaks
Training of PAs
Quality Assurance
Waking night
Housing related support
Recruitment of PAs
Management of team of PAs
On-call & out-of-hours
support
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Costing the offer
Overhead activity
Activity Based Costing/Insurance
Premiums
Client Group/Postcode
Specials
Refunds/Discounts/Free offers
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Human Resources
Bespoke - Person Specification
- Job Description
- Employment Contract
- Rates of Pay
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You Decide – We Employ
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Human Resources
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Our second journey
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Plan
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So what changed for Anne Marie?
• New people in her relationship map
• Voluntary work
• Unpaid support
• New places
• Re-connected with old friends
• Busier and happier
• Better relationship with estranged sister
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Reflections on our learning so far
• Ensure all leaders and key organisational players are actively engaged and prepared for the change.
• Establish what good will look like - for your organisation, the people you support and your staff - as soon as possible.
• Be realistic about what you try to achieve - major change takes courage, determination and time.
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Reflections on our learning so far
• Be prepared to feel comfortable with discovering some things that are not good enough and must change.
• Be prepared to engage in honest and open dialogue and avoiding the ‘blame game’.
• Develop your organisational response to dealing with a member of staff whom nobody wants to support them.
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Reflections on our learning so far
• Develop your own views very early as to how you will manage and account for individual income streams
• Consider the impact upon your organisation when the people you support decide how you spend your funding.
• Staff find change easier when engaged in the process of change and receive support, training and independent challenge.
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Reflections on our learning so far
• Everyone, including business support, but particularly every member of operations must be familiar with and ‘fluent’ in person-centred thinking tools.
• Help your staff understand they must have their own personal offer for the people they are supporting. If they haven’t got one, help them to develop one.
• Incorporating feedback from people being supported and their families into individual supervision and appraisal is very beneficial when trying to change staff attitude and behaviour.
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Managing through the tough times
• It is easy to under-estimate the impact of broader organisational change upon local services and their attempts to improve how they provide support.
• Find anchor points that are real and use stories and journeys to connect people to change.
• Accept it will never be right and just keep on going.
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“If you want something different to happen, you have to do something different”
Sharon Di Santo
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• @sscown #OzAdventure
• www.dimensions-uk.org