Our Experience of Person Centred Reviews of Support Plans and

How These Outcomes Can Influence Future Commissioning

Kate Burgess

Locality Commissioning Manager

Overview

• A bit of history

• Where are we now?

• Case Study – From passive recipient – To personal budget holding tenant– Co production & commissioning

A bit of history…….

• Initial work with people with Learning Disabilities

• In Control Pilot

• Development of the Self Directed Support team

• Realignment

• Developing the pathways

Where are we now?

• 500 people using personal budgets

• Sign up to Total Transformation

• 2011 target of over 10,000 people

• Strong emphasis on commissioning

• Several large scale projects recommissioned using personal budgets

Laidleys Manor

From Passive Recipient

• The closure of a residential care home

• Many concerned and anxious people

• Lots of worried families

• A few really excited people......

The Process

• Self rating questionnaires completed • Support planning in line with the

indicative budget• Work with local housing provider &

architect• Meet and greet with potential providers• Interviews• A provider is selected

The Process

• The tenants and new provider start to get to know each other

• The support plans are completed and agreed by the programme board

• The flats are completed – with the exception of a large snagging list

• Nineteen people move into their own flats in August 2007

November 2008

• Meeting with the tenants and provider at Laidleys Manor

• Reviews undertaken

• The support plans don’t reflect the support people need and how they are spending their budgets

• We used the first version of the review template

Nick

We were worried what would happen to Nick when we weregone, but now those concerns have eased significantly. Nick hasgrown in confidence and is so happy here, and he gets to choosewhat he watches on TV now!.”RayNick’s father

What we learnt

• In the main people seemed really happy both with their new homes and with their support

• There was one person whose support was not working for them

• The template worked apart from a few tweaks, but needed to be more interactive

March 2009

• Five tenants were invited to have person centred reviews

• Facilitated by the person centred review coordinator

• Using boards and a revised template• The process was much more interactive

than using pieces of paper• Again support plans needed updating

The next step

• The five people and their families were invited to join a group of commissioners, providers and social workers

• Asked people to tell us their top three– Working– Not working– What’s important to you in the future

Co producing in action

Co Production

• The outcomes were gathered into themes• This told us what was working for groups of

people• And what wasn’t working for groups of people • We applied the “Why” theory• We then looked at peoples priorities for their

futures

What’s not working

“I don’t always ask for help when I need it”

Our light bulb moment!

• The majority of tenants buy background support out of their budget

• This support is provided via a buzzer system

• The response to this buzzer is provided via staff who are also providing support to tenants.

• Which leads to peoples one to one support being disturbed

What we did

• Looked collectively at the support plans

• Ensured that they accurately reflect the support people need

• The background support is now completely separate to one to one hours

The advantages of using this model of review

• From the outcomes of the individual review we knew people felt that they didn’t always feel they could ask for support

• But we didn’t know why• We put the onus on the individual• Or the support staff• But really it was the buzzer• This knowledge will support future

commissioning activity

What does success look like?

• To people who use services

• To providers

• To commissioners

What we have learnt

• The outcomes people identify in their support plans must be clear

• The outcomes of the person centred reviews must be clear

• The appropriate people need to be in the room

• Don’t rely on first impressions – always ask why

• Although it feels time intensive it can save time in the long run

The final say goes to Glenys

“I’m in control for the first time in 61 years”