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East Midlands Personalisation Programme

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					        East Midlands Personalisation Programme

                   Final Report to JIP Executive

                             September 2010

Author: Jan Clark, Personalisation Programme Director

Introduction
In order to support the nine local authorities in the East Midlands Region in their
delivery of the Transformation of Adult Social Care as set out in the concordat Putting
People First – December 2007, the JIP Executive agreed to appoint a
Personalisation Programme Director and Support Officer. These posts were to be
funded by the regional DH SCR grant under secondment arrangements until
September 2010 and March 2011 respectively.

The Personalisation Programme Director was to work on behalf of ADASS and report
to the Personalisation Programme Board Chair, to ensure that the overall JIP
programme developed in a coherent way and was driven forward in co-operation with
the regional DH team under the DRD. The Personalisation Programme Support
Officer was to develop the project plan, chase up programmes and actions and
provide support to the co-ordination and delivery of consultancy programmes that
might be commissioned. The objectives and expected outcomes from the programme
were set out in a Project Initiation Document agreed at JIP Executive November
2009.
The Project’s expected outputs comprised the following;
      Improved regional communication and co-production processes:
        development of and support to regional stakeholder networks including the
        Self-Directed Support network and sub-groups, ULO/Expert By Experience
        and co-production network.
      Support to council leads to implement personalisation which includes
        Personal Budget systems, making sure that they are kept informed of
        national best practice and guidance.
      Support for councils to deliver information, advocacy and brokerage models
      Support across JIP Programme Boards to ensure priority is on
        personalisation across work streams. This should take place within an
        environment that safeguards vulnerable people effectively while increasing
        people’s choice and control to live as active citizens within their community.
      Regional services are being developed that are increasingly inclusive of all
        impairments and diverse populations.
      Progress in all councils against the Putting People First Milestones
      Delivery of N130 target for introduction of Personal Budgets
      Local authorities in the region will be linked to the latest thinking, research
        and good practice from the national Transformation Team and other regions.
                                         Personalisation PID V9 (revised Jan 2010)




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This is the closing report from the Personalisation Programme Director as
the project comes to an end on 30 September 2010. This report is also
intended to be the covering report to the document Putting People First in
East Midlands; What Good Looks Like – Sept 2010 which can be utilised
by the JIP Executive as a monitoring tool for on-going work-streams which
are subject to the revised JIP regional governance arrangements.

Key Project Achievements
Regional communication and co-productive processes. These have
been improved significantly over the course of the project. The
Personalisation Programme Board has been effectively supported to drive
forward a range of developments and has continued to be a focal point for
local authority PPF leads to identify areas of common interest, problem
solve and share good practice. The Programme Board has agreed to
continue to meet bimonthly as the regional Personalisation Leads
Network. Chaired by Jill Buchanhan- Huck, Personalisation lead for
Lincolnshire, this will support further regional PPF development and
facilitate on-going connectivity across JIP programmes. The
Personalisation Programme Board, Commissioning & Market Development
Board and SDS Network all had citizen Leaders as active members helping
to increase co-production at a strategic regional level. Connectivity
between some regional networks (RAS, Direct Payment, Workforce
Development & Training group, Mental Health Network) was improved by
the development of an infrastructure under the Personalisation
Programme Board. A co-produced East Midlands response to the Right to
Control consultation was initiated and co-ordinated by the Programme
Director and Support Officer.

Co-productive approaches are becoming embedded and mainstreamed in
most regional LAs as a result of the programme. East Midlands was the
first region where all LAs agreed a definition of what constitutes “Full
Engagement” in TASC processes and systems. Most authorities in the
region have taken steps towards being able to demonstrate co-productive
approaches to service and systems development eg. Derbyshire, Derby
City, Lincolnshire. All authorities have developed a more sophisticated
understanding of co-production as a result of the Regional co-production
Events in June 2009 and May 2010 and, in some areas, cohesion with
LINkS increased eg Derbyshire, Lincolnshire.

The East Midlands ULO Development and Support Programme will run
until April 2011 and has received national attention. In June 2009, there
was a significant underachievement in ULO development across the
region, other than in a small minority of councils. Authorities were asked
to develop ULO action plans and NCIL were contracted to provide
specialist consultancy support to individual authorities based on these
action plans in phase 1 of the programme. Regional roadshows ensured a
consistent level of understanding about ULOs across the region and what
was expected under Milestone One. A successful bid secured additional DH
funds to pump-prime ULO development and was allocated to two LAs
requiring the most support to develop an effective ULO.




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Authorities made varying use of the NCIL support days in phase 1 and in
phase 2 the consultancy resources available were targeted at those areas
needing the most help and those motivated to take forward
developments. A new ULO was launched in Nottingham City in July 2010
as a direct result of the Personalisation Programme. Councils continue to
be well supported in their development of a range of ULO models best
suited to local need rather than a “one-size fits all” approach. Over the
past 12 months, established ULOs in the region have developed closer
relationships with their councils and with each other. Work is now
underway through a small ULO planning group, supported by the regional
programme, to develop the East Midlands ULO Network. This will be
supported by a web-based forum through NCIL and it is hoped that this
will launch in the new year (Jan 2011).

East Midlands was one of only two regions nationally to develop a regional
Personalisation Website. This was very effectively managed by the
Personalisation Programme Support Officer and operated through the DH
Care Networks website until the migration to the new PPF website recently
launched nationally. The website is an effective repository of good practice
examples and guidance documents and continues to be well used.

Support to council leads to implement personalisation which
includes Personal Budget systems. The Personalisation Programme
Director met with Personalisation Leads in their authorities bimonthly and
with DACS quarterly, to monitor progress on all aspects of Personalisation,
identify areas needing additional support and share good practice. This
support was well used by authorities and helped to ensure that regional
support was targeted at priority areas. Although there was an increased
focus through DH on the delivery of target numbers of personal budgets
under NI 130 in recent months and a national programme of support
available to councils, the focus of support and discussions through the
Programme Director was to ensure the quality of outcomes for service
users and carers. Two councils received an initial support visit from the
national DH team to ensure their development of PBs was fully supported.
These meetings affirmed the sufficiency of the regional programme that
was in place and no further support from the national team was sought.

The SDS Network, chaired by the Programme Director, was a key forum
for managers leading on implementing SDS operationally to share issues
and good practice. This has continued to develop strongly as a valuable
network for these key staff; occupying a different space from that
occupied by the EM Personalisation Leads Network. Jill Buchanhan- Huck,
Lincolnshire, has offered to chair this network through the next few
months to support its evolution into the next phase of PPF and new JIP
arrangements. This ensures cohesion and continuity as Jill will chair both
SDS Network and Personalisation Leads Network at least in the short-
term. Focused sessions for the SDS have included Common RAS, Right to
Control consultation, Personal Budgets and Older People (National
Development Team for Inclusion), Individual Service Funds.

The Personalisation Programme Director commissioned a facilitated Action
Learning Set for the regional RAS Group and, with the DH TASC


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Programme Manager, participated in these sessions which gave additional
opportunity to the RAS Network to work on common issues and share
good practice. A regional benchmarking exercise is currently underway,
co-ordinated by Derbyshire, and is due for completion by 30 September.
This good practice example will be written up and shared nationally
through the TASC Programme Manager.

A Re-ablement workstream was identified by the Programme Director in
August 2009 and from this a further two re-ablement events were
developed to support newly established re-ablement as well as looking to
the future for the more established services. These events were delivered
in co-operation with CSED and a small regional planning group. The
resulting products were an East Midlands Reablement Evaluation Tool
(EMRET) and What A Good Re-ablement Service Looks Like. These are
available on the website.

Support across JIP Programme Boards to ensure priority is on
personalisation across work streams.
The Personalisation Programme Director was a participating member of
two JIP Boards; The Personalisation Programme Board and the WorkForce
JIP Board and received papers from the Safeguarding JIP Board and the
Prevention & Early Intervention Board. There was good information
sharing and some cross over work between the Programme Director and
the DH TASC Programme Manager and the DH leads for Performance,
Learning Disability (Valuing People and Person Centred Planning),
Prevention & Early Intervention and to a lesser degree, safeguarding
leads. Joint events were delivered on personalisation and Person Centred
Planning, led by DH Lead and supported by Programme Director. The
Regional Workforce Task Group comprising DH Performance Lead,
Personalisation Programme Director and Skills for Care was formed in
October 2009 to help deliver the work of the Workforce JIP Board as set
out in the PID. The Workforce Task Group supported Lincolnshire to
develop the regional exemplar PPF Workforce Strategy and Plan. The Task
Group, with a Citizen Leader, undertook a Workforce Strategy Healthcheck
across all the councils, gave detailed feedback to assist local workforce
development and had active input into the Workforce Development Plans
for Northamptonshire and Nottinghamshire, who were further supported
to develop the regional exemplar Dementia Workforce Strategy.

Progress in all councils against the Putting People First
Milestones. The introduction of the PPF Milestones in November 2009
was in some ways a mixed blessing. National targets and milestones with
expected dates of delivery on specific aspects of PPF did act as a driver for
action on the specific areas included giving councils the necessary impetus
for action. This was beneficial and East Midlands was unique among the
regions in agreeing through the JIP Executive to customise the PPF Self-
Improvement Framework for the December 2009 and June 2010 returns
to the Programme Director to give the region richer detail and more useful
information to guide regional support programmes. Responses were
collated through the Programme Support Officer and only the responses to
the national framework template were submitted to the National TASC
Director, other information remaining within the region. The draw back to


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the introduction of the Milestones was that it did narrow the focus of work
of the Programme Director and Support Officer to some degree as
capacity had to be given to collecting and collating returns for national
submission. Although the information from the returns was helpful in
developing regional support, it did becoming more challenging to ensure
that the Programme Director was not seen in a performance monitoring
role. Only good practice was ever attributed and where any authority was
finding it difficult to deliver, this was anonymised.

Delivery of N130 target for introduction of Personal Budgets. Further to
achievements set out previously in this report, the JIP Executive agreed
that progress against NI 130 was to be routinely reported to the
bimonthly Personalisation Programme Board (PPB). A report matrix based
on Nottinghamshire’s reporting framework was developed by the DH
Performance Lead, DH TASC Programme Manager and the Personalisation
Programme Director. This was to be populated with each LAs data and
returned through the regional performance leads group and reported at
the PPB. While this was a good decision by the JIP Executive and handled
appropriately by regional leads, some confusion was generated by the
overlapping national request for data through the Facts & Figures Survey.
Clarification was sent out through the DH Performance Lead although
some confusion still pervades across LAs. The unhelpful national output
from the Facts & Figures survey has undermined regional confidence in
sharing information across authorities to some degree. The bimonthly
regional PB return matrix is to be reviewed at the Performance Leads
group for accuracy, pertinence and value. Recommendations should be
made to JIP Executive as to whether it continues to be useful to collect
this data regionally and how it will be reported under the new JIP
Governance arrangements.

Local authorities in the region will be linked to the latest thinking,
research and good practice from the national Transformation
Team and other regions. The Programme Director has acted as a
conduit for regional LAs to share areas of concern or challenge and has
shared requests for information sent to her as well as good practice
examples across regional and national networks. Similarly, the
Programme Director has moderated and disseminated information on
relevant national training events and conferences as well as sharing
research and information on good practice from other regions as deemed
appropriate. Feedback from LAs indicates that this aspect of the role was
valued and will be missed when the project ends as strategic managers
often lack capacity to undertake this activity.

Additional events were organised through the programme giving LAs
opportunities to explore their approaches to other aspects of Putting
People First. These included community capacity building – ImPOWER
facilitated workshop and A Glass Half-full workshop facilitated by IDeA
consultant in September 2010. An evening seminar for Personalisation
Leads to explore approaches to Universal Services was held in November
2009.




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Areas for Development

Support for councils to deliver information, advocacy and
brokerage models. The Personalisation Programme has not fully
delivered on this expected output to date. It did prove difficult to collect
Information, Advice and Advocacy Guidance from some local authorities.
Some good practice in approaches were identified and shared with other
councils eg. Derbyshire and Lincolnshire. It had been intended to
undertake a “healthcheck” exercise similar to that undertaken by the
Regional Workforce Task Group on Workforce Development Strategies but
a period of sick leave for the Programme Director inhibited this process.
Most authorities have draft IAG strategies or report planning to have
these in place by October. Co-productive approaches to the development
of IAG strategies and plans have largely been adopted, which take longer
to deliver eg Nottingham City, and this is also true where a corporate IAG
strategy is in development as in Lincolnshire. This may be an area that
the regional networks will be able to support further.

Regional services are being developed that are increasingly
inclusive of all impairments and diverse populations. This is a
difficult output to measure but is likely to remain an area for further
development for some time. It is too early yet to fully determine how the
provision of Personal Budgets and increased choice and control being
exercised by Personal Budget holders is changing the profile of support
services. Research is underway nationally through DEMOS and in East
Midlands Region by Age UK to identify how markets may be beginning to
change. This is an area for JIP Executive, the EM Personalisation Leads
and the SDS Networks to continue to monitor and progress check. The
strengthening of co-production and ULO development in the region gives
good opportunity to ensure that services and communities develop to be
increasingly inclusive.

Additionally, LAs might have made more use of the Programme Director
as a “Critical Friend”. Some authorities did use the role in this way to good
effect, particularly Derby City, Nottinghamshire and Lincolnshire. For
others, it may have been difficult to see the role as being focused on
support, facilitation and development rather than a performance
monitoring role. This latter perception may have been supported by
knowledge of the Programme Director’s substantive post with CQC, or by
the Programme Director’s role in relation to collating the PPF Self-
Improvement Framework returns. While the Programme Director strived
to operate as a facilitator and enabler, this may not always have been
apparent to LAs and may have been an area for development.


Recommendations
That the JIP Executive agree the following;

    The East Midlands Putting People First, What Good Looks Like
     document is accepted as a tool through which the JIP Executive can
     continue to monitor progress through the next phase of PPF and
     revised JIP governance arrangements.


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    The Personalisation Programme Board to become the East Midlands
     Personalisation Leads Network. To meet bi-monthly according to
     previously agreed PPB arrangements. Chaired by Jill Buchanhan-
     Huck

    The continuation of the SDS Network (chaired initially by Jill
     Buchanhan-Huck) and sub-groups – RAS Network, Workforce &
     Training, Direct Payments

    Return of regional RAS Benchmarking Exercise by LAs to Terry
     Reilly, Derbyshire by 30 September. This good practice example to
     be written up by Terry and shared nationally through the TASC
     Programme Manager

    Regional NI 130 Personal Budgets Matrix to be reviewed by
     Regional Performance Leads Group and resulting recommendations
     to be made to JIP Executive.

    The continuation of the regional ULO Development Programme to
     April 2010. The Programme Support Officer will continue the
     established monitoring arrangements and a final report should be
     made to JIP Executive, or its replacement at the end of the
     programme.


Jan Clark, Personalisation Programme Director
Sept 2010




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