Lambeth Commission on Personalisation - DOC

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					Lambeth Commission on Personalisation
Meeting 2
29 January 2010

Attendees

Jeremy Swain, Thames Reach (Chair)
David Strong, Disability Advice Service Lambeth
Fiona Shiel, Lambeth Voluntary Action Council
Julia Shelley, Age Concern Lambeth
Elaine Aherne, London Borough of Lambeth
Seona Gordon, London Borough of Lambeth
Conrad Hollingsworth, London Borough of Lambeth
Ian Jackson, Lambeth First
Aisling Duffy, Southside Partnership
Kevin Dillon, London Borough of Lambeth
Nick Fairclough, Lambeth PCT
Jessica Ellis, Capacity Builders
Ralph Michell, ACEVO
Amy Richards, ACEVO

Speakers
Matthew Pike, ACEVO Commission on Personalisation
Ceri Shepherd, Look Ahead

Welcome and Introductions

Jeremy Swain welcomed all attendees and asked all those present to introduce
themselves. He then summarized the agenda and asked the Commission to agree to
hear from Ceri Shepherd from Look Ahead an hour earlier than outlined.

It was agreed that the main focus of this meeting would be:
    - To pin down the key objectives of the Commission
    - To understand what is meant by the term ‘business model’
    - Analyse the issues summarised in the paper put together by Fiona Shiels

Terms of Reference

There were no substantial changes to the Terms of Reference. Ian Jackson clarified
that his organisation worked across the public, private and voluntary sector and
should not be classified as a public sector organisation.

Feedback from the ‘Personalisation in Lambeth’ event

Amy Richards and Elaine Aherne reported that they had both received positive
feedback from this event. Many delegates welcomed the focus given to the service
user voice and the opportunity provided for more lengthy Q&A sessions. Conrad
Hollingsworth mentioned that he thought there was a sense of apprehension with
organisations struggling to see how personalisation will work in practice.
Best ways of communicating the Lambeth Commission’s Work

It was agreed there would be a number of ways of engaging with service users and
providers beyond the Commission:

   1) The minutes of each Commission meeting will be sent out through various
      networks (GIFTs, LVAC membership, Health and Wellbeing Forum)
   2) The minutes will also be on the Health and Wellbeing Forum website
   3) Amy Richards will investigate establishing a ‘personalisation wiki’ which will
      be a shared, interactive webspace for both the national and Lambeth
      Commissions.

Matthew Pike, Chair of the national Commission on Personalisation

Matthew Pike spoke about the ‘open and collaborative relationship’ he hoped would
develop between the two Commissions.

Links could be forged in a number of ways:

   1) Amy Richards is involved in both Commissions
   2) All paper work can be shared (facilitated by Amy Richards until a
      ‘personalisation wiki’ is established)
   3) Regular dialogue between the two Chairs
   4) Jo Cleary, London Borough of Lambeth, sits on the national Commission
   5) Organisations on the Lambeth Commission (and those operating more widely
      in the Borough) will be invited to sit on the national Commission Working
      Groups)

As the challenges with implementing personalisation are so substantial, it was agreed
that there is a real incentive to share learning.

Matthew Pike offered an overview of the next phase of the national Commission’s
work, emphasising that the Lambeth Commission would be vital in developing
practical ideas around capacity-building. Discussion focused on the following key
areas:

Social Banking and Product Innovation
   - The potential efficiencies that could be achieved through Smart Payment
       Systems (a debit card-like system which allows public sector agencies to
       implement detailed audit trails of how personal budgets are being spent)
   - The possibilities of establishing a Social Banking System, which would offer
       access to fair credit to those who are currently restricted
   - Social Insurance Products (insurance which offers funding for those with
       fluctuating conditions e.g. mental health who wish to return to employment)

Workforce Development
  - Peer Learning
  - Funding for staff training
There was some discussion about the impact on front-line and management staff, with
suggestions that big investment would be needed to drive culture change through
organisations.

It was also pointed out that there is potential for huge positives to be derived from
workforce transformation as it would raise the expectations of service users. If they
are not happy with a service, they can get rid of people.

Seona Gordon mentioned that Ken Messenger is leading on a piece of work that could
include a census of the third sector workforce in Lambeth that would give the
Commission some understanding of where skill gaps lie and what could be
commissioned to fill them. It was agreed that Ken Messenger would be invited to
speak at the next Commission meeting.

Additional comments were made about what was meant by the third sector in
Lambeth. Is it just existing third sector providers or all organisations?

Market Shaping
  - The role of Local Authorities in stimulating a market
  - Importance of ensuring the burden on providers is not increased under
     personalisation

A meeting is being set up by the national Commission to bring together key regulators
and Local Authorities in one room which should elucidate some of these issues.

Intermediating Supply and Demand
   - How third sector organisations market themselves
   - The best way of reaching demand
   - Understanding where gaps in the market lie

There was some discussion on how third sector organisations evidence impact e.g. in
Kirklees organisations are using the Outcomes Star. Some concern was expressed that
providers currently being encouraged to apply for certain quality marks could be
wasting their time if these are replaced or superseded in a few years. Matthew Pike
emphasised how essential evidencing impact will be, especially for small
organisations running preventative services where this will be relatively new.

It was agreed that initiatives such as Total Place will provide greater clarity on issues
such as how much money is in the system, how money flows, what public services
will look like in the future etc. Lambeth is an associate to the Total Place Pilots, but
this is only just beginning (agreed just before Christmas).

Discussion focused on what should be preserved in the current voluntary sector and
how the relationship between providers and service users will alter in a quasi-retail
market. However, it was stressed that the role of the voluntary sector has traditionally
been about keeping people out of a ‘crisis’ which would mean they were eligible for
state funding. This won’t change under personalisation.

Social Capital and Prevention
   -   Importance of refocusing on prevention as this is the most cost-efficient way
       of supporting people. Studies show that you get a 11 to 1 return on investment
       from preventative services.

   It was emphasised that stressing the importance on prevention locally would go
   some way towards reducing the anxieties of small organisations.

   Matthew Pike ended his speaking session by agreeing to return to the Lambeth
   Commission whenever required.

Focus areas for the Lambeth Commission

Fiona Shiels introduced her paper on some of the issues raised by the third sector on
personalisation (attached). She said it was first put together in February May 2008
and had been added to since then. Although some of the concerns may be slightly
outdated, many are still relevant e.g. how do we ensure there is equal access to
services? How is personalisation being tested with various ethnic, socio-economic,
gender groups? What do we want the market to look like in 5 years?

There was general agreement that organisations needed to be supported through the
transition and a suggestion that the learning that had already taken place in the field of
health and social care (e.g. Fiona Shiel’s paper) should be shared with organisations
in Children and Young People’s Services (CYPS) who are at a very early stage in
thinking about personalisation. Kevin Dillon stressed that the learning from Adult
Social Care had not filtered through to CYPS and that personalisation would play out
differently in different sectors.

It was agreed that the Commission must take a focused approach towards helping the
third sector make the transition to operating more widely with personal budgets. It
was agreed that the main focus for the Commission’s work over the next 10 months
would be workforce development. Some of the issues raised in relation to this
included:
    - Establishing flexible workforces
    - Understanding what service users want from a quality workforce
    - Driving culture change to ensure you are responsive to people’s needs
    - Understanding skills gaps, training requirements etc.
    - Preparing for the new challenges personalisation poses e.g. ICT, marketing
        requirements
    - Governance issues
    - The role of infrastructure organisations in capacity-building providers for
        change
    - Role of volunteers
    - Peer-learning, peer support organisations and the role of user-led organisations
    - How co-production works in practice

To understand some of the future requirements of third sector workforces it was
suggested that:
   a) the Commission look to survey current service users, self-funders, potential
       service users etc.
   b) the Commission ask some organisations to be audited for their readiness for
      personalisation

It was stressed that the Commission must not duplicate work that has already been
carried out (e.g. some service-user views have already been collected).

It was agreed that Jeremy Swain, Seona Gordon, John Kerridge (London Borough of
Lambeth) and Amy Richards would meet before the next meeting to put together a
more focused list of areas for the Commission to look at.

Ceri Shepherd, Look Ahead

Ceri Shepherd gave an overview of Look Ahead which provides housing and support
to a variety of client groups e.g. learning disabilities, mental health. Most clients have
complex needs.

Look Ahead were given Supporting People funding from Tower Hamlets to introduce
personalisation in whatever form they thought best. They started by asking staff and
service users questions such as ‘who is the main decision maker in your life’. Most
service-users said their key-worker was the main decision maker, key-workers said
the service-user or care co-ordinators were most in control. They saw a ‘pyramid of
disempowerment’.

Look Ahead introduced a model where service users were given 3 and half hours a
week to do supported activities that they chose themselves (including which member
of staff supported them to do this) and ₤40 a week to spend.

Core qualities of staff that were regularly chosen to accompany clients on their 3 and
a half hours of individual activity time were:
    - Lively
    - Engaged and engaging
    - Willing to share a bit of themselves
    - Similar cultural background
    - Shared interests

Look Ahead have had to change the way they recruit people e.g. Person Spec (have to
specify a commitment to personalisation)

Service users have spent their money on a variety of things:
   - Music lessons
   - Visiting family
   - Doing their hair/ nails
   - Gold- this was controversial, but was seen as culturally significant and would,
       therefore, deliver positive health outcomes.

Ceri Shepherd finished by saying that the launch of this project was on the 11th
January and that more work was being done to establish a staff bank which would
allow for the recruitment of support workers on 0 hour contracts. She stressed that
both Core Hours and Flexi-Hours must still be offered for the benefit and safety of the
service users.
Aisling Duffy explained how the use of 0 hour contracts at Southside Partnerships had
led to the recruitment of a more diverse pool of support workers who want to work
flexibly.

Follow up actions

   1- Send round contact details of all those on the Commission- EA
   2- Set up meeting between Jeremy Swain, John Kerridge, Seona Gordon and
      Amy Richards- AR
   3- Invite Ken Messenger to speak at the next meeting- AR
   4- Explore the opportunities for establishing a ‘personalisation wiki’- AR

Next Meeting- 25th February 2010