A Family carer perspective on what role Supported Housing providers can play in

achieving better outcomes

– Introducing the 247grid

Workshop by:

Rachel Mason : Parent carer/Time Designers Ltd

Workshop description

Rachel, a mother of two autistic sons, explains how building on their capabilities, and the innovative approach of their PAs has progressively increased their independence and reduced dependency on their paid support.

She describes what tools and resources she used to facilitates this.

Assessment

• Far too often social care fees, ISFs and personal budgets are set following an eligibility assessment that is often not in a context the customer relates to.

The assessment also assumes a level of continuing dependency, focusing on what individuals cannot do rather than highlighting their capabilities which can be built on to improve independent living potential

Measuring Direct Support v Outcomes

• The Resource Allocation System (RAS) and other self-assessment tools used are frequently inflexible and static and do not lend themselves to inspire more dynamic solutions to address a need which can’t readily be reflected in hours of support required and related costs

• Funding levels of support rather than outcomes?

Support offered pre - assessment

There is also insufficient consideration given to:

Harnessing community capital and resources

Use of Assistive Technologies

Sharing resources across services by placing them directly in the community.

These solutions are not dependent on eligibility so it can be so frustrating when offered the above solutions after waiting for a formal assessment!

What tools are there to assist a better RAS solution?

To assist this approach, there is a need for a simple tool which enables individuals to undertake in a person-centred way a self assessment of their situation.

By visualising an average week, they are able to capture all their daily activities, tasks and routines and highlight what they can successfully do themselves and where the barriers* are.

This tool could then summarise what the areas of difficulty are and the levels of support needed. It provides a powerful visual aid to focus discussion on what solutions are available and how to direct the most effective service delivery and intervention* to address them

We also need to change the conversation we have with families much earlier on!

A typical week for adult with LD in supported living

WITHOUT ANY EXPECTATIONS SET - OFTEN NO USE OF ANY SKILLS LEARNED AT SCHOOL ,DURING HOME TIME

www.247grid.com

Traditional service led delivery

THE HABIT CONTINUES - THERE IS LITTLE EXPECTATION FOR ANY SKILLS LEARNED AT THE DAY CENTRE

TO BE USED DURING TIME AT HOME

www.247grid.com

Traditional service led delivery cont...

Becoming a volunteer

Outcomes I was looking for

A picture paints a thousand words... .. The 247 grid in action!

Does current practice by Supported housing providers

support personalisation?

GEORGE

NOT ELIGIBLE FOR SERVICES

LIAM

HELEN

Maintaining friendships

NON ELIGIBLE PEOPLE WITH LD

HOSPITAL UNIT

PROVIDER 3

PROVIDER 3

RESIDENTAIL HOME

What seemed to be missing was a place where I could find like minded families/ PROVIDERS who were trying to find meaningful day opportunities, source support to take them so we share the staffing, transport and activity cost

2.5 Days £120

2.5 Days

4 Days

5 Days

5.5 Days

£8phr

£10phr

£12phr

£15phr

I’m not bored.. but I’m lonely

Service users often come up with the best solutions!

By building on my experience I have been able to clearly see where the gaps are and what resources need to be put in place to make personalisation work

I had a working knowledge of Assistive technology and fascination for ‘gadgets’ I was an experienced resource maker for our special school I sourced and set up a local networking tool, ‘My People and places'

which allows Eligible & non eligible individuals to collaborate with each other to:

Maintain friendships – find new ones Find local cost free activities Share activities together Sharing support resources, PA, transport - thus reducing costs Pooling data about interests, work & learning aspirations*

I will explain my experience with both my sons and the benefits of using these tools www.mypeopleandplaces.co.uk www.get2getherclub.com Time banking Adult learning services – flexible community lead courses*

Identifying areas for Assistive technology

Looking to see where assistive technology can be a good alternative to paid intervention (when appropriate)

Daily management and support

Staying safe travelling to an event or meeting up with a friend There is an NOCN course that can teach you this

Understanding money and managing your finances There is an NOCN course that can support you with this

Meeting and getting to know new people in the community There is an NOCN course that can help you with this

Running a micro enterprise/Time banking and volunteering takes a lot of different skills to make it happen

There is an NOCN course that can give you those skills

Learning to cook and planning a meal with friends There is an NOCN course that can deliver this

Harnessing Adult Learning to reduce reliance on services

Time banking

• Identify skills that you can learn through the activities you do : Gardening, Dog walking, Sorting, Serving, Catering,

Painting, Collecting, Delivering, Conservation, • Use any skills gained at school, college and day

opportunities to volunteer and gain credits

• Use Credits to exchange for 1:1 support or for someone to help you with something you cant do yourself: Give you a lift

Where to earn community currency?

• Adult learning

• College

• Day services

• Work steps

• Day opportunities

• Taster sessions

• Volunteering

• Activities with your PA

• Pool your DPs with others to share a PA/tutor between a small group

What are we doing to ensure we are supporting disabled people and their families to understand Social care is a temporary support .. Constantly striving to enable,

through person centred services – EVERY INDIVIDUAL to reach their maximum potential

and independence in their communities

Providing funding, support, resources and training etc With the aim NOT TO CUT.. But to withdraw eventually

where Independence has been achieved

It should be a celebration NOT a fight to keep it!

Is Social Care being seen as funding for life?

Greg has worked hard with his PAs over the past 3 years and has reduced his reliance on social care funding by £11,000pa

Does this tapering approach require new skills sets for PAs/Staff?

To achieve the tapered approach needed to reduce the reliance on paid support future staff need:

• Confidence in everyday tasks

• Community connecting – Tapered approach

• Mapping /sourcing community activities

• Networking with other providers

• Resource making

• Computer/internet

• Spontaneous/responsive risk assessment

• Flexibility and trust

How did the 247 grid play a part in this amazing journey?

What is it?

• The 247 grid is a simple but effective way to VISUALISE what you do in an average week

• It allows you to MAP your daily activities , identifying areas where you are totally independent, where you are being supported by assistive technology / resources, where you need supervision and where you need a lot of help or need someone to do things for you.

• By using the different COLOURS you can see where you need the most help

• Some families PRINT THEIR GRID to show to their social worker, teacher, day service and take it along to their annual review. Having a PICTURE of what your needs are and where you would like the services around you to focus their efforts, makes it easier for you to talk about in a meeting.

• Parent carers who have their son/daughter living at home with them use the grid to show where the highest levels of supervision and personal care are. It provides a vivid reflection of the tasks and commitment involved in caring that is often overlooked by services.

• By activating the costing tools, you can calculate how much your care package will cost*

It is essential that a good person centred care and support plan accompanies any grid

To see at a glance if a care package is balanced and good value for money

• Blue - Independent

• Aqua – good use of family, friends, community support

• Green – Use of Assistive technology

• Staff ratio/support cost rainbow

By colour coding the level of ‘dependency/cost’, you can see at a glance how balanced and innovative the support package is

Would you expect the colours to change at the next annual review?

We need Schools and Children’s services to become more aware of their impact

Year 9 Year 10 Year 11 Year 12

Introducing life mapping at 14yrs old [at the first school transition PCP Review] It would reflect the projected support needs a YP will need at 18

The young person, their family and the services around them are ultimately working

together [in a preventative approach] so as not to build an unnecessary dependence on funded support they may be ineligible for

Notice the change in the grids from year to year.

A reduction of just 1 hour a day £5000 a year [£200,000 in a lifetime] www.247grid.com

247 grids - for brokers

• Brokerage is provided to support a person to source what solutions there are around to address their care and support needs and purchase it on their behalf

• The 247grid provides the broker with a foundation on which to source community solutions or approach different service providers for their delivery offer and the costing for that support

247grids - Care & Support providers

• Preparing for a tender is a complex process. The amount of paper work, documentation and appendices that a LA panel has to read through could uniquely be supported by providing them with a summary grid that offers them a visual over view of the package you are offering.

• Show them that you have understood the person profile

• You have mapped out their desired weekly programme

• How you are going to support it

• What the staff ratios will be

• A summary of the overall costs

• Individuals looking to compare a range of care providers may not be in a position to read through their own care plan. Those care providers who are able to provide a visual plan of the support you propose to give them, may give you an edge.

247 grids - for commissioners • The 24/7 Grid is a tool that Health and Social Care professionals can use to manage a person’s

support needs effectively.

• It is a simple yet effective care management tool for understanding how support can be deployed to best effect, providing a clear breakdown of weekly support and associated costs.

• Planning for Individuals or group settings; managing shared support and core hour costs. All models of support can be costed easily without the use of calculators. It also show net costs for each in a shared setting.

• It is a great benchmarking tool to test the value for money being offered by tendered or existing service contracts. The 24/7 Grid allows you to compare % hours that are independent, aided by assistive technology or aided by natural support with that of current funded support. This information can be used as evidence for reviews.

• The 24/7 Grid can be used as an alternative to the points based resource allocation systems (RAS). It links only the real support costs (identified to ensure a person is able to live the life they have chosen) directly to their individual outcomes.

Other innovative ways we have piloted the 247 grid tool

Use 4: Ensuring a Life balance

A grid is used to show that the activities are balanced between:

• Work/volunteering

• Education

• Home/tenancy maintenance

• Personal care

• Health /diet

• Social/leisure

• Community involvement

• Chill time

Use 5: Compare VFM for current services

Residential setting: Using the 247grid to visualise the service you are receiving. What staff ratio you are getting. How this is impacting on your daily life. If you are achieving the outcomes set out in your person centred care plan The grid also helps you understand how your fees are spent by separating the core* costs [accommodation, building maintenance, utilities, food..] from the net support costs [direct staff contact] – which is ultimately reflected in the staff ratio you receive. *No housing benefit , few benefits- (Income support , DLA cc)available for people in this setting

Use 6: Assessing where Assistive technology can be introduced

Assistive Technology: Using the 247grid to identify areas where a person needs on call help [call/fall pendant] , core 24/7 supervision [ PIR room sensors, bed and chair sensors, fire and flood sensors], where they need verbal prompting [welfare calls]. Quiet care/Just checking model discretely maps the movement around the property [use of essential areas: the bathroom, fridge, oven/microwave, taps, cupboards etc..] Harnessing the technology available to reduce costly invasive interventions

Use 7. STAFF -Weekly management

Build a visual portrayal for SU to see how the week is supported:

• A grid for CURRENT week – Staff rota [costs]

• A grid for planning following week – Staff rota [costs]

Staff may want a 4 weekly rota in advance to plan their time*

Future functionality 2014

As a client identifies areas they feel they need 1:1 support, the software suggests other solutions to provide that support

House work

Take medicine

Going into town

Issue: I keep forgetting how to do the task

Suggestion: Pictorial step by step support Video prompt Assistive technology Volunteer supervision

Issue: I forget to take my medicine

Suggestion: Wall daily diary chart Assistive technology: Timed/alarmed pill dispenser, Meds watch TV message prompt Telephone / text prompt Care line comfort call Volunteer

Issue: I forget the way I get lost

Suggestion: Assistive technology: Digital photo key ring prompts Audio GPS gadgets ICE cards/medi bracelet Local supported walks scheme (dog walkers)

As a client fills in their grid by selecting time slots, the soft ware can suggest Activities, Support options and other members

Search for: Local Activity Supporter Share budget

Activities at this time: College course Volunteer opportunity Work placement

Search for: Local Activity Supporter Share budget

Supporters available at this time: Volunteer Time banker PA pool

Search for: Local Activity Supporter Share budget

Someone looking to share PB at this time: Jane Doe Helen Smith James Dolley

What are we doing to ensure we are supporting disabled people and their families to understand Social care is a temporary support .. Constantly striving to enable,

through person centred services – EVERY INDIVIDUAL to reach their maximum potential

and independence in their communities

Providing funding, support, resources and training etc With the aim NOT TO CUT.. But to withdraw eventually

where Independence has been achieved

It should be a celebration NOT a fight to keep it!

Is Social Care being seen as funding for life?

What is your role?