King’s Lynn and West Norfolk Prevention First phase 2 Living Independently in Later years

Lily+ proposals

Alliance meeting 16th October 2014

Solution proposal – approach and process

The programme was initiated by WN Alliance and supported by EELGA . A core solution group was established and has met regularly through August and September in a workshop environment. The workshops have been facilitated by David Sturgess and Jo Russell from Bluemarble. The programme Governance group and the core solution group details are shown in the table below:

Role Key Responsibilities Members

Governance Group

Programme commissioning, checkpoint challenge, permissions and releasing resources, removal of constraints and barriers

The WN Alliance acted as Governance Group to the programme. The membership of the Alliance includes: NHS West Norfolk Clinical Commissioning Group (WNCCG), Norfolk Community Health and Care Trust NHS Trust (NCH & C), The Queen Elizabeth Hospital NHS Foundation Trust, Norfolk County Council (Community Services) Borough Council of King’s Lynn & West Norfolk, West Norfolk Voluntary and Community Action (WNVCA) Norfolk & Suffolk NHA Foundation Trust (NSFT)

Core Solution Group

Commitment and participation to whole programme, analysis, creative problem solving, development of new delivery options, identification and access to information and wider stakeholders

The core solution group included: Amanda Kenny - WN Deaf Association, Cllr Elizabeth Nockolds - BCKLWN, Eamon McGrath, Age UK, Eddie West Burnham - Chief Executive of West Norfolk MIND, Emma Boore & Johnny Stromberg - Care & Repair, Emma Poucher BCKLWN, Fiona Cutts – QEH, Hannah Shah EELGA, Hanne Lene Schierff – WNCCG, Hazel Fredericks - West Norfolk Older People's Forum, Honor Howell – BCKLWN, Ian Burbidge, Kirsten Cooper, Kim Murray & Joanne Mawson - BCKLWN, Jackie Squires - BCKLWN, Jane Evans - West Norfolk Carers, Mia West – WNDIS, Judith Brown - West Norfolk Older People's Forum, Leigh Bagshaw - Norfolk Fire Service, David Cousins - Red Cross, Marie Connell – WNVCA, Matt Barber/Su Berwick – Freebridge, Paul Holley Smith & David Russell – Spice, Pippa May - WN Befriending, Sian Kendrick-Jones – NCC, Shirley Matthews - Breckland Older Persons Forum, Steve Dougall – Homechoice, Thelma Wadsley - KL Advice Hub

Solution proposal - summary

1. Difficulties people have at the moment with the current system

2. Joint ambition to make it easier for people to connect with support

3. The potential benefits for all parties

4. The core purpose and positioning of the new service

5. The people and their situations that we want to focus on

6. New products and services that will be offered

7. How the new venture could be operated

8. The outline invest to save business case

9. The proposed implementation approach

1. The difficulties people have at the moment with the current system

Commissioners/Providers • Financial envelope for statutory

funded support is becoming ever smaller

• No-one has full understanding of: - Customer numbers and profiles - All the service provision

available right down to community group level

- The total spend on older peoples’ services in West Norfolk

• This leads to: - Missed opportunities to

collaborate and deliver more joined up services and improve outcomes

- A greater likelihood of duplication

- A confusing picture for customers - An inability to join the dots

Older people/Carers • System is hard to understand

and use - Have to tell their story many

times to different agencies - Services are not coherent and

joined up - Without help hard to work out

who to go to and how to do it

• This leads to: - Unnecessary confusion and

worry - Delay in taking up early help - Situations escalating that could

be avoided - People becoming increasingly

socially isolated - Not preparing in advance for

when early help is needed - People lacking the confidence

and willingness to take up early help

2. Joint ambition to make it easier for people to connect with support

The new service model will: • Provide trusted signposting to early help that

increases - Levels of awareness of range of services/help

available - Confidence and willingness to take them up

• Enable improved living at home and reduce the number of avoidable issues escalating

• Support better preparedness for future need • Be a focal point for community volunteering • Be a focal point for enhanced collaborative

working across commissioners, agencies, communities and providers

• Provide insights into gaps in services and unmet need

• Partners have agreed ambition to work together to develop and deliver a new service model that: - Ensure that

vulnerable older people are supported to live independently in their own homes for longer

- Provides early help to avoid situations deteriorating

- Reduce demand for expensive and intensive hospital and social care services

3. Potential benefits for all parties

Older People - Tell their story once - Trusted, safe and unbiased single

point of contact - Ability to locate the right local

service - User freedom and empowerment - Happier & Improved quality of life - Help with future planning - Person-centered approach - Increased independence

Benefits mapping exercise

Communities • Improved social responsibility • A recognised brand to

recommend, engage and support communities

• Improved local access • A point of reference for carers • Help to combat social isolation • Easier routes into local

volunteering • Trusted local brand

Providers • Improved working relationships • Enhanced ways to share

information • Collective best practice with

signposting and hand offs • Increase usage of existing

services • Reduced duplication • Better communication • Maintain local service knowledge

Commissioners • Understanding the demand • What services might be most

needed/ missing • Supporting general wellbeing • Doing more for the same

resources: using the current system better

• Invest in prevention to save in the future

• Market intelligence

4. Core purpose and positioning of the new service

✓ Connecting people and services

✓ Making a complex system easier to understand

✓ Providing a focal point for information sharing and collaboration

New service

5. The people and their situations that we want to focus on

Bereavement Living alone (increasingly frail)

Rural isolation Long term illness or disability

Example situations: and profiles:

Issues: • Depression • Physical decline • Anxiety • Financial issues • Increased

vulnerability

Issues: • Physical decline • Isolation/

loneliness • Increased

vulnerability – doorstep crime

• Increased risk of injury

• Affordability

Issues: • Feeling

Isolated/lonely • Increased

vulnerability • Dependency on

car • Affordability

Issues • Negative impact

on relationship • Symptoms

worsening • Increased

Affordability

Common escalation triggers: • Reduction in mobility

and access • Increase in social

isolation • Not obtaining services

needed through lack of knowledge and fear

Focus: Helping to create new or re-establish strong networks of

support

The core client group for the new services : - People who have lost all or part of their

support networks and need a range of practical and social support to live independently

- Entering this situation for the first time - Or returning from supported H&S care - Not of any particular age - Including those currently self-supporting but

whose networks are at risk in near future

6. New products and services that will be offered

✓ Enhanced self serve features through web & mobile device

✓ Trained volunteer assisted self-serve through community access points

✓ Information and signposting hub

Providers

✓ Working with communities to help develop local early help capacity

Commissioners

✓ Enhanced Web site and App features

✓ Demand and market intelligence reports

✓ Client group profiles

✓ Dedicated information sharing areas on web site

✓ Directory of services

Older People

Communities

6. New products and services that will be offered

KLWNBC franchised to operate an assisted self-serve Lily+ within Community Information Points

Different ways of delivering and providing access Lily+ in the community

Community Groups franchised to operate an assisted self-serve Lily+

within local outlets

Agreements to locate self-serve (kiosk style) Lily+ within existing business/

public services outlets

Agreements with providers for them to use and act as Lily+ ambassadors as part of their day-to-day work with

clients

6. New products and services that will be offered (design principles)

Enhanced web site features:

Navigation • Online Virtual Advisors (Skype) • Web chat (1 advisor can host 5 chats at a time) • Easy to find what you’re looking for • Variety of search criteria options (carers, professionals

etc) • Find My Nearest style searching • Situation based sorting:

- Needs and Triggers - Keywords (identify and link words – I want to…) - Suggestions (People who viewed this, also looked

at….) - Join now / Contact or Submit a comment to this

provider

Content • Live, interactive & up-to-date (accurate, and current

technology) • Clear language (not business speak) • Approved contractors & local businesses (in a separate

section) • Possible kite marking “LILY CERTIFIED” • DDA Compliant, safe, trusted & Accessible (sight,

hearing, EAL etc) • Information in a variety of formats: • Read, Watch, View, Talk…

Additional aspects • Design group/ panel needs to be made up of service

users • Videos: “How To” Instructional Videos (including sign

language, hints & tips)

• Videos: Case Studies (facility to share stories & outcomes)

• FAQs / “Most Asked Questions”

• Basic online self-assessment (Y/N Questions)

• Human Library (people as books – volunteering)

• “I’d like to Volunteer” guidance & useful links to WNVCA Do It pages

• Newsletters & village magazine links Portal to other services

• Updates on key Issues (for info & refresher purposes)

• Promotion of local groups and activities – submit an event

• Facility for feedback ( Comments / (Star) Ratings / What’s worked / Reviews / did this help..?/ Mystery shoppers)

• Login in secure areas: User profiles – with favourites (could connect similar profiles (optional)/ Forums / Blogging (trusted people, knowledgeable: guest blogger (of the month))/ Social networking (future

6. New products and services that will be offered (design principles)

Assisted self-serve through community access • Various ways to deliver depending on community

access points that are available • Need to I.D. where provision is working well in

communities currently – and learn from this (not necessarily replicate it exactly though)

• “Community leaders” who already exist should be identified – Cllrs could help with this

• Look at existing support workers providing additional support

• Awareness raising of LILY amongst practitioners is essential

• LILY Guide/ sign poster/ Info Assistant/ Representative / Friend / Link

• Role is to signpost to or through the directory, help with enquiry, secure feedback

• Training needed and listening/ questioning/ diplomacy skills

• Pop ups in locations that make sense to communities and older people: - Mobile libraries / GPs / Hospital / Post Office / Pub /

Coffee shops / Supermarkets Village Hall / Sports clubs / Community Centres

Developing community early help capacity • An extra string to the bow of a wide variety

of individuals and groups • Harnessing support where people want to

get involved and then enabling them to • Looking at what everyone can contribute • Understanding our communities and the

needs • Reaching the isolated • Having an induction/process for their

contribution– being “accredited” • Capturing soft intelligence to be used

elsewhere • A shared “pledge” to maximise the

potential of LILY • Raising awareness • Having links to other prevention models • Social responsibility • Skills building through training • Tapping into existing groups • Not about:

- Specialist tasks for volunteers, Filling gaps in service provision in communities, Duplication for existing assessments, provision etc, Doing things to communities or individuals, Creating dependencies

7. How the new venture could be operated

Governance Board West Norfolk Alliance

Elements: • Management board to establish and oversee development

plan • Small team to coordinate and manage day to day

operations • Multiple sources of funding and investment • Marketing plan to promote and establish the brand • Information management (research , intelligence and

reporting) • Older People user engagement (formal and informal

access) • Clear lines of ownership and accountability

(Chair of Lily+ Board sits on Alliance)

Products and services

Older People user groups Marketing

Proposed initial model

• The Governance Board of partners should include providers and voluntary organisations as well as statutory bodies. This Board will act as commissioner of the Lily+ service

• The existing WN Alliance could be developed to take on this role

• A lead agency host model providing the necessary formal hosting needed for issues such as; funding, budgets, employment and procurement.

• Lily+ partners providing other support services/expertise – drawing on their core competencies, such as; User engagement, Web site design, Marketing, Training, Community Development and Volunteer training and development.

• The option to develop the delivery model into a formalised social enterprise, such as a Community Interest Company, could be considered after an initial period of successful live running,

Lily + coordinator team

Lead Agency (hosting)Lily+ Mngt Board

(users, providers, commissioners)

8. The outline invest to save business case

Benefits

Older people Trusted, safe and unbiased single point of contact User freedom and empowerment Ability to locate the right local service first time

Communities: Improved sense of social responsibility A single point of reference for friends, families and carers of older people

Commissioners: Greater understanding of demand Able to make best use of the current local offer

Providers: Reduced duplication within the system Collective sign posting and hand off best practice A tool for maintaining local service knowledge

Implementation cost summary (full breakdown spreadsheet available) Rev Cap Source

New operation (staff) Lily + coordinator 36,000 0 BCKLWN / WNP

Web content & marketing 12,000 0 BCKLWN / WNP

New operation (non staffing) Website 20,000 72,000 BCKLWN

Marketing 2,000 8,000 BCKLWN

Pop-ups 37,000 73,000 S&W Funding

Ambassador Programme 50,000 4,000 S & W Funding

The invest to save approach • The Lily+ programme is designed to enable the development of more

resourceful and resilient older people and their communities. • It will be an ‘invest to save ’ programme through which commissioners

and providers will be able to realise more efficient and effective use of resources

• Over the longer-term it will support statutory services in managing down demand and being able to operate with reduced spending levels

• Xxx • xxx

Implementation funding • Strong and Well…. • BCKLWN… • WN Alliance….

9. An outline implementation approach

Detailed design work and pathfinder implementation readiness • Workstreams • Task a& Finish

groups • User

engagement • Provider &

commissioner engagement

Pathfinders x 3 • Rural • Urban • Coastal

2014/15 2015/16 2016/17….

Phase one Phase two Phase three

Refine and develop design Readiness for wider roll-out

Wider roll-out

plan

On-going feedback and improvements

Evaluation & benefits plan

Evaluation & benefits plan

Features of proposed implementation approach:

• Incremental not big bang, with roof of concept pathfinders

• Continued involvement of solution group and wider user engagement in finalising design and pathfinders

• WN Alliance provide programme governance

• Evaluation and benefits plan agreed with governance group

• Learning from pathfinder informing on-going design and improvements

Implementation next steps (phase one – by end of December): • Programme governance and manager established

• Implementation plan created and signed off

• Pathfinder locations agreed

• Task and finish groups established and working on detailed design:

- Web site and products

- Marketing and awareness

- Community based pathfinders

- Management Board and Governance

• User groups established and contributing to detailed design and implementation

Evaluation & benefits plan

There are 12 categories on LILY. Every category has a “Landing Page” which links to other relevant sections and information

Users can either enter a keyword, or click the view services button to access the listings on LILY for that category