Outcome Based Domiciliary Care Commissioning

A West Sussex ApproachSouth East ADASS Regional

SymposiumTranslating a Contractual Framework

to meet the PPF Agenda

Objectives of the Presentation

• Look at the West Sussex experience and compare with other authorities.

• To develop a shared understanding of Self-Directed Support

• To look at how “Outcome Based Commissioning” is starting to work in practice

• Explore challenges and opportunities for domiciliary providers

1. Right to Independent Living

I can get the support I need to be an independent citizen

2. Right to a Personal Budget

I know how much money I can use for my support

3. Right to Self-Determination

I have the authority, support or representation to make my own

decisions

4. Right to Accessibility I can understand the rules and systems and be able to get help easily

5. Right to Flexible Funding

I can use my money flexibly and creatively

6. Accountability Principle

I should tell people how I used my money and anything I’ve learnt

7. Capacity PrincipleGive me enough help, but not too

much; I’ve got something to contribute too

Principles of SDSPrinciples of SDS

What is an outcome?

“The aim of an outcome based approach is to shift the focus from activities to results, from how a programme operates to the

good it accomplishes”

“The impact, effect or consequence of help received”

Individual Outcome in Social Care

• Maintenance

• Change

• Process

The West Sussex Approach

• Background information• Demographics and domiciliary care

provision• Contractual arrangements• Pilots and approaches to progressing

personalisation• Domiciliary care; moving to meet the

changing culture of Self-Directed Support.

December 2007 Consultation Process Commenced

• Three month consultation period• Letters to all contracted providers• Presentations to West Sussex Domiciliary

Care Provider groups.• Local independent discussion groups• Feedback to WSCC early March 2008Decision then made to progress to a new form

of contract for Domiciliary Care.

Through consultation with customers, commissioners and providers it became clear:

• New contractual arrangements would be required, to enable people to have more control over how their services are to be delivered.

• People need simple systems to assist with making choices.

• Providers wanted support to develop personalised services and track spend for customers under contract.

Developing the new contract

• Outcome based specification• Publishable rates in a simple comparable

format• Sharing customers stories and provider

feedback through workshops• Promoting social inclusion through

collaborative working.

Managing the money

• Direct Payments• Indirect Payments• Council Managed Budgets

(Managed Individual Accounts)And for the future:• Individual Service Funds

(Provider quote from the IBSEN evaluation report for the individual Budgets pilot)

‘We have spent year after year after year brainwashing our carers. “Stick to the Care Plan, don’t do this, don’t go outside this, do this,”…

…this is a totally different, almost alien way of working’

West Sussex Independent Domiciliary Care Provider

How is WSCC supporting providers in the delivery of

SDS?• Provider/Customer workshops to share good practice

and challenges

• Free training throughout 2009 on outcome based practice

• Web-based information about local community services

• A shared Excel spreadsheet to track spend and accruals of personal budgets

• Care Commissioning Teams to work as brokers and intermediaries supporting both customers and providers.

To move from fitting people around services to fitting support around people

Being outcome focused – “it’s about getting a life not a service”

Supporting self-determination – choice must be real even if the budget remains notional

Challenges aheadChallenges ahead

Questions & AnswersThank you – and did this meet your

outcomes?