CEO Network Meeting

1. CEO Network Meeting 4 October 2012

2. Housekeeping • Toilets • Fire • Evacuation • Refreshments • Agenda

3. Policy Update Tracey Lazard

4. Introduction: Draft Care and Support Bill

5. Context Care in Crisis - many needing support are not receiving it Local councils cutting funding for care and support Costs of care have increased Eligibility criteria tightened Independent Living Fund under threat Impact of Welfare Reform Act: DLA/PIP and Universal Credit Deaf & disabled people’s organisations are closing

6. Draft Care & Support Bill July 2012 Draft care and Support Bill (draft Bill) was published in July 2012 alongside a white paper. Draft Bill is first step in putting the government’s long term ‘vision’ contained in White Paper into action. Out to consultation till 19 October 2012.

7. Who does the draft Bill cover? England only Adults only, but… Duties for local authorities to ease the transition from children’s to adult services Duties to give support to children and carers

8. What does the draft Bill contain? Draft Bill provides a range of duties for Local Authorities (LAs) The draft Bill has 3 parts: Covers care and support Covers health provision General provisions

9. Wellbeing Overarching aim is to put health, well-being, independence and rights of individuals “at the heart of care and support”. LAs will need to promote the well-being of individuals when decisions are made If LA fails to follow the duty, they could be challenged through judicial review.

10. Information Information about the services in your local area, who provides them and how to access them will be provided by your LA. Information about how to raise concerns about the safety of an adult will also be provided.

11. Diversity of Services Duty to promote diversity and quality amongst care and support providers in the local area. How will this duty be enforced? How can it be challenged if not implemented?

12. Prevention A duty to provide or arrange services that prevent, delay or reduce people’s need for care and support. If support is only provided for those with critical needs, how will prevention be possible?

13. Children in Transition Children will have the right to request an assessment of their care and support needs in advance of their 18th Birthday, to support transition planning.

14. Adult carers Any adult providing care to a child will have a right to an assessment. Duty aims to provide access to certain services only available through adult care and support. In addition to rights you have now.

15. Young carers A young carer will have the right to request an assessment of their support needs in advance of their 18th Birthday to support transition planning.

16. Personal budgets & direct payments For the first time, there will be a right to a personal budget for both adults and carers. Direct payments must be made to an adult that requests one. However, payments can be stopped and repaid if funds are not used to meet the needs specified in the support plan. Will this take away choice and control?

17. Preference for particular accommodation LAs will have to “ensure that an adult should have a choice of accommodation…” Currently, the right to choose accommodation is limited to care homes, but this extends the right to other forms of accommodation. Does it include the right to live at home?

18. Continuity of care Care must be provided by the ‘sending authority’ until an assessment and care is put in place by the authority being moved to. This is not portability of care.

19. Funding - Deferred Possibility of deferred payments to the council - individuals will not have to sell their house to pay for their care. Proposals in the draft Bill are weaker than Dilnot Commission’s recommendations, which are cap of £35,000 on lifetime cost and asset threshold to rise from £23,350 to £100,000. Disappointment that government’s progress report on funding reform did not set out long term plans for funding.

20. Inclusion London’s vision Most fair and sustainable system is that support and care funded out of general taxation. Independent Living Fund to be retained and expanded. Support and care is available for all that need it, regardless of age. Assessment to be user-led and not dictated by budget. Support to enable independence and inclusion in the community. Disabled people to have choice and control over funding and support.

21. How do you think care and support for disabled people can be improved?

22. Next steps Respond to the consultation on draft Care and Support Bill or send your views, comments and experiences to Henrietta Doyle at:henrietta.doyle@inclusionlondon.co.ukto inform Inclusion London’s response to the consultation. Write to your MP and them know about your experience of care and support, and the improvements you think are needed.

23. More information Full text of the draft Bill is available at:http://careandsupportbill.dh.gov.uk/home The ‘Caring for our future: reforming care and support’ White Paper is available at:www.dh.gov.uk/health/2012/07/careandsupportwhitepaper/ A ‘Caring for our future progress report on funding reform’ can be found at:www.dh.gov.uk/health/2012/07/scfunding

24. Campaigning Geraldine O’Halloran

25. The reasons DDPOs say they don’t campaign Concern over their relationship with the local authority Worried about what funders will say Not enough skill or knowledge about campaigning Board/trustees not being clear of its campaigning role No time – too busy Too many other commitments

26. The reasons DDPOs say they don’t campaign… “Other people are campaigning - we don’t need to do it” Not enough interest amongst their membership Worry about managing volunteers who campaign …………………..

27. Why Campaign? Campaigning can be a tool to: Give a voice to those without one Promote participation Social change Bringing people together Improving user involvement, confidence and decision-making There are many different ways to campaign or spread your message.

28. Why campaign…. To make your mark locally as the lead organisation for Deaf/disabled people’s user involvement To share experiences of local Deaf/disabled people with a wider audience To give local Deaf/disabled people the confidence to get together and share ideas, experiences and campaign messages.

29. Top tips 1 Be clear Check your evidence and research Is anyone else doing the same? Check for campaign partners, get them involved or join their campaign. Develop your strategy/plan: What outcome do you want to achieve? Who is the target and why? Who will be involved and for how long?

30. Top tips 2 Use different sources of local media: email, tweets, local press, local radio, leaflets, articles. Meet and tell people about your campaign - your local councillors, MP, CVS and anyone who needs to know Make sure that BEFORE you start to campaign or lobby, you have tried other means for change first! For example, a 1:1 meeting with relevant team/person. Lobbying is a last resort for change.

31. Top tips 3 Make sure your trustees/board membership, volunteers and staff know what the campaign is about Ensure you have one or two contact people for decision-making and presenting to the media Always have an outcome established Is there a time-line? Short term, medium term, long term… Evaluation, evaluation, evaluation! What can be learnt/improved?

32. Need more help? Check out the Inclusion London Website (www.inclusionlondon.co.uk) We have resources that will help you to develop your target, write letters and find out how to get involved in national campaigns Set up and/or support a local DPAC Campaigning is more important than ever

33. Hardest Hit Tracey Lazard

34. Hardest Hit - More info Info & Resources - The Hardest Hit Campaign [www.inclusionlondon.co.uk/the-hardest-hit-campaign] News - Join us in a week of Hardest Hit Action starting 20 October [www.inclusionlondon.co.uk/join-us-in-a-week-of-hardest-hit-action-starting-20-october] Or visit the Hardest Hit website: [http://thehardesthit.wordpress.com/] If you would like more info on the Hardest Hit Campaign, visit the Inclusion London website, under:

35. Tea Break

36. Demonstrating Added Value Tracey Lazard Tess Mc Manus

37. What HM Treasury requires • What are the direct and indirect resources involved. What is the true economic cost? • Where do these fall upon internally and externally. Who incurs what costs? • What costs are incurred at set up and what are running costs? • Can benefits be attributed to the service, or what proportion of benefits can be explained by the service. Do we know for certain that it was the service and not some other factor that brought about benefits? • What are tangible and intangible benefits, and where do these accrue. Who benefits from what?

38. Different approaches & their uses • Depending on your answers to the prompts, you will be clearer about which techniques are appropriate. • There may include: • Cost consequence analysis • Cost effectiveness analysis • Cost benefit analysis • Cost utility analysis • Cost minimisation analysis • Cost avoidance analysis • (Social) Return on investment

39. Cost consequence approach (CCA) • Does not require all benefits to be measured in same unit, such as monetary units. Can be: • A heading or category (e.g. improved service user satisfaction) • A measurement (e.g. service user satisfaction improvement of 20%) • Costs are simply presented against different individual types of benefit • Not seeking to calculate a single dividend

40. Cost effectiveness analysis (CEA) • Compares costs and outcomes of alternative interventions which share common goals • Outcomes are expressed in natural units as opposed to monetary values (e.g. number of people who take up service, reduction in unemployment, etc) • Results are presented in a cost effectiveness ratio, which expresses the cost per outcome (e.g. the cost unit of employment created)

41. Cost benefit analysis (CBA) • Compares costs with the monetary value of benefits generated by it • Strives to measure and monetise all costs and all outcomes • Results are presented as a ratio

42. Cost utility analysis (CUA) • Specialised form of CEA • Transforms all outcomes into Quality-Adjusted Life Years (QALYs) • Effectiveness of different treatments/interventions assessed in terms of QALYs

43. Cost minimisation approach (CMA) • Compares different approaches for achieving same outcome, and identifies the lowest cost • Does not require outcome to be monetised • Requires outcome to be equal/identical

44. Cost avoidance approach (CAA) • Looks at avoided spend, not necessarily decreased spend • Uses current condition as starting point • Assesses costs incurred without intervention against current condition • Scenarios

45. (Social) Return on investment ((S)ROI) • ROI and SROI are both forms of CBA • ROI = (Gains – investment cost) divided by investment costs • ROI dividend = ratio of gains to costs (e.g. for every £1 spent, £12.63 of benefits were realised) • SROI – as above but underpinned by a specific set of principles. Places monetary values on social, environmental, economic outcomes

46. Defining social value Social value is about maximising the impact of public expenditure. It looks at what is created, and sometimes what is forsaken, through a commissioning process. It is therefore also about what we value in the public realm. (NAVCO) Social value considers more than just the financial transaction. It includes: Happiness Wellbeing Health Inclusion Empowerment

47. Social Value (public service) Act 2012 • The Act applies to the provision of services, or the provision of services together with the purchase or hire of goods or the carrying out of works. • The wording of the Act states that…  The authority must consider (a) how what is proposed to be procured might improve the economic, social and environmental well-being of the relevant area, and (b) how, in conducting the process of procurement, it might act with a view to securing that improvement.

48. Feedback on Private Sector Opportunities Tess Mc Manus

49. Inclusive and Active 2 Alex Gibbons (Relationship Manager, Interactive)

50. CEO Network Round Up