Domiciliary Care Workshop

1. Domiciliary Care Workshop Waterfront Place, Chelmsford 11 October 2007 Gill Herbert, Consultancy & Development Ltd

2. Person Centred Care Gill Herbert September 2007

3. Where did the idea come from? • Social work professional values • HAP professional values • Tom Kitwood’s work in dementia care • NSF Older People Standard 2 “NHS and social care services treat older people as individuals and enable them to make choices about their own care. This achieved through the single assessment process, integrated commissioning arrangements and integrated provision of services, including community equipment and continence services.” And most policy initiatives in the last decade Gill Herbert, Consultancy & Development Ltd

4. Practice Conflicts & Inconsistencies in the last decade • Service-led responses vs person-centred care avoiding process and pathway oriented case management and clinically focused approaches (Matrix, 2005) • Resource management for cost efficiencies vs commissioning and provision for quality finding “smart commissioning” solutions with outcome focus (SPRU, 2003) • High caseloads driving short-term interventions vs whole person approaches over time long-term care management models Gill Herbert, Consultancy & Development Ltd

5. And more conflicts… • Tight eligibility criteria vs investment in prevention and well-being Modernising social care, 2007 • Bureaucracy vs professional integrity duplication & single assessment process • Uni-professional interventions vs inter-disciplinary working experiences in intermediate care & mental health • Task-centred time allocations vs enablement & person centred support packages Social care and PFIs Gill Herbert, Consultancy & Development Ltd

6. Initiatives that make a difference • Everybody’s Business – DH guidance on making sure all services respond to OPMHP • “In control” – support for people with learning disabilities to use direct payment • “HOOP” – support for people to make their own decisions relating to housing needs • “Intermediate Care” – a real shift of emphasis to rehabilitation and re-ablement for those who access it Gill Herbert, Consultancy & Development Ltd

7. Challenges for commissioners • Understanding how outcomes for individuals relate to outcomes for populations or groups • Making sure commissioning does result in person-centred care for individuals – across agencies and professions as well as within service • Enablement focus rather than just crisis interventions • Ensuring links are made to voluntary, community groups and social networks • Turning individual budgets into well managed market development Gill Herbert, Consultancy & Development Ltd

8. Challenges for Providers • Ensuring quality through active listening to customers • Achieving consistency, stability and practice which enables and supports independence • Developing partnerships with voluntary and community groups and social networks which work • Developing monitoring and evaluation systems which can inform future commissioning Gill Herbert, Consultancy & Development Ltd

9. And to make it all work? • Active partnerships between commissioners and providers to encourage learning and service improvements • Good information • Supportive management that drives change • Encouraging, not disabling, social networks and voluntary support Gill Herbert, Consultancy & Development Ltd