Colin Angel Policy Director United Kingdom Homecare Association Memberled professional association Represent 33 of UKs independent and voluntary sector homecare agencies Promote high quality sustainable care services so that people can continue to live at home and in their local communit ID: 316268
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Slide1
Individual Service Funds
Colin Angel, Policy DirectorSlide2
United Kingdom Homecare Association
Member-led professional association
Represent 33% of UK’s independent and voluntary sector homecare agencies
Promote high quality, sustainable care services so that people can continue to live at home and in their local community
Provide campaigning, leadership and supportSlide3
What is an Individual Service Fund (ISF)?
The management of a service users’ personal budget to achieve agreed outcomes
Council pays budget directly to the provider
Provider arranges care according to the users’ wishesSlide4
Individual Service Funds for Homecare from In Control
Authors:
Caroline Tomlinson (In Control)
Michelle
Livesley
(Helen Sanderson Associates)
Sponsors:
UKHCAMears Care LimitedContributors:People who use servicesWirral and Lancashire councilsGet the publication from In Control [Link]Slide5
Where ISFs fit with Government policy
White
paper “Caring for our future”:
Services
close to
home
G
reater choice and controlThe Care Bill:Commissioning for wellbeingPersonal budgets as an entitlementDirect payment as the preferred delivery methodSlide6
ISFs and degree of control(for illustration purposes)
Council
commissioned
service
Council or
3
rd
party managed personal budget
Direct
payment
to
buy
services
Individual Service
Fund
Direct payment to employ personal assistant(s)
Less individual control
More individual controlSlide7
Why is UKHCA supporting ISFs?
Benefits for users, providers and commissioners
Traditional purchase models don’t make best use of scarce resources
Prescriptive planning
Pressure on price & visit timesSlide8
The impact of current funding on homecare visit duration
Source:
Angel, C (2012) Care is not a commoditySlide9
How and ISF works(A simplified overview)
User receives personal budget allocation
from council to meet outcomes
User designs their support plan with the provider
Budget is paid to provider on a regular basis
User can buy additional services, if desired
Provider
delivers the serviceincluding buying services from elsewhere, if necessaryProvider able to account for how the budget is spent in “near real time”Council that desired outcomes are achievedSlide10
The relationships within an ISF
Specifies compliance
requirements
and
obligations
1
. Agreement & funds
What is provided
and when
3. Support Plan
Statement of amount paid
and user contribution
2. ISF details
Council
Provider
Service
userSlide11
The benefits for…
People who use services
Can increase chance to remain at home
Reduces implications for the individual of:
Managing a direct payment
Becoming the direct employer of a PA
Greater control over service
Individual can prioritise what's most important for themReduces "time and task” / inflexible commissioningSimilar control as enjoyed by private purchasersPotential to be used by people who lack capacityWith appropriate support and advocacySlide12
The benefits for…
Homecare providers
Offers greater flexibility:
User and provider can negotiate care plan
to find ‘best fit’ between choice and resources
Avoids prescriptive or inflexible plans, with unnecessary authorisation procedures for minor changes
Greater assurance of payment:
Avoids credit control costs, reduces write-offsBetter cash-flow, with predictable incomeHigher satisfaction for customers and staffSimilar processes to private-purchase workSlide13
The benefits for…
Local authority commissioners
Can create a fast-track process to get people onto personal budgets
Has the assurance that outcomes are defined
Agrees the outcomes with the person using the service
But leaves the detail how and when to the experts
Reduces
contracting effortBut savings need to be passed to providers, who take on this roleSlide14
People with an ISF should be able to say…
“I am fully involved in decisions about my own support and
how
the
wider service
develops”
Co-production
“I choose how I am supported and my support workers know
this is
important to
me”
How?
“I get support on the days and at the times that are right for
me”
When?
“I choose who I want to support me. My support workers
know me
and I know
them”
Who?
“I am supported where it makes sense for me; at home and
out
and about”
Where?
“I can use my hours/budget flexibly and can choose what I
am
supported with”
What?Slide15
Some practical considerations
How the payment made?
In advance or arrears?
Is users’ contribution paid to council or provider?
Provider-collection is higher risk, but may increase QA
Need a system for dispute resolution
Eg. missed visits, or user not at home when expected
What is the price?Management costs different to high-volume contractsDevelop experience in responsive plansEspecially if not already supporting self-fundersSlide16
Making ISFs work in practice
ISFs need to be an available option
to
all
Willing providers must be identified and
able to deliver
Effective contracts need to be in place
All parties must understand their responsibilitiesA specimen from Lancashire included in paperMonitoring to ensure that outcomes are achievedReviews 6-weeks to check bedded-down, then annually, or when needs changeTrust is required between councils and providersSlide17
How to contact me
Website:
www.ukhca.co.uk
E-mail:
colin.angel@ukhca.co.uk
Telephone:
020 8661 8152
Twitter:
@colintwangel