Provider workshop Learning Disability January 2016
Purpose • Introductions – Getting to know you • Honest & open communication and dialogue • Understanding how we can work in partnership • Understanding the challenges we are facing • Identifying opportunities
Agenda • Introductions • LD demographics in North Yorkshire • National and Local context • Children’s LD Services • Challenges for Commissioners & Providers • Workshops – ‘Turn the Curve’ • Next steps
Commissioning and Quality Who are we and what do we do? Commissioning • Lead and direct HAS Commissioning function in a specific locality and with a specific portfolio • Working in partnership with CCGs, district councils and providers – joint commissioning/integration • Developing strategy and implementation plans Quality • Quality monitoring/Quality Assurance • Procurement • Brokerage
LD within North Yorkshire • The total number of adults aged 18-85 and over with LD is predicted to be 11,338 in 2015, rising to 11,870 by 2030 • There are 310 people with LD who also have autism. The largest cohort of 162 are age 18 – 34 • 40% of people with LD also have physical and/or sensory impairments • In 2014-15, NYCC spent approximately £45.6 million on social care provision for people with LD which represents 30% of the overall Adult Social Care Budget (excludes funding received from the NHS and expenditure relating to supported employment) • Range of LD Services: Respite, Residential, Supported Living, Shared Lives, Employment based services, Community services, Personal Budgets, Domiciliary Care
Social Care Provision District Res. Res. % Occ. at Res/ Res/ Nurs. Nurs. Beds % Occ. at Dom Council Homes Beds 23/11/1 Nurs. Nurs. Homes 23/11/15 Care Area 5 Homes Beds H’ton 7 204 96.2 8 371 3 130 96.3 10 R’mond 5 175 3 173 1 60 4 S’boro 47 1007 92.8 5 218 8 213 94.1 22 Ryedale 14 265 0 0 2 104 11 H’gate 58 1096 96.5 0 0 21 1194 90.6 31 Craven 12 234 1 45 8 369 9 Selby 20 348 95.8 5 291 1 35 92.1 10 TOTAL 163 3329 22 1098 44 2105 97
National Context • Putting People First Concordat - development of personalisation (2008) • Valuing People Now – Department of Health (2009) • Death by Indifference and Getting it Right Charter (2007/10) • Winterbourne Concordat 2012 • Valuing Every Voice, Respecting Every Right (2014) • Care Act (2014) • Children and Families Act (2014) • No Voice Unheard, No Right Ignored – (2015) • Building the Right Support (2015)
Local Context • ‘Live Well, Live Longer’ – strategy for people with LD 2015 -2020 – Increase independence and choice – Improving health and reducing health inequalities – Improving social inclusion – Providing support for families and carers – Supporting young people into adulthood – Reducing the number of out of area and long term accommodation placements
How will we get there – Our Strategy? Personalisation Prevention Right care, right place Empowerment and Enablement Caring for carers Preparing for adulthood http://www.northyorks.gov.uk/ldstrategy
Disabled Children’s Services • There are five teams in North Yorkshire which assess needs and commission packages of care for disabled children, young people and their families. • Families have a range of support needs: care in the home, individual support with activities, overnight breaks or daytime care in school holidays.
New - Transitions 14 – 25 years • From April 2016 Young people will remain with Disabled Children’s Services during a Transitional period, which may be up to the age of 25 years. • This is to support young people with Preparing For Adulthood, as required by the Care Act 2014 and the Children and Families Act 2014.
Preparing for Adulthood • Young people’s preparation for adulthood will be flexible, the Council is seeking providers able to deliver services for young people from 14 years, depending on individual needs. • The Council will be seeking to commission age appropriate services for young people aged 14 – 25 which maximise their independence and assist with preparing for adult life.
Overnight Short Breaks • Currently children and young people with complex needs use 5 residential short breaks units across the County. • The Council is undertaking a review of this provision. • During 2016 the Council will be consulting families, partner agencies and providers about future ways of meeting this need.
Overnight care 18 + • There are gaps in provision of overnight short break care for young people over 18 years with very complex needs. • Many families need this support until the young person is ready to move into their own accommodation. • This can help young people remain in their own community.
New - Personal Budgets for Care • Personal Budgets for Disabled Children and Young People will launch in April 2016 • Families will work on their own “Support Plans” and have choice and control over how they use their Personal Budget. • Families will want flexible services to meet the individual needs and circumstances of the young person and their family.
WHAT CHALLENGES ARE WE ALL FACING?
Provider Challenges • National Living Wage • Recruitment and Retention of high quality staff • Sustainability of the market • Voids and nomination rights • Communication with commissioners • Finance • Sleep overs • Innovation • Market confidence • Family Customer Expectations
Commissioning Challenges • Provider challenges – mirror commissioning challenges e.g. recruitment • Austerity – how do we develop person centred services in a budget we can afford? • How do we better understand the market in North Yorks and develop relationships with providers? • How do we develop the LD market for younger people? • Rurality - How do we help people access services in their own communities?
Procurement Challenges • Personalised services with some consistency in costs and quality • How best to monitor performance, outcomes and improvement for individuals? • No framework for some services e.g. supported living • Providers understanding procurement processes and restrictions
Health Commissioning Challenges Solutions: not straightforward! • Annual Health Reviews 1. Health Inequalities • Health Action Plans 2. Co-existing long term • Cancer Screening • Bespoke Health Promotion health conditions 3. Transforming Care / • Investment in Community services Building the Right Support • Highly individualised long-life 4. PMLD and ‘Behaviour care/support planning that Challenges’ • Small scale supported living
What are we doing to support providers? • LD Strategy • Market Position Statement - MPS • Surveys • Provider Bulletin • Service Mapping • Capturing new ideas /new business
Workshop 1 – Turn the Curve • 5 mins STARTING POINT – Timekeeper – Reporter – Identify issue to work on • 15 mins – Where are we now – Focus on issue and consider the story behind this issue – Causes and forces at work? – What makes it an issue? • 15 mins – What works – What could we do better? – How can each partner contribute? – No cost/low cost ideas • 5 mins – Top 3 actions – Identify your best top 3 actions to share with group – be specific
Workshop 2 • Have we captured all the issues? • How do we continue to support and build the relationship with providers of LD services – what are the mechanisms that work for you? • What should we focus on – future agendas?
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