Thursday, 10 March 2016
West Midlands Individual Service Fund Action
Learning Set
Present:
Heart of England Mencap;
Solihull
Warwickshire;
Telford and Wrekin;
Birmingham;
Coventry;
Wolverhampton;
New Directions Rugby;
Midland Mencap;
Age Uk Solihull;
Wolverhampton;
Herefordshire,
Herefordshire.
Helen Turner, Improvement and Efficiency West Midlands
Chris Howells, Centre for Welfare Reform
Winning Hearts and Minds
Addressing the question, ‘What does ‘good’ look like?’, group discussion indicated a common
understanding of what benefits ISF's can/should offer across the board
 More independence, more control
 Social workers comfortable with what ISF can achieve
 Safe and accountable
 Sustainable, offering creativity and choice
 Delivering greater independence and happiness for customer
 Driven by service user outcomes
 Shared risk between council and provider
 Facilitate more offers into the market place and opportunities for micro provision
General agreement that ISFs are part of a system and culture change, not just a pilot and we
should not use the term as ‘pilot’ can be seen as temporary before ‘normal service’ is resumed
(we may need to test what systems will work best but language is important here).
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Thursday, 10 March 2016
Shared Learning
1. Calderdale
Calderdale experience key points:
 Did a lot of work in advance with providers and social workers and developed information
for both public and staff about ISF's
 Started working with a small number of providers and engaged with both users and staff
 Cultural change, not a quick fix
 Social value is a key component
 Building community capacity through Community Builders and Asset based approach.
Link to Calderdale presentation
Angela_Gardner_-_I
ndividual_Service_Funds_Calderdale_York_12_01_16_v2.ppt
Wolverhampton and Warwickshire have similar examples and Solihull are going to use Local Area
Coordinators. Conclusions were that Case Studies really help to convince and justify. On Social
Value for example, Derby have evaluated the Social Return on Investment of their Local Area
Coordination
–
see
http://www.thinklocalactpersonal.org.uk/BCC/Latest/resourceOverview/?cid=11013
2. Provider Events.
Solihull Council have recently held a series of market shaping events led by their director of
commissioning in which they have signaled their intention to introduce ISF’s A total of 23
providers attended as well as council staff from procurement, finance, quality monitoring, social
care practitioners and CCG's colleagues. There were short presentations about the developing
local offer, the aim of which is to enhance prevention and wellbeing through improved information
and advice, community development via Local Area Coordinators, and the introduction of more
flexible outcome focused contracts (including ISF’s). The events generated a broad open
discussion and there was a mostly positive response to ISF’s, particularly about the ability to be
flexible and bank hours. The events were pitched very much as a shared journey and further
shared learning events between providers and social care staff are being planned.
Pace of Change
Issues
Heart of England Mencap.
For us – leadership. For our trustee board this is a big shift. Some of our older carers do
not want to take control of the money but newer carers do want to take control.
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Thursday, 10 March 2016
Warwickshire.
Social workers struggle to come to get to grips with outcome focused way of working. They
are under pressure and think this will be more work, Asking providers to work with the service user
to take on support planning would free up social work time although providers are not currently
allowed to take initiative and any flexibility is tied up in contracts. (NB not having to do the care
and support planning has been a selling point in Solihull)
Wolverhampton
Looking at paying in advance and flexing personal budget over 3 months and with a view
to it being over a 6 month in future. This will allow greater flexibility when care and support
planning. Pre paid cards can satisfy some of the perceived risks Some councils already have ISF's
in place but not badging it as such. 3rd party accounts are ISF by another name. Let's look at
where we have already made progress
Midland Mencap.
Our trustees bought into In Control model pilot. Citizens are waiting for this to happen.
Midland Mencap keen on going ahead with ISF’s and working closely with Birmingham on this.
ISF’s have many benefits including co production, shared ideas and pooled budgets to make
money stretch further
Herefordshire.
Should we be badging ISF 's as delivering savings? There will be savings generated from
streamlining systems and processes For example, pre-paid cards save time and money on
unscheduled reviews by allowing provider to change the support, working to connect people more
into leisure services and other community support there are examples from Midland Mencap of
pooling budgets. But savings are not up front and not immediately cashable.
Coventry.
Have discussed with some providers, but they appear more concerned about their capacity
to deliver on current services.
A general issue was how can we make ISF’s and flexible contracting work for older adults?
Smaller packages may mean less creativity and Age UK Solihull's experience is that there are
often no support plans or fewer plans in place for older people. Older people want reliability,
consistency and to be able to change packages of support, just like any one else. Calderdale's
examples are useful here as a reference. (See above).
Warwickshire, Coventry, Herefordshire and Solihull are all looking at a Domiciliary Care retender
plus outsourcing reablement work (for some) and are looking to include ISF’s as part of this
retender. It was clear that everyone is at a different stage but key messages were
 trust your providers to deliver, this will
 free up your time, and
 work with the willing to begin with.
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Solutions
Strategic Commissioning - Are ISF’s in your Market Position Statement? If they aren’t, include
them. Develop a process and be clear about responsibilities
 Social care staff complete needs assessment, determine eligible needs, generate
an indicative amount of personal budget to meet eligible needs and a high level
support plan based on outcomes then pass this to
 the Provider to develop the detail and have creative conversations with the users.
Note that Warwickshire have developed a high level process map for explaining
where ISF’s fit within customer journey.
TLAP resource on Delivering Care and Support planning is a useful reference here.
http://www.thinklocalactpersonal.org.uk/_library/Resources/SDS/TLAPCareSupportPlanning.pdf
Telford & Wrekin and Herefordshire. Councils have the flexibility to commission more outcome
focused contracts. Dynamic purchasing systems - Light touch regime allows commissioners the
flexibility. Need to make use of it.
http://www.local.gov.uk/documents/10180/7519026/lg+procurement++National+social+care+category+strategy+for+local+government/dc65f5a4-5c2d-4ba4-92c7a25b8f58fa09
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/469057/LTR_guid
ance_v28_updated_October_2015_to_publish__1_.pdf
Midland Mencap has developed a dash board of performance information that councils can
interrogate remotely. This was for Carers contract. What information do councils need? They need
to trust providers to manage this better.
Several councils have been involved in discussions with audit re ISF’s and electronic monitoring,
predominantly only used for older adults services. How do councils and providers work together
to have an auditable system for ISF’s? CM 2000 has an ISF module that monitors delivery over
a period of time. Or will pre paid cards do this anyway?
Several councils may wish further discussion re audit and role of CM 2000 - Wolverhampton
Coventry, Solihull, Herefordshire.
Payment Methods
Shared learning from Wolverhampton. How pre paid cards can help deliver ISF’s?
Wolverhampton is working successfully with a pre paid card provider, PFS, to deliver on Direct
Payments and there are now plans to extend this into Individual Service Fund delivery.
https://www.prepaidfinancialservices.com/about-us/
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The company has just delivered a demonstration for providers and council officers to show the
capability of the system. Providers have a pre paid account which is visible to them on line plus
access to a helpline. Within the provider account individual accounts are set up for each service
user and payments are made in accordance with the individual personal budget. There is the
flexibility for the account to pay other services such as leisure services, micro providers. It can
also pay out cash. The provider can access the system and view it as can the council. Plus there
is no cost to the provider. There are still some questions to be asked: Can service users view their
account information? How can customers with fluctuating needs be managed within the system?
but most thought that this prepaid provider system offered good flexibility and protection for all.
Birmingham is also going down the Pre paid card route and are about to chose their provider.
Brent have been using pre paid card with ISF's already.
Types of Agreements (2 way vs 3 way agreements)
Warwickshire. Initially going with a 3 way agreement as that is what they have developed and
don't want any further delays. They have identified 2 clients with Heart of England Mencap who
will move across on to an ISF but are looking to move to a 2 way agreement at end of 6 month
pilot.
Wolverhampton are paying provider gross on a 2 way agreement. They have a good debt
collection team and slick financial process which mitigates the need for detailed audit processes.
Most councils are looking at a 2 way Agreement and the consensus was that this is definitely the
preferred route. That is a 2 way Council to Provider and a 2 way Provider to Service User. Centre
for Welfare Reform has an example Council - Provider agreement on the website
http://www.centreforwelfarereform.org/library/by-az/example-of-flexible-support-contract.html
and Birmingham have used it as a framework for their approach.
Midland Mencap agreed to send through a copy of an agreement between Provider and Service
User.
Provider Role
Heart of England Mencap
Sees ISF’s as a strategic route moving forward. Recognise the value of people having
personal budgets as it gives people the opportunity to connect more with their communities.
Provider can/should facilitate this connection but have to make a shift in the way care is delivered.
Most importantly, Councils need to start the dialogue with providers
Midland Mencap
Tested out lots of principles in the past. People have brokered what they want already so
the ISF approach is now new. Noted that Transport is an expensive part of care plans and asked
the question how best to broker and share taxis to make the budget stretch.
New Direction, Rugby.
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Thursday, 10 March 2016
This is a great opportunity to help people make more changes. There are challenges for
care staff as ISF requires a different culture for support. Those that have a time/task approach will
need to develop and use their initiative as this is a cultural shift. Noted that the impact of national
living wage makes it a difficult time to be recruiting staff with the right approach to care under ISF.
Next Steps
Is the Action Learning Set useful? Where next?
Feedback was that it has been extremely useful to share views and make connections.
Work streams that people are interested in:
 Working with Procurement
 Role of Pre paid cards / CM 2000
 How do you sell ISF’s? Communications and case examples
 Getting buy in from social care staff - involve social workers in next ALS
 Leadership – Helen and Chris to attend West Midlands Councils Strategic Commissioning
Network. Date in May
 Levering change locally- Herefordshire would welcome some external (neutral) input.
Helen Turner
Social Care Insights Ltd
Associate to Improvement and Efficiency West Midlands
Chris Howells
Koru Consulting Ltd
Fellow, Centre for Welfare Reform
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