819148731 Working to Put People First The workforce development strategy for Adult and Community Services Including 0 819148731 Contents Executive Summary 2 Chapter 1: Introduction 4 Chapter 2: Vision 8 SECTION A: WORKFORCE PLANNING Chapter 3: Workforce Planning in ACS 11 Chapter 4: Market Shaping 14 SECTION B: ADULT & COMMUNITY SERVICES Chapter 5: Cultural Change in ACS 17 Chapter 6: Technical Skills & Knowledge in ACS 21 SECTION C: ENABLING MARKET SHAPING Chapter 7: Delivering in the PVI Sector 24 Chapter 8: Cultural Change in the PVI Sector 25 Chapter 9: Technical Skills & Knowledge in the PVI Sector 27 Chapter 10: Service Users and Carers 29 APPENDICES APPENDIX 1: Summary of Workforce Development Strategy supporting Devon’s 31 Putting People First programme Including 1 819148731 Executive Summary Delivering the national vision set out in Putting People First is a critical objective for Adult & Community Services in Devon. The programme must be fully implemented by April 2011. This landmark protocol sought to set out and support the Government’s commitment to independent living for all adults. It also outlined the shared aims and values, which will guide the transformation of adult social care. It was unique in establishing a collaborative approach between central and local Government, the sector’s professional leadership, providers and the regulator. It sought to be the first public service reform programme which recognised that real change would only be achieved through the participation of users and carers at every stage. It recognised that sustainable and meaningful change depends significantly on our capacity to empower people who use services and to win the hearts and minds of all stakeholders, especially front line staff. Local government would need to spend some existing resources differently and the Government would provide specific funding to support system-wide transformation through the Social Care Reform Grant, in line with agreements on new burdens. A number of projects and initiatives have already been put in place to move towards the objectives set out in Putting People First. Some of these projects have now ended but others continue (e.g. REMAS, Personal Budgets, Telecare) but all activity has now been brought together under one Putting People First Programme, which has been developed to focus on four major themes: Universal Services Early Intervention and Prevention Social Capital Choice and Control Existing projects and ones created in the future under this programme may have an impact on the size, structure and skills of the whole workforce. This needs to be described in a workforce strategy. Workforce development is a vital underpinning element to this programme and will therefore sit across the programme structure and will be represented on each of the project boards. In April 2009 Working to Put People First: The Strategy for the Adult Social Care Workforce in England was published. This document replaced The Workforce Strategy Interim Statement – Working to Make it Happen, which outlined workforce issues at the heart of delivering on Putting People First. This strategy identified six key priorities for the workforce going forward: Leadership. Recruitment and retention. Workforce remodeling and commissioning. Including 2 819148731 Workforce decelopment. Joint and integrated working between social and health care and other services Regulation, assuring public safety and raising standards of care in the social care workforce. The Social Care Workforce Development Team aims to provide strong support in the delivery of this demanding programme. Our vision, drawn directly from Working to Put People First, is one of a confident, enabled, and equipped social care workforce – a workforce who are able to deliver truly person centred care and understand and see the key role that they are making to delivering transformation. We see a workforce that is growing in confidence, learning and skills, led by inspiring leaders and championed by government. A workforce which supports the cultural shift from: Clients to citizens Expert to enabling Safety net to spring board Welfare to well being ‘Freedom from’ to ‘freedom to’ Transactional change to transformational change Against this context we have identified a five-stream approach that will deliver effective interventions across the programme. The five streams are: Workforce Planning Cultural change Technical knowledge and skills Service Users and Carers Market shaping in the Private Voluntary and Independent (PVI) Sector This document sets out our workforce development strategy, provides details of the development interventions to be implemented and highlights how these align to both the Working to Put People First national strategy and also the Putting People First programme that has been set up by Adult & Community Services in Devon. We and our team of highly skilled and professional Workforce Development and Senior Workforce Development Advisers aim to deliver this programme by fully utilising our established business partner model. By working closely with our frontline Adult & Community Services colleagues to understand their challenges and development needs we are able to provide high quality workforce development solutions that are innovative, effective and practical. This also enables us to be flexible and respond to the changing needs of Adult & Community Services. We believe this approach will be crucial to the delivery of this strategy. Piers Tetley Workforce Development Manager Katy Kerley Tom Woodward Workforce Development Team Manager Workforce Development Team Manager Including 3 819148731 Chapter 1: Introduction 1. 2. 3. Demographic trends combined with financial constraints demand a fresh look at how Adult & Community Services deliver services, to target its resources at those most in need and empower others to maximise their independence. The transformation of services will be developed in partnership with existing service users (both public and private), their carers and interested parties. User reference groups have been set up to facilitate engagement and other reference groups (e.g. staff) will follow. 5. Personal choice and control are at the heart of this transformation. All citizens will have access to information and advice regarding how to identify and access options available in their communities to meet their care and support needs. Devon already has a modernised care pathway for our assessment process. Devon already has a single point of access for universal offer but it centres on Older People and People with Physical Disabilities and has not yet been properly applied to Learning Disability and Mental Health. Devon have developed a brokerage service to negotiate the best deals for individuals. Devon’s Complex Care Teams are already integrated and this programme will help target their work to those in greatest need. 7. To achieve the outcomes required within the Putting People First strategy there will be significant redesign in process, practice and culture to transform adult social care into a system capable of delivering support tailored to individuals and local population. 8. A programme has been developed to focus on four major themes through which specific projects have been developed to deliver the required changes: Universal Services This theme covers access to universal services such as transport, leisure and education as well as information, advice and advocacy with the key principle being that there is an offering available to all, irrespective of their eligibility for Social Care Funding. Social Capital The aim of this theme is to ensure Devon faces a particular set of challenges and opportunities in relation to this transformation: Challenges Even higher financial constraints than other local authorities because of: Devon still has expensive in-house residential and domiciliary care services. Opportunities This national government programme must be fully implemented in Devon by April 2011. 4. 6. Personalisation is to be the cornerstone of public services. This means that every person who receives support, whether provided by statutory services or funded by themselves, will have choice and control over the shape of that support in all care settings. The national vision is set out in Putting People First. This vision is jointly owned across central and local government, user-led and professional leadership organisations and employers. Higher demographic pressures due to Devon’s ageing population. Including 4 819148731 that everyone has the opportunity to be part of the community and experience the friendships and support that can come from families, friends and neighbours. This will be achieved by using the potential of people within the community to transform the way Social care is delivered and will result in reducing social isolation and provide a sense of belonging. also provide practical delivery of equipment and monitoring. Early Intervention and Prevention This theme focuses on helping people early enough and in the right way, so that they stay healthy, recover quickly and maintain their independence. Choice & Control This theme will ensure that people have the choice and control over their own care which enables real decisions to be made. Devon will seek to increase the number of Personal budgets held by clients, encourage person centred outcome based planning and deliver greater choice to clients in meeting those outcomes. Devon will look to ensure that people who need support can design it themselves, understanding quickly how much money is available for this, and having a choice about how they receive support and who manages this. The principal features within this theme will be to provide crisis intervention, providing immediate care packages with the aim to reduce dependency on acute care. It will Figure 1: Programme Structure Including 5 819148731 This theme focuses on two key elements: The assessment and provision of personal budgets available to meet identified needs. The review and implementation of greater choice in delivering care. 9. The programme has been structured around these themes, with specific projects identified. Each theme will be sponsored by a Programme Board member, with each project stream led by a senior business manager (See Figure 1). 10. In April 2009 Working to Put People First: The Strategy for the Adult Social Care Workforce in England was published. This document replaces The Workforce Strategy Interim Statement – Working to Make it Happen, which outlined workforce issues at the heart of delivering on Putting People First. 11. This strategy identified six key priorities for the workforce going forward: Leadership – leaders will need to work together across sectors to drive change, supporting and involving local communities. Recruitment and retention – the workforce should be drawn from a wide base of cultures, skills and attributes within local communities but this remains a challenge. Workforce remodelling and commissioning – it is important to re-shape the workforce so it has the right people with the right skills undertaking the roles and tasks which people using services want. Workforce development – aimed at creating a more confident, empowered and diverse workforce with increasingly sophisticated skills in order to secure the dignity, quality of services and quality of life of those people receiving social care. Including 6 Joint and integrated working between social and health care and other services – so that people who use services can be reassured that the workforce will work across organisational boundaries to meet their needs. Regulation, assuring public safety and raising standards of care in the social care workforce – this is a priority for employers but will also be promoted through professional regulation by the General Social Care Council (GSCC) and through service regulation by the Care Quality Commission (CQC). 12. As workforce development is a vital underpinning element to this programme it will sit across the programme structure and will be represented on each of the project boards. It also has overlaps with the communications strategy for the programme. 13. This paper sets out the Workforce Development strategy for delivering Putting People First in Devon. It is divided into two major sections. Section One focuses on internal workforce development strategy. Section Two focuses on workforce development strategy in the private, voluntary and independent sector. 14. Each section will highlight where the strategy links to the programme themes and to the national Working to Put People First strategy. 15. Adult & Community Services is made up of 6 divisions: Business Support and Finance. Joint Strategic Planning and Commissioning. Learning Disability. Older People and Physical Disability. Mental Health. Adult Learning. 819148731 16. 17. 18. Adult & Community services has a workforce of 2,933 undertaking a wide range of roles, including: Manages Service User and Carer involvement in learning and development. Social workers and Social work support staff. Residential care workers. 6.4 FTE posts. Day care workers. Home care workers. Registered managers. Commissions and delivers training for Adult & Community Services and Children & Young People’s Services provider teams. Occupational therapists. Other staff in support roles. Includes Devon Care Training, which offers a free training and workforce planning service to the private, voluntary and independent sector workforce. The private, voluntary and independent sector providing social care in Devon has a workforce of approximately 23,500 and provides a wide range of services, including: Private, Voluntary and Independent Sector Team Residential Care. Domicillary Care. Additional support for the implementation of this strategy will come from our close working relationship with the following teams within the Workforce Development Service: Specialist Dementia Care. Leadership and Management. End of life Care. Qualifications. Personal Assistants. Recruitment. Supported Living. Social Work Education. 19. The Social Care Workforce Development Team is part of the Corporate Resources Directorate. It is headed up by a Senior Manager who is business partner for Adult and Community Services and Children and Young Peoples Services. The team is divided into 2 sub teams, each managed by a Workforce Development Team Manager: Commissioning, Safeguarding and Involvement Team 6.5 FTE posts. Commissions and delivers training for Adult & Community Services and Children & Young Peoples Services commissioning teams. Manages Devon’s multi-agency Safeguarding Adults training. Including 7 819148731 Chapter 2: Vision 20. 21. 22. 23. Putting People First sets out a vision to transform the social care workshop. As the purpose of this strategy is to deliver Putting People First in Devon it is appropriate that our strategy should adopt the same vision. roles and ways of working will be demanded by people who use services. Our vision is therefore one of a confident, enabled, and equipped social care workforce – a workforce who are able to deliver truly person centred care and understand and see the key role that they are making to delivering transformation. We see a workforce that is growing in confidence, learning and skills, led by inspiring leaders and championed by government. A workforce which supports the cultural shift from: 24. ‘The transformation of adult social care will also impact as much upon those people working in the direct delivery of care and support as it will upon those people leading, managing and commissioining adult social care. 25. ‘The introduction of personal budgets means that carers – family, friends, neighbours and volunteers – who have helped people to live their lives so fully over many years may become more formalised. More people using services may chose to employ people directly. This means that there will be both challenges and opportunities in ensuring people are supported and developed to do their job, as well as enabling people who use services to be effective in their role as employers.’ 26. Clients to citizens. Welfare to well being. Expert to enabling. Transactional change to transformational change. ‘Freedom from’ to ‘freedom to’. We believe that a four-stream approach to our workforce strategy will enable us to achieve the vision and address the issues identified above. The four streams are: Safety net to spring board. Bringing about cultural change within social care. Giving staff the technical knowledge and skills required to deliver personalisation. Supporting service users and carers Managing the market in the private, voluntary and voluntary sector. The implementation of Putting People First will represent a change for everyone, though the scale of this change will be different for different people. This change will affect staff in both Adult & Community Services and the private, voluntary and independent sector. As it states in Working to Put People First, ‘In the future, people will increasingly employ their own workers and access services where the norm will be multi-agency teams comprising social workers, occupational therapists, personal assistants and managers working alongside health workers, housing officers, leisure assistants, volunteers, and carers. Increasingly new 27. Cultural change This is the largest and most important of the streams. There are a number of hurdles around staff beliefs and attitudes which will impact on the success of Personalisation and which would need to be addressed as part of this strategy: Including 8 Staff accepting the idea that providing social care does not have to involve 819148731 direct control and that people can make their own choices and seek their own outcomes, even if this is not what we would have done. Belief that people will want the task of organising their own care. Fears that people will abuse the system. Concern that Personalisation will reinforce inequalities. Doubt about capacity in the market. Personalisation does not address people currently ineligible and ‘lost to the system’, attracting new demand. 28. Technical Knowledge & Skills This stream is aimed at ensuring that staff understand the key systems and offerings that underlie the Personalisation agenda and also have the basic skills required for social care. It is also aimed at ensuring managers have the right skills to lead that change. 29. Service Users and Carers For Personalisation to work effectively, Service Users and Carers need to be able to understand what is involved for them and also have the ability to take on the new responsibility that comes with choice. An element of this would be covered by Care Management workers at the time they discuss this with the Service User or Carer but we believe that there would be some benefit in upskilling key Service Users and Carers to help facilitate this. Although this will not directly create an enabling workforce, we believe it would indirectly support this objective by making it easier for staff to introduce personalisation to Service Users and Carers. 30. Market Management in the Private Voluntary and Independent (PVI) Sector The success of Personalisation will also depend greatly on the capacity of the market to be able to deliver services required by individuals who are receipt of Direct Payments or Individualised budgets. It is essential to ensure that the workforce within the PVI sector are ready to respond to the demand of both increased service delivery and the development of new and innovative services that may not have been available in the more traditional approach to Social Care. Any activity in this area will need to focus on: Creating mutual trust between staff and service users/carers (the latter’s involvement in any delivery, especially around people who have successfully experienced personalisation will be vital). Shifting staff from a ‘telling’ to a ‘listening’ mindset. Encouraging staff to let go of ‘professional’ control. Promoting the ideas of supporting, enabling and empowering – what this mean (theoretically and in reality) and why it is important. Emphasising that Personalisation can work for anyone. Demonstrating that there is an innovative market that can cope with the Personalisation agenda. Engagement with staff will be crucial to the success of our plans around cultural change and this will have to begin in the development stage. Therefore a Staff Reference Group will be set up to be both a potential reference point for all the changes related to Personalisation but also around the plans for Cultural Change training. Including 9 819148731 Section A Workforce Planning Including 10 819148731 Chapter 3: Workforce Planning in ACS 31. At its simplest, workforce planning is about ‘trying to predict the future demand for different types of staff and seeking to match this with supply’ (A Health Service of all the talents: Developing the NHS workforce). Effective workforce planning helps organisations identify future workforce challenges and priorities. It provides a sound foundation to develop a successful local workforce development strategy. There is no one set model of workforce planning, nor is it a mechanistic or static process. Essentially, it is about analysing our current workforce, and then extending that analysis to identify the future skills and competencies needed to deliver new and improved services. Workforce Planning for ACS must be undertaken as a collaborative approach between Human Resources and Workforce Development and Senior Operational Management. This must also be done in partnership with NHS Devon and Devon Partnership Trust if it is going to be relevant and successful. The comparison between the present workforce and the desired future workforce will highlight shortages, surpluses and competency gaps, whether due to external pressure or internal factors. These gaps become the focus of a detailed workforce plan, identifying and implementing strategies that will build the relevant skills and capacity needed for organisational success. 32. Strategic Analysis Strategic Analysis, also called future mapping (Idea), is a powerful process for creating vision, deciding how to achieve it and generating a motivation to act. It helps creative thinking and the sharing of ideas and builds a strong sense of common purpose. This process will be an essential aspect of the PPF programme and will need to be undertaken at an early stage. Initially this should be done by the board including key service senior managers and will set the direction of travel for the future. 33. Demand Forecasting Predicting the demand must be based on the strategic analysis and vision for how our services will need to look in the future Workforce planning underpins and supports service delivery improvement. It helps an organisation to: Explore the future, assess options and define its objectives. Identify the best-fit future workforce to meet these objectives. Put in place an effective programme of action to develop its future workforce. It is about finding practical solutions to identify, attract and retain the right people to deliver the organisation’s vision. Including 11 819148731 to deliver the personalisation agenda in Devon. change necessary for organisational success. Putting a good Human Resource and Workforce Development plan together requires the business to make a reasonably accurate forecast of workforce size. Key factors to consider in this forecast are: Reports from our computerised information systems such as PRISM and the National Minimum Data Set (NMDS) are the most effective way to manipulate workforce data. However as we know, one of the key issues with this is the accuracy of and access to the data. If information is not accurate the activity provides limited effective support. Whilst workforce planning is not a science, the availability of good data is crucial to the process. Demand for existing and new services: 34. Business disposals and service closures, such as our residential services. Introduction of new technology (changes to Care First 6). Cost reduction programmes (most usually involve a reduction in staff numbers somewhere within the business). Changes to the organisational structure. Strategic partnerships with NHS Devon and DPT. 35. Supply gaps can be associated with national and local labour market shortages. This may include a wide range of professions but in particular for ACS those of social workers. Forecasting Supply The starting point for estimating supply is the existing workforce: ACS should take account of: Gaps can also be identified by understanding: Scheduled changes to the composition of the existing workforce (e.g. Changes to OT workforce, integrated teams, transfer of residential staff to PVI sector). Normal loss of workforce - e.g. through retirement, ‘normal’ labour turnover. Potential exceptional factors - e.g. actions of other Local Authorities that create problems of staff retention such as Social Workers. Gap Analysis In simple terms by comparing the forecast workforce demand and supply it is possible to compile a forecast of net workforce size. This then needs to be compared with the strategic requirements for the business. The result is the ‘workforce gap’. The ability to gather the correct, accurate information must be the foundation stone for effective workforce planning. The amount of information and the information sources will of course depend on what ACS is hoping to achieve and the breadth and depth of the Including 12 Changes in demand associated with modernising the way that services are to be delivered including changing roles, new skill mixes, different ways of delivering services e.g. externalising residential services, partnerships with Health. Skills shortages within the workforce. This may include basic/essential skills, customer care skills, statutory qualifications, managerial competences, project management and skills required to deliver egovernment. Areas of inefficiency in the directorate caused by poor performance management, inappropriate job design and lack of training. 819148731 36. Wastage caused by the ageing workforce including ill health and early retirement. Recruitment challenges in ACS The local government workforce survey 2008 indicates that the local government sector is addressing many of its workforce challenges. However, it also shows that there are still many occupations where local authorities struggle to recruit and retain suitably skilled staff. One of these areas is Adult and Children services Social Workers. Locally this analysis of workforce data, such as turnover and age, and the gap analysis of skills needed and shortages for the future allows us to pinpoint priority areas for developing the workforce. 37. Strategy Development The role of HR and WD across the three organisations will be to develop plans to close the gap such as: Recruitment Strategies. Retention Strategies. Workforce Development Strategies. These can be developed through enhancing existing approaches and focusing on the areas identified in the gap analysis and supply forecasting. Including 13 819148731 Chapter 4: Market Shaping 38. 39. In A to Z: Mapping long-term care markets, the Resolution Foundation described how the system of long-term care for older people operates as a mixed market of funding (coming from the state and the individual) and supply (with care provided by the state, private and third sectors). The market is mixed in this way mainly because care is a ‘social’ good: i.e., something which the state has a responsibility to provide (either directly or increasingly via financial contributions) to the most vulnerable in society, and those who cannot afford to buy it themselves. 40. As such, the ‘social market’ of care is quite different from a ‘private market’, supplying consumer goods. For example, the supply of care cannot be left to regulate itself with minimal state interference, as people need a ‘safety net’ of state protection. Pure efficiency is also not desirable in a social market, as this needs to be balanced with fairness and equity. In this context, the state has a role to play to ensure that the market operates fairly, so that everyone, even the most vulnerable, can access good quality care at a reasonable price. Sufficient volume: Enough services in their area to access care when they need it. Variety: A mixed range of services to choose from so they can access the type of service that best meets their needs. 41. Adequate quality: Good quality services so that they can choose services freely, without worrying if they are sub-standard. Affordability: Affordable services, so they have real choice and are not priced out of the market. Including 14 Regarding supply: Robust Market Intelligence and supply mapping which highlights areas of gap in provision. Care providers are supported to remain sustainable in the market and improve their services. A wide range of different providers (large, small, voluntary and for profit, specialist and mainstream etc.) are actively encouraged. Care providers are encouraged and rewarded for being flexible and responsive to older people’s needs and reacting quickly to changes in demand and niches in the market. Entry by new providers to meet niches and unmet demands is facilitated. Care providers are helped to provide value for money services whist remaining financially viable. Regarding demand: Care users, their carers and families are supported by a well developed system of information, advice, advocacy and brokerage to make choices which meet their needs, or have their care planned and purchased for them. Local infrastructure also helps support older people make choices (e.g. transport, housing, and mainstream services such as libraries and colleges). Care users, their carers and families are encouraged to plan ahead and consider the costs of care in advance so they have sufficient resources to access the care they want when they need it. 819148731 42. By shaping a market effectively, the range, quality and quantity of care available will meet the needs of the entire older population – local authority- and self-funders alike. This will help support independence and choice, as well as achieve a range of wider goals, such as promoting wellbeing and inclusion. 43. This can also deliver efficiency gains: stimulating third and private sector care supply, reduces the burden on local authorities to provide their care ‘in house’, and shaping a care market which focuses on keeping people in their own homes and preventing intensive care needs, saving resources in the longer term. 44. Market shaping can also deliver a range of economic benefits – such as bringing businesses in to the local area, creating local employment and improving adult skills. Challenges to overcome Poorly informed consumers who lack the ability and/or confidence to make an active choice of care provider and express their needs clearly. Poor financial preparation for care costs on the part of consumer, leading to financial constraints among those financing their own care. Local authorities acting as purchaser on behalf of statefunded older people meaning needs are aggregated into a fixed ‘menu’ of services, thereby obscuring real demands from providers. As local authorities are often the single largest purchaser in an area, providers focus their time on winning council contracts rather than identifying and responding to individual consumer needs. Including 15 Overall, there is little information collected regarding the needs and purchasing behaviour of older people, particularly self-funders, so suppliers have poor market information. Reliance on informal care can mask unmet need in the market and makes it harder for providers to identify potential new niches and clients. 819148731 Section B Adult & Community Services Including 16 819148731 Chapter 5: Cultural Change This is the largest and most important of the strategic streams as this cuts across the whole programme. There are a number of hurdles around staff beliefs and attitudes which will impact on the success of Personalisation and which would need to be addressed as part of this strategy: 45. Staff accepting the idea that providing social care does not have to involve direct control and that people can make their own choices and seek their own outcomes, even if this is not what we would have done. Belief that people will want the task of organising their own care Fears that people will abuse the system. Concern that Personalisation will reinforce inequalities. Doubt about capacity in the market. Personalisation does not address people currently ineligible and ‘lost to the system’, attracting new demand. mean (theoretically and in reality) and why it is important. 46. Any activity in this area will need to focus on: Creating mutual trust between staff and service users/carers (the latter’s involvement in any delivery, especially around people who have successfully experienced personalisation will be vital). Shifting staff from a ‘telling’ to a ‘listening’ mindset. Encouraging staff to let go of ‘professional’ control. Promoting the ideas of supporting, enabling and empowering – what this 47. Any attempt to shift an embedded and long-standing culture cannot adopt a single approach or expect to happen quickly. The key to a successful culture shift will be to deliver a consistent message that staff can engage with through a number of channels and at all levels within the organisation. In consequence, we see this strategy requiring close linkage with the ACS Communications Team and its communication strategy. 48. We do not underestimate the level of change that this will involve for some staff and it is therefore appropriate to adopt a robust change management approach. A variety of change management models are available but for simplicity this strategy will adopt Lewin’s Three-Step Model, also known as Unfreeze-Change-Refreeze. This model comprises three stages: Strategic Objectives Emphasising that Personalisation can work for anyone. Unfreeze This first stage of change involves preparing staff to accept that change is necessary, which involves breaking down the existing status quo before we can build up a new way of operating. Key to this is developing a compelling message showing why the existing way of doing things cannot continue. As with the Personalisation agenda itself Service Users will need to be at the centre of this process as we believe they will be able to communicate the most convincing message to staff about the reasons for change. To prepare staff, we need to start at Including 17 819148731 the core of the culture – we need to challenge the beliefs, values, attitudes and behaviours that currently define it. time, and that they are incorporated into everyday business. Although change is a constant, this refreezing stage is still important. Without it, staff get caught in a transition trap where they are not sure how things should be done, so it does not get done properly. In the absence of a new frozen state it is very difficult to tackle the next change initiative effectively. If we do not allow time for the change to sink in change will be perceived as change for change’s sake, and the motivation required to implement new change will not be there. This first part of the change process is usually the most difficult and stressful. When we start cutting down the ‘way things are done’, we put everyone and everything off balance. This will evoke strong reactions in people, but that is exactly what needs to be done. By forcing people to reexamine their core beliefs, you effectively create a (controlled) crisis, which in turn can build a strong motivation to seek out a new equilibrium. Without this motivation, we will not get the buy-in and participation necessary to effect any meaningful change. An important part of this process will be to celebrate the success of change – this will help people to find closure, thank them for enduring a painful time, and help them believe that future change will be successful. Change After the uncertainty created in the unfreeze stage, the change stage is where staff will begin to resolve their uncertainty and look for new ways to do things. Staff will start to believe and act in ways that support the new direction. 49. The transition from unfreeze to change does not happen overnight – people take time to embrace the new direction and participate proactively in the change. Strategic Goals 50. In order to accept the change and contribute to making the change successful, people need to understand how the changes will benefit them. Not everyone will fall in line just because the change is necessary and will benefit ACS. None of this should be seen as divorced from wider organisational change and it will also be important for the success of this strategy that it is supported by providing staff with the appropriate resources, and technological and administrative support to deliver Personalisation. Refreeze When the changes are taking shape and people have embraced the new ways of working, the organisation will be ready to refreeze. This stage needs to help people internalise the changes. This means making sure that the changes are used all the 51. Including 18 The Unfreeze stage of the strategy will have the following strategic goals: Establish management buy-in to the changes. Provide managers with an understanding of their role in the change process and the tools with which to do this. Establish staff buy-in to the changes. Involve Service Users and Carers in the delivery of the message. The Change stage of the strategy will have the following strategic goals: 819148731 in to the Putting People First programme and thereby engaging them more fully in the change process. To provide staff with the interpersonal skills to deliver Personalisation. This will include: How to enable people to make choices. Listening skills. Dignity – what it means and how we deliver it. Understanding issues around Safeguarding Adults. Understanding the impact of the Mental Capacity Act and Deprivation of Liberty Safeguards. Being risk aware not risk averse. To remind staff of the transformation that has taken place and the benefits this will bring. To thank staff for their work in making this possible. To share new success stories from Service Users and Carers that demonstrate the benefits that are already being seen. The following sets out the proposed implementation plan to achieve the strategic goals outlined above. The final detail of the plan will be developed through consultation with a Putting People First Staff Reference Group (see below). In the Unfreeze stage, this will include: ACS Programme Themes: All Management team sessions are delivered explaining in detail the role that managers will have to play in the change process. This will be a development of the existing Ready, Steady, Change workshops currently delivered by the Leadership and Management Team in Workforce Development. It will be important to include Service Users in these sessions to make the message real for managers. Managers to deliver briefings to their own staff on the changes to come using briefing packs developed to ensure that managers deliver a consistent message. Use of DVDs of Service Users and Carers extolling Personalisation. Understanding Transforming Social Care roadshows to be run at key locations around the County, delivered by Service Users and Carers. Personalisation e-learning. Simple guide to Personalisation produced and issued to all staff outlining: The Refreeze stage of this strategy will have the following strategic goals: Implementation 53. Senior management to deliver a launch message to Management Team and outline the high-level training plan. To provide staff with the knowledge and skills to help staff ensure the safety of Service Users within the context of Personalisation. This will include: 52. 52. Establishment of a Staff Reference Group to allow them to have an input Including 19 Definition of Personalisation The background to Personalisation Why we need to change. Responsibilty for Personalisation. Time table for Personalisation. What has been done so far. 819148731 54. Exploding any myths about Personalisation. How Personalisation will affect the work of front line social care staff. In the Change stage, this could include: ACS Programme Themes: All Frontline staff to attend specially designed Personalisation workshop. Personalisation e-learning. Managers to continue to provide briefing updates on Personalisation implementation. Best practice and guides to delivering personalisation produced and issued to all staff. What has already been done 56. Work that has already been done in this area includes: Personalisation e-learning has been purchased. This now requires alteration in collaboration with appropriate subject matter experts to ensure that it meets the needs of Devon. Ready, Steady, Change workshop has already been developed and delivered by the Leadership and Management Team in Workforce Development. ACS Programme Theme: Choice & Control Staff to attend existing Equality and Diversity Training as appropriate. A briefing template for managers already exists and can be developed for this area. ACS Programme Themes: Choice & Control and Early Intervention & Prevention How this fits with the national Working to Put People First strategy 55. Measuring behaviour through assessment of qualifications and line management supervision, this last point underlines the important role of leadership in the successful implementaion on these changes. 57. This strategy focuses on the following key priorities of the Working to Put People First strategy: Staff to attend existing Safeguarding Adults workshops as appropriate. Articles in Steller showing how staff using new skills have successfully delivered the Personalisation agenda. Workforce Development. Recruitment and Retention. In the Refreeze stage, this could include: Regulation, assuring public safety and raising standards of care in the social care workforce. ACS Programme Themes: All Managers to continue to provide briefing updates. Ongoing business as usual training to include: Safeguarding Adults workshops. Personalisation workshops. Personalisation e-learning. ACS Programme Themes: Choice & Control and Early Intervention and Prevention Development of career pathways for staff. Including 20 819148731 Chapter 6: Technical Skills & Knowledge This stream is aimed at ensuring that staff understand the key systems and offerings that underlie the Personalisation agenda and also have the basic skills required for social care. It is also aimed at ensuring managers have the right skills to lead that change. 58. Ensure staff have the core skills and social care knowledge as required for their role and identified in job-specific competency frameworks. Deliver a range of training interventions to provide the core management skills required in a process of change. Ensure that staff in commissioning roles have the skills, aligned to World Class Commissioning, to deliver effective and efficient commissioning. Using workforce planning data to influence the funding for skills development/accreditation/ qualifications that will be required to meet development needs at a local level. Strategic Objectives 59. Any activity in this area will need to focus on: Ensure that staff have an awareness and understanding of key processes and offerings linked to Personalisation, including: Direct Payments. Personal Budgets. Rapid Equipment and Minor Adaptation Service (REMAS) – includes Telecare. Implementation Ensure that staff have the key skills to deliver Personalisation, including: 61. The following outlines a suggested implementation plan to achieve the strategic goals outlined above. Customer service. ACS Programme Themes: All Assessment skills. Commissioning. Managers to attend the Ready, Steady, Change workshops delivered by the Leadership and Management Team in Workforce Development. Managers to attend the core management skills training available through the Leadership and Management Team in Workforce Development as determined by individual need and priority. Ensure managers have the skills to be able to lead staff through the transformation of social care. Strategic Goals 60. This will involve the following strategic goals: Raise awareness and understanding of Direct Payments, including what they are, how people qualify for them and how they are made available. ACS Programme Theme: Choice & Control Raise awareness and understanding of Personal budgets, including what they are, how people qualify for them and how they are made available. Deliver training on the use of the new RAS tool. Staff to complete Direct Payments elearning. A Senior Workforce Development advisor and the manager of the Direct Payments team will visit each CDP Ensure staff have basic customer service skills. Including 21 819148731 area to meet with the cluster teams and CDP staff at least once a year for a refresher training and question and answer session. Direct payments will form part of any training delivered around assessment and care planning and will be referred to in any other relevant training. Practice Managers and Team Leaders to attend an event to support understanding of and decision making around eligibility and use of direct payments. Deliver a programme of basic customer service skills training. Negotiations skills training for personal brokers. number of roles and others are under development. Suite of management skills training, aligned to management competencies, is already available through the Leadership and Management Team in Workforce Development. Assessment skills training already developed. Direct Payments e-learning already available. Direct Payments Champions Network in place. FACS e-learning (basic awareness and application) in place by October 2009. REMAS care pathway workshops delivered to Assessment and Review Teams in October and November 2009. ACS Programme Themes: Choice & Control; Early Intervention and Prevention; and Universal Services Telecare Superuser training delivered in September 2009. Develop job-specific competency frameworks, milestone training plans and skills audits for all social care roles. Telecare e-learning and workbook. How this fits with the national Working to Put People First strategy A programme of assessment skills to be delivered to all frontline staff encompassing the changes required for personalisation. 63. ACS Programme Theme: Service Review Transformation Induction programme to support new Learning Disability Service model.1 What has already been done 62. Work that has already been done in this area includes: Job-specific competency frameworks have already been developed for a 1 Until the new model has been developed and agreed it is not possible to give more detail on what this will involve. Workforce Development’s experience of delivering a similar programme as part of the modernisation programme will be valuable here. Including 22 This strategy focuses on the following key priorities of the Working to Put People First strategy: Leadership. Workforce Development. Regulation, assuring public safety and raising standards of care in the social care workforce. 819148731 Section C Enabling Market Shaping Including 23 819148731 Chapter 7: Delivering in the PVI Sector Strategic Vision 64. 67. DCT is managed by a steering group which is led by providers and chaired by a service user and carer. The group meets quarterly to review the Workforce Development requirements across the sector. The workforce plan is set at an annual action planning day; this ensures that DCT’s priorities are accountable to the steering group and that providers are kept up to date of any information and guidance from ACS, as well as, any changes in commissioning requirements for future consideration. 68. The Training Strategy Implementation (TSI) Group, is a sub-group of DCT and is made up of key stakeholders from the care sector including representatives from service user and carer groups, nonstatutory care employers, the three local authorities (Plymouth, Torbay, and Devon), it sources information and funding to aid the 'upskilling' of the care sector workforce across the County. The group bids for and distributes funding for training from a variety of national and regional sources including Skills for Care, Training Strategy Implementation (TSI) funding which offers a set fee for each approved NVQ units and some core induction units, such as First Aid, Food Hygiene and Manual Handling. To engage with the Social Care Services provider market to ensure that it has access to guidance and training to develop the PVI workforce to meet future care requirements for the people of Devon in accordance with the national quality standards as set by the Care Quality Commission (CQC) and local quality standards as set by Devon’s integrated commissioning team. Devon Care Training 65. Devon Care Training (DCT) is supported by Devon County Council to lead the local authorities Workforce Development interface with Health and Social Care services within the PVI sector for the past 8 years. DCT currently has over 215 provider members working in over 575 establishments across the County of Devon. 66. DCT commissions training and development programmes from both internal and external providers to enable the PVI workforce to achieve National Minimum occupational standards as well as offering guidance and facilitating best practice throughout the County, DCT regularly engage with providers regarding workforce planning issues and work in partnership to find workable solutions. During 2008 DCT commissioned 192 training courses, providing 2,021 places for training. The work of DCT has been highlighted as a strength in the 2008/09 Performance Assessment Process as validated by CQC, and also as part of the Workforce Development Business Plan 2008/2009. The increase in membership and raise in profile for DCT has resulted in double the commissioning activity for 2009/10, with 410 courses, providing 5,000 places for training. PVI Sector Workforce in Devon 69. Including 24 Skills for Care (SfC) have developed a National Minimum Data Set (NMDS), which providers are asked to complete annually, providing valuable information about the workforce across the County. The findings so far for 2009 shows that there are approximately 23,500 people working in the PVI sector. 819148731 Chapter 8: Changing Culture in the PVI Sector 70. Many of the challenges that face the PVI sector are the same as those within ACS. The additional challenge to implementing this aspect of the strategy within the PVI sector is that influencing frontline staff can only be achieved indirectly through appropriate networks, forums and regular communication with business owners. This is reflected in our implementation plans. Establish staff buy-in to the changes. Involve Service Users and Carers in the delivery of the message. To provide staff with the interpersonal skills to deliver Personalisation. This will include: Strategic Objectives 71. Any activity in this area will need to focus on: 72. Creating mutual trust between staff and service users/carers (the latter’s involvement in any delivery, especially around people who have successfully experienced personalisation will be vital). Shifting staff from a ‘telling’ to a ‘listening’ mindset. Encouraging staff to let go of ‘professional’ control. Promoting the ideas of supporting, enabling and empowering – what this mean (theoretically and in reality) and why it is important. Emphasising that Personalisation can work for anyone. How to enable people to make choices. Listening skills. Dignity – what it means and how we deliver it. To provide staff with the knowledge and skills to ensure the safety of Service Users within the context of Personalisation. This will include: Understanding issues around Safeguarding Adults. Understanding the impact of the Mental Capacity Act and Deprivation of Liberty Safeguards. Being risk aware not risk averse. To share new success stories from Service Users and Carers that demonstrate the benefits that are already being seen. Implementation 74. Any attempt to shift an embedded and long-standing culture cannot adopt a single approach or expect to happen quickly. The key to a successful culture shift will be to deliver a consistent message that staff working in the sector can engage with. In consequence,the strategy requires close links with the Provider Engagment Networks and Brokerage Teams. Strategic Goals 73. Changing culture in the PVI sector will have the following strategic goals: Including 25 The following sets out the implementation plan to achieve the strategic goals outlined above. ACS Senior Mnaagement Team to lead Provider Engagement Network to update PVI market on Personalisation. Delivery of Change programmes for managers through DCT. It will be important to include Service Users in these sessions to make the message real for managers. 819148731 Support for Managers/business owners via DCT and the Provider Engagement Network webpages. Personalisation e-learning. What has already been done Simple guide to Personalisation produced and made available online outlining: 75. Definition of Personalisation. The background to Personalisation. Why we need to change. Responsibilty for Personalisation. Time table for Personalisation. What has been done so far. Exploding any myths about Personalisation. How Personalisation will affect the work of front line social care staff. Delivery of Equality and Diversity Training accessable through DCT. Access to existing Safeguarding Adults workshops and e-learning as appropriate. Ambasadors to focus on the delivery of personalised care and promotion of choice, independence and control. Personalisation e-learning has been purchased. This now requires alteration in collaboration with appropriate subject matter experts to ensure that it meets the needs of Devon. Provider Engagment Network is established and meetings running quarterly in each locality area. Provider Engagement web pages developed and updates regularly. ACS managers are using both the forums and the web pages to communicate with the PVI market. Access to safeguarding, MCA and DOL equality & diversity training available through DCT. Regular articles from providers included in the quaterly DCT magazine. DCT annual Conference supported by over 400 delegates form the PVI market. Articles in DCT magazine showing how staff in the PVI sector are using new skills have successfully delivered the Personalisation agenda. How this fits with the national Working to Put People First strategy 76. Development of a Leadership and Management Programme for the PVI sector, accessible through DCT. Development of tools and bite size sessionso for in-house staff and managers to smooth the transistion from providing an in-house service to delivering in the PVI sector. Further development of Learning Exchange Networks to identify opportunities and challenges for providers and share good practice. Care Ambassadors training programme with newly recruited Care Work that has already been done in this area includes: Including 26 This strategy focuses on the following key priorities of the Working to Put People First strategy: Workforce Development. Recruitment and Retention. Regulation, assuring public safety and raising standards of care in then social care workforce. 819148731 Chapter 9: Technical Skills & Knowledge in the PVI sector This stream is aimed at ensuring that staff understand the key systems and offerings that underlie the Personalisation agenda and also have the basic skills required for social care. It is also aimed at ensuring managers have the right skills to lead that change. 77. Strategic Goals 79. This will involve the following strategic goals: Raise awareness and understanding of Dementia care, aligning training development with Devon’s local stratgey in repsonse to the Naional Dementia strategy. Raise awareness and understanding of End of Life care, providing quality care, promoting dignity independence for those who choose to die at home. Managers and business owners are able to access leadership and management programmes in order to lead staff through significant changes within the sector and enable their businesses to evolve in order to meet changing commissioning requirements. Ensure provider staff have the knowledge and skills to deliver a REMAS service in peoples homes. Ensure staff have the core skills and social care knowledge as required for their role and identified in job-specific competency frameworks. Deliver a range of training interventions to provide the core skills required in delivering Person Centred Care. Using workforce planning data to influence the funding for skills development/accreditation/qualificatio ns that will be required to meet the sector needs at a local level. Strategic Objectives 78. Any activity in this area will need to focus on: Ensure that staff in the PVI sector have an awareness and understanding of the key links to Personalisation, including programme development for: Dementia Care. End of Life care. Providers who delliver Devon’s Rapid Equipment and Minor Adaptation Service (REMAS) – includes Telecare. Rapid Response. Personal Assistants (PA’s). Developing the workforce to work in new ways. Ensure that the sector has access to funding or programmes of training for key skills to include: Common Induction Standards. NVQ level 2/Diploma level 2, 3, and 4. Leadership & Management of Care Services awards. Ensure managers/business owners have the skills to be able to lead staff through the transformation of social care. Implementation 80. Including 27 The following outlines a suggested implementation plan to achieve the strategic goals outlined above. 819148731 Transistion from Care Worker to PA training in development with PVI sector Domicillary Care provider. Dementia care Training Pathways developed through a multi-agency steering group. Delivered pan Devon in partnership with Plymouth and Torbay. Funding secured through TSI subgroup. End of Life Care training programme developed with partners as above inclusive of palliative care expertise. Delivery across Devon. REMAS – a step programme to ensure training delivery forms part of the contracting arrangements for providers to include robust monitoring systems built around competency and accreditation frameworks. Rapid Response training Programme developed in partnership with NHS Devon to ensure training of all new staff to the service. Access to funding for common induction standards and qualifications through TSI sub group. Access to a wide range of learning opportunities including alternative ways of learning through DCT. Develop training programme for PA’s to include transition from Care worker to PA. Develop a programme of accredited learning opportunities for project workers in the PVI sector who support individuals with complex needs and dual diagnosis. Access to TSI funding and administration support for providers to claim funding. Multi-agency steering group established and competency frameworks agreed for Project workers supporting individuals who have complex needs and dual diagnosis. Appropriate qualification established and funding identified for up to 100 workers. Comprehensive training programme delivered through DCT. What has already been done 81. Work that has already been done in this area includes: Development of Dementia Training Pathway. REMAS training programme devloped including Compentency framework and accreditation framework. Rapid Response Training modules developed in partnership with NHS Devon. Including 28 819148731 Chapter 10: Engagement of Service Users and Carers. 82. 83. 84. The Workforce Development Team are committed to the involvement and engagement of Service Users and Carers in the design and delivery of the learning opportiunities that are accessed by our staff and Carers. they deliver may impact upon their lives. Devon’s Joint Engagment Strategy sets out the organisations principles of involvment, engagement and consultation into practice, resulting in an overview of enegagment activity which is practical, measureable and outcomefocused. A single access point will be developed via a User Led Organisation (ULO) called Fusion. Ensuring the involvment, consultation and engagement with service users and carers is sought at the appropriate stages on commencemnt of the design or delivery of learning opportunities and at the point of review of exsiting programmes. The following outlines a suggested implementation plan to achieve the strategic goals outlined above. 87. In response to the National Carers strategy Devon’s 5 year partnership strategy for carers, values states that ‘Carers providing regular and substantial care have a right to expect that their needs will be taken account of, including a right to access or maintain work, education and leisure activities’. Development of a multi-agency steering group to determine a model of how carers can access learning and development opportunities across the County. Service User delivery of Initial Award in Learning Disability (IALD) qualification for workers who support people with Learning Disabilities. Raising the awareness and understanding of frontline staff and managers to the roles of carers through the delivery of Learning to Involve’s ‘Real Lives’ Programme. Supporting the development of Devon’s engagement strategy and User led Organisation, Fusion. Any activity in this area will need to focus on: Ensuring Carers have access to appropriate training and learning and development opportunities to meet the needs of their caring role. Involvement of Service Users and Carers in the design and development of learning opportunities. What has already been done Consultation with Carers about their training needs and priorities. 88. Strategic Goals 86. Raise awareness and understanding of how carers can access education and employment opportunities. Implementation Strategic Objectives 85. Multi-agency steering set up for Carers training and education. Commitments from statutory agencies regarding Carers This will involve the following strategic goals: Work that has already been done in this area includes: Raise awareness and identification of Carers and how the role in which Including 29 819148731 access to already existing training opportunities free of charge. The Learning to Involve working group, involving representatives from DCC’s Workforce Development Team, Devon Partnership Trust and Service Users and Carers, which develops and implements strategies for involving Service Users and Carers in staff learning and development. Putting People First (Learning Disability organisation) commissioned to enable the delivery of IALD by Service Users. Fusion accepted as Devon’s official ULO. Draft Joint Engagement Strategy with NHS Devon approved by SMG. Consultation with Carers regarding their training needs for the coming year. Development of a single point of access for Carers training has begun. Delivery of ‘Real Lives’ programme to nine Health Centres whose workforce includes, Health Assistants, Practice Nurses, Pharmacists and GP’s. Including 30 819148731 Appendices Including 31 819148731 Appendix: 1 Summary of Workforce Development Strategy supporting Devon’s Putting People First programme Underlying all themes Service Review Theme Choice & Control Theme Early Intervention & Prevention Theme Universal Services Social Capital Theme Senior Management Launch Message Management Team Sessions based on Ready, Steady, Change Management Briefing Packs for staff Understanding Transforming Social Care Roadshows Personalisation e-learning Guide to Personalisation Personalisation Workshop Manager’s Briefing Updates Including 32 Best Practice and Guides to delivering Personalisation Core Management Skills training 819148731 Underlying Service Review Theme Service Review Theme Residential Care Review LD Future Options Job-specific competency frameworks etc. Transformation Induction Guinness Care & Support Project Including 33 819148731 Underlying Choice & Control Theme Choice & Control Theme Charging Policy Safeguarding Adults Workshops Steller Articles Develop Career Pathways Equality & Diversity Workshops Practice Manager and Team Leader training on eligibility Job-specific competency frameworks etc. Customer Service training Assessment Skills training Financial Sustainability Model Personal Brokerage Negotiation Skills training Market Management Including Personal Budgets RAS tool training RAS RAS tool training Direct Payments Direct Payments e-learning Assessment & Care Planning training Refresher training with cluster teams 34 819148731 Underlying Early Intervention & Prevention Theme Early Intervention & Prevention Theme Safeguarding Adults Workshops Steller Articles Develop Career Pathways Job-specific competency frameworks etc. Assessment Skills training Telecare Superuser training Telecare e-learning EMCS REMAS/ Telecare CDP REMAS training Mobile Response Community Equipment Rapid Response Modules developed in partnership with NHS Intermediate Care Reablement Including 35 819148731 Underlying Universal Services Theme Universal Services Devon Care Directory Self-Funded Vision Care Pathway Review Job-specific competency frameworks etc. Assessment Skills training Public-facing Care Directory Including 36 819148731 Underlying Social Capital Theme Social Capital Theme Carer Strategy Set up of Multiagency steering group Single point of access for Carers training in development Dementia Strategy Dementia elearning Dementia Training Pathways developed Community Engagement Including 37
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