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The
FlexiCare
Grant
Content
• Objectives for Flexicare
• Background and rationale
• How Flexicare will work
• FAQs
Flexicare Objectives
• A service model which:
– can be consistently applied;
– provides the right services;
– offers appropriate choice and control;
– is affordable for people living in Flexicare and the County
Council;
– is viable for providers; and
– safeguards people.
Housing
Management
Housing
Support
Care
Housing
Contract
Housing
Contract
Care
Contract
Care
Contract
Supporting
People
Contract
Supporting
People
Contract
CARE SUPPORT
Strategic Review 2009
• Block Contracts for Care:
– Does not allow for client choice / personalisation
– Bandings can be restrictive
– Can residents without care needs access unplanned care?
• Should the County Council commission services
separately?
Why provide choice / personalisation?
• Older adults generally report personal budgets as
having a positive impact on their lives, where there is:
– Self determination
– An adequate budget
– Help with support planning
• However, older adults more likely to have a ‘managed
budget’ and miss out on some of the positive impacts.
Outcomes of
personal
budgets
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Supported with Dignity
Getting Support you Need
Being in Control of Support
Being as Independent as you Want
In Control of Life
Your Mental Wellbeing
Your Physical Health
Choosing Where to Live
Feeling Safe
A lot better Better No Difference Worse A lot worse
Centre for Disability Research
Older people and personal budgets:
A re-analysis of data from the National Personal Budget Survey 2011
Housing
Management
Housing
Support
CareCare & Support
Care
Care
Care Care
Care
Care
Care
Care
Care
Care
Care
Care
Care
The Flexicare Strategy
• Recognised benefits of an ‘Integrated Service’
– Better services for residents
– Better value for money
• Impact 2020
– Flexicare housing will be seen as a positive, high quality,
affordable, value for money option
– People who live in flexicare housing will have choice and
control
Housing
Management
Housing
Support
CareCare & Support
Care
Care
Care Care
Care
Care
Care
Care
Care
Care
Care
Care
Care
Activities
Catering
Smith_220413
Housing
Management
Housing
Support
Care
Old way
Housing
Management
Care & Support
Care
Care
Care
Care
Care
Care
Care
Care
Care
Care
Care
Activities
Catering
The Flexicare Way
Flexicare
MENU
Main
On Site Staff
24/7 Cover
Emergency Alarm / Assistive Technology
Emergency / Unplanned Support
Housing Related Support
Activities
?? Catering ??
£~?? per week
Extras
Personalised Care & Support, e.g.:
Home help
Shopping
Cleaning
Washing
Dressing
Going out
Leisure activities
Computer lessons etc, etc, etc
That’s the theory….
Making it happen
• Turn to the internet…
Housing
Management
Housing
Support
Unplanned Care
Care
Care Care
Care
Care
£Rent from
Resident or
Housing
Benefit
£SP funding or
Resident
£Fairer
Charging
£??????????
Must allow choice
of planned care
provider
Who pays for unplanned care?
• Social Care in full?
– Can tender and have a contract
– Unaffordable for the Council
• Residents in full?
– No relationship with the Council
– Expensive for residents?
• Social Care and Residents shared?
– How?
Fairer Charging
• National Legislation on charging to meet assessed
care needs
• Must leave a person with pension credit + 25% to live
on
• Charge must be related to assessed care needs
• Can only have a flat charge in certain restricted
circumstances
GRANT FUNDING
County
Council
Landlord
(Community Anchor)
Residents
Provider
Provider
Funding the Integrated Service
Flexicare Grant
Residents
Housing Benefit
Care Services
Housing Services
Grant to be around £50k pa
Cost per unit per week (not rent)
0 10 20 30 40 50 60 70 80
Avg Flexicare
Avg Existing
Service
Support
Other
£50k grant for a typical 60
unit scheme is worth £16
per week per unit
Value for Money examples
• Ways to take advantage of integrated service delivery:
– private arrangements with residents for shopping, preparation of
meals, cleaning, etc.;
– staff on call at night carrying out laundry and quiet cleaning;
– some parts of housing support being delivered as floating support;
– using care staff to provide housing support;
– using assistive technology to check on residents; or
– offering services to the wider community (e.g. day opportunities)
FLEXICARE
FLEXICARE
24/7 Care
• At least one person on site 24/7 who can provide ‘care’
• Can have more, dependant upon
– Care profile of residents; or
– Residents willing to pay
FLEXICARE
Grant Funding - benefits
• No contractual relationship, so Fairer Charging rules
don’t apply
• Housing providers can get on with providing a full
service in their scheme
• Share costs between Council & Residents
• Residents get a say on what is spent
• Maximise economies. Minimal procurement
Grant Funding – more benefits
• Grant conditions – can still monitor
• Bidding round for housing providers
• 3 year grants
• Potential for converting sheltered housing?
• Charge to residents may be partly covered by
proposed changes to Housing Benefits?
FAQs
• Who can bid for the grant?
– Only landlords of suitable accommodation
• So what is ‘suitable accommodation’?
– Self contained units of accommodation (‘own front door’)
– Generally for older people
– Access to communal facilities
– 24/7 CQC registered care service on site
FAQs
• Where would the grant be funded from?
– The existing SP and current waking nights funding
• What if I don’t bid for / secure grant funding?
– Council would then only pay for assessed care needs (fairer
charged)
FAQs
• How would flexibility in care needs be ensured
– Direct payments include a 4 week ‘buffer’ which allows for
week-by-week variations and short episodes of increased
needs
• What if I’m a landlord who doesn’t provide care
– Need to subcontract or arrange for CQC registered provider
FAQs
• Would this affect allocations?
– No, would still want to see balanced communities. SCC
would retain nomination rights where they exist.
Need minimum number of residents with care needs (20-25)
• What about charges to residents?
– For providers to decide in consultation with residents
– Maximum linked to Pension Credit Guarantee
– Unless residents agree otherwise
Current & Proposed Extra Care (Rental Units)
0
100
200
300
400
500
600
Cannock Chase East
Staffordshire
Lichfield Newcastle South
Staffordshire
Stafford Staffordshire
Moorlands
Tamworth
Proposed
Existing
2030_Needs
2020_Needs
2015_Needs
2010_Needs
Smith_220413
Extra Care Suitability
at LSOA
Seeking to encourage more
development –
Many providers told us that they will only
build if they can provide services too
Core & Cluster
Approach
The Flexicare Grant
• Giving providers the freedom to develop and deliver
excellent services to meet the needs of their residents
• Giving residents excellent services, transparent cost
structures and choice and control over the care they
need
• Giving the County Council a consistent approach to
commissioning, and a real alternative to residential
care
The
FlexiCare
Grant

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Smith_220413

  • 2. Content • Objectives for Flexicare • Background and rationale • How Flexicare will work • FAQs
  • 3. Flexicare Objectives • A service model which: – can be consistently applied; – provides the right services; – offers appropriate choice and control; – is affordable for people living in Flexicare and the County Council; – is viable for providers; and – safeguards people.
  • 6. Strategic Review 2009 • Block Contracts for Care: – Does not allow for client choice / personalisation – Bandings can be restrictive – Can residents without care needs access unplanned care? • Should the County Council commission services separately?
  • 7. Why provide choice / personalisation? • Older adults generally report personal budgets as having a positive impact on their lives, where there is: – Self determination – An adequate budget – Help with support planning • However, older adults more likely to have a ‘managed budget’ and miss out on some of the positive impacts.
  • 8. Outcomes of personal budgets 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Supported with Dignity Getting Support you Need Being in Control of Support Being as Independent as you Want In Control of Life Your Mental Wellbeing Your Physical Health Choosing Where to Live Feeling Safe A lot better Better No Difference Worse A lot worse Centre for Disability Research Older people and personal budgets: A re-analysis of data from the National Personal Budget Survey 2011
  • 9. Housing Management Housing Support CareCare & Support Care Care Care Care Care Care Care Care Care Care Care Care Care
  • 10. The Flexicare Strategy • Recognised benefits of an ‘Integrated Service’ – Better services for residents – Better value for money • Impact 2020 – Flexicare housing will be seen as a positive, high quality, affordable, value for money option – People who live in flexicare housing will have choice and control
  • 11. Housing Management Housing Support CareCare & Support Care Care Care Care Care Care Care Care Care Care Care Care Care Activities Catering
  • 16. Main On Site Staff 24/7 Cover Emergency Alarm / Assistive Technology Emergency / Unplanned Support Housing Related Support Activities ?? Catering ?? £~?? per week
  • 17. Extras Personalised Care & Support, e.g.: Home help Shopping Cleaning Washing Dressing Going out Leisure activities Computer lessons etc, etc, etc
  • 19. Making it happen • Turn to the internet…
  • 20. Housing Management Housing Support Unplanned Care Care Care Care Care Care £Rent from Resident or Housing Benefit £SP funding or Resident £Fairer Charging £?????????? Must allow choice of planned care provider
  • 21. Who pays for unplanned care? • Social Care in full? – Can tender and have a contract – Unaffordable for the Council • Residents in full? – No relationship with the Council – Expensive for residents? • Social Care and Residents shared? – How?
  • 22. Fairer Charging • National Legislation on charging to meet assessed care needs • Must leave a person with pension credit + 25% to live on • Charge must be related to assessed care needs • Can only have a flat charge in certain restricted circumstances
  • 25. Funding the Integrated Service Flexicare Grant Residents Housing Benefit Care Services Housing Services Grant to be around £50k pa
  • 26. Cost per unit per week (not rent) 0 10 20 30 40 50 60 70 80 Avg Flexicare Avg Existing Service Support Other £50k grant for a typical 60 unit scheme is worth £16 per week per unit
  • 27. Value for Money examples • Ways to take advantage of integrated service delivery: – private arrangements with residents for shopping, preparation of meals, cleaning, etc.; – staff on call at night carrying out laundry and quiet cleaning; – some parts of housing support being delivered as floating support; – using care staff to provide housing support; – using assistive technology to check on residents; or – offering services to the wider community (e.g. day opportunities)
  • 28. FLEXICARE FLEXICARE 24/7 Care • At least one person on site 24/7 who can provide ‘care’ • Can have more, dependant upon – Care profile of residents; or – Residents willing to pay FLEXICARE
  • 29. Grant Funding - benefits • No contractual relationship, so Fairer Charging rules don’t apply • Housing providers can get on with providing a full service in their scheme • Share costs between Council & Residents • Residents get a say on what is spent • Maximise economies. Minimal procurement
  • 30. Grant Funding – more benefits • Grant conditions – can still monitor • Bidding round for housing providers • 3 year grants • Potential for converting sheltered housing? • Charge to residents may be partly covered by proposed changes to Housing Benefits?
  • 31. FAQs • Who can bid for the grant? – Only landlords of suitable accommodation • So what is ‘suitable accommodation’? – Self contained units of accommodation (‘own front door’) – Generally for older people – Access to communal facilities – 24/7 CQC registered care service on site
  • 32. FAQs • Where would the grant be funded from? – The existing SP and current waking nights funding • What if I don’t bid for / secure grant funding? – Council would then only pay for assessed care needs (fairer charged)
  • 33. FAQs • How would flexibility in care needs be ensured – Direct payments include a 4 week ‘buffer’ which allows for week-by-week variations and short episodes of increased needs • What if I’m a landlord who doesn’t provide care – Need to subcontract or arrange for CQC registered provider
  • 34. FAQs • Would this affect allocations? – No, would still want to see balanced communities. SCC would retain nomination rights where they exist. Need minimum number of residents with care needs (20-25) • What about charges to residents? – For providers to decide in consultation with residents – Maximum linked to Pension Credit Guarantee – Unless residents agree otherwise
  • 35. Current & Proposed Extra Care (Rental Units) 0 100 200 300 400 500 600 Cannock Chase East Staffordshire Lichfield Newcastle South Staffordshire Stafford Staffordshire Moorlands Tamworth Proposed Existing 2030_Needs 2020_Needs 2015_Needs 2010_Needs
  • 37. Extra Care Suitability at LSOA Seeking to encourage more development – Many providers told us that they will only build if they can provide services too
  • 39. The Flexicare Grant • Giving providers the freedom to develop and deliver excellent services to meet the needs of their residents • Giving residents excellent services, transparent cost structures and choice and control over the care they need • Giving the County Council a consistent approach to commissioning, and a real alternative to residential care