Day Services Webinar 26 January 2021 - Norfolk County ...
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Day Services
Webinar
26 January 2021 For now…
Mute your mics
Cameras off
We will be starting shortlyHousekeeping
Agenda
Welcome and Financial Future delivery Longer term Any other
summary to models ideas plans business and
date closeSummary of achievements
Activity to date
Date Activity
March 2020 • Day services advised to close buildings and individuals and families informed
April 2020 • LD Centralised staffing resource implemented to provide alternative support
May – June 2020 • Questionnaire sent to all LD individuals and their families & LD providers
• Calls made by operational teams to OP / PD adults & families
• Commissioners work with providers to confirm their interim offer to September
June – Aug 2020 • Commissioners worked with providers to develop reopening and longer-term
delivery plans
September 2020 • Most LD day services reopen buildings as per agreed plans
• Most OP, Dementia or PD services are signed off and are open or planning to
open soon, apart from providers unable to access their buildings
• NCC H&S started audits of Provider’s COVID related risk assessments
October • Second lockdown and Day Services continue to provide services
• Finance agreed and in place to end of March 2021
Nov – Dec 2020 • Survey and portal in place to record delivery
January 2021 • Third lockdown and Day Services continue to provide servicesWhat you said worked
Providing longer
Feel that the term funding
Maintaining good council are really agreements when
committed to possible, allowing
levels of funding better planning
working with
throughout the and service
Providers to delivery as a
period. Essential for develop services in result.
providing ongoing the future Receiving monies
support to vulnerable from the ICF, to
adults and sustaining cover the additional
costs incurred from
organisations through Ability to have Clear commitment and
the purchase of
very challenging clear messages from additional PPE etc,
discussions with NCC throughout this and changes to our
times
Commissioning period regarding the buildings regarding
desire to support good Infection Control
managers to
quality day service
highlight issues, provision going
to try to resolve forward, despite the
challenges
them in a timely
fashion.What you said didn’t work
Carer / family / Inflexibility of
client concerns Fulfilling
Last minute systems -
have led to requests on the
requests for trying to
reduced client portal e.g., commission
significant
numbers and service needs to Out of Hours
amounts of
increased costs be terminated information from support
and then not Providers, with
followed through very tight
Significant deadlines
communication
Survey that needs to
barriers and NCC cold calling be completed every 4
community teams parents of weeks - handy if we
do not have the Clinically could look at
Vulnerable previous ones or be
capacity to offer people, which able to print / email a
new assessments some families copy, so we have
and change have found to be them for our records
insensitive
packagesWhat you said didn’t work
Significant
communication
Social Workers /
Assistant barriers and
Practitioners cutting Lack of or community teams do
days or whole service no not have the capacity
for individuals referrals to offer new
without consultation assessments and
with providers change packages
Vaccinations
Increased pressure and testing for
to accommodate Working Age Lack of
people newly Adults not acknowledgement
referred to the prioritised of messages sent
service, but delays to Day Resource
and funding refusals email (this has
when support is improved recently)
subsequently offeredFinancial Models (planned from April 2021)
First some key principles / Intentions ✓ Payment will be based on services delivered – therefore relies on completion of templates, etc ✓ Services need to meet our duties around the Care Act ✓ Services should be outcome based i.e., demonstrate that they are contributing to an individual’s well-being / learning / abilities ✓ Engagement with people who use services and carers to identify wants, needs, restrictions, and must haves to define potential service structures and service responses is encouraged ✓ We will develop shared digital resources with providers that can be rolled out across the region to provide a wide and diverse range of activities in lieu of building based services ✓ We will investigate the potential to capitalise on direct payment / personal budget-based alternatives to mainstream services ✓ Examine volunteering and employment opportunities and the impact for people who cannot continue to attend Day Services ✓ Consider a more joined up approach across specialisms, which not only makes for a more resilient market that can manage change but also a more inclusive market
Model 1
Return to This model does
pre-COVID- not recognise
there may be a
19 model of continued
reduction in
paying per capacity which
Does not reflect could lead to
session / our commitment to provider failure
hour support new
service delivery Does not
models e.g. virtual recognise that
services may
not be back to
No change pre-COVID-19
to internal capacity
systemsModel 2
Pre-COVID-19 Increase to
model with current PoC
additional budget likely
safety net
Does not reflect
arrangement our commitment to
support new
service delivery
Familiar models e.g. virtual May not be
model and able to
supportive effectively link
approach payments to
would reduce activity
risk of
provider
failureModel 3
Provider set prices Could result in
for each delivery This could mean
the need for a
type (e.g. building significant changes review where
based, virtual, to internal systems alternative
and how future provision differs
outreach etc) services are
commissioned. from current care
To include a Impact to Ops teams and support plan
transitional safety Clear and and their
net offer to be concise understanding of
available offer
scoped as structure
which makes Providers are
appropriate linking likely to offer
payments to virtual sessions
activity simple in addition to
Less need for core services
Increased transitional safety which would
net as services increase costs
flexibility can evolve to
and choice meet situation
and payments
for can flex to reflect
individuals thisModel 4
Core service offer
with membership
Could result in
offer to access less Would need robust
the need for a
monitoring review where
traditional service framework to alternative
delivery options. review what is provision differs
To include a being delivered from current care
under the and support plan
transitional safety Less need for membership
net offer to be transitional payment
safety net as
scoped as services can
May be
evolve to meet
appropriate situation and less suited
payments can to OP/PD
flex to reflect this This could mean providers
A supportive significant changes
Increased way to to internal systems
flexibility introduce a and how future
and choice genuine services are
for blended Increases
offer resilience of commissioned. Potentially
individuals Impact to Ops teams
service offer difficult to
Increased to manage and their record actual
understanding of services
service offer future available offer received for
for minimal changes everyone
increase to
costModel 5
Could result in
the need for a
A blended bespoke review where
alternative
offer taking
provision differs
elements from from current care
model 3 and 4 as This could mean and support plan
appropriate. This significant changes to
could differ for internal systems and
each provider how future services
are commissioned.
Impact to Ops teams
and their
May be more understanding of
flexible and available offer
suitable
across all
specialismsEarly Feedback from Providers – in your words ✓ Providers require time to understand customer demand and need in order to deliver an appropriate model. This includes time allowed for stakeholder involvement / co-production ✓ The market needs to be supported to be sustainable in the long term, a rapid move to spot purchase means they will lose capacity within the market ✓ The market is about enablement and has a preventative element which prevents people going into more expensive service options and this needs to be recognised ✓ There is need to move towards a wider delivery model which could result in a better overall service for older people in the community. Will require looking in a different way at costing, as the pre-Covid model is not applicable to current service delivery ✓ Needs to be consideration regarding financial security while we move over to any new model.
Questions from Providers – in your words ✓ Are NCC able to switch to individual arrangements by April? Is there any danger of delay and if so, some contingency planning? ✓ Given the large amount of uncertainty currently and over the next 3 to 6 months, can we maintain a regular dialogue to help sustain services effectively? ✓ If new arrangements don’t work out, can they be reviewed at a later date? ✓ Are new arrangements to be based on Tender contract and service delivery plans, as discussed during 2019 (for example, can we charge when people don’t attend)? ✓ Is there a plan to apply standard market rates in the future?
Future Delivery Ideas
What Day Services have been delivering / would continue ✓Outreach Services ✓Home visits, newsletters, activity packs, wellbeing telephone / virtual calls, advice signposting and referral, 2- course freshly cooked dinner delivered, shopping, accompanied ‘out and about’ for needed appointments, shopping or leisure ✓Preventative support ✓Post lockdown could support people in their own homes with re-enablement, physical and mental activity etc.
Infection Control Fund - Round 2 (20%)
Round 2
• Providers who have sent back monies must
Grant agreement forms will be spent by
receive £140 per supported 31 March
2021
person
The 20%
• The second element of funding fund can
allows providers to make a cover spend
claim for additional funding Element 2 of between 1
• These claims will be assessed funding - focus Oct and 31
on enabling March 2021
by commissioners and paid
safe opening
quickly and safe
• Monthly reporting Feb - Apr on ongoing
spend operationAlcove Video Carephones Get involved with our pilot project!
What is the pilot project? Norfolk County Council is working in partnership with Alcove and RETHINK Partners to roll-out 200 Video Carephones as part of our response to the COVID-19 pandemic. The aim is to ensure vulnerable people can stay involved and connected to services, friends and family and protected from infection during this difficult time. We are inviting you to get involved in this exciting project!
What is a Video Carephone?
✓ An Alcove Video Carephone is an easy-to-use tablet device
which enables people to make video calls.
✓ It is like a telephone but with a screen and pre-programmed call
tiles for easy use. By touching the tile on the Video Carephone,
the recipient can call their friends or family members, support
workers or get general help and technical assistance as
required.
✓ The Video Carephones will ensure that day service users can
remain involved in services by participating virtually - during
the Covid-19 lockdown and beyond.
✓ Day Service providers will be able to use the Alcove portal or
app to make calls or run activities for day service users.
Elizabeth loves her Video Carephone! https://youtu.be/HBpp-bKu5hAHow you can get
involved We will run briefing
sessions on:
Monday 1st February
Express your interest by emailing: 11.30 – 12.30pm
integratedcommissioners@norfolk.go
v.uk by 5pm on Friday 29 January. Friday 5th February
2.30 – 3.30pm
Please insert ‘Alcove Video Carephone
Pilot’ and your organisation name in Tell us your
the subject header of the email. preferred date
when you email
Include the best contact person and
email address for your organisation. We look forward to
hearing from you!Longer term plans
Proposed Pathways
• Two year-long co-produced pilots to
start in 2021
Skills and Pilots will look at:
Wellbeing
providing meaningful
Employment • Outcomes for those who use these activity, social
supporting people services support and care for
to obtain paid those with the most
work • Impact & requirements for providers
complex needs
• We have agreement to implement
pathway Promoting
Independence
• Need to consider the impact
supporting people to
COVID-19 has had on the develop life skills and
employment market access community
• Work with the provider market to provision and
agree sensible implementation services
timescalesOP/PD Market
✓ Stabilise current provision – we know there are significant challenges in the market and our
first priority is to support providers as best as we can to stabilise current provision
✓ Developing future contracting models – this may come before developing a longer term
strategy and will form part of development of long term strategy. Exact time scales are yet be
fully defined and will be reviewed in the context of ensuring sustainability in the first instance
✓ Day service Strategy OP, PD- there has been a plan for some time to develop a long term
strategy for this market. Our plan will be to progress this work as we move through 2021
✓ Engagement with market – a key part of this will be engaging with you as providers and also
work with people who use service, to understand what they want and expect from services
✓ Key consideration
✓ One size does not fit all – There will be carefully consideration to the different roles in the
market and how we can support you as providers, while meeting our core objectives around Living
Well, Promoting Independence and supporting people with complex needs
✓ Opportunity – there is some really good work that goes on in supporting people in different ways
which we need to understand and define within this strategic approachMH Market ✓ Key consideration – majority of MH services are not building based therefore one size does not fit all – There will be carefully consideration to the different roles in the market and how we can support you as providers, while meeting our core objectives around Living Well, Promoting Independence and supporting people with complex needs ✓ Stabilise and support current provision – we know there are significant challenges in the market and our first priority is to support providers as best as we can to stabilise current provision ✓ Review MH models and whether these meets the needs of the market - Exact time scales are yet be fully defined and will be reviewed in the context of ensuring sustainability ✓ Engagement with market – engaging with you as providers and also work with people who use service, to understand what they want and expect from services
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