Individual budgets only work if there is a choice of services for the client to buy. So, councils will need to stimulate and develop the market. But even among individual budget pilot areas, this has barely begun.
Warrington Council is already applying market development to benefit users and save money – despite not being a pilot area. The independent sector provides 80% of its provision and over the past three years it has tried to improve the flow of information between users and providers to make services more responsive. That has meant working with providers to show them what the market needs, how to drive up standards of care and use more effective feedback from users to target services that aren’t working.
Helen Sumner is the strategic director of community services, and says that sharing more information with providers has helped remove waste from the system. “It was born of necessity – being a low-resourced authority we had to spend money effectively.
“We have a regular provider forum and we share our contracting and commissioning strategy and the monitoring of it with them,” she says.
The forum is designed to raise good practice, and meets at least quarterly. As well as working more closely with providers, teams inside the department have also changed. Qualified social workers have been moved into an expanded contracting and commissioning unit, while Warrington’s safeguarding and residential review teams work more closely, both being overseen by the safeguarding co-ordinator.
“When they go into homes for regular reviews, all the information they pick up is brought together. We get a picture of homes we wouldn’t have got if we left it to our old commissioning mechanisms,” says Sumner.
One of the priorities that emerged from the forums was the need to train staff. Penny Owen, the principal training officer, says that working closely with the contracting and commissioning team has allowed her unit to be more proactive in raising standards. “Sometimes companies find it hard to bring up standards and hold on to staff. We showed them how they can help that by investing in continuous development.”
Working with a forum of 80 providers means there is a diverse range of training needs. According to Owen, some of the larger organisations were, at first, reticent to the idea of working together, but being open about the process won them around.
“Quite a few larger ones are part of national organisations and have their own training, but smaller providers might look to us for most of theirs,” says Owen. “With lone workers, there will be some who will need more guidance in terms of things like employment law.”
Users have also been involved in decision-making. The Allen Street Day Centre was due a change of provider in 2007. A user panel helped the formal panels assess the tenders. By the end of the process, the users decided to join the committees.
Ray Scott was among the users on the panel, and is now on the centre’s steering group. He says that because the users were properly trained and are respected, their involvement stays useful.
“The new provider has ideas and we do too. Obviously they need to look at the financial side, but the whole process is about prioritising,” he says. “Now we have people getting into groups to work out things like going out, and we never had that before.”
As a result of regular meetings, it was agreed to build an IT room at the centre, and various groups are forming to apply for funding for new activities.
Driving up standards
Making the market more active has been pursued with a constant eye on driving up standards. New placements to five care homes have been stopped because providers weren’t performing to standard. This can be reversed when standards improve.
Market development is in its infancy, but the benefits in raising standards of dignity in care have led to Warrington being the only local authority to be awarded beacon status by the Improvement and Development Agency.
Sumner says: “It’s about working more closely with providers, sharing our good practice with them, being clear about what’s needed and giving a lead, and then calling to account to deliver.”
● Click here for more nformation or call service manager beacon co-ordinator Amanda Brown 01925 444242