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
Good practice
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."
Diverse range
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
●
The Improvement
and Development Agency's Beacon scheme
●
For more on
individual budgets