Section 10: Choose the Selection of Support
This section deals with the provision of support across the four options contained in the 2013 Act. It provides guidance on "SDS-ready" approaches to commissioning. It provides guidance on some of the issues that may arise when the person chooses a direct payment and then chooses to employ a personal assistant.
Commissioning in the context of the 2013 Act
10.1 Access to the Options provided under the 2013 Act is of very little value if there is a lack of variety in the range of providers available or a lack of variety in the type of support on offer. It is a key responsibility of the authority to ensure that there is a sufficient range of choices available to all social care users regardless of whether the supported person selects Option 1, Option 2, Option 3 or Option 4 under the 2013 Act. This section deals with the strategic commissioning and procurement function of local authorities and the role that it can play in ensuring a sufficient range of choices across all four options available under the 2013 Act.
10.2 The authority should be aware of its duty under Section 19 of the 2013 Act to take active steps to promote a variety of types of support and a range of providers of support available to those who are eligible for care and support:
Promotion of options for self-directed support
Social Care (Self-directed Support) (Scotland) Act 2013, section 19
(1) A local authority must take steps to promote the availability of the options for self-directed support.
(2) For the purpose of making available to supported persons a wide range of support when choosing options for self-directed support, a local authority must, in so far as is reasonably practicable, promote-
(a) a variety of providers of support, and
(b) the variety of support provided by it and other providers.
10.3 'Providers' in this context means any organisation providing relevant support to a supported person. This includes, but is not restricted to:
- in house (local authority) providers;
- Local Authority Trading Companies/ Arm's Length Independent Organisations;
- voluntary sector (not for -profit) providers;
- private sector (for-profit) providers;
- social enterprises;
- small and micro-providers;
- user- led providers;
- employee owned co-operative providers;
- independent support organisations; and
- personal assistants.
10.4 The authority should view its commissioning role as being a facilitator of choice. This involves both providing information about choices and commissioning and procurement processes that allow people to have a real choice of provider and type of support.
10.5 Commissioning in the context of the 2013 Act is not simply about ensuring there is a transaction between a supported person and a provider. It should be set in the wider context of the local authority's activity including community capacity building, prevention and universal services. Commissioning should shift from approaches based on "time and task" activities and towards the commissioning of support to meet individual outcomes. The authority should adopt an approach based on the principles of involvement and co-production following the model outlined below. It should be transparent and should publish its approach either as a separate document or as part of its commissioning strategy. The remainder of this section provides guidance on the four key steps in the commissioning cycle.
Diagram 3: Principles of involvement and co-production
Stage 1: Analyse
10.6 The supported person, the social work professional, independent support and advocacy organisations and support providers are all rich sources of data for building a picture of need and demand in an area. In stage 1 the authority/partnership should draw on a range of sources of evidence including:
- asking supported people in their area what service provision they need and want, or what is a good and not so good about current provision;
- asking those who have expertise in working with supported people to draw on their experience of what is needed or what is a good and not so good about current provision; this can include operational social workers, service providers; collective advocacy groups and independent support organisations;
- using assessment and review data to understand what choices people are making and what support they are using;
- drawing on learning from other local authority areas about what they found supported people need and want, and;
- drawing on published research or learning about effective support provision for supported people.
Case study example: Involvement and commissioning
'You don't know what you need until you know what you have'
Asset based community mapping (IRISS/East Dunbartonshire Council)
Facilitated by The Institute for Research and Innovation in Social Services (IRISS) a group of people who use services, practitioners and others got together to map their local area. They explored the places, people, support and services that helped them to manage their mental health and stay well. People who participated said that as well as helping them understand what was available in their community the process helped them to identify their personal assets, strengths and skills.
Community asset mapping promotes true co-production of data to inform commissioning. The process of asset mapping has additional benefits for the supported person.
Stage 2: Plan
10.7 The authority should use the information from stage 1 in order to plan what the variety of services might look like in future. This will provide information about gaps in support provision and evidence for influencing the development of new support or ways of delivering support.
Case study example: Involvement and commissioning
Co-producing services through public- social partnerships (PSPs)
The PSP process provides a structure to encourage co-produced service design. In this model the authority/partnership, a group of relevant organisations and service users come together to develop models for support and, in some PSPs, consider the best mechanism for this support to be funded. Running an effective PSP is not just about following steps in a process. Attention must be given to communication and developing relationships amongst partners.
Read more about a PSP in practice http://www.iriss.org.uk/resources/commissioning-foster-care-services-falkirk-council-public-social-partnership-approach
Stage 3: Do
10.8 The authority should bring together the results of the analysis and planning stages into what they will actually do to facilitate the choices. The actions taken at this stage will be different depending on the needs of the local area. At a minimum this activity should:
- include clear information about the commissioning or de-commissioning of services;
- include clear information about the local authority's approach to ensuring sustainability of required services;
- make clear links between strategic commissioning and procurement (how the person will choose their support in practice);
- avoid procurement activities that work against choice (such as price controlled framework agreements), and;
- address the barriers to participation - particularly for small or micro-providers.
10.9 It may include allocating additional resources for specialist support service, providing specialist training or wider "community capacity building". The authority may wish to use alternative funding models to encourage innovation or financial incentives to meet gaps in support. In all cases, the authority should ensure clarity about the requirements placed on outsourced and in-house provider services.
Stage 4: Review
10.11 The final stage (review) is an opportunity to assess whether the commissioning process has worked. i.e. if there is indeed a range of providers and types of support available. Reviewing the information provides valuable data for the next commissioning cycle. It also provides an opportunity to assess whether the process has helped supported people to meet their outcomes and have an improved quality of life.
Further guidance and hyperlinks:
Joint strategic commissioning http://www.jitscotland.org.uk/action-areas/commissioning/
Practical guidance on promoting diversity in support provision http://ipc.brookes.ac.uk/services/mac.html
Public Social Partnerships (guidance and lessons learned) http://readyforbusiness.org/programme-offering/public-social-partnerships/
Developing small and micro-provider markets http://www.thinklocalactpersonal.org.uk/BCC/About_BCC/What_is_social_capital/Social_capital_topics/Micro_services/?parent=6638&child=5784
Personalised commissioning http://www.ndti.org.uk/what-we-do/strategy-and-commissioning3/market-development/
Testing commissioning models http://www.instituteforgovernment.org.uk/publications/testing-new-commissioning-models
Procurement guidance Scottish Government (2012), Guidance on the procurement of care and support services by public bodies in Scotland http://www.scotland.gov.uk/Publications/2010/09/21100130/0
Email: Heather Palmer