Report 37: Personalisation, productivity and efficiency
Building community capacity
'Research participants used personal budgets to improve housing, stimulate the local economy, strengthen the role of voluntary organisations and help people into employment' (14)
The self-directed support approach was designed to recognise and support a person's informal support networks such as family and friends, neighbours and volunteers. Evidence is beginning to show that people who hold personal budgets are using them to increase participation and activity in their communities. Greater involvement with and access to community networks and support is being shown as having a preventative effect, and the idea of pooling personal budgets to fund community-based support enterprise is being explored.
The co-production model of care and support recognises people who use services and carers as having assets and expertise that should be valued. Coproduction means moving away from 'doing the same thing, only trying to do it more cheaply', towards sustainable public services that 'prevent needs arising and provide better outcomes'. (20) There have been tentative suggestions that initiatives, such as KeyRing Living Support Networks and Local Area Coordination (designed to increase independence and self-sufficiency/self-esteem through developing and maintaining formal and informal community networks) have the potential to be cost-effective and release individual and community resources, if implemented appropriately. Clearer evidence is appearing about the economic benefits of certain approaches to building community capacity, such as time banks, befriending and community navigators for people with debt or benefits difficulties.
CSED indicate several instances in which Support Related Housing for people with different support needs can result in efficiencies, if commissioned on an integrated service model between housing, health and social care. The Support Related Housing model is consistent with the aims of personalisation.
Changes in traditional day centre approaches for people with learning disabilities towards smaller community hubs providing personalised activities and learning opportunities are reported as delivering efficiency savings. Evaluation findings indicate that Shared Lives schemes could offer value for money by delivering high quality person-centred support at a relatively low price.
Case study: MacIntyreOpen
MacIntyre have been able to make efficiency savings of £100,000 a year. These have come from a variety of sources including through personalised contracts so that there are no longer big contracts with one or two suppliers, and by re-defining staffing roles and structures. These savings are then reinvested in the service. Reinvesting money saved from efficiency savings has provided an added incentive to work as efficiently as possible. The commitment and financial investment from both commissioner and provider and a transparent relationship has created a sound environment for transforming service provision. (11)