Context
Development of Voucher and Direct payments scheme for carers short breaks. Surrey has worked closely with carers to develop services that they find useful. Carers have been actively involved in decisions about use of the Carers Grant.
IPF comparator group - Bedfordshire, Buckinghamshire, Cambridgeshire, Cheshire, Essex, Gloucestershire, Hampshire, Hertfordshire, Kent, Leicestershire, Oxfordshire, Warwickshire, West Sussex, Wiltshire and Worcestershire.

Good Practice
Surrey has overall strong user and carer participation, with active user groups and some user led services.
Services for carers are well developed yet many carers. Revised eligibility criteria mean that more carers are now eligible for services. Support provided through Action for Carers. There is a carers' support project based in each of the 11 boroughs. Surrey has worked closely with carers to develop services that they find useful. Carers have been actively involved in decisions about use of the Carers Grant. They said that the Authority supports their initiatives and enables services to be developed that are what they want.
An additional £500,000 has been allocated to carers' breaks in 2003/4
The first indication that there might be extra money for breaks was in January 2003 and the scheme was up and running by 1 April 2003.
There has been good publicity through the carers' website at http://www.carersnet.org.uk/ , the newsletter and other local media. Carers' breaks are available through:

• Vouchers. The scheme has been developed after consultation with carers. Vouchers worth £287,000 will be allocated through Carers Assessments. The vouchers have a face value of £10, £20 and £50 and are able to be redeemed at any service on an approved list. New providers can easily be added and already several providers identified by carers themselves have been added to the list. This list includes services both in Surrey and elsewhere.
  
• They are administered in a straight forward and simple manner. Care managers have been surprised at how easy it is; the form is one side of A4 paper faxed through, then the vouchers are sent to the carer. Carers have been pleased at how quick it is.
  
• A voucher enabled a carer to stay in B&B accommodation near where the person she cared for was having a break. He had previously refused to have a break or to have any services. He has now asked for a community care assessment.
• Direct Payments . Direct Payments for short breaks for Carers of Adults are agreed through Carers Assessments. Provided eligibility criteria are met, the payment could be for a break in a residential home or substitute care in the home with the direct payment being made to the service user. It could also be for a holiday for the user or for the carer (as a "carers service"). This has already enabled one care manager to fund a couple going to Spain for a week instead of using a more expensive residential home. Where the direct payment is for a carers service, it is paid to the carer.

Benefits

• The service has been put in place quickly so that carers will have the benefit of service for the full year - often delays in putting in place new services mean that there are delays for service recipients, and money allocated for the first year is not fully used.
• There has been strong involvement of carers so the service reflects what they want
• There has been good publicity to carers - for instance through the carers newsletters available on the carers website at http://www.carersnet.org.uk/takingabreak/News5.pdf
  
• The service is simple to administer from the point of view of the carer and for care managers
  
• There is maximum flexibility for carers - carers for people with HIV have welcomed the scheme.

Context
Award winning Housing Improvement Agency which publicised its services and attracted further funding.
Good Practice
Blackpool Care and Repair is a Home Improvement Agency (HIA) provides a repair and improvements service to elderly and disabled people living in the area. It was evaluated as a part of a Best Value review and it was found to provide a valued service but to those who knew it existed. Like many HIAs, Blackpool Care and Repair had not advertised its services widely, fearing it would be overwhelmed by the response and unable to cope. Whilst It was recognised by all that being overwhelmed was a real possibility; services had to be made available in a more equitable way. In response the Blackpool Care and Repair targeted its information at professionals working in the area by:

• Producing a short video with a local college (may be able to get a link to some/all of the video footage)
  
• Produced a leaflet for professionals funded by the PCT
  
• Obtained SRB funds for a worker to raise awareness of the HIA amongst professionals

For this work the Blackpool Care and Repair was awarded, by the Office of the Deputy Prime Minister, The Foundations Award for the Best Service Reaching Vulnerable Clients. (www.foundations.uk.com)
Benefits
The results have been that responses have gone up but the higher profile of the work of Blackpool Care and Repair has attracted increased funding.
The service was awarded £10.000 by the Department of health to develop a Hospital Discharge scheme, this funding was matched by the Council and the PCT
A Falls Prevention scheme, run with Blackpool Age Concern had ceased due because its grant had run out. This has now recommenced with funding from the PCT
A new Security project has begun with Help the Aged, fitting locks and other security measures.

Good Practice
The Home Care Purchasing strategy was implemented to encourage new home care capacity and to improving the effectiveness of the capacity already available.
Hertfordshire County Council saw the need to improve the control and professionalism of it's home care commissioning and introduced District Commissioning Officers (DCO's). There are ten Officers in total who are directly line managed by the Contracts manager (Home Care).
Hertfordshire has already introduced 'electronic monitoring' of service provision with it's Block Contracted Providers and intends to roll this out with the remaining providers as appropriate by the end of 2003. The system 'logs' a Care Worker into, and out of, a service users' home recording the amount of time provided.
In addition to 'electronic monitoring' of home care Hertfordshire's' Contracts Unit (home care) has a detailed benchmarking and monitoring tool which collates and analyses data from various sources within the department.
Benefits
Creating a contracting environment offering stability to Providers by providing guaranteed volumes and contract packages in logical geographical clusters.
Once the (guaranteed volume) contracts were awarded the shortage of supply problem was immediately solved. Having effectively removed an element of competition between providers, they started working together; even to the extent of "swopping" clients and care workers, consolidating their work into their contract area.
Providers are now making better use of their limited pool of care workers and are able to offer their staff increased stability which has seen significant improvements in the recruitment and retention of suitable staff.
Click Here for further benefits

Context
London Borough of Newham Social Services Department has developed a Market Management Strategy that enables it to advantageously intervene in the market in partnership with Health Agencies and the independent sector. In the implementation of this strategy the Department has been successful in attracting external regeneration funding from Central Government and Europe through the SRB and the ESF programmes
Good Practice - Use of external funding to help regenerate and sustain a fragile social care market
In implementing the Strategy the Department has been exceedingly mindful of the profile of the community, which is the most diverse in the country, over 60 per cent are from black and ethnic minority groups with approximately 100 languages in common use in the borough. Newham has predominantly a small business economy, with 75 per cent of the businesses being defined as small to medium sized enterprises, of which 40 per cent are black and ethnic minority businesses. There is also a thriving voluntary sector, with almost 1,000 voluntary, community and faith groups, almost 75 per cent of which are black and ethnic minority agencies. Newham's health economy includes a primary care trust, an acute trust and a mental health Trust, all of whom we have developed active partnerships with to implement our market management strategy
Best Practice Examples/Projects implemented under the SRB and ESF funding streams that have been beneficial in stabilising and developing the external social care market:
The Newham NVQ Consortium
Newham is the first in London and one of only two in the country to launch an NVQ training Consortium, and by working in partnership with the voluntary and independent sector, the consortium has attracted a substantial amount of ESF money. The aim of the Newham NVQ Training Consortium is to assist independent social care provider organisations in Newham to meet the new NCSC standards for qualifications for social care staff.
The Consortium works on a co-operative basis, through a Steering Group and Terms of Reference, whereby the organisations who are members of the Consortium work together to provide and commission training for their staff.
Approximately 200 care sector workers have been trained over the lifetime of the project - 34 for the trainer/assessor qualifications, the rest for NVQ Level 2 in care.
The Dekh Bhall Project
Managed through a local Asian voluntary sector provider, is concerned with promoting training and employment opportunities for Asian people in the social care field, thus assisting social care providers working in Newham to provide more effective care to Newham's service users of Asian ethnicity. This project has been funded through the European Social Fund, SRB Green Street and Newham Neighbourhood Renewal Fund.
The First Line Supported Employment Service
Funded through the European Social Fund, supports adults with learning difficulties to access employment, offering them training courses, support in obtaining employment and advice for employees
ESF funded Supported Employment Project for People with Mental Health Support Needs
Newham SSD has been the lead agency, working in conjunction with East London & City Mental Health Trust and voluntary sector providers of services for people with mental health support needs.
The Provider Development Project
Funded by the Single Regeneration Budget (SRB) Fit for Work programmes, has promoted business opportunities for small and medium size enterprises to compete effectively for contracts from Health and Social Services agencies. This has resulted in specific initiatives such as the Meals in the Home Brokerage whereby the Project negotiated with a main provider of meals to award sub contracts for the provision of Asian and African and African/ Caribbean meals to local providers one from the voluntary sector and one from the private sector. The subcontracts are valued at £50,000 per year and the potential for the local providers to expand their outlets is also planned as the sub contractors have been invited to assist in meeting the demand for culturally appropriate meals from other boroughs.
Newham Advocacy Project
Also funded through the SRB Fit for Work Programme, has developed advocacy standards and training in the borough, including an advocacy qualification with the University of East London. It has also set up the East London Advocacy Consortium, a self-regulatory body for the development and maintenance of advocacy standards, which consists of the full range of advocacy providers in Newham.
Benefits
The range of partnership projects funded via the SRB and ESF streams that have

• Increased employment of local residents
  
• Improved the culturally appropriateness of services
  
• Improved the health and well being of service users
  
• Generated new business growth, including social enterprise growth, where specific gaps were identified
  
• Enabled the independent sector providers to meet the new NCSC standards
  
• Provided us with a wider market to purchase from
  
• Enabled the sharing of skills and experiences

Context
London Borough of Newham Social Services Department has developed a Market Management Strategy that enables it to advantageously intervene in the market in partnership with Health Agencies and the independent sector. In the implementation of this strategy the Department has been successful in attracting external regeneration funding from Central Government and Europe through the SRB and the ESF programmes
Good Practice - Use of external funding to help regenerate and sustain a fragile social care market
In implementing the Strategy the Department has been exceedingly mindful of the profile of the community, which is the most diverse in the country, over 60 per cent are from black and ethnic minority groups with approximately 100 languages in common use in the borough. Newham has predominantly a small business economy, with 75 per cent of the businesses being defined as small to medium sized enterprises, of which 40 per cent are black and ethnic minority businesses. There is also a thriving voluntary sector, with almost 1,000 voluntary, community and faith groups, almost 75 per cent of which are black and ethnic minority agencies. Newham's health economy includes a primary care trust, an acute trust and a mental health Trust, all of whom we have developed active partnerships with to implement our market management strategy
Best Practice Examples/Projects implemented under the SRB and ESF funding streams that have been beneficial in stabilising and developing the external social care market:
The Newham NVQ Consortium
Newham is the first in London and one of only two in the country to launch an NVQ training Consortium, and by working in partnership with the voluntary and independent sector, the consortium has attracted a substantial amount of ESF money. The aim of the Newham NVQ Training Consortium is to assist independent social care provider organisations in Newham to meet the new NCSC standards for qualifications for social care staff.
The Consortium works on a co-operative basis, through a Steering Group and Terms of Reference, whereby the organisations who are members of the Consortium work together to provide and commission training for their staff.
Approximately 200 care sector workers have been trained over the lifetime of the project - 34 for the trainer/assessor qualifications, the rest for NVQ Level 2 in care.
The Dekh Bhall Project
Managed through a local Asian voluntary sector provider, is concerned with promoting training and employment opportunities for Asian people in the social care field, thus assisting social care providers working in Newham to provide more effective care to Newham's service users of Asian ethnicity. This project has been funded through the European Social Fund, SRB Green Street and Newham Neighbourhood Renewal Fund.
The First Line Supported Employment Service
Funded through the European Social Fund, supports adults with learning difficulties to access employment, offering them training courses, support in obtaining employment and advice for employees
ESF funded Supported Employment Project for People with Mental Health Support Needs
Newham SSD has been the lead agency, working in conjunction with East London & City Mental Health Trust and voluntary sector providers of services for people with mental health support needs.
The Provider Development Project
Funded by the Single Regeneration Budget (SRB) Fit for Work programmes, has promoted business opportunities for small and medium size enterprises to compete effectively for contracts from Health and Social Services agencies. This has resulted in specific initiatives such as the Meals in the Home Brokerage whereby the Project negotiated with a main provider of meals to award sub contracts for the provision of Asian and African and African/ Caribbean meals to local providers one from the voluntary sector and one from the private sector. The subcontracts are valued at £50,000 per year and the potential for the local providers to expand their outlets is also planned as the sub contractors have been invited to assist in meeting the demand for culturally appropriate meals from other boroughs.
Newham Advocacy Project
Also funded through the SRB Fit for Work Programme, has developed advocacy standards and training in the borough, including an advocacy qualification with the University of East London. It has also set up the East London Advocacy Consortium, a self-regulatory body for the development and maintenance of advocacy standards, which consists of the full range of advocacy providers in Newham.
Benefits
The range of partnership projects funded via the SRB and ESF streams that have

• Increased employment of local residents
  
• Improved the culturally appropriateness of services
  
• Improved the health and well being of service users
  
• Generated new business growth, including social enterprise growth, where specific gaps were identified
  
• Enabled the independent sector providers to meet the new NCSC standards
  
• Provided us with a wider market to purchase from
  
• Enabled the sharing of skills and experience

Context
An entrepreneurial and professional approach to transport and catering has lead to substantial savings and improvements in quality.
Comparator groups: Cheshire, Derbyshire, Durham, Essex, Gloucestershire, Lancashire, Leicestershire, Lincolnshire, Norfolk, Northamptonshire, Northumberland, Staffordshire, Suffolk, Warwickshire and Worcestershire.
Good Practice
These services have been run as a Business Unit since July 2000 and the efficiency of their operations has won them Centre of Excellence status. The byword of the Unit is 'avoiding sub-optimisation', that is to say, making best possible use of the available resources. This is exemplified in initiatives in both services:
In Catering:

• consolidated invoicing arrangements have been introduced;
  
• catering officers have negotiated rebates on food contracts;
  
• the service has diversified into catering for special functions;
  
• plastic packaging is to replace foil containers so as to expand the market for microwavable food; and
  
• unit cost increases have been kept under 1 per cent over the last two years.
  In Transport:
  
• drivers have flexible contracts to double as care assistants;
  
• a partnership agreement with the Ambulance Service reduces the down-time of the vehicles; and
  
• The Dial-a-Ride service is now so popular that it has 26,000 bookings a year.

Both services now regularly receive a satisfaction rating from their users of over 90 per cent, yet both services are still striving to be more responsive to users' needs and preferences. The take up of places is 80.4 per cent which means that it is efficiently run, given that it is a bespoke service.
Benefits
In Catering:

• consolidated invoices have reduced transaction costs substantially. Paying one invoice each week, consolidating as many as 32 transactions into one when a each transaction costs 90p results in an estimated saving of £140pw across the service. Further the payments section can achieve its target for the payment of invoices and further discounts can be gained for prompt payment.
  
• Purchasing offices achieve savings on bulk purchases and retrospective discounts when orders have passed pre set levels. However cost is not everything and quality remains important and a quarterly meeting discusses quality and cost issues on a "we are what we eat" basis.
  
• Catering for special functions has made an important contribution to overheads, as well as diversifying catering to produce a range of culturally appropriate foods.
  
• Plastic packaging enables meals can be heated at home expanding the range of meals delivered chilled rather than hot. This has substantial quality benefits.
  
• Reviewing officers visit users once a referral has been made to see how the service can best meet their needs from a range of options which include frozen, chilled or hot meals. There is also a range of breakfasts lunches and dinners. Salads are a regular feature.
  In Transport:
  
• The partnership with the Ambulance services to use down time during the middle part of the day to take people to and from hospital has resulted in an income stream which offsets overheads, but the major benefit is the improved quality of service compared to the alternative namely taxis.
  
• Dial a ride is efficiently run providing a valued service which increases the independence of disabled people.
  
• Claiming the Bus Service Operators grant available to all councils but not always claimed has yielded a further £68,00

Context
Redesigning residential service and developing "floating support" has resulted in cost effective way of providing community support.
Comparator authorities: Trafford, Swindon, Bristol, Peterborough, Milton Keynes, Warrington, Derby, York, Coventry, Thurrock, Calderdale, Darlington, Plymouth, Luton and Southampton.
Good Practice
Focus House provides accommodation for adults recovering from severe and enduring mental health problems in two large adjacent buildings. Residents in one house have 24-hour care and residents in the other house have access to support staff. There is also an Outreach Team, which provides support to six other service users in group homes.
The Team provide structured care plans and opportunities for 'move-on accommodation' in partnership with social care landlords. Three residents have moved into this accommodation - benefiting from independent tenancies and access to traditional housing benefit together with ongoing support from staff from Focus House.
Benefits
Focus Support has offered the clients the reality of effective resettlement support from a specialist team who already work closely with the service user. We are able to develop individual packages of support based clearly on need, that allow the provision of medium term support where appropriate. Since the inception of our floating support scheme in August 2002, three clients have established individual tenancies, supported by the team.
In future the service will enable greater through-put in our residential unit and hostel, allowing us to offer a realistic rehabilitation route for service users to live independently. Our hostel and group homes have also benefited from supporting people funding, allowing us to offer an improved environment, as well as introducing personal support plans for service users of our group homes.
Click Here for more information

Context
A fresh approach to supported living, has enabled two people to be supported in the community with no cost to the council.
Good Practice
Judy and Wendy both have learning disabilities and attend the same day centre. Wendy lived with-in an adult placement scheme and Judy lived at home with her parents but went to the same placement scheme for respite. The Carer running the scheme became unwell and could not continue. The local Mencap worker and a local housing association saw a possibility of providing accommodation using the Supporting People grant. The care coordinator was enthusiastic but the scheme nearly foundered because of lack of interest by senior social services managers and lack of innovative thinking by housing services.
The key problem was the Housing Department's reluctance to say that they could not accommodate Judy and Wendy and make a referral to the Housing Association. Hull Council has many vacant properties but they tend to be in areas where people with learning disability do not feel safe. Eventually it was accepted that Judy and Wendy's needs could not be met and a referral made to the Housing Association. The Housing Association bought a property in which Judy and Wendy could live. They were both included in the choice of house and shared too in the trauma of house purchase including its disappointments.
Judy and Wendy now live in a lovely small house on a private housing estate supported by their tenancy support workers. The current cost to social services of this arrangement is nil. Because it took so long for the council to accept this scheme as viable, it is too late to develop other similar schemes.
Benefits
Both Wendy and Judy live in a much enhanced standard of accommodation
The support costs are very small and there are no costs for the council.
It can provide a model for future living arrangements

Context
Surrey has active user and carer groups who are involved in service planning, in performance management and who run services.
IPF comparator group - Bedfordshire, Buckinghamshire, Cambridgeshire, Cheshire, Essex, Gloucestershire, Hampshire, Hertfordshire, Kent, Leicestershire, Oxfordshire, Warwickshire, West Sussex, Wiltshire and Worcestershire.
Good Practice
Examples include

• Joint Equipment Services. This is a joint service with Health. Planning started over 2 years ago. At that stage the service was fragmented with poor facilities. Surrey nevertheless had a good record for providing small items of equipment quickly. A steering group was set up with representatives from the Surrey User Network and Action for Carers. There was excellent and widespread consultation. The user questionnaire was designed by service users. The strategy and policy work has been substantially drafted by a service user. Users are strongly committed to the new service. Representatives from both Surrey User Network and Action for Carers are board members. User sample surveys are to be built into the quality assurance process.
  
• User led mental health day services. A range of day services are provided by service users. These are well liked by service users and are seen as more stimulating than traditional services. The services promote recovery through building confidence and skills which enable people to be more independent. Also supports people into employment which Surrey expect to able to show measurable results. The user led services are contributing to user involvement more broadly and to the development of new services. For instance the Leatherhead Clubhouse is leading on developing a crisis house which could provide intensive support around independence. User involvement is actively supported by the mental health practice development centre which promotes mental health awareness and has service users as trainers and undertaking qualification courses.
  
• User led organisation providing support for direct payments. Surrey Independent Living Council is contracted to provide information and support to enable the take up of direct payments.

Benefits

• Service users are positive about the services that they help design and manage as the following quotation demonstrates: "We are the architects of our own services" Action for Carers
  
• The longstanding commitment to user and carer participation including their involvement in planning and training has contributed to imaginative and flexible care planning (see Joint Review Report October 2003)
  
• The involvement of service users and carers in the Joint Equipment Service has improved the service design.
  
• Surrey has a good record in supporting people with mental health problems to live at home (C31 adults with mental health problems helped to live at home as consistently been at top band performance) User involvement is a cornerstone of the mental health services and contributes to good performance
  
• Surrey has substantial numbers of users and carers across all adult user groups who are using Direct Payments. Support from a user led organisation has been critical in this success

Context
Reorganisation of transport services has resulted improved services at lower costs
Good Practice
The Transport Services Team was set up in Nov 2001 initially to coordinate the in-house fleet, provision of home to school transport, and to coordinate all Social Services transport needs. More recently it has also taken on the wider public transport role and the organisation of concessionary fares. Use of an external contractor to lead the Best Value Review brought specialist expertise and external challenge to the process. Authority staff have welcomed the changes, recognising the improved quality of service for the user, the cost savings and the reduction in workload for frontline staff. Validation of the process is primarily through financial management, but also through user satisfaction.
Benefits
The director of community care and housing estimates that so far the integrated team has achieved savings of around £200,000 for the directorate with comparable savings also showing within the education budget. There is also an improvement in quality with almost all users now benefiting from comfortable and reliable vehicles.

Context
Tameside Learning Disability Quality Scheme seeks alternative ways of communicating information using different mediums is essential to meet the needs of people with learning disabilities. Effective strategies for empowerment must have at their hearts policies, which ensure that information is freely available in a form that people can use.
Comparator authorities: Derby, Rotherham, Walsall, Gateshead, St Helens, Bury, Calderdale, Wigan, Darlington, Wakefield, Oldham, Kirklees, Dudley, Rochdale and Bolton.
Good Practice
The Quality Development Team strive to improve peoples' knowledge about relevant social policies, legislation, procedures and service developments, which seeks to decrease experiences of marginalisation and discrimination, overthrowing traditional practices and values.
As one service user confirmed, "Sometimes I get stuff where the words are too small and too long, I need big writing, pictures and joined up writing".
One of the roles of the Quality Development Team is to produce information for service users, which is written in easy-to-understand language. The information produced includes a pack on anti-bullying which covers issues around preventing, identifying and dealing with bullying; pictorial information on the assessment process; an audit tool to monitor satisfaction of service users living in supported housing, and flyers and information sheets publicising groups or events. The team also work on other projects, which promote user empowerment and involvement.
The team have produced a Catalogue of Work which includes other available documents such as: Anger Management Tool, Better Care Higher Standards, Customer Satisfaction Survey, Direct Payments, Equal Opportunities and much more (see full catalogue attached).
The team are in the process of developing a website for the Learning Disabilities Service and are hoping that this will go live by the end of September 2003. Once this is live a direct link to the website will be available.
Benefits
Quantitative data from Quality Assurance Study, Learning Disability Service, August 2003:

• 82 per cent of service users stated that they receive good information about service developments, national policies and general information on important personal developments such as advocacy and preventing bullying. Service users stated that good quality information can improve their quality of life, promote self development and increase their decision making capabilities.
  
• 83 per cent of service users receive different types of information and were generally aware of the different accessible formats available including pictorial documents, tapes, Braille and picture cards.
  
• 53 per cent of service users felt that the information received was easy to understand, this included generic information, for example gas bills, doctors appointments etc.