ISSUE 25
an online interactive publication | www.iese.org.uk
iESE develops CMS for social care sector How our Case Management System could revolutionise care record keeping Partners sought for top-up profiler tool Learn about a new top-up funding profiler tool and how your organisation could get involved Also inside: • iESE launches new Fair Care Charter • CareCubed launches place-based licence • Social care and technology at the iESE conference • iESE appoints two new staff
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Page 2-3 Introduction from Dr Andrew Larner, Chief Executive at iESE and News
Page 4-5 Feature: iESE prepare to enter CMS market
Page 6 In focus: the new iESE Fair Care Charter
Page 7 In focus: CareCubed updates
Page 8-9 Feature: Top-up profiler tool
Page 10-11 Write up: technology in social care at the iESE conference
Page 12 Advert EDITORIAL CONTACTS TRANSFORM IS PRODUCED BY: iESE www.iese.org.uk Email: enquiries@iese.org.uk @iESELtd CREDITS: Designed by SMK Design Editorial by Vicki Arnstein Views expressed within are those of the iESE editorial team. iESE Transform is distributed to companies and individuals with an interest in reviewing, remodelling and reinventing public services. © Copyright iESE 2021
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Putting the spotlight on health and social care W
elcome to this latest edition of Transform which focuses on health and social care. As an organisation which helps local government transform its services, social care has always been a key area of our expertise. Now we are excited to announce that iESE is set to enter the Case Management Software market. This is a big investment for us, going up against several key players, and a move we hope will revolutionise what care management looks like. You can read all about this development on pages 4 and 5.
Dr Andrew Larner, Chief Executive
@LaverdaJota This is not iESE’s first venture into the care management software market. We launched our CareCubed tool as a successor to our Care Funding Calculator, which is now used by more than 80 organisations, including a third of local authorities. The tool brings transparency to negotiations between care providers and commissioners when agreeing a care package. You can read an update about CareCubed on page 7. We know from our model of the future that the nature of care itself is set to change dramatically. With the predicted shortfall in carers in the future there is a need both to make the sector more appealing as a career choice and make these roles more rewarding by switching the focus from record keeping to giving care workers greater time on the ground to create better outcomes. As demand for services increases, the need to use technology to free up staff time is even more necessary. You can read a partial transcript from a talk given at our recent conference about technology in social care on pages 10 and 11. In this issue we also look at a new top-up funding profiler tool designed to help allocate top-up funding for children whose care within school or college reaches more than £6,000 a year. The tool’s designer, Social Kemistri, is looking for one or more local authorities with large numbers of children with SEND and ECHPs to invest and take the prototype to product stage. See pages 8 and 9 for more information. Get in touch with any feedback on this issue or with views for inclusion in a future edition by emailing Annabelle at annabelle.spencer@iese.org.uk
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Australia’s Child Wise builds child safeguarding in the UK CHILD WISE, AN AUSTRALIAN NOT-FOR-PROFIT WHICH SUPPORTS A RANGE OF ORGANISATIONS INCLUDING LOCAL GOVERNMENT TO IMPROVE THEIR CHILD SAFETY PRACTICES, IS NOW OPERATING IN THE UK. The organisation (a social enterprise of Save the Children Australia) does a diverse range of work for local government councils and authorities around the world, ranging from seconding its own staff to work within organisations to act as advisers to reviewing child safe organisational practice, policies and much more. It has also developed a virtual learning system which takes users through examples of scenarios and decision making around child safety. Child Wise is entering the UK market after recognising that whilst there are many UK companies offering such services for adult care,
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there are fewer providing services to help assess how safe children are from abuse in council-backed provision. Natalie Siegel-Brown, Managing Director of Child Wise, welcomed UK local authorities to get in touch to see how the organisation can help, including around reassessing service safety as models of delivery have changed through Covid. “We can’t assume that as we’ve changed services through Covid and post-Covid that everything is fine. These services need to be put through safeguarding checks. “If councils want to understand how safe their services are and the vulnerability of their service delivery to children and their families we can come in and test the system and provide solutions. You can come to us if you are concerned that you haven’t done that test but if you haven’t asked that
question yet then that should be a priority.” Siegel-Brown said learning through Child Wise’s virtual learning platforms had been shown to work well. “A lot of people, even if they know the basic principles, become paralysed when the situation is in front of them and there is no way to directly translate what was learnt in an online session to what you see. “Our virtual learning system gives an example of what might happen in a council service provision and the user sees the consequences play out as they make decisions. That type of learning means that when they are in the environment providing services, they have built the neural connections in the brain having previously had the experience of making that decision.” • To find out more about Child Wise and its services contact: info@childwise.org.au
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iESE signs up to support Care England IESE IS NOW A SUPPORTER MEMBER OF CARE ENGLAND, A LEADING REPRESENTATIVE BODY FOR INDEPENDENT CARE SERVICES. Care England works on behalf of small, medium and large care providers in England, from single care homes to large associations to give them a single unified voice. Through its supporter membership iESE will have
the opportunity to input its views and comments into relevant government consultations participated in by Care England. There will also be the opportunity to engage with key players in areas of policy, regulation and government through Care England events and the organisation also keeps its members up to date with care sector issues.
“We are delighted to become a registered supporter member of Care England,” said Dr Andrew Larner, Chief Executive of iESE. “We view Care England as a valuable organisation representing this important sector. We are pleased to contribute to its work and to have the chance to publicise our CareCubed online care pricing tool to Care England members who could benefit from it.”
CMS build is underway IESE HAS APPOINTED THE DEVELOPER MIRACLE MILL TO BUILD THE CASE MANAGEMENT SYSTEM (CMS) IT HOPES WILL REVOLUTIONISE CARE MANAGEMENT. Going up against a few key players, iESE plans to launch a reimagined and innovative CMS which will alter the way social workers make and keep records. It aims to give access to real time
information from multiple stakeholders, including the recipient of care, allowing social workers to make more informed decisions and spend less time inputting data and more time with their clients. Andreas Öhrvall, CTO and Co-Founder of Miracle Mill said it was a privilege to work on a system that would do so much good by improving the lives of social workers and their clients. He also credited
iESE appoints new staff NIK JONES NIK JONES HAS JOINED IESE AS SALES EXECUTIVE TO GIVE ADDED SALES SUPPORT TO CARECUBED AND APPGUARD. He has 25 years’ experience in the health and social care sector and has been a branch manager for the past 12 years for Voyage Care, a company which provides support for young adults with learning difficulties to local authorities. He said he was pleased to join another organisation with a service ethos. “If we can benefit the lives of the people who are supported by local councils and the social workers themselves, if it makes their job easier then we have done our job and that is what it is about. I see the significant strain the sector is under so to help with this will be rewarding,” he added.
LYDIA WOOTTON LYDIA WOOTTON STARTED AT IESE IN APRIL THIS YEAR AS A SUPPORT ANALYST. She is mainly working on CareCubed supporting users directly with queries and building step-bystep run-through models using a tool called WalkMe which is helping to demonstrate CareCubed processes to customers. This is her first role supporting local government, having completed a degree in Biology at Leeds University and worked as an artist. She has been enjoying working with customers and helping with day-to-day support enquiries. “I really like working in a small team and it is a role where I really feel like I am able to help people. It is also a rewarding sector to work in,” she said.
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iESE for their intensive input, adding that he had not previously worked on a project that was so well researched. “The key to success when building such an application is the combined involvement and dedication of both the client and the development team,” he said. • To find out more about the CMS project see pages 4 and 5
DIGITAL TOOLS SHOWCASE
Wednesday 20th October 2021 09:30 – 10:30 | Online Event As a not for profit, for the good of the sector, iESE continue to scan the horizon for digital solutions that are making a real difference and have cherry-picked three which focus on some of the biggest challenges facing local government right now – including social care commissioning, contextual safeguarding in childrens services and the threat of cyber criminals to local government. These latest digital innovations are providing critical support to councils during these challenging times – saving money, making services more efficient and improving the lives of local residents. This session will be very beneficial for senior leaders responsible for adults or children's services, finance and IT.
REGISTER YOUR FREE PLACE BY CLICKING HERE.
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The next generation of care management iESE is now in the development stage of building a new Case Management System (CMS) which has the potential to revolutionise how social workers keep and use client records.
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reimagined innovative CMS which is currently being designed and built by iESE aims to give access to real time information from multiple stakeholders, including the recipient of care, allowing social workers to make more informed decisions and spend less time inputting data and more time with their clients. By taking on this challenge, iESE is entering a market dominated by a few key players. Working extensively with industry technology providers and local government during the past year, iESE has clearly understood the issues faced with the current systems and what needs to change and how. It is now about to start building the system which it hopes will revolutionise care management. “The current CMS market is dominated by a few players. Prices are very high, they are not very innovative and the records generated are not much better than the manilla folder that used to sit on the side in the home of the recipient of care that the social worker would pick up and make notes in,” explained Dr Andrew Larner, Chief Executive at iESE. “We are looking to bring something to market that is more affordable and more open so that internal systems talk to each other and data from external partners can also be brought into the system to give a real time view of the client. It will also be easier for new technology to be plugged in
without it costing a fortune and without having to rebuild connections every time.” As well as lowering the costs for local authority and providing a more intuitive CMS, iESE wants the database to be able to pull in information from different stakeholders and providers to give a complete and real-time picture of the client. The nature of care is changing with more use being made of predictive analytics and the Internet of
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Things, such as sensors within the home and wearable devices. By having this data linking into a CMS it could be possible in the future to predict a fall, for example, rather than waiting for the event to be reported and providing aftercare. “We want to flip it around into what decision do you make and who do you involve if it looks like someone is presenting a need – you shouldn’t just record it, you should do something about it, and so all of a sudden the CMS is part of decision making rather than a record keeping system,” explained Dr Larner. The product, which will be native in the cloud and fully secure, is now in the first design stage with a provisional plan to start testing with a few agreed local authority partners by March 2022. It is hoped the product will be commercially available by the middle of next year. iESE plans to make the interfaces to the new platform publicly available which will mean competitors can also adopt the standards. As a not-for-profit, iESE feels this would be a win for the sector and this approach will also mean technology providers will have a standard interface which they can build into their design and not have to spend vast amounts of money trying to interface with legacy systems. Jill Thorburn, Director at Mind Of My Own, a company which provides apps allowing young people to interact with their care providers, has been involved with the design phase of the CMS. “Our services are currently more joined up than our systems and everybody I talk to wants integrated
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systems. Services are being held back by systems that aren’t modern and aren’t talking to each other,” she explained. “I am excited to be involved with the work iESE is doing because there is an opportunity to completely disrupt how things are done and we absolutely should be doing that. It is time someone did something different and it is time someone listened to the users much more. Ultimately, I hope it changes practice for the better because what really matters are the people receiving the service. If their social worker is spending 80 per cent of their time on the computer and 20 per cent of their time with people, let’s flip that on its head because that makes a difference commercially and to people’s outcomes and that is why we do what we do.” David MacFarlane, Transformation Project Manager at the Royal Borough of Windsor and Maidenhead, who was previously a social worker, has also been involved in the system design. He is excited and optimistic about the work iESE is doing. “I was a children and families social worker for just under five years and now work as a project manager trying to best solve the issue of how difficult it is to get good practice done on behalf of people who really need support. What I found is that we would spend about 80 per cent of our time at our desks and about 20 per cent of our time doing face-toface work in the community. We would be pushing and pulling data through quite old and clunky systems, often for the sake of process rather than to aid a person. There is always going to be some
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recording but listening to people and understanding their needs ought not to be relegated to second place.” As part of the system design, iESE will be creating a set of Application Programming Interfaces (APIs) to allow data push and pull requests to happen automatically by allowing two applications to talk to each other. “If you are working in children and families social work you are often on the phone or email trying to get data from education providers, courts, the police or others, because none of the systems currently communicate with each other. When it comes to integration, the integration we are most excited about is simply the ability for our own internal systems to communicate with each other, for example I wouldn’t need to call the hospital to ask for all sorts of complicated information about someone being discharged, because it is just all there in front of me,” he explained. It is also envisaged that the new CMS will allow the client to have input into their own records, which would be a welcome change in MacFarlane’s opinion. “If you look at social work research, particularly in the last few years, you will see that the more empowered an individual feels to be able to run their own life and their own social work intervention, the more likely it is to have a positive and lasting outcome. The evidence also shows that this ‘Fort Knox’ system we have created, which locks people out of knowing their own data and what professionals are writing about them, also
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doesn’t support the kind of change that we believe children and families should enjoy.” MacFarlane is keen to encourage other local authorities to get behind iESE and the new CMS. “We are all very aware of the issues that the sector is facing when it comes to clunky and timeconsuming systems and processes. Out of the back of the pandemic we are going to see greater need and vulnerability in our communities, and I don’t think we can kick this can down the road any further. If we are not challenging the systems and processes that we are using now, when are we going to do so? Our recovery from COVID-19 provides us an ideal opportunity to innovate and strive for better,” he added. • Find out more about the CMS solution by emailing Sherif directly at sherif.attia@iese.org.uk or go to www.iese.org.uk/social-care-casemanagement-system
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iESE publishes new Fair Care Charter iESE’s Fair Care Charter, developed in conjunction with local authorities and technology providers, outlines the principles iESE would like to see become industry standard around information and data management in person-centred care practice.
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he Fair Care Charter covers three key areas of information management: Systems, Control Over Records and Meaningful Records. The aim is that local authorities will sign up to follow the Charter in their own care services and that the document will also set the standards and principles iESE wants the new Care Management System (CMS) which it is currently developing to meet. Sherif Attia, Design and Research Lead at iESE, believes the time is ripe for public bodies to drive greater standardisation of data management and information processing within the health and social care space, with the need for greater interoperability between public bodies never more apparent than during the COVID pandemic. Another key driver for iESE is the empowerment of care recipients, their families and supporters. Through the research phase, iESE identified that care users have needs and desires around data and privacy that are inadequately met by the current system. The work iESE is doing around the Charter and the CMS seeks to offer them greater opportunity to contribute to and control their own records. “It is about creating a system that is inclusive and if you are affected by technology having some level of purchase over that. One of the key drivers is giving people control over their records. The whole
idea is to give a voice to the user and allow them to own, contribute and control their own records where possible. Where that is not possible, we want to empower their guardians to do that,” explained Attia. Recipients of care who want to view their own records must currently request this information under the Data Protection Act 2018 using a Subject Access Request Form. In effect, people are locked out of their own records unless they make a formal request. This can take up to a month to be granted, after which the records still belong to the organisation rather than the individual. There is no opportunity to contribute directly to these records unless the care recipient or their guardian requests a change, however, whether the change is made is up to the authority holding the file. As part of the development of the CMS, iESE is also working on an app called Life Tree, which would act as a digital passport of a person’s health record, and which could be contributed to by the care recipient. It would include the softer elements of a person’s life and wellbeing such as photos of their family and information about loved family pets, for example. It could also hold power of attorney documents. “Life Tree will help people get their views across to the people who are looking after them. When
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people have cognitive decline, such as dementia, something like Life Tree would help ensure that what is important to them is maintained,” explained Attia. One of the points in the Charter under the Control Over Records section states: We will give voice to care users by allowing them to own, control and contribute to their own records to the greatest extent possible. Where it is not possible for the care user to control the record, they should have the right to request inaccuracies are corrected in a simple way. Under the Meaningful Records section, one of the points outlines: We will support the care user in sharing their records with their supporters and family and empower their guardian/care giver to advocate or challenge records on their behalf. Attia added that as well as being a standard, the Charter outlines iESE’s design principles for the CMS. The section headed Systems, for example, states: We will drive innovation by using systems that not only interface to, but maximise the potential from, new systems and technologies. From self-reporting apps and sensors providing real time data to predictive analytics, we will allow new developments to reshape the role and function of the case management system. “The Charter was developed in consultation with local authorities and technology providers. The Systems section talks around a system which places the care user at the centre and uses codesign to achieve that objective. It then explores how we want systems to drive innovation but also support best practice in terms of social care and then the final bit is about how the system should be interoperable to allow data sharing,” said Attia. “The idea is to challenge what is happening in the sector around legacy systems but also to put the care user in that conversation as well.” Attia added that the new iESE CMS which is earmarked for release in mid 2022 would need to meet the standards and statements set out in the Charter to be a success. • To find out more about the CMS read the article on pages 4 and 5 of this supplement. • To find out more about the Charter contact: sheriff.attia@iese.org.uk
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CareCubed supports collaborative working iESE’s tool CareCubed is continuously evolving to add greater functionality and to support collaborative working for its ever-growing user base. Here we outline some key recent updates.
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areCubed is the market-leading care tool offering a transparent solution to help local authorities, Clinical Commissioning Groups (CCG) and care providers agree the cost and scope of care packages. There are secure online versions of the tool for both the children’s and adult market and iESE is committed to ongoing development of these products to ensure that they stay current with changes in the market and emerging policy and practice. Bearing in mind the place-based agenda, iESE has recently launched a place-based CareCubed licence to facilitate collaboration between local authority, CCG partners and care provider partners by giving them secure managed access to share cases. Vanda Leary, Digital Lead at iESE, said: “The place-based module is now live and that gives real opportunities for local authorities to work with their partners, knowing that they are working from the same information in a streamlined way, and keeping the needs of the individual at the heart of all their work together. “CCGs can benefit just as much as their local authority partners in using CareCubed. Although they are typically commissioning fewer care placements, those placements are often very high cost. iESE is also seeing an increase in the number of care providers using CareCubed. They value CareCubed’s clear, structured approach as an independent and well-established model to support negotiation on value for money and sustainability of the care market.” As well as the place-based module, recent major enhancements to CareCubed include: • Expanded supported living case options to better align CareCubed with activity within the sector, bringing a wider range of cases within CareCubed’s scope. • Enhanced reporting and dashboard features to provide at-a-glance management information. • Digital assistant help features to facilitate rapid and effective on-boarding of new users.
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Join the CareCubed Community As a not-for-profit, one of iESE’s missions is to create opportunities for knowledge-sharing and cross-collaboration within local authorities. One way it is fulfilling this ethos is with the recently launched CareCubed Community, which already has more than 100 members and is rapidly growing. Every CareCubed user has an automatic invitation. “We would encourage CareCubed users to join when they receive their invitation,” stressed Leary, “What members will get is access to CareCubed resources, shared documents, videos and, most importantly, the ability to directly reach out to other users to ask questions, get advice and to share experience. We are seeing from the posts within the community forums and from the feedback we are getting that it is useful to have this peer-to-peer support.” iESE-hosted CareCubed user forums have been taking place online monthly, with presentations and opportunity for questions and discussions. Recent sessions have included previews of upcoming CareCubed releases, as well as case study presentations from CareCubed users. As conferences start to resume face-to-face operation, iESE is presenting CareCubed and looks forward to interacting with current and new customers. In September and November iESE will be presenting workshops at The National
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Commissioning and Contracting Training Conferences (NCCTC) Children’s and Adult events. The September workshop will look at negotiation skills, whilst the November one will include a presentation from CareCubed user Essex County Council. Both workshops are designed to be of interest to all commissioners, whether or not they are CareCubed users. Older persons care is expected to be the subject of the next major CareCubed update and iESE has been recently carrying out some research in this area. “We are doing ongoing research on how best to expand CareCubed to cover aspects of older persons care and CCG placements for people with complex health needs. We know we have customers who are already successfully using CareCubed for aspects of older persons care and we are confident that we can widen CareCubed’s use in this area for greater benefit to our customers,” added Leary. There have recently been several new CareCubed case studies added to the database, including one on how The London Borough of Hackney is using CareCubed for commissioning children’s care. Access CareCubed case studies on the iESE website: www.iese.org.uk/project/carecubed/ • Find out more about the NCCTC events here: www.ncctc.co.uk • For a demonstration of the CareCubed tool, please get in touch with us directly at carecubed@iese.org.uk
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A top-up funding tool which could transform the market Fairly allocating top-up funding for children and young people with an Education, Health and Care Plan (ECHP) and Special Educational Needs and Disability (SEND) is an issue many local authorities grapple with. Additionally, increasing numbers of ECHPs being issued means the system and budgets may soon be unable to keep up with demand. Redesigning and transforming how top-up funds are allocated is now possible – even necessary – and there is new technology available to help.
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uman-centred design agency Social Kemistri has built a digital decision support system to help local authorities allocate top-up funding awarded to children whose care within school or college reaches more than £6,000 a year. The tool uses clustering technologies and applied artificial intelligence to accurately assess what a child or young person’s needs are and then suggests a support package which can be adjusted by a support worker for a better fit. It is designed to make fairer, more consistent and accountable decisions about funding and eliminate many of the disparities and inequities found in current models. The initial project was funded by Better Futures
for Children (BFfC), a not-for-profit organisation which delivers children’s services in Reading (see box). Social Kemistri is now looking for one or more local authorities with large numbers of children with SEND and ECHPs to invest and take the prototype to product stage. “The brief was to explore and investigate the potential of using of data analytics and applied artificial intelligence to improve BFfC’s SEND Top Up Funding model,” explained Tom Penney, CEO and Change Architect at Social Kemistri. “The current model is driven by the place where children or young people attend. There is a consensus that the model
should be needs driven and that the funding should follow the child. Joining up a child’s assessed needs with outcomes and costed provision is difficult to say the least. It requires expert judgement and the ability to summarise, analyse and interpret complex facts and evidence. All this data is of course encapsulated in a child or young person’s EHCP. “Our challenge was to find a way that would enable BFfC to perform that complex analysis fairly, accurately and consistently,” he added. “Matching funding to a child’s assessed needs is crucial. Overfunding implies waste and underfunding risks unmet needs. Our approach is always to check how
Pictured: Social Kemistri's needs profiler output example.
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Pictured: Social Kemistri's needs profiler system schematic example. humans do this work and then help them to use their compassion, empathy, experience, knowledge and expertise to do it better. We design and build decision support systems that recognise their unique human attributes and allow them to focus on the things they do best and that really matter.” To build the tool, Social Kemistri worked in partnership with three local authorities which provided sample data. From this it was able to conclude that the needs of a child with SEND and an EHCP could be accurately classified and assigned to nine clusters or groups. “Our method means more signal and less noise. Each cluster is sufficiently distinct as to be well differentiated one from another. A child or young person cannot be in two clusters at one time. This set of nine needs-clusters covers the entire SEND landscape. Each cluster is information rich but simple enough to understand to be accessible. It carries the essential data to join up needs (severity and complexity) with outcomes and provision. It simplifies how we communicate about a child’s needs and provision without reducing information content,” Penney added. Using the tool, a case worker enters the child’s age and answers 20 questions about their needs to enable them to be assigned to a cluster. In essence, it takes the 16-20 pages and 4,000 to 5,000 words of the ECHP and provides an ultimate summary. Penney added that the emphasis is on a system that supports professionals to make complex decisions better and more consistently. However, it is not a one-size-fits-all solution and therefore helps with compliance with The Special Educational Needs and Disability Regulations 2014 legislation, which includes the requirement to take the views, interests and aspirations of the child and their parents into account.
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There is a realisation that adopting the technology is not for the faint-hearted. It will require a period of adjustment where a local authority needs to correct any disparities and misalignment of how resources are currently allocated. Through looking at data from four local authorities so far, Penney acknowledges that process would be the same for any council. “There are no quick fixes. You have to give the schools space and time to adjust to the new realities that are revealed by the data and the model. Our approach is truly transformative – it really does change things for the better. Every child or young person with an EHCP and SENDs has a better chance of getting what they need from their education. This really matters in delivering better outcomes and life experiences for children and is even more important for their life chances as adults. “Better outcomes, and that's what parents and children really want and deserve, depend on more accurate targeting of resources. Data analytics uncover and shine a spotlight on the inadequacies of the existing system and processes so it's not surprising to find some local authorties are reluctant to take the next step. Some are really worried by change because they're concerned things might not work out or they will lose control. This is just a system or service reset based on some sound principles, values, simple maths, and common sense. The funding should follow the child and be commensurate with that child's needs and assessed outcomes. The provision should be matched to the outcome and needs and funded according to the cost. Our model and system does that quickly, consistently, and accurately,” Penney added. Social Kemistri estimates that an investment of around £500,000 is needed to create a fully operational system. A significant chunk of that money will be used to create a contextual feedback system to give children and parents more say about how well the EHCP is working for them. The company is developing efficacy metrics which will drive true outcomes-based commissioning and help with demand profiling and market shaping. That level of investment also funds a large-scale trial and developing a transition strategy and impact model. The core technology is in place and now the database requires populating to agree the detail and specific costs of each of the nine provision maps.
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Getting a consensus of a fair pricing across an education authority is time consuming and the schools need to be involved in the process. “The costing of recommended or standard provision maps and tables must be co-produced with schools to ensure they are realistic and fair. We have produced a financial impacts model which makes it easy to collaborate with schools to cost recommended provision profiles within any new top-up funding decision support system. Any winners and losers, by definition, are short term. A new model cannot, however, solve the problem of inadequate capacity or what might be perceived as excess demand. What it can do, is make sure that funding follows the child or young person and their needs. And that the local offer is better profiled to meet future demand. It can also allow the child or young person, their parent and carers a better chance to engage with and influence the system they deeply depend upon,” Penney concluded. • To find out more contact Tom Penney at Social Kemistri: tom@socialkemistri.com
CASE STUDY:
Brighter Futures for Children Gary Pyke, Interim Head of Transformation and IT at Brighter Futures for Children (BFfC), commissioned Social Kemistri to create the top-up funding modeller. BFfC is a not-for-profit organisation which delivers children’s services in Reading. Social Kemistri took 140 EHCPs from BFfC and did cluster analysis against the population of 1,400 EHCPs across the whole of Reading. Pyke explained the challenge that BFfC and other local authorities are facing and why he commissioned the project: “We have a schools education top-up funding challenge. We are spending a lot of money and a lot of that money is spent on a small number of children, so we need to find a way of allocating that money better,” he said. The organisation also wants to move away from a model which is cost-driven to one which is needs based. “We have got to create a model that is more efficient, taking time out of the system of people who are having to read a twenty-toforty-page document to determine funds allocation. I think the technology has now developed sufficiently that this is a viable use of AI to help the person in the loop to make better decisions. With a system like this, we can defend why an award is as it is. If we have something that acts as our base determinate, we can vary it up or down as required but it gives us something that is a very good starting point that can be developed very quickly and efficiently,” Pyke said. BFfC found that the product did what was required but was unable to invest the required amount to make it a viable product at this stage due to prioritising other needs.
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Social Care at the iESE
Delegates at the recent iESE Conference heard from an esteemed panel on issues around digital and technology in the social care sector. Here we draw out some highlights from the conversation. To watch the complete talk ‘ Click this link. PANELLISTS: Dr Jules Maitland, founder and managing director of human-centred design agency all In. Joanne Harding, Executive Member for Adult Social Care at Trafford Council. Mark Allen, Head of Tech and Digitally Enabled Care at Hampshire County Council. Craig McArthur, Director of Health and Social Care at East Ayrshire Health and Social Care Partnership. Chaired by Dr Andrew Larner, Chief Executive at iESE.
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Dr Andrew Larner (AL): What is the need for the humancentred approach to services, why is it important and what does that mean? Jules Maitland (JM): “When we have top-down approaches to fixing especially complex problems they often break apart and they often break apart because there is no one viewpoint that can solve these complex problems. Clinical experts are important, but they are not experts in the lives of the people that are impacted by these complex social problems. The people experiencing the problems and those delivering the care on a daily basis are not traditionally at the table when decisions are made about policy or programmes or technology solutions. Taking a human-centred design approach elevates that voice.” Joanne Harding (JH): “One of the things we need to be ever mindful of when we think about our solutions for the future is that we don’t lose sight of the people that we are trying to serve and represent. We all know that social care is a very hot topic at the moment and there have been lots of conversations about funding, but to me it isn’t just about how we fund social care, it is about how we reform social care and we reform social care by involving the people in receipt of care and also those people delivering care. Whatever we do in the future around digital transformation and saving lives, we make sure that we include and involve people who are in receipt of care and staff who are delivering that care and that to me is imperative, we have to involve the people who have that lived experience.” Mark Allen (MA): “My job in Hampshire County Council is to implement technology in a social care setting and it isn’t about technology, it is about how can we deliver effective and efficient care services for vulnerable people. The approach we take is very much outcomes based. All the time we are looking at how we can integrate technology into the care process. It is very easy to get caught up in the shiny object and new thing but what we try to do is make sure that we can blend that in with different sorts of care so that people’s holistic needs are met as far as we possibly can. Use of technology enables us to do things that are less intrusive, easier for people to use and are available 24/7 which is really a key element of it and actually can be bespoke to those individuals, which for me is a really important part of this – when we look at technology, how useful is it going to be to Mr Jones.” Craig McArthur (CM): “Digital is not always the answer. We always have to remember that people should be at the heart of what we are doing, sometimes a digital solution is the right solution but there is a process to get there and that is understanding and talking to people and seeing what they want and seeing what the best delivery method might be. One of the challenges for us is accessibility to the technology to actually access the service in the first instance and that is a big part of what we need to build into those design processes as well, understanding
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how we can make it as accessible as possible to everybody. We can’t lose sight of the fact that what we are is a people business, it is about our staff talking to people who use the services and fundamentally we are about that level of engagement and if digital can help the process that is great, but we can’t lose sight of the people part.”
AL: What technology are you currently exploring using? MA: “We are using robotics to assist care delivery. When we look at these things we look at the challenges we face and the problems we have got and start to ask the question how can we address them, there might be traditional ways of doing it but there may be other ways. We are looking at a deficit of carers in the Hampshire County Council area of about 6,000 by 2025, that is a huge challenge for us and we are also understanding challenges of being a carer, it is a tough job and when we were looking at this we thought what could we do in that space, we fell on the idea of potentially using robotics so we embarked on a whole process of trying to explore what was available. We are now working with a company in Japan which is supplying us with co-bots which the carer wears. It is lumbar region thing that someone wears like an exoskeleton.” CM: “Some of the technology enabled solutions we wanted to put in place have been prohibitively expensive before and are now very easily available and tie in naturally to what you want to do anyway. We have seen real opportunities there to reduce some of the 24-hour care we had in place, so people perhaps getting care overnight, sometimes that just involved the carer being there at night and sleeping just in case something happened but now the technology can alert you and you can respond to that really quickly. It is about the consumer type product now rather than medically specialist.” JH: “Social care is not just about caring for older people and people with long term chronic conditions. Social care is about supporting people to regain and retain independence. As well as the grand ideas I think we should be paying attention to some of the small basic things that make people’s lives better.” JM: “It is a balance between being forward-looking but not overlooking those simple solutions and what can seem like a small problem to a health authority. To individuals in the home social isolation is crippling. The trick is to look at what technology is good at and use it for those purposes. Really good technology will free up the humans to do what humans are good at, let’s look at where humans excel and use technology to amplify those skills.”
AL: We have talked about residents but in terms of the care workers themselves are you seeing digital technology helping them? JH: “A lot of staff at the moment are firefighting and trying to do day-to-day delivery and making sure that care packages are in place. One of my concerns is about changing culture sometimes in organisations and staffing teams. Some people are genuinely terrified of digital technology.” MA: “One of the challenges for us is how to embed use of technology into systems and make it accessible and fair. We have embarked on a long process of culture change and getting social workers to accept this and bed that in there
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so that when they are assessing someone’s needs they are thinking much more broadly than the traditional arsenal of approaches they may have taken previously. In Hampshire we have 1,300 people that we support using technology. We are starting to move beyond that into our workforce being curators of knowledge that can be passed onto people. It is about empowering our social workers to say ‘you might want to use this in this way’.” CM: “The use of technology across the whole care sector is changing and we are seeing it changing. Eighty per cent of time spent on record keeping is clearly not acceptable but there always has to be some record keeping and if we can make that as quick as possible rather than something being handled [multiple] times, if you can do that once at the point of contact and streamline everything down that has to be good for everybody, including the end user. There are a number of issues in there about legacy systems, around the cost of upgrading systems, at a local level these are all challenges that you are trying to tackle just now. There are a number of new systems coming in all designed to improve that efficiency because it is the right thing to do in terms of governance but also the right thing to do because you can provide so much care for the same initial amount of money and that money goes so much further.”
AL: Is the ability to have some foresight [through data] something you are seeing already in social care? CM: “We have got all the data and refer to ourselves as being data rich but intelligence poor, we don’t know what to do with it sometimes as there is so much of it. If we could understand and analyse it better, we could then use that to be so much more predictive in what we do and hopefully start to see problems coming before they are even there. Some of that is about the early intervention stuff that the technology will be able to flag up to us, a lot of it is just about understanding what the demands of the future are likely to look like and getting a workforce in place to be able to deal with it rather than where we are right now, which to be brutally honest is on the back foot and responding to crisis after crisis, we need to try and get ourselves more on the front foot.” MA: “There are loads of sources of data and joining those up is really challenging. The issue around predictive stuff is that there is a lot of technology starting to emerge that claims to be predictive and give you data, it is lacking in evidence as far as I am concerned at the moment. There is nothing we are seeing that is giving us real quality information. If we could sit and look at data coming in, for example, for very frail over 85s about their frailty increasing, if we could start to understand that effectively, not only would it impact on social care delivery, it would impact on health. Those things are key and they will be the future but they are not here yet.” JH: “We are bombarded with data but a key thing we miss is that we have all these reports that tell us everything but we very often neglect to ask people. Asking questions of people – what would make you happy? It is dead easy really, it isn’t a trick question. We can be over prescriptive in social care, we decide what people want. For me, a richness of data comes from the people who are living that life and we should go back to basics and just say what makes you happy, what would improve your life and how could we make that happen?” • To watch the complete talk visit: www.youtube.com/watch?v=Tl7bJ29fjtA
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