are we support providers or community organisations? kate fulton nov 16

Support Provider or Community Organisation? Kate Fulton

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• Explore the context of market place economics and human services

• Explore Providers potential contribution to Community

• Propose what Support Providers might consider going into the future

Overview

The world according to me – Kate Fulton

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• Economic context – consumerism • Market place economics - supply and demand • NDIA – regulator of the market place via price setting, service options and compliance

• Do better on less• ‘Do or die’ – consumers will choose

Are Providers simple suppliers?

Tension

Consumerism Social Justice

NDIS Citizenship

National Disability Insurance Scheme Australia

Line Item $$

Agreed Plan• Outcomes• Strategies

= Budget

Planning

Sho

ppin

g

Reasonable & necessary

Human Services

Service Land

WorkColleague

sMoney

HomeNeighbours

Pets

FriendsHobbies

Parties

Being ME!

LoveMarriage

College

Special Bus

Special Swimmin

g

Special College Courses

Special homes

Special Schools

Day Centres

Service Land• The systems offer can isolate people from their peers, families and community connections

• Services may be in the community, but don’t draw on it’s resources

• People’s ‘label’ or deficit becomes the most important thing, not their capacities and resources (their real wealth)

• Power and autonomy - There is a tendency for staff to take over decision-making and to make the rules

• People’s needs are seen through the service ‘frame’ and service solutions become the only solutions.

Building centred, system centred, service centred NOT person centred

Service solutions become the solutions

• Placements – Young people• Care Homes – Older people• Day Centers – People with a disability or mental ill health • Groups homes – people with intellectual disabilities• Programs not allocation of resources

The flow of money drives the solutions and people try to make them work best they can

Human Services

NDIA SUPPORT

CATALOGUE

‘Prescriptions instead of plans’

We want facilitators of thinking - exploration, possibility and design

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• People and families do not want simple standard supply

• Individually tailored, co-designed supports that make sense for them in their own context, in their own communities and in way that builds their own capacity and connection

• Supports with a partner of their choice; in a relationship that is respectful and in the hope that this partnership will evolve flexibly over time

My experience and partnerships tell me…

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• ‘what’s on the plan is what we deliver’.

• UK experience - energy, effort and money to move money into the hands and control of people and families

• An individual allocation of money does not result in the right things on offer to buy

• Poor design impacts on the outcomes experienced by people

Moving money for what outcome?

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• Find their sense of purpose, • Have the freedom and support to pursue it,• Have enough money to be free • Having a home where we belong• Getting help from others we choose• Making a life in the community• Finding love and relationships that matter

This cannot possibly be delivered by the NDIS or any other resource allocation system alone

Our ‘business’ is not supply, its supporting Citizenship

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• Shared Management • Partnerships with other organisations and

networks that support citizenship • Genuine investment in the workforce

beyond suppliers • Community Networks

If our business is supporting citizenship…

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Shared Management A partnership

OVERVIEW

Money to Agency

Employer / Purchaser

All management responsibilities

Contractual relationship is with the

Agency

Money to approved Partner

Person manage day to day support

Responsibility is shared Contractual

relationship with partner – based on a

partnership agreement

Money to Person

Employer or Purchaser

All management responsibilities

Contractual relationship is with the

person

A partnership

• Design• Set Up & Establish • Management • Development• Monitoring • Acquittal & Accountability

• Share Manages with Avivo to direct and manage most aspects of his wife's support

‘shared management works for us because we are not controlled but we are not alone’

• Avivo supports over 1000 older people to direct their supports. Third of this population share manage

Robert

Robert

‘

Incentives

• UK Management Options- Choice & Control - Economic benefits – individual and Government level

• WA Management Options- Choice & Control- Economic benefits – addition / negotiation

• Early data suggests a reduction of overall costs over time – more control & better outcomes

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Partnerships with people who know what they are doing

Providers should not be doing it all

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• Supports 3000 people across Western Australia

- People with a disability- People who experience mental

ill health - People who are older and or

frail

- Largest Shared Management partner in WA

- ‘what makes sense to you’

Avivo

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Befriend

A social networking community

We are ‘Includers’ with a mission to sweeten your social life!

5000 members connecting socially across Perth, WA

• Focused on supporting citizenship and inclusion • Investment to develop • Shared learning on what it takes to really include people – starter kit

and sweet skills • Hugely successful for people and support staff (and their families) • Barriers – ‘they are our people, that’s our job!’

A partnership

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• Supporting people across Perth • Support staff disconnected and with the

least autonomy in the organisation • Avivo ‘on community, not with

community’ • Local, local, local - Communities need

resources and people who can mobilize others

• Investment in communities and in the workforce

Community Networks

Avivo Neighbourhood Network

Support Workers

Support Worker

Support Worker

Support Worker

Support Worker

Support Worker

Support Worker

Home and Community Worker

LocalSelf managing

teams with responsibility

for supporting people in their

network The focus • People and their

relationships• The resources of

the community• Investment in the

community

Mental Health worker

Mental Health worker

Mental Health worker

Mental Health worker

Mental Health worker

Network of local teams

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and

Community

Worker Home and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Wellness Network

Dedicated teams for people

Personal Assistant/Advisor

Bob’s team A

Mary’s team B

Julie’s team C

John’s team DTravis’s team E

Erin’s team

Doris's team G

Mental Health worker

Mental Health worker

Mental Health worker

Mental Health worker

Mental Health worker

Network of local teams

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and Community Worker

Home and

Community

Worker Home and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

WorkerHome and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Home and

Community

Worker

Personal Assistant/Advisor

Customer team A

Customer team B

Customer team C

Customer team D

Customer team E

Customer team F

Customer team G

Customer team H

Customer team I

Customer team J

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• Trusting in your relationships with people and the community

• Autonomous networks – focus on decision making close to people and the networks

• Salaried staff – good terms and conditions

• Focus is not on delivery but connection for themselves and the people they serve

Investment in support staff & communities

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• Shared Management • Partnerships with other organisations and

networks that support citizenship • Genuine investment in the workforce

beyond suppliers • Community Networks

• All kinds of social innovations - resource for Communities

If our business is supporting citizenship…

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What can we do?

Working with community not on it

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• All roles move from paternalism to partnership

• Develop a deep understanding that people are the experts of their own lives

• A partnership has benefits for both partiesPeople and communitiesEmployees and Organisations

Promote an understanding of Citizenship across the organisation

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• People and families are the best Advisors • Trusting people to make decisions in

partnership with people and families • The organisation needs to not get in the

way, but facilitate and support• Support Staff who work in their local

community are working on an asset for themselves and their families

Co-design, co-production or simply working together?

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• Investing in and supporting peer to peer connection

• Routinely asking, ‘would you be willing to share your experience with one other person, if we thought it might benefit them?’

Facilitating and supporting peer support

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• Self directed support can increase accountability

• Partnerships offer a platform for accountability in action

• Accountability offers strength to people and families

• Opportunity to find a new partner, new organisation based on what we hold each other accountable for

Accountability

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• Our context can push us in a direction that may not be where we had hoped to travel

• More of the same will have minimal results and impact • Courage and integrity in how we work with people and how we work

with Governments is needed

Creativity

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www.avivo.org.au

Kate.fulton@avivo.org.au

Stay in touch with Avivo

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