Making it Real Islington “We said, we did” Final Evaluation Report August 2016

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Making it Real Evaluation – Executive Summary

The Making it Real Programme commenced in September 2013 and was completed in March

2016. We are extremely proud of our progress towards achieving the Making it Real vision for

people in Islington.

The Making it Real programme has been a shared effort across social care and health. Voluntary

sector partners have been well represented on our Board and with our Experts by Experience at

the heart of the programme. Our approach was based on genuine co-production and power

sharing at the most senior level.

The Making it Real Islington Action Plan was the centrepiece of the programme and it set out our

commitment to make services more personalised in Islington. The Action Plan was developed

through co-production. The evaluation provides detailed progress on each action in the Action

Plan. This is set out in the ‘We said, we did’ table, which demonstrates our commitment to co-

production in the development and delivery of the actions. We made clear progress toward most

of our agreed actions. Most of the actions for the three priority themes were in place by the end of

the programme. For the actions that need more work and monitoring and review we have agreed

to a lead person or service.

As part of this evaluation report, we also took the opportunity to review our approach to Making it

Real and to assess the wider impact of the programme. Co-production as an approach has been

widely adopted among Making it Real Board members and partner organisations. Islington’s

corporate plan includes a clear commitment to co-production as a way of working across the

council. The Experts by Experience are having an impact on changing organisational culture, in

particular in how staff relate to the people who use services. Plus the Experts by Experience have

benefitted in knowledge, skills, confidence and increased capacity and motivation to be part of

and lead change.

Making it Real’s achievements represent the start of a journey towards a new way of working for

Islington. We look forward to continuing to work together and maintaining the connections from

our Making it Real journey. This will be achieved through the launch and development of our new

Islington Centre for Inclusive Living (CIL) in 2016. The CIL aligns directly with the legacy of the

Making it Real Board and it will build on the local and existing peer support carried out by the

Islington Personal Budgets Network to help people tackle challenges they face across health and

social care.

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Section Contents

Page

1 Working together

4

2 Supporting statements

5

3 Forward from co-chairs 6 Our vision

7

4 Introduction

8

5 Summary of outcomes and achievements

9

Structure chart 10

Action plan 10

Key highlights and achievements 11

Coproduction cordat 13

Wider impact 13

Department of Health survey results 14

Peer Research 15

POET Survey

16

6 Detailed progress update 16 Action plan progress

16

7 Wider impact 25 Peer Research 25

POET Survey findings

26

8 Recommendations and next steps

29

9 Conclusion and closing statement

30

10 Board membership

31

11 Appendixes

32

12 Contact information

32

13 Partners 33

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1. Working together

Being part of Making it Real has made me evolve into a better person. I’ve learnt so much for myself and other people with learning disabilities. Nick Avlonitis, Expert by Experience

As an expert by experience, the MIR project has given me the opportunity to experience working with professionals in social care. I have witnessed social workers embracing personalisation to make it work in their practice. However, this is on-going as social care and housing providers need to be more engaged with personalisation in how they deliver services. George Topping, Expert by Experience

MIR has really shown me the true value of co-production and working together with service users and carers. I found it quite inspirational working with people who really understand what it is like to be on the receiving end of services. I think it’s really made a difference. Neil Chick, Head of Learning & Development

I have enjoyed being involved and seeing the end results. I’ve made it real for others and myself. Being an expert by an experience and overseeing the co-production of the action plan has helped me get back the self- respect I left in the bottom of a glass a few years ago. Mick Havens, Expert by Experience

I am proud to have been a member of Making it Real for the last 2 or 3 years. Via all the meetings held we have talked, been listened to and made lots of useful connections. Fiammetta Schofield, Expert by Experience

Whilst on the whole I still feel that personalisation and personal budgets in mental health still have a long way to go I have valued the Making It Real Board immensely. Having a place where, collaboratively, issues have been raised, points made and knotty problems acknowledged has the real potential for a longer term positive impact. It has been helpful to see a bigger picture too. I have been impressed with the dedication and skill of the Experts by Experience and the genuine dedication to partnership working throughout. Ginny Sell, Hillside ClubHouse

Islington is a progressive borough and there has been a real willingness to make a difference. Making it Real has really worked hard on co-production and ensuring all stakeholders have been able to have an equal input at looking at solutions to difficult issues. The development of the co-production concordat was very important as it made sure we were all on the same page. We have worked hard to make services more joined up. The separate Complaints’ Feedback Focus Group in particular learned extensively from reviewing case studies, customer satisfaction and feedback forms over an extended period. Rose McDonald, Healthwatch

Before Making it Real I was just a carer in a bubble - I didn’t know how to make a difference. Two years on I have learnt so much about how social services, safeguarding and the complaints system, in particular, works. It’s had a massive impact on me and I have gained so much. I feel Islington council are listening to carers and that we now have an equal partnership. We can’t stop now just because the MIR Board has ended, we need to continue to work together to deliver services in the best interests of our sons and daughters. Niroo Patel, Expert by Experience

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2. Supporting Statements

The Making It Real project has been a fascinating one. I have watched the

experts by experience grow in stature and self-confidence to the extent that they

were able to give talks and presentations to groups of staff members both locally

and nationally. This has been a project which, from my perspective, has been a

genuine attempt at co-production between the Council and service users. In

some ways it may be easier for officers to come up with changes to services

behind closed doors, but that is a sterile way of working and if the changes they

come up with are unpopular and don’t work, then that exercise has been

unsuccessful. Service users are in a much better position to explain what they

want and, perhaps counter-intuitively, the services they want are often cheaper

to deliver. Rightly, our Making It Real project has attracted national recognition;

from my perspective, I have very much enjoyed being a (peripheral) part of it and

would like to thank everyone involved.

Councillor Janet Burgess MBE Deputy Leader and Executive Member for Health and Wellbeing

Over the past year Islington Clinical Commissioning Group (CCG), Islington Council and the wider NHS have all made significant progress in delivering personalised services whilst facing the challenges of rising demand. Personalisation has been key in allowing Islington CCG and the Council to tackle the difficulties posed by issues such as an ageing population and a significant increase in people living with long term conditions. Early work to develop Personal Health Budgets has found that given this responsibility, people are often not only able to find more clinically effective solutions for their needs, but also more cost effective ones too.

Without the project’s Experts by Experience who are at the center of the

Making it Real programme, this would not have been possible. Making it Real

in Islington has also prompted a new kind of working with providers, the third

sector, carers, clinicians, and service users. It is only through such

collaboration that policies, procedures and services have all been reshaped to

deliver what is a personalised and integrated offering for Islington.

Dr Katie Coleman

Vice Chair of Islington Clinical Commissioning Group

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3. Foreword from the co-chairs

Our Making it Real Programme started in September 2013 and closed in March 2016. We

are pleased to present this final evaluation report. We are proud of our progress towards

achieving our Making it Real vision for people in Islington. It is the outcome of a lot of work

and represents an effort to bring together a wide range of people and views.

Our Making it Real programme has been a shared effort across social care and health, with

voluntary sector partners well represented on our Board and with Experts by Experience at

the heart of the programme. We are proud that a third of Board members were Experts by

Experience. These are people with lived experience who helped to make sure that our

Programme was meaningful to people who use our services. Our approach was based on

genuine co-production and power sharing at the most senior level. This started with us as

the Board Co-Chairs, an expert by experience and Islington council’s Service Director for

Adult Social Care.

We would like to thank all our Board members and our Experts by Experience in particular

whose commitment and participation has been inspiring. There are many benefits of

working in this way with our Experts by Experience, tapping into their knowledge, skills and

creativity to develop our Action Plan that was both ambitious and realistic.

Making it Real’s achievements represents the start of a journey and a new way of working

for Islington. We are proud of what has been achieved. We look forward to continue working

together and keeping the connections from our Making it Real journey through the launch

and development of our new Islington Centre for Inclusive Living (CIL) in Spring 2016. The

CIL aligns directly with the legacy of the Making it Real Board and will build on the local

existing peer support carried out by the Islington Personal Budgets Network CIC, to help

people tackle challenges they face across health and social care.

Sandy Marks Chair

Islington Personal Budgets Network CIC

Simon Galczynski Service Director

Adult Social Care Islington Council

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4. Introduction

Early in the process, the Islington Making it Real Board agreed that we would work on all six

Making it Real themes to develop our action plan. We used the Making it Real ‘I statements’

as a basis for discussion with people who use our services. We also encouraged staff to

think about the statements and what they might mean for people who use our services. The

Making it Real Action Plan focused on the three priority themes was published on the Think

Local Act Personal website in April 2014. In July 2015 we had an agreed action plan for all

six themes. See appendix 1 for details.

The Making it Real Islington Action Plan was the centerpiece of our programme and it

set out our commitment to make services more personalised in Islington. The Action Plan

was developed through co-production. We held many small working groups to develop the

actions for each theme. The small working groups included representatives from the local

authority, Experts by Experience, the NHS and voluntary sector organisations. The Action

Plan was then approved by the Making it Real Board.

The evaluation gives detailed progress on each action in the Action Plan. This is set out in a

‘We said, we did’ table, it reflects our commitment to co-production in the development and

delivery of the actions.

As part of this evaluation report we also took the opportunity to review our approach to

Making it Real and to assess the wider impact of the programme. We trained peer

researchers to help us to gather feedback from people that use services. We received over

100 responses using a postal survey called POET (Personal Outcomes Evaluation Tool). The

survey responses help to understand local people’s experiences of personalisation and

personal budgets and how this compares nationally.

We also considered responses from a larger Department of Health postal survey which is

sent to all local service users and carers .These results make up our local account of adult

social care and helps us understand what we have achieved and how our services are

performing.

This report highlights our progress and achievements to date and makes recommendations

for the next 12 months.

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5. Summary of outcomes & achievements

Our approach

To prepare for the Board meetings a co-chairs meeting was held before each meeting

The project managers supported the co-chairs to plan each meeting agenda and agree

proposed meeting outcomes and invite guest speakers

A co-chairs meeting was held after each Board meeting so the co-chairs could reflect on

discussions and lessons learnt in order to improve the next meeting

Meeting accessibility and support requirements to facilitate participation was valued by

people involved in the Making it Real programme

We developed guidance and procedures on when the Experts by Experience would

qualify for acknowledgement and expenses payments, in line with HMRC, DWP

legislation and the London Living Wage. These payments are known as ‘Reward and

Recognition’

All Board meetings were well attended and engagement and participation was strong

throughout the programme

To help the experts by experience prepare a week before each board meeting they met

with the project managers to go through the agenda, provide feedback on table

discussion ideas and agree how they wanted to participate in the meeting

The board members sat at small tables at the Board meeting to support small working

group discussions

The tables were rotated at every meeting to encourage networking and getting to know

each other

Staff and Experts by Experience valued the opportunity to work alongside each other as

equals in pursuit of common goals

As a result the Board members came together and developed the co-production

agreement or concordat which outlines our approach and commitment to co-production

All partner organisations on the Making it Real Board adopted the Making it Real

Islington co-production concordat. We asked all partner organisations to demonstrate in

a practical way how the concordat is being implemented and how it will continue

Some board members were concerned that as Housing and local home care providers were

not represented on the Board, that they would not adopt co-production or embrace

personalisation to the same extent as Board members

Board members remained hopeful and optimistic that the Making it Real programme

legacy will achieve positive change. There were concerns about the scale and pace of

change and the difficult financial context in which we are working

Making it Real had a dedicated programme team of two project managers and a project

support officer

These staff members set up the programme and monitored the progress alongside the

co-chairs

Key roles included facilitating the small working groups and experts by experience

preparation meetings, keeping records, monitoring the action plan, and evaluating the

programme

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Making it Real structure and links

Action Plan

Our Action Plan was co-produced and monitored by the Making it Real Board

We developed the skills and confidence of a diverse range of Experts by

Experience who increasingly lead on the delivery of our Making it Real

programme

We developed a separate Making it Happen meeting, co-chaired by

Islington’s personalisation lead and an expert by experience

The lead for each action attended this 6 weekly meeting to update on progress

and feedback on how the action was being co-produced

The meeting highlighted which actions were on track and where more work was needed

We made good progress on most of our agreed actions. Most actions for the 3

priority themes were in place by the end of the programme

For the actions that needed more work and monitoring and review we agreed a

lead person or service

Fiammeta Schofiled & Niroo Patel at the Mayor’s Civic Awards 2015

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Key highlights and achievements

Theme 1: Flexible integrated care & support

We are making progress towards more joined up, integrated health and social care

We achieved integration ‘pioneer’ status

We co-produced a personalisation policy, a Direct Payments Agreement and Direct

Payments factsheets that work across health and social care

We are embedding personalisation and co-production across our frontline services. We

introduced a new approach to assessment which is based on assets and strengths

We made direct payments easier to manage with pre-paid cards

Theme 2: Information and Advice

We trained staff in plain English so that communication is easier to understand

We introduced a new online service directory that improves staff and the public’s access

to information about local care and support services

A new point of contact to adult social services was set up so there is now one way to

access social care services

People now have access to an independent advocate as outlined in the Care Act. We

will co-produce a single statutory service in the next twelve months

Theme 3: Workforce / My support staff

We developed our co-production concordat and it has been adopted more widely than

Making it Real

We established a new forum to learn from complaints, compliments and suggestions

based on principles of co-production

We co-produced engaging personalisation training programmes for staff. This was co-

facilitated by Experts by Experience and council officers. The Centre for Inclusive Living

(CIL) will be involved in a review of the learning needs of people involved in

personalisation

We co-produced and co-facilitated staff training sessions on strength or asset based

assessments to reflect the changes brought in by the Care Act 2014

The Islington Personal Budgets Network (IPBN) is a well-established peer support

network for people who receive a personal budget or personal health budget, carers and

people who manage a personal budget on behalf of someone. We are supporting the

IPBN to grow and reach more people as part of the new Centre for Inclusive Living

In the last year, over 400 people attended peer support and training events

We are supporting direct payments employers to pay their staff the London Living Wage

We developed a simple Personal Assistant register for direct payments employers and

self-funders

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Theme 4: Active & supportive communities

We did focused work on what support carers need in order to continue in their role

We raised awareness about Making it Real and peer support through events and

regular meetings

We contributed to the work of the local Employment Commission to support more

disabled people and carers into paid or voluntary work.

For more information see http://www.islington.gov.uk/advice/employment/employment-commission

We are working in partnership with home care services to hold regular service user

feedback forums. This will help us to recognise and share good practice and to

improve home care services based on feedback

Theme 5: Personal Budgets

The IPBN is co-producing training for direct payments employers and personal

assistants. This will help increase the take up of direct payments and provide more local

employment opportunities

We co-produced new information on personal budgets and direct payments

More work is needed to ensure support plans and personal budgets are more flexible

and focused on the personal goals of service users and carers

The CIL will build upon the work of the IPBN and deliver support groups to help people

increase their confidence

Theme 6: Risk enablement – feeling in control and safe

We want to make sure all staff have access to training on positive risk taking. This

will be included in a new learning organisation

We reviewed our current end of life training for staff and put all our linked resources

online so all stakeholders can access them

The Islington Carers Hub are progressing actions to support carers to continue caring

and when their caring role ends

Together we are Making it Real

http://www.islington.gov.uk/advice/employment/employment-commission

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The wider impact

Co-production as an approach has been widely adopted by the Making it Real Board

members and partner organisations. Islington’s corporate plan includes a clear commitment

to co-production as a way of working across the council

We are promoting co-production in Islington and changing how people interact with

services

Approximately 50 staff attended co-produced training on asset based assessments during 2015.

Staff spoke about how helpful and inspirational it was to have service users and carers

experiences at the center of this training

A Making Safeguarding Personal approach has now been adopted by Islington. This is an

example of a co-produced process that involves the service user and carer from the beginning

and on agreeing on the outcomes

Islington’s Making it Real programme is viewed as best practice and is inspiring people and

organisations around the country to embrace co-production. Several London boroughs,

Hackney, Camden, Barking & Dagenham and Greenwich, attended Board meetings to learn

from our co-production approach

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Experts by Experience acted as ambassadors for personalisation and co-production in

Islington and at a national level. A presentation from the Experts by Experience was highly

valued by staff at the Housing & Adult Social Services staff conferences

The Making it Real Islington programme presented at the Think Local Act Personal

(TLAP) 2014 conference in Liverpool

Islington MIR ran their own conference in partnership with TLAP in September 2015, called

Making it Real, Making it Happen – Come Together, Share the Learning. Islington MIR wanted

to showcase their achievements and share the approach with others

The Experts by Experience are having an impact on changing organisational cultures, in

particular on how staff relate to people who use services

Experts by Experience have benefitted in knowledge, skills, confidence and increased

capacity and motivation to be part of and lead change

John Thomas & Mick Havens at the Mayors Civic Awards March 2015

Department of Health survey results

We continue to be one of the highest proportions of service users and carers using direct

payments in London and are committed to doing more to encourage the take up of direct

payments

Our annual Department of Health survey indicates a number of improvements in the year

2014-15 including more people with learning disabilities living in the community to 78.3%

We achieved our target in 2014/15 to get 5.8% of social care service users with mental illness

into paid employment

In 2014/15 we also asked service users specifically to tell us about feeling safe. Most people

who responded told us that their home care workers, personal assistants and staff in supported

accommodation or residential care helped to make them feel safe. As well as the help with

personal care, around the home, and in helping people to get out and about in their local

communities, the skills and attitudes of staff and the way they supported service users were

particularly important in terms of feeling safe and quality of life

Some people also talked about housing and local services as influences on having a good

quality of life. We are continuing to work closely with health and housing partners and services

to deliver more joined up services via our Health and Housing programme

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Local peer research findings

Local Peer Research indicates that some people do feel they have choice and control to

lead an independent life, feel safe and feel included in the community. More work is

needed to ensure personalisation works well for everyone

The research also highlighted that the impact of Making it Real needs to be wider. More

work is needed to ensure that people with sight and hearing loss and people living in

residential care can access personal budgets See Appendix 2 for more details

Rosemary Lamport presents the Peer Research results at the TLAP Islington conference September 2015

Personal Outcomes Evaluation Tool (POET) survey results

Our POET survey results indicated that a high proportion of service users have positive

experiences of support planning. See Appendix 3 for the full report

The quality of support is good or very good for most people

The survey results tell us that we need to improve the overall quality of information

provided to service users receiving personal budgets

The results also show that we need to do more to improve access to the wider

community, work, training and leisure

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6. Detailed progress update

Action plan progress

Theme 1 - Flexible integrated care & support

We said We did Cultivate good ideas for improving our services by working together with our Experts by Experience and staff

We recruited 10 Experts by Experience to the Making it

Real Board. We provided support to the Experts by Experience to prepare for and participate in Board meetings and other work groups. We agreed what co- production means locally and by a process of co- production we developed a co-production concordat. All Making it Real Board partner organisations have adopted the concordat at a Board level. Our Making it Real Action plan was developed through co-production and it is regarded as a national example of best practice.

Progress

We will visit other places to get good ideas and arrange guest speakers for the Board

We made several visits to other places and attended a number of

conferences. Experts by Experience were always involved in

these activities.

We arranged guest speakers who have shared their knowledge and experience with us, including Sherone Phillips from the National Co-Production Advisory Committee, Professor Peter Beresford and John Waters from In-Control.

Progress

Develop a personalisation policy based on choice and control that works for health and social care

We co-produced a single Personalisation policy across

health and social care. We commissioned the Design Council to help us. They held several workshops with key stakeholders, including NHS staff, Experts by Experience, patients with personal health budgets and Islington Council staff. More work is underway on a joint personal budgets and direct payments policy.

Progress

Ongoing monitoring & review lead Heidi Rossetter & Joint Commissioning

Oct 2016

Ensure that people know if there are charges for their services up-front and that people can get help to complete financial assessment forms

We co-produced new template letters in plain English for use by the Finance Department. We developed an Easy Read guide about financial assessments. We are committed to providing personalised support options for service users and carers in relation to financial assessments. This includes home visits, when required, to meet access needs.

Progress

Join up the work across the council and the NHS. We will have a shared vision and share our learning and work plans

We have shared visions and programme plans.

We achieved Integration Pioneer Status. Representatives were on both the Making it Real Board and the Integration Board. We re-organised our services to achieve care coordination and co-location of health and social care staff. Simon Galczynski continues to champion integration across Adult Social Care and the Clinical Commissioning Group.

Progress

Agree a set of ‘I’ statements that work across health & social care

We agreed usage of standard 'I' statements across physical health, mental health and social care.

Progress

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Develop options for setting up and managing a direct payment using pre-paid cards

We developed the pre-paid card option and it is now available to

all new people taking up direct payments and to existing direct

payments users who would like to take up this option.

We are committed to on-going feedback to help further develop and improve how the card works for people.

Progress

Review and simplify how we support people across health and social care. Make it simpler and quicker for service users and carers

Our co-production approach to developing policies and services

is helping us to stay focused on what is important and what

matters to service users and carers. We reviewed how our health and social care staff work together and introduced a more coordinated way of working. We trialed a new approach to assessment and support planning that is person centered and focused on people’s assets and strengths. The pre-paid card now makes financial monitoring of direct payments more simple for service users and carers. We need better understanding of how people experience services across health and social care.

Progress

Ongoing monitoring & review lead Claudia Thompson March 2017

Support people to get together and pool their direct payments. Explore how we can encourage creative pooling arrangements.

We supported the development of stronger peer support

among service users and carers by funding the Islington

Personal Budgets Network.

We are keen to explore new ways personal budget holders can

use their personal budgets –how groups of service users can

be supported to come together to purchase support collectively

and to increase the variety of support available to purchase by

personal budget holders.

The Islington Centre for Inclusive Living (CIL) will support

pooling by encouraging peer support among service users.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

Develop options for setting

up and managing a direct payment with Individual Service Funds

We are reviewing how ISFs currently work in Islington. A best practice model of direct payments support needs to be co-produced.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

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Theme 2 - Information and Advice

We said We did

Develop Easy Read and plain English guidance documents about personal budgets

We co-produced a set of simple direct payments factsheets, to support service users and carers to understand their options and responsibilities.

Progress

Develop a training programme for staff about communicating in plain English

A group of staff in Adult Social Care received accredited training in

plain English. These staff are now acting as ‘Plain English

Champions’ in their teams and supporting the development of more

accessible documents for the benefit of service users and carers.

Plain English training is included in our core training offer for staff and managers.

Progress

Develop a useful and

accessible web directory that will help people to get information about care and support locally

We developed and launched a new online service called Links for Living www.linksforliving.islington.gov.uk Experts by Experience helped to design and test the new directory. We are committed to continuous improvement and updating of Links for Living.

Progress

Review and strengthen independent support and advocacy options for service users and carers

People now have access to an independent advocate to help them

make decisions about their health treatment or social care support as

outlined in the Care Act. The Council has commissioned separate

advocacy services for IMCA (Independent Mental Capacity Advocacy)

and IMHA (Independent Mental Health Advocacy).

We will co-produce a single statutory advocacy service to support everyone entitled to statutory advocacy.

.

Progress

Ongoing monitoring & review lead: Joint Commissioning & CIL March 2017

Develop a clear advice and guidance plan about personal budgets and community based support across the council and health partner organisations

The plan pulls together other pieces of communications work within

the action plan which are already underway. This includes work

around the review of the Islington Council website and information

leaflets.

We produced a resources toolkit for local voluntary sector organisations so that they can give better advice and information about local services and social care to people they work with.

Progress

Ongoing monitoring & review lead: Joint Commissioning & CIL March 2017

Ensure that we have useful and accessible web pages about personal budgets and community based support across health and social care

An initial review of the Council’s web pages was completed with

our Experts by Experience.

We will align our work with a wider review of the website that will

happen in the next year.

We have agreed with colleagues in the Communication Department

that this work will be co-produced with Experts by

Experience.

Progress

Develop a Single Point of Contact service for information and advice about health and social care

The new Access and Advice service was set up in April 2015.

It is the first point of contact for all initial enquiries including safeguarding concerns, community physiotherapy services, speech and language therapy and the Community Rehabilitation Team. The service provides information, advice and care support for people with physical disabilities, sensory disabilities, older people, their friends and family. We are committed to ongoing feedback to develop and improve services for people.

Progress

http://www.linksforliving.islington.gov.uk/

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Theme 3 - Workforce / My support staff

We said We did

Agree what co- production, working together, means in practice, what our priorities are and how we will do it locally

We held a number of workshops with Making it Real Board members

to work on this action. We discussed this at board meetings and

proposed a draft co-production concordat. Our agreement sets out

what co-production means in Islington and our commitment to working

in this way.

Our co-production concordat has been adopted more widely than the Making it Real Islington Board. Partner organisations are actively working to implement it. The corporate plan now includes a clear commitment to co-production as a way of working across the council.

Progress

Communicate our vision to staff and service users using plain English, videos, team briefings and presentations at events

We co-produced a strong and clear Making it Real programme

mission. It is featured in our Action Plan.

We communicated our vision widely in a number of ways, including in newsletters, events and conferences. We created a short film about Making it Real in Islington.

Staff engagement was strong and knowledge of the Making it Real

programme was shared across the department.

Progress

Develop the skills and confidence of the Experts by Experience who are supporting the Making it Real programme

We provided individual and group support to develop the skills and

confidence of the Experts by Experience who are supporting the

Making it Real Islington programme.

The Experts by Experience participated in a bespoke Community

Leadership Programme that was developed and delivered by the

Head of Learning and Development, Islington Council.

Our Experts by Experience presented at local and national

conferences and are ambassadors for co-production and

personalisation. They co-facilitated staff training on asset and

strength based assessments and Whose Shoes sessions sharing

their experiences of being service users and carers.

We provided training in peer research (participatory appraisal) for the

Experts by Experience, service users and carers. We identified

opportunities for experts by experience to be involved in the Centre for

Inclusive Living and further policy and service development work once

the Making it Real programmes closes. The lessons learnt from the

experts by experience will help shape Islington’s co-production policy.

Progress

Explore ways that we can learn from complaints, compliments and suggestions

We established a new forum to learn from complaints, compliments

and suggestions. Experts by Experience were involved in co-

producing the scope, purpose and terms of reference for the new

group. They chaired the group on a rota basis. The group reviewed

and learnt from anonymous complaints. Very positive feedback was

consistently received from participants about the approach taken.

This resulted in members feeling empowered to express their

feedback.

The group co-produced a report summarising their learning.

Recommendations were made to improve the complaints and

feedback system across the department and to help secure service

improvements by learning from complaints.

Progress

https://www.youtube.com/watch?v=LVButGU5Stk&feature=youtu.be

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Look at all the learning needs of people involved in personalisation in Islington. Develop a plan that will meet any gaps in skills and knowledge

Direct Payments e-learning has been co-produced.

The Embedding Personalisation and Co-production in Practice (EPCIP) project helped to develop a learning needs analysis to support a change in ways of working for staff. Service user feedback from the EPCIP project was very positive. We need to do more work in order to apply an asset based approach to assessment and support planning, informed by the values of personalisation and co-production. More work is needed to ensure that all staff have the required skills and knowledge to ensure service users and carers receive personalised support.

Progress

Ongoing monitoring & review lead Claudia Thompson March 2017

Develop personalisation training for staff, including using Whose Shoes electronic board game

To date over 50 staff and service users have participated in Whose

Shoes workshops. These workshops are co-facilitated by a

member of staff from Islington Council and an Expert by

Experience.

Feedback from the workshops was overwhelmingly positive with

participants valuing the opportunity to discuss and reflect on issues

and challenges alongside Experts by Experience in a nonjudgmental

and supportive environment. We have now made this training

available to more people on an on-going basis by including it in our

core training programme.

Progress

Support the Islington Personal Budgets Network to develop peer support for people using personal budgets

We supported the Islington Personal Budgets Network to grow and

develop. The network held a number of events including learning and

training sessions and informal coffee mornings. The IPBN hosted the

International Day of Disabled People. 298 people attended the event

in 2015, the largest number yet!

On a small budget we supported over 20 people to apply for Skills

for Care funding and ran assertiveness, confidence building and

supervision training sessions. We had peer support sessions

throughout the year introducing people to new training and learning

as well as meeting new people. We encouraged people to share

their resources and knowledge, learning from each other. The IPBN

will now focus on establishing the CIL that will continue the legacy of

Making it Real in Islington.

Progress

Support direct payments

employers to recruit and keep good quality Personal Assistants by paying the London Living Wage

We got a commitment that Direct Payments employers will get

enough money in their personal budgets to pay their staff the London Living Wage

The direct payments team have supported Direct Payment employers

to update their support plans and staff pay rates and will continue to

do so.

Progress

Link with the Islington Employment Commission and work together to help disabled people and service users get support to access job opportunities

We held a workshop and co-produced a submission from the

Making it Real Board to the Islington Employment Commission. Future Ambition – a new employment support offer for young disabled adults has started. We are developing a trial of health-led employment support provided in primary care in partnership with the NHS. Employer engagement is focused on increasing job opportunities for disabled people.

The Centre for Inclusive Living will work with experts by experience to

help lead and shape a new Health and Work programme for Islington.

Progress

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Improve access to and availability of Personal Assistants for people with direct payments by developing a PA sharing service and a PA register

We co-produced a simple, low cost, local PA register. Opting

for a much lower cost solution is a direct result of solutions proposed by Experts by Experience and it highlights the financial case for co-production www.islington.gov.uk/pafinder The CIL will help further develop informal PA sharing arrangements. We will continue to work to improve and develop our PA finder service and increase the number of available PA’s. We will include self-funders in the work we do in this area.

Progress

Ongoing monitoring & review lead Nicola Martinez-Herrero & CIL March 2017

Theme 4 - Active & supportive communities

We said We did

Hold events to promote

peer support, Making it Real, and to raise awareness about support that is available from the council and community organisations

IPBN hosted weekly peer support meetings for three months. A joint TLAP and Islington Making it Real – Making it Happen conference was held on 22 September 2015. We supported the IPBN to host International Day for Disabled People 2015, with a record number of people in attendance.

Progress

Explore role of job

brokers to support people to job share and work flexible hours

This was completed as part of the employment commission work. The

recommendations and aspirations of the commission have been

included in the work of the Learning, Skills and Employment service.

Progress

Do some focused work on Making it Real for Carers – Check out how things are working and develop a separate action plan for carers

A small working group did some focused work in this area.

Rather than co-producing a separate action plan for carers two specific on-going actions were agreed 1. Co-produce and monitor a comprehensive carer communication plan for the carers hub, care professionals and providers and 2. Co- produce learning opportunities for carers hub, care professionals and provider.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

Promote and host

community learning and

training workshops on

Dementia, Epilepsy,

Mental Health First Aid and

expert patients programme

We hosted a meeting for the Expert Patients Programme and encouraged people to join. We linked with Dementia friends. We invited all of these groups to be part of International Day for Disabled People. We shared information about current training events for the expert patient’s programmes.

Progress

Support people to become volunteers so they can share their interests, skills and abilities, to include Timebanks

This is an action that needs more work. There is the potential for the Centre for Inclusive Living to help support this work through promoting peer support.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

http://www.islington.gov.uk/pafinder

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Inform home care organisations about personalisation and explore what this means for how they work with service users and carers

Organisations attended our co-produced Whose Shoes sessions.

We are working in partnership with home care services to hold regular service user feedback forums, to recognise and share good practice, and also to improve home care services based on service user feedback. Our personalised home care model for providers is planned to start after March 2016. We will co-produce our Local Account which will tell us how well we are doing in social care and inform future developments.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

Develop a

commissioning strategy to promote and develop peer support

Islington is committed to achieving this. There are already good examples of peer support in Islington and the Centre for Inclusive Living will support the development of the strategy.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

Theme 5: Personal Budgets

We said We did Make the Direct Payments set up process quicker and easier

We reviewed the steps in the process. Charge assessments are

now completed earlier on in the process.

We co-produced the PA Finder to help speed up the recruitment

process. We co-produced a Plain English DP

agreement to make it easier to understand the Direct Payments rules and responsibilities. We know that more work is needed to make the process quicker and easier so more service users and carers can benefit from direct payments.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017 Make sure that people know what their Direct Payments can be used for

A support planning guide was co-produced to help people plan and

organise the support that makes sense to them, based on their

strengths and goals. A plain English Direct Payments Agreement and

a series of Direct Payments factsheets have been coproduced to

outline how direct payments work. More work is needed to ensure that

support plans are focused on goals rather than specific services and

that these payments are spent more flexibly.

Progress

Ongoing monitoring & review lead Commissioning & CIL March 2017

Develop a timeline of the actions involved in setting up a Direct Payment

We co-produced a simple road map of the set up process so that everyone can understand what to expect. It focused on the key steps rather than the time taken to set up as this will be different for each person.

.

Progress

People paying for their own care will have access to advice and support

Our services have been redesigned under the Care Act. The

Information and Advice service and Direct Payments Team provides information, support and signposting for people who fund their own support. Links for Living is available to all residents. www.linksforliving.islington.gov.uk

Progress

Get feedback on people’s experiences using direct payments

We signed up to POET and completed the survey in December 2015. We received a summary report from In Control which benchmarked us against other authorities.

Progress

http://www.linksforliving.islington.gov.uk/

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Develop peer to peer

buddies to help people work through the process

The Centre for Inclusive Living will build upon the work of the IPBN. They will deliver support groups to help people to increase or regain their confidence.

Progress

Ongoing monitoring & review lead CIL March 2017 Make sure service users and personal assistants can access training

Adult Community Learning are co-producing training for potential

PA’s and Direct Payments employers.

We are co-producing a one day induction course for new and

existing personal assistants and Direct Payments employers, to

include signposting on to other training opportunities. We co-

produced a flyer outlining all local training opportunities available.

Progress

Ongoing monitoring & review lead Neil Chick March 2017 Join up and improve how we review support plans and financial monitoring

The pre-paid card supports a lighter touch approach with financial

monitoring. More work is needed to ensure that support plans are

focused on goals rather than services and that those payments are

spent more flexibly.

We will do this in co-production with Finance and the IPBN.

Progress

Ongoing monitoring & review lead Simon Galczynski March 2017

Theme 6 - Risk enablement – feeling in control and safe

We said We did

Enable staff to have

difficult conversations around crisis prevention with service users and carers. This will ensure that contingency planning is included at the assessment and support planning stages

No one training course will achieve this but it is being incorporated into all other relevant training for staff so they have the necessary skills.

We want to continue to offer a range of training for all staff and this

offer will be brought together as part of the future learning

organisation.

Progress

Co-produce training for

staff to support people with positive risk taking and making decisions

This has not been completed but will be part of the future learning organisation.

Progress

Ongoing monitoring & review lead Rene Corrie & Neil Chick March 2017 Reduce social isolation by promoting voluntary organisations and services

This is being driven by Islington’s prevention strategy and is a priority

for council corporate departments. A key priority is to encourage

people to use services that help reduce social isolation. The work is in

its early stages and will be co- produced.

Progress

Ongoing monitoring & review lead Jess McGregor March 2017

Co-develop a pathway of support to prevent carer breakdown

A small working group, including Experts by Experience, met.

Each of the members shared in initial discussions about the wider carers pathway group at Centre 404 and Islington Carers Hub. All the actions will be taken forward by Islington Carers Hub.

Progress

Ongoing monitoring & review lead Andy Murphy & Islington Carers Hub March 2017

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Co-develop a pathway of support to promote a life after caring when the caring role ends

A small working group met including experts by experience and each of the members fed-back the discussions to the wider carers pathway group at Centre 404 and Islington Carers Hub. All the feedback will be taken forward by Islington Carers Hub.

Progress

Ongoing monitoring & review lead Andy Murphy & Islington Carers Hub March 2017

222012017 Co-produce tools and resources for staff to have conversations with service users and carers around dying

Our experts by experience attended commissioned end of life

training and shared their experiences and ideas to inform future

training.

Useful written resources were collated from various teams and added to OLLIE, our online learning portal so that staff, service users, carers and personal assistants can access them.

Progress

Making it Real with the Leader of the Council, the Mayor & Mayoress, Pearly King & Prince of Finsbury & Elizabeth Jones BME at International Day for Disabled People December

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7. Wider impact

Peer Research

Four of the Making it Real experts by experience became peer researchers, together

with six other Islington service users and carers. They were supported by two Making it

Real staff team members who also participated in the training

The researchers were trained in participatory appraisal (PA) techniques. PA is a

community based approach to research and engagement that gives priority to the views

of local people, on the basis they are the experts, and are best placed to come up with a

programme of collective action. In this way, it is in keeping with the philosophy of the

Making it Real programme. Through PA, people can explore and share their knowledge

of life and local conditions, as well make decisions, and plan and carry out actions to

effect change for service users

The training was facilitated by Susie Hay www.shortwork.org.uk . It comprised 30

classroom hours learning the principles and techniques of PA, five hours of fieldwork in a

variety of settings in Islington, as chosen by the researchers, and presentation of the

findings. The training is accredited by the Open College, and all of the peer researchers

passed the course and received their accreditation in February 2016

The peer researchers completed some face to face research into the impact of the

Making it Real programme at International Day for Disabled People event on 3

December 2015

The peer researchers spoke to around 50 people in total, asking a couple of overarching

questions early in the day; later on testing out a couple of the Making it Real ‘I

statements’ they felt would be relevant to this particular audience

The full report is available in Appendix 2. A summary of the findings is below

“I have choice and control to lead an independent life”

Most of the 19 responses were positive

A range of issues were cited as evidence that things were working well, including specific services, barriers being broken down and people leading active, independent, social lives

Lengthy timescales, delays, limited accessibility of support, Personal Budgets for those with sight and hearing loss and in residential care and more general concerns including getting into employment and potential future cuts to services were all cited areas for improvement

Personalisation – what does it mean to you?

24 people responded with a range of comments

Those for who it was working well, it gave them and other disabled people independence, choice, doing things differently and having a say

For others it was too complicated, not always working in practice and not available to everyone

For a few people, the term ‘personalisation’ didn’t mean anything

“I feel safe and can live the life I want”

Nine out of the ten people who responded agreed with this ‘I statement’

Comments were positive about the local area and support services

https://protect-eu.mimecast.com/s/LKJ6BtgpAvT3

26

Nick Avlonitis & Cllr Janet Burgess MBE at the MJ Awards ceremony in June 2015

“I feel included and welcome in my community”

Ten people responded, with only two stating they did not feel included in

their communities, the other eight responded positively

Comments included some people seeing services as controlling, and some people not

having equitable access to their communities

What can Islington learn from the Peer Research?

The Peer Research indicates that some people do feel they have choice and control to lead

an independent life, that they feel safe and included in the community but that more work is

needed to ensure personalisation works well for everyone.

The research also highlighted that the impact of Making it Real needs to be wider. More

work is needed to ensure that people with sight and hearing loss and people living in

residential care can access personal budgets and personalised services.

It is clear that this one-off research has only scratched the surface as a small number of

people responded. It does tell us about some of the issues that are currently important to

disabled people in Islington and it gives us some insight into their views of personalisation

at the end of the Making it Real programme. It indicates that we need to keep monitoring

progress towards achieving the Making it Real Vision.

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Poet Survey Findings

Alongside the peer research, in December 2015, 110 personal budget holders in Islington

completed the POET (Personal Outcomes Evaluation Tool) survey. The survey asked

people about their experiences of personal budgets.

The survey was sent to 600 randomly chosen Islington residents, which represents about

one fifth of the total personal budget users in Islington.

In Control, a national charity compared the Islington data against responses from 2,144

personal budget holders in other parts of England and have used the most recent version

of the POET tool.

Islington respondents were more likely to be male, over 65 and more likely to report mental

health needs compared to respondents from other parts of England.

The results of the survey reveal the following key points about services in Islington.

See appendix 3 for full details.

What’s good about receiving personal budgets in Islington?

A greater proportion of service users receive direct payments compared to respondents

from other parts of England

A high proportion of service users have positive experiences of support planning, with

84% considering their views to be taken fully or mostly into account, 81% feeling that

their support plan includes the outcomes they wish to achieve, and 80% feeling that they

have fully or mostly achieved the outcome described. However, this was lower

compared to respondents from other parts of England

The quality of support is good or very good for almost 80% of respondents. This was

slightly lower compared to respondents from other parts of England

Personal budgets have a positive impact on the health of the service user for around

69% of people and this is similar to respondents from other parts of England

What can Islington learn from the POET survey?

Not everyone realises they are receiving a personal budget (18%) although this is higher

compared to respondents from other parts of England.

Only 36% know how much money is in their personal budget compared to 61% of

respondents from other parts of England. However we would not expect people to always

know the value of their personal budget if it’s a service organised or commissioned by the

council. 53% said they have good or very good access to information about different support

options and this is similar to respondents from other parts of England.

15% employ a personal assistant, which is lower compared to respondents from other parts

of England. Is this because a personal assistant wasn’t needed for many of the people

surveyed? Or is it because people don’t have enough information and support about how to

employ a personal assistant? We know that more good information about support options is

crucial.

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These points indicate that lessons could be learned about the overall quality of information

provided to service users receiving personal budgets. We will continue to promote direct

payments take up by reviewing local direct payments information, providing on-going staff

training and ensuring service users and carers have access to peer support as highlighted

in the action plan.

65% believe they have very good or good levels of choice and control in their support, a

slightly lower proportion than people in other parts of England (71%). More than half of the

respondents didn’t feel that the personal budget was helping improve access to

relationships, friends and family, to work training and leisure and to their ability to engage

with the wider community. The results show that we need to do more to improve access to

the wider community, work, training and leisure.

The survey is worth building on over the coming years, to see how the picture might change.

It gives people an opportunity to share details of their experience with personal budgets more

than any of the other surveys.

Making it Real Experts by Experience complete the Community Leadership Programme August 2014

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8. Recommendations and next steps

Keep co-production at the heart of everything we do

We will embed the learning about co-production in the development of the Centre for

Inclusive Living (CIL).Our aim is for there to be meaningful service user involvement

and co-production in all levels of the service from overall design, specific delivery, to

individual users and the organisations governance. The aim is for the CIL to be regarded

as an important local service in Adult Social Care and a national best practice example

of a co-production approach in commissioning, service development and delivery

We will explore how all funded and commissioned services can sign up to the MIR

concordat and principles of personalisation as more work is needed

We will include co-production and personalisation into staff appraisal objectives for

2016-2017

We will co-produce our Local Account in 2016-2017 in line with the co-production

concordat principles

Monitor and Review progress towards the Making it Real vision

We will continue to check the list of outstanding actions with the named leads for

progress and to check each action is being co-produced

We plan to hold an annual ‘recall conference’ and reconvene the Making it Real Board to

review further progress towards personalisation and Making it Real in Islington. We will

ensure housing and home providers are represented

We will set up arrangements to support the trained peer researchers to be able to

undertake more peer research in Islington. They will be housed within and supported by

the IPBN

We will explore the option of participating in future POET surveys so we can check

progress on the experience of personal budgets

We will work with Healthwatch to conduct ‘mystery shopping’ events to check how

services are working in personalised ways

Continue to support the workforce to change

We will establish a learning organisation. This will support organisational cultural change

and will help to ensure the workforce has the knowledge and skills needed to deliver

personalisation and more joined up health and social care

We will use the tools we have co-produced to help with the induction of new staff and

development of existing staff, such as the Making it Real Video

We will develop a plan to embed a strengths based approach into our service delivery

model in Adult Social Care. This is to support a focus on what people can do and to

build on people’s skills, knowledge and strengths

We will embed ‘Whose Shoes’ training into the Learning and Development programme,

so that Whose Shoes workshops will be a fixed offer in the Learning and Development

calendar. Whose Shoes board games have been purchased and Experts by

Experience have registered interest in being co-facilitators

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Further encourage peer support and community inclusion

The Islington Personal Budgets Network is a well-established peer support network for

people who have a personal budget or personal health budget, carers and people who

manage a personal budget on behalf of someone

Islington will support the IPBN to develop and begin providing services under the Centre

for Inclusive Living. The Centre will remain independent from the Council

The Centre for Inclusive Living will have a strong emphasis on community inclusion and

citizenship and will provide a range of information and services related to peer support,

personal budgets and direct payments

We will encourage and embed peer support and on-going engagement opportunities for

the Experts by Experience from Islington Council. The Experts by Experience have

developed their own peer network post March 2016 and the council will provide updates

on Learning and Development and engagement opportunities

9. Conclusion and closing statement

We said we would make it real and we are, together. It is still early days in what developed

into a significant change management programme. The Making it Real programme has

made significant progress towards meeting the commitments outlined in the Making it Real

Islington Action Plan and vision.

The key legacy of Making it Real is co-production. The Board and namely the Experts by

Experience have ensured that working together is now both valued and prominent across

Islington council and its partner organisations.

The CIL will now continue the work and vision of Making it Real. The CIL will be based on

the principles of independent living and co-production and include a range of services

related to peer support, personal budgets and direct payments.

It is only fitting for an expert by experience to have the final say.

I was initially skeptical about the role of the Making It Real Board. What did 'Making It Real' really mean?

Were 'personalisation', 'co-production' and 'Think local, act personal' anything more than fashionable buzz

words and aspirational slogans?

But after more than a year and a half on the MIR Board I am convinced that it represents a genuine attempt

to kick start and reinforce fundamental changes in the culture of adult social care and health services in

Islington. It has raised awareness of the essential role of the service user in shaping policy and practice. It

has illustrated in practical ways how co-production can enhance the personalisation agenda. And it has

begun to show how adult social services, the local health service and the voluntary sector can work together

to design and deliver more effective user-centered services.

But this is just the beginning. These changes need to be accepted, absorbed and embedded within the

health and social care services. Hopefully this will be one of the legacies of the Making it Real Board.

Certainly it will be a major challenge for the future. John Thomas, Expert by experience

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10. The Board Alison Greenhalgh Head of Social Work & Social Care, Camden & Islington NHS

Andy Greene Disability Action in Islington

Andy Murphy Chief Executive, Age UK Islington

Barry Garnham Expert by Experience

Bola Gboyelade Expert by Experience

Chika Wogu Case Manager South Social Care & Rehabilitation Team

Clare Henderson Programme Director Integrated Care, Islington CCG/LBI

Claudia Thompson Assistant Director of Assessment and Personalisation, LBI

Cllr Janet Burgess MBE Deputy Leader and Executive Member for Health & Wellbeing

Deborah Wright Head of Social Work and Social Care, Camden & Islington NHS

Dr Katie Coleman Vice Chair, Islington CCG

Fiammetta Schofield Expert by Experience

George Howard Associate Director, Joint Commissioning, Islington CCG/LBI

George Topping Expert by Experience

Ginny Sell Programme Manager, Hillside Club House

Jenny Mackley Deputy Team Manager, Islington Learning Disabilities Partnership

Jess McGregor Assistant Director, Strategic Commissioning

Jim Beale Service Lead, Islington Learning Disabilities Partnership

Jo Mackie Centre 404

John Thomas Expert by Experience

Laura Gordon Service Lead, Islington Learning Disabilities Partnership

Linda Wan Commissioner Islington Council

Liz Mercer Islington Carers’ Hub Manager

Maisie Heather Expert by Experience

Mandy Woods Mental Health Social Worker

Marilyn Nikkie Bello Expert by Experience

Mick Havens Expert by Experience

Neil Chick Learning and Development Manager, LBI

Nick Avlonitis Expert by Experience

Niroo Patel Expert by Experience

Pat O’Driscoll Mind

Paul Davies Expert by Experience

Ramesh Logeswaran Senior Commissioning Manager- Older People, LBI

Robbie Rainbird Head of Processing Services, LBI

Rose McDonald Healthwatch

Rosemary Lamport User & Carer Initiatives Manager, LBI

Sandy Marks Co-chair

Sara Little Commissioning Lead and Project Manager for NHS CHC

Simon Galczynski Co-chair

Sita Chitambo District Nurse

Sophie Partridge Expert by Experience

Stephanie Earnshaw Centre 404

Steven Pruner Commissioning Manager, Continuing Healthcare

Theresa Rattigan Case Manager North Social Care and Rehabilitation team

Theri Thompson Service Lead, Social Care & Rehab Service

Tony Bamforth Chief Executive Elfrida

Valerie Garnham Expert by Experience

Victoria Gedge Social Worker, Islington Learning Disabilities Partnership

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Programme Team

Andrew Richardson Project Manager

Mary Keats Project Manager

Jayne Moran Programme Support

Thank you to all board members, partner organisations, staff, volunteers and supporters who helped to Make it Real in Islington.

11. Appendices

Note: Appendices embedded as attachments are not available in the PDF version of this document.

Appendix 1 Islington’s Making it Real Action Plan Available at www.islington.gov.uk/makingitreal

Making it Real Islington Action Plan

Appendix 2 Peer Research summary report

Peer Research findings.pdf

Appendix 3 The POET Survey Data Report February 2016

POET local report

2016 - Islington.pdf

12. Contact information

www.islington.gov.uk/makingitreal www.ipbn.co.uk

http://www.islington.gov.uk/makingitrealhttp://www.islington.gov.uk/makingitrealhttp://www.ipbn.co.uk/

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13. Partners