ISF PILOT IN
SOUTHAMPTON
ISF Evaluation Report
2014
Written by: Southampton Mencap, 187a Portswood Road, Southampton, SO17
2NF
12/1/2014
ISF Pilot Evaluation Report [Southampton Mencap element] 2014
1. INTRODUCTION
Southampton Mencap strongly believes in the personalisation of services and strives at all
times to design and deliver cost effective and quality services. The organisation fully backs
the principle that personalisation is a key driver for health and social care to support people
who have care and support needs to achieve the outcomes they want in their lives, in ways
that best suit them.
SCC already purchases services from Southampton Mencap which have all proved to be of
good quality and value and, alongside its registration on the Support with Confidence
Scheme in 2013, the organisation was delighted to be involved in the Individual Service Fund
[ISF] pilot with Southampton City Council
This one-off “Demonstrator” pilot explored the introduction of an ISF service as a delivery
mechanism to facilitate personalisation in Adult Social Care. Two organisations were
involved in the “Demonstrator” - Southampton Mencap and Spectrum who both helped SCC
to explore different models of an ISF to enable a full “compare and contrast” evaluation.
Southampton Mencap offered the service to adults with learning disabilities and Spectrum
offered it children with Special Educational Needs and Disabilities [SEND]; this element was
also specifically connected to the SEND Pathfinder Pilot scheme.
Southampton Mencap ran the ISF Pilot for 15 months from 1st March 2013 to 31st March
2014 [with an extension of funding to the end of June 14], with the purpose of identifying:a) The specific benefits (or dis-benefits) of an ISF for customers, family carers, providers
and the Council;
b) Customer demand for an ISF;
c) The costs of delivering an ISF.
Outcome measures included the evaluation of the impact of ISF on: Customer choice and control over services;
 Customer and carers satisfaction;
 Culture change in relationships between customers, provider and SCC;
 Service costs;
 Progression to a full Direct Payment for people with a learning disability.
Information was also collected during the course of the pilot to inform an assessment of: The potential future demand for ISF;
 The impact of ISF on the likelihood of progression to a full Direct Payment.
The eligible participants for the pilot were customers of the Mencap “Own2Feet” day
service programme.
The following were the achievements of the pilot:a) A minimum of 4 ISF’s were established by April 2013 – up to a maximum of 7 in total
during the life of the pilot;
b) 3 consultation/briefing group sessions on ISF were held for participants and their
family carers;
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
c)
d)
e)
f)
g)
h)
i)
Structured feedback was collated from all parties (pilot start, mid-point and end);
100% of participants and their family carers agreed that the ISF information
materials were accessible, and that a person-centred approach and co-production
had governed the development of the ISF;
Mencap worked collaboratively with SCC to create a range of formal agreements and
protocols for use between SCC, Providers and individual participants;
Individualised support plans were developed for all participants;
A “Step-by-Step” Guide was produced jointly between Mencap and Spectrum for
other providers on creating and delivering the ISF offer;
An “interim” Report on progress, finances and findings was produced in August
2013;
An Evaluation Report was made available at the end of the pilot.
The grant available covered both the up-front planning and development of the pilot as well
as the delivery costs. Southampton Mencap produced a clear cost analysis and separation of
the development activity from the service delivery activity – so that the future cost of
running an ISF service offer was more accurately ascertained.
The pilot was able to start immediately as a staff team with a clear understanding of the
way forward and the work involved was in place.
2.
THE PROJECT
In the ISF pilot, Southampton Mencap managed the participants Personal Budgets rather
than the Council and provided most of the direct support services to individuals. Mencap
was accountable to the Council and the participant for spending the Personal Budget in
accordance with the Support Plan, which included purchasing services from other providers
on behalf of the individual. The participants were enabled to have as much of a say as
possible about any support provided.
3. STAFFING FOR THE PILOT
a)
b)
c)
d)
Alexandra Iles, Mencap CEO
Brian Strevens, Mencap Trustee
Jennifer Strevens, Mencap Trustee managed the financial aspect of the pilot
Project Staff drawn from Mencap’s experienced operational staff
4. MANAGEMENT
a) Mencap’s Board of Trustees/Directors took a keen interest in the pilot and
received full reports at quarterly meetings.
b) A Project Steering Committee worked closely with SCC’s designated officer to
monitor progress in line with the set outputs and targets and to ensure that all
relevant data was being recorded and collated as agreed.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
c) Regular meetings with the designated council officer during the entire pilot
period ensured that all staff engaged in the pilot were adequately supported,
directed and monitored.
5. FINANCE
a) Systems and processes were established to ensure that individual participants
were in receipt of accurate information concerning their purchased services on a
monthly basis.
b) Accounting procedures were put in place to record receipts and payments as well
as identifying core demonstration pilot costs.
c) David Mant, Mencap auditor from Abraham and Dobell Chartered Accountants
was engaged as part of the setting up process.
d) A unit cost of providing the service was available at the end of the pilot.
[See Appendix B – ISF Financial Aspects]
6. PARTICIPANTS
Southampton Mencap’s Own2Feet programme was seen as an ideal vehicle to “test out”
the practical issues involved in working differently in an ISF- to enable participants to
achieve maximum choice and control over services.
The pilot was of benefit to all participants and their family carers who were individually
supported to explore personalisation in a practical, structured and supportive way.
Evidence was collated during the development of the pilot which clearly demonstrated that
participants and their family carers are confused about the various options of a Personal
Budget or a Direct Payment. Whilst wanting opportunities to understand all the issues,
choices and responsibilities in taking more control, they needed the support to explore this
at their own pace, with time and structured support available through an already trusted
source. Offering an ISF to Own2Feet participants enabled them to have direct practical
experience of more choice and control without jeopardy to the service they were receiving.
Southampton Mencap worked with 7 participants; 6 of these were receiving a “managed
account” service from SCC and 1 in receipt of a direct payment but felt no longer able to
manage this and offered an ISF to each of them. There was an additional participant from
the “Own2Feet” programme already receiving a Direct Payment – and it was possible to us
him as the “control” steer for the pilot.
The pilot offered support planning, brokerage and personal budget account management.
This included the establishment of the necessary individual recording and accounting
systems to report to participants and to enable an analysis of the cost to Mencap in
delivering this service. All actions were recorded in detail and it was possible to work jointly
with Spectrum to produce a “Step-by Step” Guide to inform other potential providers. The
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
pilot tested the premise that any additional costs of an ISF can be factored as a set charge
per head.
The principles of person-centred working and co-production governed service delivery and
all ISF materials were adapted in accessible formats. Consultation meetings/briefing
sessions for participants and their carers were held, as well as specifically collating feedback
from all parties at the start, mid-point and end of the pilot.
Mencap provided an “Interim Report” on the pilot in Aug 2013 and this is the final
evaluation report.
[Appendix A gives details of the 7 participants with the outcomes at the end of the pilot]
7. END OF PILOT
The Pilot Project ended as of 31st Aug 2014. Although this was a small pilot consisting of 7
participants, the good cross-mix of individual circumstances tested out what would, and
would not work, in an ISF.
16 different organisations were involved in providing services to the 7 participants, which
was again made up of a cross-mix of small independent providers and national providers.
Although most of the participants already knew and trusted Mencap as the ISF Provider
most of the other organisations had not worked with the organisation before.

In Summary
Despite its size, the completion of the pilot has provided clear evidence of a positive
customer demand for ISF. Southampton Mencap worked closely with SCC to ensure the
transition was as smooth as possible with 4 participants transferring back to an SCC
“managed account” and 3 opting for Direct Payment with one in a position to take this on
immediately and the other 2 requiring interim on-going support from Mencap. Reviews
with their family carers were conducted jointly with Mencap and a Care Manager before the
closure of the ISF. Mencap will also liaise with Spectrum DP Support Services and signpost
them across for additional support as relevant. If the desire is for Mencap to continue to
provide a Third Party Account service this will have to be funded from the individual’s own
resources. [See Appendix A]
8. SUCCESSES
Through this project, participants and their family carers benefited from more choice and
control over the care and support services they received. Guidance was made available,
tailored to their individual needs to better understand their agreed support package and
exactly how much money was available to them. Participants received support to deal with
any concerns or make changes to their services, and person centered Support Plans have
been developed with their full cooperation. All money matters have been managed by
Mencap on their behalf; client contributions toward services have been directly invoiced
and providers of services accessed by participants have been paid directly by Mencap. In
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
summary, all participants have benefited through having more flexibility, choice and control
over the budget awarded to meet their assessed support needs.
Care Managers felt very positively about the pilot and as their involvement was only
necessary where any significant changes were concerned, this helped them to gain back
time to help with their other clients. The pilot also enabled the Local Authority to better
understand what changes were necessary to its processes and systems in order to
encourage more people to receive direct payments and for this to take place effectively.

In Summary
a) Participants and their family carers reported experiencing an increase in choice and
control over services, and overall increased customer satisfaction because of being in
an ISF.
b) Other service providers to the ISF customers completed a survey about their
experience – and gave a universally positive response. In particular, 63% of
respondents identified a specific business benefit of working with an ISF provider i.e.
saving time/money.
c) Care Managers submitted feedback on their experience of the ISF and an 86%
response rate was achieved! Of those respondents – 83% identified a specific benefit
to themselves in terms of time being released from dealing with day-to-day queries
on a care package, so that more time was available for other casework, assessment
and reviews. All made positive comments about the ISF.
d) Participants and their family carers experienced culture change, e.g. a personalised
purchaser; provider relationship between themselves and Mencap, because they
paid their Client Contribution for services directly to Mencap.
e) Several participants and their family carers indicated that they would now positively
consider taking a Direct Payment as the next stage of their experience of
personalisation.
[Appendix C provides further details on all the above]
9. COMPLICATIONS
a) There were many financial challenges during the course of the pilot
b) Changing all the computer records/programmes that help the Council agree what
services each person is receiving, how much each person should pay towards those
services, and how /when to pay the organisations providing the services was
challenging, complicated and time consuming. The pilot proved that some of the
Council’s computer systems do not easily “talk” to each other.
c) Some providers continued to send invoices to the Council instead of Mencap which
took time and effort to sort out.
d) Additional problems over Value Added Tax (VAT) in an ISF were discovered as VAT
liability was not an issue on SCC ‘managed’ accounts.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
e) There was confusion over the Client Contributions and an automatic process to
resolve these needs to be in place; although highlighted in advance and supposedly
addressed, this was not implemented
f) Many of the care packages were not accurate
g) A separate bank account was set up to receive the ISF payments, but SCC continued
to pay these into the main Mencap account
h) The slow start of the pilot as a result of the above impacted on the potential to
increase the number of participants as it became difficult to promote due to its short
term nature.
i) There was a need to maintain confidentiality due to the huge variance in individual
packages
j) Mencap contributed a significant amount of time to this project, particularly as
specific, initial and intense support was needed, and it is this goodwill from the
organisation that led to the success of this project.

In Summary
The findings / learning from the Pilot demonstrated clear evidence of a positive customer
demand for ISF. In a relatively short space of time it was possible to find 7 willing
participants. There was more interest shown toward the end of the pilot but with at least 4
new referrals from Care Managers, it was necessary to put these on hold as it was deemed
inappropriate due to the uncertainty of whether the pilot would continue beyond June
2014.
[See Appendix B – ISF Financial Aspects]
10. WHAT HAPPENS NEXT?
The Council has indicated that more work is necessary before an ISF can be offered on a
wider basis and consideration given to the best and most cost-effective way of introducing
ISF options to clients. An initial analysis of the cost to SCC of having a provider offer an ISF
compared to managing it themselves has shown that whilst the costs are broadly similar
there are additional complications with the VAT Liability.
SCC’s People Directorate Management Team (DMT) has recommended that work should
continue to confirm costings, establish legal Agreements etc. so that ISF can be offered on a
wider basis.
The learning from the ISF Pilot will be shared with Southampton City CCG to contribute to
the development of the Personal Health Budget offer.
Southampton Mencap will continue to offer a chargeable ISF service to clients on request.
If you have specific questions about the ISF Pilot please contact Alexandra Iles on
alex@southamptonmencap.co.uk or on 023 80 584088
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
If you would like to be kept in touch with the Council’s “next steps” –please contact: or
Madeleine Cato on Madeleine.cato@southampton.gov.uk or on 8083 2391.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
APPENDIX A - ISF PILOT PARTICIPANTS
Name
Other services
Start Date in
ISF
08.07.13
Type
1
Applicant A [DT]
Male: 20 years old
Previously on an SCC
“managed” account.
Care Agency
2
Applicant B [KCG]
Male: 21 years old.
Previously on a Direct
Payment.
Care Agencies
Respite
Day Activities
Payroll Services
Physiotherapy
Transport
02.09.13
Full ISF
(total care package at
net value transferred
into ISF account)
Carer was able to
take on the Direct
Payment through
improved
processes and
procedures
3
Applicant C [EC]
Female: 25 years old
“Shared Lives” service
Day Activities
Transport
30.09.13
Full ISF
(total care package at
net value transferred
into ISF account)
4
Applicant D [PH]
Male: 32 years old
Previously not
accessed any services.
Family finding it
difficult to provide
total support.
Day Activities
Care Agency
30.09.13
Full ISF
(total care package at
net value transferred
into ISF account)
We were
informed that as
this was a Shared
Lives placement a
DP could not be
taken
Continues with
ISF for 6 months
to support carer
through the
transition of
taking on a DP
5
Applicant G [NR]
Male: 19 years old.
Transition into ASC
Care Agencies
Respite
Day Activities
28.10.13
Full ISF
(total care package at
net value transferred
into ISF account)
6
Applicant D [AP]
Male; 28 years old.
Previously on an SCC
“managed” account.
Not utilising all
aspects of care
package.
Applicant F [GM]
Male: 33 years old
Previously on an SCC
“managed” account.
Day Activities
Transport
Respite
28.10.13
Split package ISF
(Some monies retained
and “managed” by SCC
e.g. to pay staff,
escorts.)
Day Activities
Respite
23.12.13
Split Package ISF
(Some monies retained
and “managed” by SCC
e.g. day services.)
7
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Full ISF
(total care package at
net value transferred
into ISF account)
Outcome at end
of ISF Pilot
Reverted back to
a SCC service
managed account
Continues with
ISF for 6 months
to support carer
through the
transition of
taking on a DP
Reverted back to
a SCC service
managed account
Reverted back to
a SCC service
managed account
ISF Pilot Evaluation Report [Southampton Mencap element] 2014
APPENDIX B – ISF FINANCIAL ASPECTS
1. Setting Up Procedures.
a. Ideally a totally separate accounting system should be set up
i. Separate bank account;
ii. Separate software or software with different cost centres;
iii. Separate trading company if possible.
b. All providers of services must be informed of the arrangement.
c. Clients must ensure that
i. Anyone employed by them directly pays PAYE and if necessary NI.
Help can be given to
1. Either act as an agent for PAYE or
2. Find a suitable agency to provide this service.
ii. Anyone claiming expenses provides receipts which have been
authorised by the client. Systems should be set up to ensure this.
d. Client contributions must be agreed and a system set up to collect these.
e. Agreement should be reached about the payment of VAT where this is
charged by the provider.
2. On-going Procedures
a. Changes in the client contribution should be confirmed with the client and
the council. This usually happens in April each year, but can occur at any
time. A system needs to be in place by which the agency is informed by the
Care Manager, not just the client.
b. Providers sometimes need a reminder to submit invoices as some submitted
these very late.
c. Monthly statements did not give an accurate picture as many invoices had
not been received by the end of the month.
d. Quarterly statement issued about 6 weeks after the end of the quarter would
be more accurate and much more feasible to produce.
e. Agreement should be reached with the care managers about use of surpluses
and whether these should be allowed to build up.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
f. A close watch needs to be kept on the payments received from the council as
experience has shown these were not always accurate.
3. Closing Down
a. At least 2 months’ notice should be given of the intention to close/transfer
the account.
i. Providers need to be informed;
ii. New arrangements have to be in place;
iii. Accounts have to be finalised;
iv. It will take about 6 weeks to transfer any remaining money as invoices
are often submitted in arrears.
4. Problems Encountered
a. Setting Up
i. Although a separate bank account was set up and SCC was given bank
details, payments continued to be made into the Mencap main
account;
ii. Everything would have been much easier if dedicated financial
software had been purchased. This would be done if Mencap was to
take on ISFs on a larger scale;
iii. Although kept as a restricted fund, the ISF money for clients was
shown in Mencap accounts giving the false impression that Mencap is
not in need of grants/donations;
iv. A great deal of work went into ensuring that cash payments made to
casual help/care given were properly accounted for;
v. In one case a PAYE system was in place, but the fact that employees
would be taxed prevented respite being used;
vi. VAT was not included in some of the care packages and some
providers charged VAT. Whilst SCC can claim this back Mencap
cannot. This made the cost of care 20% greater in some cases. SCC
has since paid the total VAT involved to Mencap.
b. On-going
i. Some changes in client contributions were incorrectly notified to
clients. The correspondence relating to this was given to Mencap. It
is thought that in one case the client did not inform Mencap when
this letter was corrected.
ii. One provider was very late submitting invoices and the last period
covered was to 15 June 2014.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
iii. SCC made several incorrect payments during the course of the pilot.
These were corrected but it took a meeting with the SCC finance
department. Carers wishing to take a Direct Payment might have
more trouble. It is quite difficult to spot the errors as calculations are
made per week and payments are made per calendar month.
c. Closing Down
i. The end of the pilot was officially 30 June, but no real preparations
had been made in time for this to happen;
ii. The end of the pilot was finally 30 August, but SCC continued to make
ISF payments to Mencap in September. A correction was made to
this in October but double the money was taken from Mencap’s main
bank account. Errors continued to be made in November. This
created a huge amount of work trying to sort out correct payments
and transfers.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
APPENDIX C – EXTRACTS FROM STAKEHOLDER SURVEYS
1. CUSTOMERS AND CARERS HAVE DECLARED EXPERIENCING AN INCREASE IN CHOICE
AND CONTROL OVER SERVICES, AND OVERALL INCREASED CUSTOMER
SATISFACTION BECAUSE OF BEING IN AN ISF
Of those respondents who had previous experience of working with ASC, 100% said the ISF
was a better experience, e.g. people felt better informed and more involved in discussing
/agreeing services and activities; and they had more choice and control over how their PB
was spent, “We had previously never even seen a bill from anyone!”
A key factor for the carers/family was the accessibility of Mencap e.g.
a) “Much easier to access by email or phone to answer a question”
b) “Easy contact is the most beneficial difference”
c) “I feel I can approach Mencap if I have any problems or questions”
SCC has collated specific feedback from Care Managers about their perception of the impact
of ISF for their clients.
An 86% response rate was achieved, of which 100% commented that the experience had
had a positive impact for the client, e.g.
a) It has been well organised and we were impressed with how smoothly the transition
in the ISF arrangement happened"
b) “It takes all the worry out of it for the customer – but they still have some choices
and
control.”
c) “The customer is a completely different person in terms of his mental health which
has had a positive effect on his carers. The family are happy with the ISF service they
have experienced and this was fed back at review.”
d) “The ISF gave more control and choice to the customer and the family throughout the
process.”
e) “Really gone well - and a big help to XX (Carer) who was struggling to manage.”
f) “My particular case has been very positive in general throughout.”
2. CULTURAL CHANGE/PRACTICE CHANGES
Payment arrangements between Mencap and other Providers
63% of Providers declared a specific business benefit to them of working with an ISF
Provider i.e. saving time /money. Provider comments have been universally positive e.g.
g) “It has been well organised and we were impressed with how smoothly the transition
into the ISF arrangement happened.
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ISF Pilot Evaluation Report [Southampton Mencap element] 2014
h) “We were cautious about this new arrangement as our general experience of
previous changes has not always been positive – but we had initial contact from the
Council to explain it all and it’s been fine.”
i) “We have had no problems at all with this arrangement.”
j) “Previous experience with SCC involved more than 6 phone calls and 4 emails in
respect of a delayed invoice payment.”
Care Manager and Provider relationship:83% of Care Managers declared a specific benefit to them in terms of time being released
from dealing with day-to-day queries on a care package, so that more time was available for
other case work, assessment and reviews, e.g.:a) “My case involved contact when setting up the package and then there has been no
need for further contact due to smooth running of the package in the ISF”.
b) “Reduces contact with Providers, minimises the brokerage side of the suppo9rt
planning aside from necessary reviews etc.”
Care Managers also declared needing to spend less time on day-to-day queries from
customers, e.g.
c) Mencap has put in 1:1 time that has saved so much input from SCC staff time that
might not have been as effective, because of the way customers’ perceive their
relationship between themselves and SCC.”
“Queries dealt with by ISF so reduces the level of input required by me.”
Examples of other comments ASC Care Managers gave about their experience of the ISF
Pilot:d) “I wish I had more of my clients on an ISF”
e) “In my experience, it has been very well organised and was quick to set up once the
paperwork was completed. There haven't been any problems.”
f) “My experience has been a positive one.”
g) “I hope ISF continues and that SCC should maintain it and continue its funding beyond the
Pilot. Other local authorities I have worked in have similar schemes, it works, it supports
families to sustain their care packages and it supports the uptake of Personal Budgets. As a
care manager it supports me in reducing the support required from myself and therefore
releases my time for other cases.”
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