Self Directed Support Jim Pearson
What is Self-Directed Support? Self-directed support (SDS) is a way of organising social care; SDS is part of the mainstream of social care delivery, It is puts the principles of independent living into practice so that people can take control of their lives SDS enables people to be active citizens (with full range of human rights)in their communities. It is about flexibility, choice and control and having a decent quality of life.
Core Principles of Independent Living • Choice, Control, Freedom, Dignity, Enablement, Empowerment, Fairness, Inclusivity • These principles are compatible with internationally agreed principles of human rights known as PANEL • Participation • Accountability • Non Discrimination • Empowerment • Legality
Potential benefits of SDS for Carers • allowed more flexibility about the care they provide; • carer can choose to access fewer support staff with greater continuity, communication and consistency; • carer can achieve a better balance in their life beyond caring role, sustaining the carer in employment, or • chance to see the individual they care for enjoying greater opportunity and an enhanced quality of life.
Background & Related Developments • Changing Lives: Report of the 21st Century Social Work Review • Self- Directed Support: New National Guidance • Draft Self Directed Support Strategy for Scotland • Self Directed Support Bill • Scottish Ministers have also committed to: • National Dementia Strategy • National Strategy for Carers • Reshaping Care and Support for Older People
Barriers to Self Directed Support • Barriers include • lack of knowledge and understanding • prevailing culture and attitudes • assumptions and attitudes about the characteristics of people who may benefit from them, • limitations on the use of the allocated budget • to some extent a vested interest in the status quo • existing social care framework (eligibility criteria and thresholds)
Draft Self Directed Support Strategy for Scotland • Draft SDS Strategy • recognises that financial pressures, and demographic changes mean that improved outcomes cannot be delivered with more of the same. • responds to increasing interest in reshaping care and support in Scotland. • aims to drive a cultural shift around the delivery of care and support (seeing people as consumers of services as opposed to service users, as equal citizens with rights and responsibilities). • recognises that a 10 year vision is needed now to deliver social care that is fit for the future. • makes 26 recommendations
Draft Bill on self-directed support • Draft Bill proposes • consolidating and updating existing legislation on direct payments. • introducing and defining the term self-directed support into statute, • providing a legislative framework that would allow extending direct payments in the future (NHS funding) • self-directed support to be provided on an opt-out as opposed to an opt-in basis. • considering expanding the categories of persons who can receive direct payments on behalf of an adult with incapacity. • remove the restriction to direct payments and other forms of self-directed support for people with mental health problems • considering options to amend or remove the restriction on the use of direct payments for the purchase of residential care • remove the restriction placed on local authorities to provide direct payments or other forms of self-directed support to unpaid carers
Self- Directed Support Strategy(test sites) • Three local authority test sites • Glasgow • Dumfries and Galloway • Highland • Test site themes • cutting red tape, • investing to save, • leadership and training • NHS & Lothian Council • Project aimed at ensuring use of health board monies in SDS packages
Legislative Framework • The Social Work (Scotland) Act 1968 • The Community Care (Direct Payments) Act 1996 • Regulation of Care (Scotland) Act 2001 • Community Care and Heath (Scotland) Act 2002 • The Community Care (Direct Payments) (Scotland) Regulations 2003 (SSI 2003 No. 243) • The Community Care (Direct Payments) (Scotland) Amendment Regulations 2005 (SSI 2005 No. 114) • The Mental Health (Care and Treatment) (Scotland) Act 2003 (Modification of Subordinate Legislation) Order 2005 (SSI2005 No. 445) • The Disability Equality Duty (DED) • National Health Service Reform (Scotland) Act 2004 (asp 7)
Individual Budget Funding Streams • Local authority care budget • Funding for equipment and temporary adaptations • Supporting People • Free Personal Care • Independent Living Fund • Health monies to meet continuing health needs.
Independent Living Fund (ILF) • To qualify for ILF, the person must: • get at least £340 worth of support a week from social services. This can include direct payments; • get the higher rate care component of Disability Living Allowance (DLA); • be at least 16 and under 65 at time of application. (ILF funding can continue after the persons 65th birthday as long as you still meet all the other conditions; • be living in the United Kingdom (UK); • have less than £23,000 in savings/capital (this includes any money your partner has. • From 1 May ILF has new priorities • maintaining support to existing recipients of ILF • support those in work for at least 16 hours per week. • new applications will only be accepted from applicants in paid work of at least 16 hours per week
Who can get self-directed support? • Those eligible for SDS include • Disabled adults assessed as requiring community care services including housing support services • Older people aged 65 years (assessed as needing community care services)
Managing self directed support A person • should be able to arrange support and manage funds, or • have someone authorised to do it for them (e.g. an attorney or guardian) • SDS should not be refused on basis of needing help to manage it now or in the future. SWD must consider what help is needed.
Help to manage self-directed support Help could include • advocacy • communication support • record keeping • pay roll service • good employment practice • managing self-directed support on an ongoing basis even through periods of fluctuating or deteriorating condition.
Ability to manage self-directed support • Where the authority decides, in exceptional circumstances, that a person is unable to manage self-directed support, • The reasons for the decision must be communicated in writing. • The Authority should also make the individual aware that they can use the complaints procedure to challenge the local authority’s decision not to offer self-directed support.
Consent and Capacity Issues • Almost any disabled or older person should be able to get self-directed support if they choose it. • Eligible people must give their consent to do so, or if they evidently lack the capacity to do so, consent can be given by an attorney or guardian. • Appropriately trained advocacy workers should be made available to support people effectively through the process. • Cognitive impairment of any kind should not be a barrier to a person having more, or more effective, control of their lives.
Employing Family Carers as Personal Assistants • Current rules only allow this • “…where securing the service from such a person is necessary to satisfactorily meet the service users assessed needs.” • This could provide best outcomes, for example when: • a person requires end-of-life care • there are limitations in the availability of suitable service providers, for example, in rural or remote areas • it is considered to be the most appropriate way of meeting an individual‟s cultural needs • a feature of the person’s disability is challenging behaviour towards strangers.
Service user contribution: Charging Policies • Section 87(a) of the Social Work (Scot) Act 1968 enables the local authority to require the individual (except those eligible for free personal care) to make a financial contribution to the cost of any services need to meet their assessed needs. • People using self-directed support are charged in the same way as those using the authorities’ equivalent services. • The individual budget can therefore consist of a combination of an individual’s own contribution, a contribution from the local authority, and money from funding streams such as the ILF which are not means tested.
Useful web links • http://www.ilf.org • http://www.socialworkscotland.org.uk/index.php • http://www.scotland.gov.uk/Resource/Doc/181224/0051499.pdf • http://www.mentalhealth.org.uk/publications/?EntryId5=76412 • http://www.scotland.gov.uk/Publications/2008/05/30134050/0 • http://www.selfdirectedsupportscotland.org.uk/
Glasgow Centre for Inclusive Living 117-127 Brook Street Bridgeton Glasgow G40 3AP Phone: 0141 550 4455 Email: email@example.com Website: http://www.gcil.org.uk East Dunbartonshire Direct Payments Support Service Suite 1 Enterprise House Southbank Business Park Kirkintilloch G66 1XQ Phone: 776 2219 or 776 6342 Fax: 0141 776 2219 Email:firstname.lastname@example.org Website: www.eddpss.co.uk Support Services in Glasgow and East Dunbartonshire