Self Directed Support What does it mean The Theory and the Practice Speaker: Ian Hood
Have you got a Direct Payment already? • Yes • No
If you haven’t got one, do you want one? • Yes • No • Maybe
If you have one, why did you get it? • To have more control • To have more choice • Couldn’t get a good service otherwise • My previous service was bad • Other reason
How much do you know about Self Directed Support? • Nothing • A little – you had better keep it simple. • Some - Enough to talk about it in the pub • Lots - Enough to write a book
Direct Payments • Been around since 1997 • Not a huge take up by people with learning disabilities (Scotland 2011 – 1249 – 25% of total) • Aberdeen 97 (doubled) • All Ayrshire 49 (slight increase) • Edinburgh 273 (50% increase) • Glasgow 34 (decrease) • Mostly small packages of care (£16,300 per year) • Average is 20 hours per week.
The mechanics • Anyone who gets a social care service can ask for a Direct Payment • Most have a RIGHT to get one • The direct payment should be enough to buy the same amount of support if the council organised it for you. • You can only spend it on what you have agreed with the council
Who can get a Direct Payment • an older person who needs community care services • a disabled person over 16 years old • a parent of someone who is disabled • a carer • a disabled person who needs help being a parent • helping someone who cannot look after the money on their own.
More mechanics • You can employ a personal assistants to provide care • You can hire a provider agency to organise and deliver care. • You must have a separate bank account to receive the Direct Payment in. • If you are an employer you must keep financial records • You can pay someone else to do this for you.
What can’t you spend it on • help from the council • paying your husband, wife or partner • paying a close relative who lives in the same house as you unless the council has agreed • long-term residential care • Anything not related to your care needs
Even more mechanics • You do not need to be a guardian to get a Direct Payment on behalf of your son/daughter. • Banks may have a different view on the money handling. • Some councils are introducing the “Card” system to make it easier. This means the council has an online check on finances.
New Terms • Direct Payments – cash not services • Individual Budgets – a total budget for all your services • Self Directed Support – budgets linked to assessment and outcome planning • Individual Service Fund – a budget kept by local authority • Personalisation – possibly just the same as Self Directed Support • In Control – A brand name for personalisation
Self-directed Support • The support individuals and families have after making an informed choice on how their individual budget is used to meet the outcomes they have agreed. • Scottish Government preferred term • Focus of their new bill and strategy
Expected Benefits • Giving people choice and control • Flexibility on how money is spent • Able to negotiate meeting your needs better • Hire or choose support staff you want • Try new things that could make a difference
Possible Drawbacks • More work in administration • Worry about managing money • Keeping the books • Dealing with the council to get the money • Paying the bills • Managing Staff • Employer responsibilities in some cases
Self-directedsupport The process • Supported (self) assessment (evaluation) • Agreeing outcomes • Setting the budget available towards meeting these outcomes. • Review
Self Directed Support The mechanisms • A Direct Payment, • Direct payments managed by a third party. • Council keeps the budget to arrange person’s choice of support from a provider. • Council arranges services to value of budget
Aims of Self Directed Support Strategy • Better outcomes for the individual • Transition to adult life support smoother • Tailored support to needs • Choice of mechanism • Choice of provider • Clarity about budget
Strategy Implementation Improved communications and leadership Independent advice and support Training strategy covering who, what and why Workforce development across all sectors including Personal Assistants Impact on commissioning with support to help providers adapt
The draft Self Directed Support Bill • General principles in law • Definitions • A new default – choice and control • Advice and assistance • A right of review (by the local authority) as to eligibility • Direct payment legislation: consolidate and modernise • People with limited capacity: flexible and proportionate arrangements • A power to help Carers (but not a duty) • Restrictions: only when there is clear justification.
Is it a good thing that Self Directed Support become the default? • Yes • No
Should there be a right of review • On eligibility for a direct payment • On the level of a budget • On the final assessment • Other things Answer as many as you want
Should councils have… • A power to help carers if it is more efficient? • A duty to help carers if it is more efficient? • Not sure
Personalisation • Just a buzz word? • Resource Allocation System • Points means pounds • Negotiation to individual needs • Planned outcomes • Spending budget in any way to meet outcomes • 4th mechanism of previous list
On the ground • Different Local authorities have different approaches • North Lanarkshire - increasing/gradual use of individual budgets through RAS & Guided Self Assessment • Aberdeen - indicative budgets to a small group, as an alternative to day care places, through basic RAS with three price levels • Glasgow - whole systems change using SEQs and RAS, with Provider Pathway and Care Manager Pathway
North Lanarkshire Assessment Points Use of “multipliers” to reflect current levels of support.
Across the Country • Local authorities draw up new models • Similarities and differences • Assessments • RAS • What its applied to – eg. Day centres • Early days • Options for Influence