1 self-directed support – older people’s service providers evoc thinkspace 20 june 2014
TRANSCRIPT
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Self-directed Support –Older People’s Service
Providers
EVOC thinkSpace20 June 2014
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Agenda
• The nuts and bolts of how self-directed support is working in Edinburgh
• Principles behind the new assessment process
• How is it bedding down• Challenges/solutions, future thinking
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Key messages 1
It’s a 10 year strategy with 6 years to go – that makes it
a marathon not a sprint!
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What we needed to have in place for 1st April
Outcome focused assessment
Support for informed choice
Able to offer 4 options of SDS
Indicative budget
Promote a diverse market
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Principles in SDS Act
•be as involved as they wish in their assessment and support
•be provided with assistance to express their views and make informed choices
Supported person must:
•collaborate with people in respect of assessment and support
•take reasonable steps to ensure people’s right to dignity and participation in the life of their community is respected
Local authority must:
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The Person’s pathway
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It’s not only what you do the way that you do it is often more important
Key messages 2
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The Practicalities
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Assess people who present to us as
appearing to have needs which the local
authority should meet
The Council’s obligations in terms of assessment have not
changedWe still have a duty to:
Make provision available to meet any
needs we have identified as being
“eligible”
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Critical
Substantial
Low Moderate
EligibilityCriteria
• Worker’s professional decision based upon assessment
• Must be recorded
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What service users want from assessment
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Assessment
• Person centred
• Outcome focused
• Conversational
• Collaborative
Approach
• Needs and abilities
• Eligibility
• Personal outcomes
• Risks identified
• Resources required
Outputs
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The Assessment Tool• Electronic not paper based• Gathers general details• Identifies needs & abilities• Identifies current supports• Records views of others• Records risks• Considers the person’s level of capacity• Generates a score based upon the
professional judgement of the assessor• Identifies outcomes
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Needs and abilitiesNeeds and abilities rated in 7 domains and expressed as a numeric score:
• Personal support needs• Nutrition• Important decisions about my life• Work and learning• Leisure and community• Caring for my family• Risks to my wellbeing
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Needs and abilities continued• Tool should be used to record
conversation not lead it• Free text with prompts
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Funding Allocation System
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Generating the score
Step 1
Step 2
Step 3
Needs and abilities expressed as a score
Quantify informal support
Quantify impact on informal carer
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Step 1 – Level of need
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Assessment levels & bandings
I am able to manage for
myself
I need total Support
A A A BBB C DCC DD
9.1 9.2 9.3 9.4I do things I
want to in my community. I need support to continue to
do these
I need support to do more in
the community
I need someone to support me closely to help me to make or
maintain connections with friends, relatives
and people in the community where I
live
I do not need
support
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Step 2 – Informal supportRecorded for each domain and used to adjust the score
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Step 3 – Impact on carer
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The final score
• The final score is arrived at by adding together: the scores for each domain adjusted
to take account of informal care
and the score for the impact of providing
informal care on the carer
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Measured approach
Bandings• Rather than specific amounts
Maximum amount• Limited to £500 per week (£26,000 per annum) initially
People with complex needs• Deal with on a case by case basis
Controls• Assessments approved by seniors• Ongoing monitoring
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What people say they want from support planning
How do I want to live my life
Worker knows “what’s out
there”
Be creative
If it’s not working who do
I go to?
Same people involved to build
trust
As person centred as possible
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Support planning
Purpose• Decide how support needs and outcomes should be met
Collaboration• Person to have as much involvement as they wish, including
deciding who should support them to produce their plan
Scope• Not just about eligible needs and outcomes – but money is!
Proportionate• Appropriate and sensible approach
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Option 1
Option 2
Option 3
Option 4
Direct Payment
Individual selects support and asks the local authority or a third party
organisation to arrange
Local authority selects and arranges the support
Mix of options 1, 2 and 3 for different aspects of the person’s support
4 options of Self-directed Support
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Edinburgh approach to Option 2
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ISF Process
Supported Person
Personal Plan Terms
and Conditions
ProviderFramework AgreementCouncil
Supp
ort Pl
an a
nd
Fund
ing
Allo
cation
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Service delivery
• Flexible• Person-centred• Directed by the individual as far as they
wish and is appropriate• Choice, control and collaboration is not
just for those eligible for the 4 Options of SDS
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Reviews
Outcomes Needs Support
PlanSDS
Option
Reviewing and transitioning existing service users to SDS
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Early indications …
• Too early to get any really clear picture, but:▪ some evidence that assessments are taking
longer▪ some examples of creativity▪ some consistency issues being picked up by
seniors and managers▪ Need to train more staff more quickly
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Challenges, opportunities and future thinking
• Embedding SDS across whole staff group
• Ensuring a proportionate approach• Fostering creativity• Collaborative approach to evaluation
and monitoring
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How does it feel to you?