Personalisation

Personalisation means….

Starting with the person as an individual with strengths, preferences and aspirations and putting them at the centre of the process of identifying their needs and making choices about what, who, how and when they are supported to live their lives.

Addressing the needs and aspirations of whole communities to ensure everyone has access to the right information, advice and advocacy to make good decisions about the support they need. It means ensuring that people have wider choice in how their needs are met and are able to access universal services such as transport, leisure and education, housing, health and opportunities for employment regardless of age or disability.

(Personalisation briefing, SCIE, 2009)

Beliefs for social care

Disabled people are vulnerable and should be taken care of by trained professionals.

Existing services suit people well – the challenge is to assess people and decide which service suits them.

Money is not abused if it is controlled by large organisations or statutory authorities.

Family and friends are unreliable allies for disabled people and where possible should be replaced by independent professionals.

Duffy, 2005, p10

Beliefs for self-directed support

Every adult should be in control of their life, even if they need help with choices.

Everybody needs support that is tailored to their situation to help them sustain and build their place in the community.

Money is most likely to be used well when it is controlled by the person or people who care about the person.

Family and friends can be the most important allies for disabled people and make a positive contribution to their lives.

Duffy, 2005, p10

Valuing People (DH, 2001)

Four key principles: Rights Choice Independence Control

In Control 2003

Joint leadership of Mencap and the Valuing People Support Team

Resources from buildings and pre-paid services to individuals

Six local authorities responded to in Control’s invitation to pilot (and fund) new ways of working in their own areas.

Spot the difference

Old ‘professional gift’ model: State uses the money it receives from taxes to slot people into pre-

paid services through the work of professional assessors and gatekeepers

Care manager identifies needs, then services, then funding

New ‘citizenship model’: Disabled person is at the centre of the process, is part of the

community and organises the support they need and want Individual identifies their needs, is given an indicative budget and

then plans provision to meet the identified needs: self-directed support.

Seven steps to self-directed support

Set a personal budget Plan support Agree plan Manage personal budget Organise support Live life Review and learnwww.in-control.org.uk

Setting the budget

Initial assessment screening to check eligibility

Completion of self-assessment questionnaire

Number of points scored is multiplied by the price point to give the budget available to meet the needs identified.

Funding for Individual Budgets

Variety of existing funding streams: Adult social care Community equipment Independent Living Fund Access to Work Supporting People.

Government support for personal budgets

Demonstrated in four government publications in 2005:

Independence, Wellbeing and Choice (Green Paper) Pilots in 13 sites

Improving the Life Chances of Disabled People (Strategy Unit Report)Assessment and advocacy

Opportunity Age (DWP report)

Labour Party manifesto

Putting People First (2007)

Signatories: Six government departments National health and social care organisations Local government

‘The time has now come to build on best practice and replace paternalistic, reactive care of variable quality with a mainstream system focused on prevention, early intervention, enablement, and high quality personally tailored services. In the future, we want people to have the maximum choice, control and power over the support services they receive.’

(HM Government, 2007, p2)

Transformation agenda

Based on Putting People First and guidance in local authority circulars Transforming Adult Social Care (2008 and 2009)

System wide transformation aiming at personal budgets for everyone receiving social care funding except in emergency situations.

Social Care Reform Grant provides ring-fenced funding for three years from 2008 to support local authorities to make the changes needed.

Has prompted new Fair Access to Care eligibility criteria guidance, with the consultation period ending in October 2009.

Expansion beyond adult social care

Pilot of personal health budgets announced in 2009.

Health Bill 2009 Proposes provision for direct payments by health authorities£520m from health to local authorities

Children’s Services pilots Other local and national government

departments

Social work’s contribution

A preventative approach The ability to work with complex situations and

with different agencies and sectors The capacity to perform a wide range of tasks

including brokerage and advocacy Flexibility and accountability

GSCC (2008)

Statutory role in seven steps

When a decision is made about the amount of the personal budget

When the support plan is agreed (including ensuring the plan is safe and that people have any necessary representation)

When the plan is reviewed

New roles for social workers Advisers

Navigators

Brokers

Service providers

Risk assessors and auditors

Designers of social care systems

Resistance from social workers Suspicion about government’s motives Lack of training and information Workload implications Inadequate funding of direct payments and personal budgets Concern that directly provided services and the people using them will become the

poor relation Fears that service users will be left vulnerable to abuse or at risk of significant harm Issues around exploitation of care workers and women Concern that some people will be packed off with a personal budget because they

are seen as trouble-makers Doubts about individuals managing their own support and budgets PA recruitment difficulties Desire to maintain professional status and role

Glasby and Littlechild (2009, p 131-132)

Managers’ concerns

All of the above, with emphasis on: Protecting in-house services Controlling expenditure through a traditional

gatekeeping role Safeguarding at the expense of rights and

responsibilities Protecting their resources from an increased risk

of fraud and financial abuse

A way forward

Ensure that: Social workers are involved in planning change Points of resistance are treated as indications

that important issues need to be tackled Implications for individual workers are addressed Social workers have the skills and support

needed to work differently.

References Duffy, S (2005) ‘Will “in Control” at last put people in charge of their lives?’ Community Living, vol 18, no 4, pp 10-13 Glasby, J and Littlechild R (2009) Direct Payments and Personal Budgets: Putting Personalisation into Practice

Bristol: The Policy PressGSCC (2008) (Digitised chapter on Blackboard) The GSCC response to putting people first making it

happenhttp://www.gscc.org.uk/Policy/Consultations/ResponsePuttingPeopleFirst [ accessed on 1/12/09 SCIE (2009) Personalisation: a Rough Guide London: SCIE (See SCIE website)

Legislation, reports and guidance LAC (DH) (2008) 1 Transforming Social Care LAC (DH) (2009) 1 Transforming Adult Social Care HM Government (2007) Putting People First: A shared vision and commitment to the transformation of Adult Social

Care, London: HM Government DH (2001) Valuing people: a new strategy for learning disability for the 21st century . Norwich: The Stationery Office DH (2005) Independence, Well-being and Choice, London: The Stationery Office DH (2006) Our Health, Our Care, Our Say, London: The Stationery Office DH (2009) Prioritising need in the context of Putting People First: A whole system approach to eligibility for social

care, London: The Stationery Office HM Government (2005) Opportunity age: meeting the challenges of ageing in the 21st century, London: Department

of Work and Pensions Prime Minister’s Strategy Unit (2005) Improving the Life Chances of Disabled People, London: Prime Minister’s

Strategy Unit