Self-Directed Support

Personalisation ‘It enables the individual alone or in groups to find the right solutions

for them and to participate in the delivery of a service. From being a recipient of services, citizens can become actively involved in selecting and shaping the services they receive’.

“Personalisation means that people become more involved in how services are designed and they receive support that is most suited to them.”

“Personalisation means enabling people to work with professionals to manage risk and resources. It isn’t about withdrawing professional support or indeed ignoring risk or the limits of resources, but about actively engaging people in a dialogue about how to manage risk and to use the money and support that are available to them in the best way.”

“Personalisation should lead to services which are person centred (both around individuals and communities), which can change when required, are planned, commissioned and sometimes delivered in a joined up way between organisations.”

All the above is taken from Personalisation: An Agreed Understanding from the Scottish Government.

Personalisation means thinking about care and support in an entirely different way – starting with each 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 how and when they are supported to live their lives. It requires a significant transformation of adult social care so that all systems, processes, staff and services are geared up to put people first.

It means:

• Tailoring support to individual needs• Ensuring people have access to information, advocacy and

advice to make choices about their care and support.• Finding new collaborative ways of working (sometimes

known as co-production) that support people to engage in the design, delivery and evaluation of services.

• Developing local partnerships to co-produce a range of services for people to choose from and opportunities for social inclusion and community development.

• Ensuring all citizens have access to universal community services and resources.

• Developing the right leadership and organisational systems to enable staff to work in creative, person centred ways.

The above paragraphs are taken from Personalisation: A Rough Guide – the Social Care Institute for Excellence.

Self Directed Support – the VisionThe Vision for Self Directed Support in Scotland - as statedby the Scottish Government – is“The quality of life for people who require care and support is improved through increased choice and control over the support they receive”.

“Putting people at the heart”The Values:Respect; Fairness; Independence: Freedom; Safety.

The Principles:• Collaboration• Dignity• Informed Choice• Innovation• Involvement• Participation• Reciprocity• Risk Enablement

Self-Directed Support – the Journey

• National Guidance issued in 2007.• 3 test site areas chosen – Dumfries and Galloway, Highlands and

Glasgow – funded for initial 2 years.• Self-Directed Support: A National Strategy for Scotland – published

in November 2010, setting out a 10-year strategy.• Social Care (Self Directed Support) (Scotland) Bill went through

Parliament – became Act in January 2013.

• Expected it will actually come into force in June 2014.

• Guidance will be issued for consultation in spring 2013.

• There will be national standards for information and support services.

Self-Directed Support – describes the way in which individuals and families can have informed choice about the way support is provided to them. It includes a range of options for exercising that choice.

It places a duty on local Authorities to have regard to 5 Principles:

• Involvement• Informed Choice• Collaboration• Dignity of the person is to be respected• Participation in the life of the community

Self-Directed Support – the 4 options

1. Direct PaymentThe making of a direct payment by the local authority to the supported person for the provision of support.

2. Direct the available support

The selection of support by the supported person, the making of arrangements for the provision of it by the local authority on behalf of the supported person and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of that provision.

3. Local Authority arranges support

The selection of support for the supported person by the local authority, the making of arrangements for the provision of it by the local authority and, where it is provided by someone other than the authority, the payment by the authority of the relevant amount in respect of the cost of that provision.

4. Mix of options

The selection by the supported person of Option 1, 2 or 3 for each type of support and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of the support.

Self-Directed Support – the local context

Implications of SDS – working at three levels

IndividualServicesCommunity

7 key steps From assessment, get an estimated budget• Consider the outcomes you want to meet and the support you

require to do this.• Decide how you want your support and budget managed• Get agreement from Social Work to your support plan and how you

will use your individual budget• Organise support• Live your life• Review and Account for the use of the money

Resource Allocation System (RAS)

• A system for allocating funding to individuals• Based on the in-Control RAS model• Worked out from a local desk top exercise with 100 examples• An estimated budget allocation is based on an assessment of

the support required by the individual and takes account of support provided by family and friends

SDS Pilot in the Scottish Borders aimed to offer people:

• Increased choice and control over how care needs are met • Opportunity to make very different choices …. with focus on

achieving the agreed outcomes • Clear information about how much money is allocated to them• Support to be full and equal participants in society.

April 2011 – 12• Originally for 20 people – 40 people actually took part• Most people chose to manage their money using the direct

payment option (Option 1)• Two people chose an Individual Service Fund (Option 2)• Two people chose a mix of Social Managed and Direct

Payment (Option 4)

Participants - By area:Berwickshire 13; Central 6; Kelso 10; Hawick 7; Peebles 4By ‘care group’:People with a learning disability 13People on autistic spectrum 2People with a physical disability 14Older people (65 and over) 7People with dementia (65 and over) 2People with dementia (under 65) 1People with a brain injury 1(This includes two people who have a mental health problem)

Key challenges of local implementation• Change in culture and approach for all.• Adapting services to customers with purchasing power .• From tasks and timetable to outcomes and support plan.• Commissioning arrangements – promoting individualised support.• Different contractual framework.• Understanding of SDS for children and their families.• Addressing these issues whilst maintaining momentum and interest

in SDS.

Current situation• Recommendation to Council on 21 June 2012 to continue to

phase in the introduction of SDS• Pilot continues - from July 2012, offered to people who want

SDS and to people involved in the learning disability day service review.

• Subject to review,will be phased in to meet legislative requirements.

Positive Risk Management

‘Positive Risk Management Guidance – supporting individual choice and control’ - June 2011

Empower individuals to meet their needs and outcomes in best way for them

Involvement in risk discussion and management: Identify, assess, manage, and review risk