Transforming Adult Social Care In Derby: Self-Directed Support and Personal Budgets Oonagh Mckay : Senior Practitioner David Clayton : Senior Practitioner Everton Osbourne : Senior Practitioner 2012

A G E N D A Personalisation

Aims and objectives of this briefing To enable you to have a greater understanding of the Personalisation Agenda To outline the Self Directed Support process and To outline what is direct payments and how it can help to promote independence

Beyond ‘Community Care’ “While acknowledging the Community Care legislation of the 1990s was well intentioned, it has led to a system which can be over complex and too often fails to respond to people’s needs and expectations.” HM Government (2007) Putting People First: A shared vision and commitment to the transformation of Adult Social Care.

Adult Social Care System is fundamentally broken and cannot be tinkered with around the edges but needs fundamental change

Personalisation will fundamentally challenge health and social care professionals to refocus and rethink their practice

The underlying system of power: ‘we know best’ Professionals work out what you need Which turns out to be what they are delivering Services stuck in their own past... People stuck in services... From Professional Gift to Citizenship Put the person in the driving seat Keep them connected to their community Give them a Personal Budget Let them control their support

The old ‘welfare’ model of allocating resources A new system of RAS

Pre-contact Sources of information Build on and build up people’s social capital / wealth Sign-post to and maximise use of universal services EXIT Information, Advice, Advocacy and Support available to everyone (self-funders, non-FACS eligible and FACS eligible): Commissioned by DCC from voluntary / 3rd sector / social enterprises etc (‘grant funded’) Provided by voluntary / 3rd sector / social enterprises etc from their own resources – either ‘free’ or at a cost Commercially available from independent providers, including micro-providers Long Term Support Self-directed support Personal Budgets In-Control 7 Steps Review Initial Contact Screening Reablement, Recovery, Rehabilitation Initial / Crisis / Emergency intervention Assessment Safeguarding FACS eligibility V2.0 3 May 2011 EXIT The Personalisation Customer Journey in Derby

Personal Budgets Customers and carers still need to be eligible The customer (or their representative) is informed about a clear upfront allocation of council funding The customer or their representative is able to decide how they can use the money in ways and at times of their choosing There is an agreed support plan making clear what is to be achieved with the money Support exists to enable and empower the customer to arrange their own support or to have a service managed for them

Understanding the different terms used Independent Living/recovery - The Goal Personalisation – The Policy or Approach Self Direct Support – The System Individual Budgets – combining funding sources Personal Budgets – single funding from the council Provided ServicesDirect Payments

Options for managing a personal budget

Outcome Based Supported Assessment (OBSA) Personal Budgets Is the main assessment tool – Duty to assess Brings a number of processes together:- CCA, FACS, RAS Outcome Based Supported Assessment establishes eligibility for support: Substantial and Critical If Eligible, the individual (or their representative is informed about a clear upfront allocation of funding (the Resource Allocation System or RAS), enabling them to plan their support arrangements

A Supported Assessment Approach Looking at strengths as oppose to weaknesses Viewing customers as resources Working together in partnership with customers Developing transparent approaches

10 outcome domains in Derby Meeting personal care needs Keeping myself safe Eating and drinking Making decisions and organising life Being part of the community My role as a parent or carer Running and maintaining my home Having work and learning opportunities Managing my actions Family carer and informal support

Understanding The Resource Allocation System (RAS)

What is a Resource Allocation System (RAS)? How much money a person can get in their personal budget A points based system that allocates money (turn points into £’s)

Directly responds to the assessment (OBSA) by showing how the customer would like their eligible needs to be met Brings together the customers aspirations, goals and desired outcomes and how these might be achieved Examines how a customer’s personal budget might be used to assist with achieving these outcomes What is a support plan?

7 key criteria to look for within a support plan and know the answers too. What is important to the person? What is it that the person wants to achieve How will the person be supported How will the person use their personal/individual budget How will the person’s support be managed (see below) How will the person stay in control of their life How will the plan happen See ‘Agreeing the Support Plan’ Guidance

The principles when agreeing a support plan S afe E ffective and realistic A ffordable L awfull

Support brokerage is best done as close as possible to the customer – normally by themselves and/or their family/friends Where customers do not have this support, peer or community based support is developed to provide a credible alternative If no natural support can be found to support the customer, then paid support is provided either externally or by the council Empower and Enable In Derby City

Working with Direct Payments

Direct payments are part of a change in practices, led by disabled people “Day-to-day control of the money and care package passes to the person who has the strongest incentive to ensure that it is spent properly on the necessary services, and who is best placed to judge how to match available resources to needs.” Direct Payments Guidance: Community Care, Services for Carers and Children’s Services (Direct Payments) Guidance England 2003 Department of Health

Direct Payments – self managed (the default) Direct Payments to Representative – paid to a friend or family member Options when receiving a Direct Payment

Direct Payment to a ‘Suitable Person’ – when the customer lacks capacity Direct Payment to a third party organisation or provider Direct Payment to a User Trust Options when receiving a Direct Payment

Flexibility Creative Outcomes Vs Services Choice Control Social inclusion Religious, cultural and ethnic needs Benefits of direct payment

ISSUE i.e. Can’t make decisions, unwilling to integrate with others, suicidal thoughts INCAPACITY i.e. depression creates barrier to independence Desired OUTCOME i.e. The person wants to be able to integrate with others, uplifted mood, lead a normal life NEED i.e. support to Lift mood, integrate Linking Outcomes and Need Support Provided i.e. Personal Budget OUTCOME achieved i.e. The person is able to go out and integrate with others, lead a normal life, not viewing suicide as the only way forward

Evidence of higher satisfaction ratings by customers and carers Research shows it improves staff satisfaction and retention Key to a person centred and personalised approach to support planning Why focus on outcomes?

Any Questions or thoughts?