People want choice and control in their own Home Both public expectations and demand are rising Money available is tight and unlikely to grow There is increased rationing and restricted choice Social Care In England 2007
Expenditure on long-term services for older people with dementia in England set to rise from £5.4 billion, 2002 to £16.7 billion, 2031 (0.6% to 0.96% of GDP) Alzheimer's soc(LSE and King’s College) Dementia UK
73% say a person requiring social care should be able to choose their services and be given money by the government to pay for them, rather than have the government decide. MORI poll 2004 The Commission for Social Care Inspection
90% of the public would like social services or public agencies to provide support for them to stay in their own home. 87% would like to be given the choice to not live in a residential care home. MORI poll Disability Rights Commission (July 2006)
poll revealed only half of the public supports an increase in tax in order to fund better adult social care. MORI poll Disability Rights Commission July 2006
7 / 10 people receiving support only if their needs are in the top 2 of 4 possible levels (substantial or critical) situation is set to get worse not better 80 per cent of councils planning to tighten eligibility criteria further. Local Government Association social services finance 2005/06
‘In my view the time has come, in terms of social care, for a new settlement between the state the family and the citizen.’ Speaking on Radio4 Today program 27th February 2007 Ivan Lewis Parliamentary Under Secretary of State for Care Services
‘Demographic pressures on society are one of the questions we’ve most got to answer; as politicians and as citizens working together and deciding between ourselves what is fair’ Speaking on Radio4 Today program 27th February 2007 Ivan Lewis Parliamentary Under Secretary of State for Care Services
Change the organisation of social care in England so that people who need support can take more control of their own lives and fulfill their role as full citizens: This means the complete transformation of social care into a system of Self-Directed Support. Mission
Self Directed Support
Says how much money is available early and upfront Creates a deal between the citizen and the state Is clear about what must be achieved not what must be done Allows the person and their family to be in charge Encourages flexibility and creativity Encourages a mixture of community family and state support Rewards efficient use of resources Achieves better outcomes for individuals
Current System in England
Problems with current approach to resource allocation pick and place bidding up of needs bidding up. of costs tension of gate keeping conflict stifles creativity slow & costly Slots people into services Rules are unclear
In-Controls approach
Some Benefits of Self directed support Allocates money in line with need Enables self-assessment of entitlement Supports good governance Removes disincentive for family, friends community Supports meaningful long-term planning
Local Government Families & Disabled people Provider Organisations National Government All these people are working together to define best practice in Self-Directed Support and change the system. inControl is a unique partnership bringing together
The inControl Partnership Includes 95 English Local Authorities
In Control believe that to achieve the goal of citizenship disabled people should know how much money they have available to meet their needs, and that this money be held in an individual budget, under the control the disabled person.
In Control believe that to achieve the goal of citizenship disabled people should know how much money they have available to meet their needs, and that this money be held in an individual budget, under the control the disabled person. This does mean they have to have that money as a direct payment
PersonRepresentativeTrust BrokerProviderCare Manager Who can manage the money
People who do not want direct control of their own money People who cannot manage their own budget People who shouldn’t manage their own budget This means self directed support is Universal and can work for….
Initial inControl Pilot Small pilot Local Authorities 60 people with personal budgets
What we found…