1 Self-directed Support – Older People’s Service Providers EVOC thinkSpace 20 June 2014

2 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

3 Key messages 1 It’s a 10 year strategy with 6 years to go – that makes it a marathon not a sprint!

4 What we needed to have in place for 1 st April Outcome focused assessment Support for informed choice Able to offer 4 options of SDS Indicative budget Promote a diverse market

5 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:

6 The Person’s pathway

7 It’s not only what you do the way that you do it is often more important Key messages 2

8 The Practicalities

9 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 changed We still have a duty to: Make provision available to meet any needs we have identified as being “eligible”

10 CriticalSubstantial LowModerate Eligibility Criteria Worker’s professional decision based upon assessment Must be recorded

11 What service users want from assessment

12 Assessment Person centred Outcome focused Conversational Collaborative Approach Needs and abilities Eligibility Personal outcomes Risks identified Resources required Outputs

13 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

14 Needs and abilities Needs 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

15 Needs and abilities continued Tool should be used to record conversation not lead it Free text with prompts

16 Funding Allocation System

17 Generating the score Step 1 Step 2 Step 3 Needs and abilities expressed as a score Quantify informal support Quantify impact on informal carer

18 Step 1 – Level of need

19 Assessment levels & bandings I am able to manage for myself I need total Support AAA B BB C DC C D D I 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

20 Step 2 – Informal support Recorded for each domain and used to adjust the score

21 Step 3 – Impact on carer

22 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

23 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

24 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

25 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

26 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

27 Edinburgh approach to Option 2

28 ISF Process Supported Person Personal Plan Terms and Conditions Provider Framework Agreement Council Support Plan and Funding Allocation

29 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

30 Reviews OutcomesNeeds Support Plan SDS Option Reviewing and transitioning existing service users to SDS

31 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

32 Challenges, opportunities and future thinking Embedding SDS across whole staff group Ensuring a proportionate approach Fostering creativity Collaborative approach to evaluation and monitoring

33 How does it feel to you?