Self Directed Support

Jim Pearson

What is Self-Directed Support?

Self-directed support (SDS) is a way of organising social care;

SDS is part of the mainstream of social care delivery, It is puts the principles of independent living into

practice so that people can take control of their lives SDS enables people to be active citizens (with full

range of human rights) in their communities. It is about flexibility, choice and control and having

a decent quality of life.

Core Principles of Independent Living

Choice, Control, Freedom, Dignity, Enablement, Empowerment, Fairness, Inclusivity

These principles are compatible with internationally agreed principles of human rights known as PANEL

Participation Accountability Non Discrimination Empowerment Legality

Potential benefits of SDS for Carers

allowed more flexibility about the care they provide;

carer can choose to access fewer support staff with greater continuity, communication and consistency;

carer can achieve a better balance in their life beyond caring role, sustaining the carer in employment, or

chance to see the individual they care for enjoying greater opportunity and an enhanced quality of life.

Background & Related Developments

Changing Lives: Report of the 21st Century Social Work Review

Self- Directed Support: New National Guidance Draft Self Directed Support Strategy for Scotland Self Directed Support Bill Scottish Ministers have also committed to:

National Dementia Strategy National Strategy for Carers Reshaping Care and Support for Older People

Barriers to Self Directed Support

Barriers include lack of knowledge and understanding prevailing culture and attitudes assumptions and attitudes about the

characteristics of people who may benefit from them,

limitations on the use of the allocated budget to some extent a vested interest in the status quo existing social care framework (eligibility criteria

and thresholds)

Draft Self Directed Support Strategy for Scotland

Draft SDS Strategy recognises that financial pressures, and demographic

changes mean that improved outcomes cannot be delivered with more of the same.

responds to increasing interest in reshaping care and support in Scotland.

aims to drive a cultural shift around the delivery of care and support (seeing people as consumers of services as opposed to service users, as equal citizens with rights and responsibilities).

recognises that a 10 year vision is needed now to deliver social care that is fit for the future.

makes 26 recommendations

Draft Bill on self-directed support Draft Bill proposes

consolidating and updating existing legislation on direct payments. introducing and defining the term self-directed support into statute, providing a legislative framework that would allow extending direct

payments in the future (NHS funding) self-directed support to be provided on an opt-out as opposed to an

opt-in basis. considering expanding the categories of persons who can receive

direct payments on behalf of an adult with incapacity. remove the restriction to direct payments and other forms of self-

directed support for people with mental health problems considering options to amend or remove the restriction on the use

of direct payments for the purchase of residential care remove the restriction placed on local authorities to provide direct

payments or other forms of self-directed support to unpaid carers

Self- Directed Support Strategy(test sites)

Three local authority test sites Glasgow Dumfries and Galloway Highland

Test site themes cutting red tape, investing to save, leadership and training

NHS & Lothian Council Project aimed at ensuring use of health board monies in

SDS packages

The Social Work (Scotland) Act 1968 The Community Care (Direct Payments) Act 1996 Regulation of Care (Scotland) Act 2001 Community Care and Heath (Scotland) Act 2002 The Community Care (Direct Payments) (Scotland)

Regulations 2003 (SSI 2003 No. 243) The Community Care (Direct Payments) (Scotland)

Amendment Regulations 2005 (SSI 2005 No. 114) The Mental Health (Care and Treatment) (Scotland) Act 2003

(Modification of Subordinate Legislation) Order 2005 (SSI2005 No. 445)

The Disability Equality Duty (DED) National Health Service Reform (Scotland) Act 2004 (asp 7)

Legislative Framework

Individual Budget Funding Streams

Local authority care budget Funding for equipment and temporary adaptations Supporting People Free Personal Care Independent Living Fund Health monies to meet continuing health needs.

Independent Living Fund (ILF) To qualify for ILF, the person must:

get at least £340 worth of support a week from social services.  This can include direct payments;

get the higher rate care component of Disability Living Allowance (DLA);

be at least 16 and under 65 at time of application.    (ILF funding can continue after the persons 65th birthday as long as you still meet all the other conditions;

be living in the United Kingdom (UK); have less than £23,000 in savings/capital (this includes any money

your partner has.

From 1 May ILF has new priorities maintaining support to existing recipients of ILF support those in work for at least 16 hours per week. new applications will only be accepted from applicants in paid

work of at least 16 hours per week

Who can get self-directed support?

Those eligible for SDS include

Disabled adults assessed as requiring community care services including housing support services

Older people aged 65 years (assessed as needing community care services)

Managing self directed support

A person

should be able to arrange support and manage funds, or

have someone authorised to do it for them (e.g. an attorney or guardian)

SDS should not be refused on basis of needing help to manage it now or in the future. SWD must consider what help is needed.

Help to manage self-directed support

Help could include advocacy communication support record keeping pay roll service good employment practice managing self-directed support on an ongoing basis

even through periods of fluctuating or deteriorating condition.

Ability to manage self-directed support

Where the authority decides, in exceptional circumstances, that a person is unable to manage self-directed support,

The reasons for the decision must be communicated in writing.

The Authority should also make the individual aware that they can use the complaints procedure to challenge the local authority’s decision not to offer self-directed support.

Consent and Capacity Issues

Almost any disabled or older person should be able to get self-directed support if they choose it.

Eligible people must give their consent to do so, or if they evidently lack the capacity to do so, consent can be given by an attorney or guardian.

Appropriately trained advocacy workers should be made available to support people effectively through the process.

Cognitive impairment of any kind should not be a barrier to a person having more, or more effective, control of their lives.

Accessing Self-Directed Support

Managing an individual budget

Employing Family Carers as Personal Assistants

Current rules only allow this

“…where securing the service from such a person is necessary to satisfactorily meet the service users assessed needs.”

This could provide best outcomes, for example when: a person requires end-of-life care there are limitations in the availability of suitable service providers,

for example, in rural or remote areas it is considered to be the most appropriate way of meeting an

individual‟s cultural needs a feature of the person’s disability is challenging behaviour towards

strangers.

Service user contribution: Charging Policies

Section 87(a) of the Social Work (Scot) Act 1968 enables the local authority to require the individual (except those eligible for free personal care) to make a financial contribution to the cost of any services need to meet their assessed needs.

People using self-directed support are charged in the same way as those using the authorities’ equivalent services.

The individual budget can therefore consist of a combination of an individual’s own contribution, a contribution from the local authority, and money from funding streams such as the ILF which are not means tested.

Useful web links

http://www.ilf.org http://www.socialworkscotland.org.uk/index.php http://www.scotland.gov.uk/Resource/Doc/181224/00

51499.pdf http://www.mentalhealth.org.uk/publications/?EntryId5

=76412 http://www.scotland.gov.uk/Publications/2008/05/301

34050/0 http://www.selfdirectedsupportscotland.org.uk/

Support Services in Glasgow and East Dunbartonshire

Glasgow Centre for

Inclusive Living

117-127 Brook Street

Bridgeton

Glasgow

G40 3AP

Phone: 0141 550 4455

Email: gcil@gcil.org.uk

Website: http://www.gcil.org.uk

East Dunbartonshire Direct

Payments Support Service

Suite 1

Enterprise House

Southbank Business Park

Kirkintilloch

G66 1XQ

Phone: 776 2219 or 776 6342

Fax: 0141 776 2219

Email:direct.payments@eddpss.co.uk

Website: www.eddpss.co.uk