Support Individuals with Self-Directed Support

1. Understand self-directed support:-

1.1 Explain the principles underpinning self-directed support and how this differs from traditional support:-

The principles underpinning self-directed support and how it differs to traditional support is as follows:- Right to independent living – If someone has an impairment they should be able to get the support they need to live an independent life. Right to a personal budget – If someone needs ongoing support they should be able to decide how the money that pays for that support is used. Right to self-determination – If someone needs help to make decisions then decision-making should involve that person as much as possible and reflect that person’s own interests and preferences. Right to accessibility – People must be able to understand the systems and rules to maximise the ability of the person to control their own support.

Right to flexible funding – When someone is using their personal budget they should be free to spend their money in a way that best makes sense to them, without unnecessary restrictions. Accountability principle – The person with support needs and the government both have a responsibility to each other to explain their decisions and to share what they have learnt. Capacity principle – People with support needs, their families and their communities must not be assumed to be incapable of managing their support, learning new skills or making a contribution.

1.2 Explain the benefits of an individual having self-directed support:- The aim of self-directed support is to promote independence by offering more flexibility in how services are provided to many people who are assessed as being eligible for social services support. It enables individuals to take more control over decisions which affect their lives. It is intended to support independent living by giving people more choice and control over their own care. You can employ who you choose, determine their hours of employment and the tasks you require a personal assistant to undertake or you can choose a provider to arrange support for you but you still direct this support. 1.3 Explain how legislation, policy or guidance underpin self-directed support:-

The key policy guidance is Safeguarding vulnerable adults: regional adult protection policy and procedural guidance. In addition ‘Safeguarding vulnerable adults: a shared responsibility’ (2010) sets out eight key safeguarding standards, criteria to achieve those standards and guidance for good practice in safeguarding vulnerable adults. It is targeted at organisations in the community, voluntary and independent sector, although providers of regulated services can also use these standards to enable their compliance with the requirements for the protection of vulnerable adults set out in the Minimum Standards published by the DHSSPS and in the Quality Assessment Framework under Supporting People.

1.4 Explain what the following terms mean:-

a. Indicative allocation

An indicative allocation is based on what it would cost to meet an individual’s needs, as determined by the Resource Allocation System (RAS). The indicative budget allows individuals to create a support plan that will deliver the outcomes to best meet their identified assessed needs.

The indicative budget is used only as a guide. A final personal budget amount may be set higher or lower than this amount, depending on how a support plan shows the person’s needs can be met.

b. Supported self-assessment
With a supported self-assessment you will be supported to fill in an Assessment of yourself to find out what support you will need in the future. The Indicative Allocation is the money you will be allocated to use with your personal budget. You will be supported by people who know you best and care for you to create a support plan that meets your health and social needs aswell as planning to meet your future goals that you will have to spend on your support plan which will be determined by the self-assessment. c. Support plan

Your Social worker will help you do your support plan and then it will be taken to a panel who will then agree it when they feel it meets your needs.

d. Outcome focused review

An outcome-focused review is part of the self-directed support process. It is a way of carrying out reviews that puts the main focus on the results being achieved for the person and his or her family. The purpose of an outcome-focused review is to:

Review progress in using a personal budget to achieve the outcomes set out in the person’s support plan Share learning about what has been tried and worked or not worked Identify next steps to achieve these goals

Update the support plan
Make clear if the person’s support needs have changed, and Help the council to check if the person is still eligible for social care.

The outcome-focused review process is designed to be used for people who already have a personal budget. However, it can work effectively for people who have not yet completed the self-directed support process, for example people who have an existing direct payment and those with a traditional care package.

1.5 Outline the possible barriers to self-directed support:-

Some possible barriers to self-directed support are as follows:-

Self-directed support is publicised insufficiently.
If the local third sector is not actively involved then practical and peer support for individuals may be insufficient. It is not always clear how self-directed support works with other parts of welfare or public services. It is not easy to decide what are health or social care responsibilities and how self-directed support systems fit with other provision. Processes and procedures can seem under-developed leading to uncertainty. Staff are concerned about their jobs and roles in the light of self-directed support. Some fear self-directed support may worsen working conditions for social care staff–especially care workers or families.

There is concern that self-directed support may be more expensive than block contracts (buying social care in bulk so that unit costs are less). Some may feel the administrative burden of self-directed support is too great. Users (or carers) do not always want the responsibility of managing their own money/services. Employment of Personal Assistants (PAs) is not always simple. Employment of family members may not be easy or best.

Funding allocation systems and the rules on expenditure are not always clear to users and carers These may not be clear and lead to worries about accountability and blame Rules vary and change, leading to confusion

2. Understand how to support individuals to direct their own support and develop their support plan:-

2.1 Explain how to use person-centred thinking to enable individuals to think about what is important to them, and how they want to be supported:-

Person-centred planning begins when people decide to listen carefully and in ways that can strengthen the voice of people who have been or at risk of being silenced. Person-centred planning is a process of life planning with individuals using the principles of inclusion, and a social model rather than a medical model. With a medical model, a person is seen as the passive receiver of services and their impairment as a problem; this often leads to segregation and places to live and work that are away from the community. A social model sees a person as being disabled by society. In this model, a person is proactive in the fight for equality and inclusion. The concept of person-centred planning is not a new one. One of the first people to develop the model was John O’Brien. His ‘five accomplishments’ (respect, choice, participation, relationships and ordinary places) were the foundation for person-centred planning in the USA. 2.2 Explain how individuals can direct their own support if they do not have a personal budget:-

Individuals can direct their own support if they do not have a personal budget when they are assessed and their needs and care are being planned. The individual has a right to choices and decisions about their care and needs is ultimately their choice, with the support and guidance by family members.

2.3 Explain how person-centred planning can be used to inform a support plan:-

Person-centred planning can help with the production of a support plan as it is a practical way of giving individuals choice and control in their own lives. It will help the individual making decisions on how they want to live and how best to use their personal budget. Person-centred planning allows individuals to live an independent and inclusive life which will have a huge benefit on the individual’s life.

2.4 Explain the roles of others who can assist individuals in developing their support plan:-

The support plan is developed by the individual needing the care, but often the individual will need support from a family member, friends or a trusted advisor, it is always good to have support from another individual as they may be able to offer some extra support and help the individual think about different options or ways to express their needs and wishes.

2.5 Describe different ways that individuals can develop a support plan:-

There are 5 ways of producing a plan. People can:

1. Complete it themselves
2. Complete it with support from friends and family
3. Complete it with support from the local authority
4. Purchase the support from an independent person, or people
5. Have a plan completed on their behalf – by any of the people in 2, 3 or 4. Support Planning

2.6 Describe a range of person-centred thinking tools that can be used to help individuals think about different ways they can spend their personal budget:-

Individuals can get advice and support from their family, social services, advice centres etc about the ways they can spend their personal budget. The personal budget can be spent on care services, day centres, equipment, or other services that support the individual to live independently and a full life.

2.7 Describe what might be included in the costings for a support plan:-

In the support plan it will detail the assessment that has been done and the package that suits your needs.

You can manage your money in different ways. Your local council has to agree how you will manage your money. In the support plan you must show what your support will cost every week, every month, then every year. You should also have some spare money in case you need it.

3. Understand the different ways that individuals can use their personal budget:-

3.1 Explain the different ways that individuals can use their personal budget to buy support:-

The individuals can use their personal budget to buy support, this can be by way of carers visiting, and using Personal Assistants, which most local authorities hold a list of Personal Assistants in the Borough with contact details and an arrangement can be made between them. There are also a number of advice services that can help individuals get the services they need and what they want to use their personal budget for.

Individuals can also employ friends and family to provide services to them, for example, cleaning, shopping etc.

A personal assistant or support worker

Buying services from an agency or organisation
Paying expenses for unpaid helpers
Holidays – instead of respite care you might want to pay for a supported holiday
Buying equipment to help you be more independent
Enrolling on an adult learning course
Paying for vets bill or expenses for a support dog or pet
Buying gym membership/joining a sports club
One off payments for deposits, purchases etc.
Transport
Equipment to keep you safe like a personal call system, smoke detectors, fall detectors etc. Making changes to your home (this applies to adaptations that cannot be funded through a Disabled Facilities Grant – DFG. To find out more

3.2 Research innovative ways that individuals can spend their personal budget other than buying social care services:-

Innovative ways that individuals can spend their personal budget other than buying social care services as long as their agreed needs are met could be the following:-

Paying someone to take them to the shops
Paying someone to make meals for them
Transport to leisure centres
Paying someone to take them out to a local café to meet their friends for example.

3.3 Explain what restrictions may be imposed on personal budgets:-

Things that do not improve your life

Things that don’t meet your outcomes
Unregistered domiciliary care agencies providing you with personal care Illegal activities
Gambling
Employing someone who could place you at risk of harm
Things that meet only health needs
Things that should be funded by other funding streams

3.4 Describe the criteria that are used to sign off a support plan:-

The following 7 points outline the criteria used to sign off a support plan:-

1. It Must Be Person-Centred – The support plan must be about a real and recognisable person. It should describe the person accurately and develop a picture of the individual, their likes, dislikes, aspirations, personal and family situation.

2. Set Clear Outcomes – The support plan should record achievable and measurable goals. These should be identified by the person and be easy to understand by all concerned.

3. Describe the Planned Support – The support plan must identify the support that the person needs, this should be related back to the Resource Allocation System and the 6 broad outcome areas as money has been allocated on the basis of these identified needs. This does not necessarily mean that the Individual/Personal Budget has to be spent on these identified support needs but an understanding of how these support needs are going to be met must be in the support plan.

The support arrangements should reflect the identified outcomes. The plan can be imaginative about how the person might want to achieve their outcomes.  Planned support should maximise the use of natural and community resources and should enable the person to build and sustain their presence and participation in the community.

4. Keep the Person Healthy and Safe – The support plan should identify any significant health and safety concerns. The emphasis is around supporting informed choice and enabling people to manage their own risk. A balanced approach to risk taking is essential, risk is inherent to life and should be identified and managed accordingly. For individuals who are reliant on the support to manage tasks such as personal care, meal preparation etc. contingency arrangements should be identified in the support plan. The review interval should be stated in the support plan. There is a statutory obligation to provide an annual review, but if a review is required more frequently than this it should be negotiated directly with the person.

5. Staying in Control – The support plan must show how the person will maximise their control over their life. There must be good reason for a decision not being made by the person. If the person cannot make decisions for themselves then there should be a clear agreement about who the alternative decision makers are. The plan should not be agreed if it appears that others are making decisions that the person could reasonably be expected to make themselves.

6. Management of the Support – The plan should be explicit in identifying who will manage the support. Whether this is the person, a representative, a trust or an organisation it must be clear that they will be responsible for meeting obligations under Health and Safety law, Employment law, Inland Revenue rules and any other regulations that may apply.

7. What the Support Will Cost – The support plan should include a detailed break down of the cost implications of the proposed support. This should include any financial contribution that the person is required to make. The plan should be clear about how the money is to be spent.

8. 3.5 Describe a person-centred approach to risk that ensures that individuals have what is important to them whilst staying healthy and safe:-

A person-centred approach to risk that ensures that individuals have what is important to them whilst staying healthy and safe is to have a risk assessment done on the individual, to see what their capabilities are and what they are able to achieve physically. It is also important to allow the individual to do as much as they can as long as it is safe to do so. When an individual’s care plan is being discussed this should be person-centred to the individual’s wishes taking into account their safety and health at all times.

4. Be able to support individuals to direct their support:-

4.1 Support an individual to express what is important to them in how they want to be supported in the future:-

It is important that an individual has full support to express what is important to them in how they want to be supported in the future. Giving the individual choice and control allows the individual to have the care and support that is tailored to their specific needs. It is also important while promoting independence and choice to the individual that this needs to be balanced alongside making sure the risks and safety of the individual is not compromised.

It is also important to make sure that if the individual is vulnerable that they are carefully protected against the possibility of abuse.

4.2 Use person-centred thinking tools to support an individual to have maximum choice and control in their life:-

It is important that while supporting an individual they are giving as much choice and control of their life while still ensuring the individual is safe and not vulnerable. The individual should be listened to and able to express what is important to them in their life and able to make their own choices on how they live their life.

Being person centred in supporting the individual is a way of finding out what is important to a person and a way of turning an individual’s ideas and aspirations into reality. It provides a way of listening to and working with the person, their ideas and aspirations and working with their families in partnership.

4.3 Use person-centred thinking tools to support an individual to develop their support plan:-

Being person centred when developing an individual’s support plan is listening to the individual and finding out what is important to a person and a way of turning an individual’s ideas and aspirations into reality. It provides a way of listening to and working with the person, their ideas and aspirations and working with their families in partnership.

4.4 Support an individual to identify any others who could work with them to develop their support plan:-

Supporting an individual to identify any others who could work with them to develop their support plan would be encouraged, family members or close friends who know the individual will help support them in making decisions on their support plan. To help make sure this happen we can work with self-advocates and independent advocacy to enable and empower the person with learning disabilities to making decisions about their lives.

5. Be able to support individuals to use their personal budget in different ways:-

5.1 Support an individual to understand the different ways they could develop their support plan:-

An individual will need to be supported while developing their support plan to enable them to use their personal budget to their maximum benefit. The individual should be given all options of what they can use their personal budget for and in what way is best to support them in living their life using their own choices.

5.2 Support an individual to understand what restrictions may be imposed on their personal budget:- Supporting an individual to understand what restrictions may be imposed on their personal budget is important. The restrictions should be explained to the individual and supported in making the right choices. There are certain areas that a personal budget does not cover for example illegal activities, gambling etc. or anything that puts the individual at risk.

5.3 Support an individual to think about different options for spending their personal budget:-

The individual should be informed and supported on using their budget to benefit them as much as possible. The individual should be advised of the choices available and options for them to use their personal budget to allow them to live independently and to the fullest.

5.4 Demonstrate a person-centred approach to balancing risk with individuals when making decisions about their personal budget:-

During the process of obtaining a personal budget there will be a risk assessment done on the individual. There is a genuine concern for vulnerable groups obtaining personal budgets and their safety unless of course this denies the individual their choice, rights or control.

6. Be able to support individuals with an outcome-focused review:-

6.1 Explain the process of an outcome-focused review:-

The process of an outcome-focused review is as follows:-

1. Assessment – The initial assessment will identify areas where a person has an eligible need for social care.

2. Support Planning – For each of the needs identified in the assessment, the person then decides how they want this to be addressed in their support plan, and the outcomes they want to achieve. To develop a support plan, the person will need to discuss questions which are on the support plan.

3. Agreeing the Support Plan – To complete a support plan, the person needs to record the outcomes highlighted in the support planning process. The support plan shows for each goal, how the support arrangements will enable these changes to happen. The council and the person agree the plan to confirm that the money can be used in this way.

4. Review – The review process looks again at the outcomes. It asks what is working and not working for the person and checks how much progress has been made towards the goals.

5. 6.2 Support an individual to prepare for an outcome-focused review:-

To prepare an individual for an outcome-focused review, the process should be explained fully so they are aware of what will be discussed and to give the individual time to think about what is and what isn’t working in their life at that time and what the best outcome would be for the individual to live their life as they wish making sure they are safe and well.

The individual should be told that someone from the local council will be visiting to carry out the review and that they will ask questions surrounding the individuals whole life not just what services they want from the review.

An outcome focused review checks whether the outcomes have been achieved. It is a chance to say what is and is not working. The review is also a chance to make changes. As a result of the review, your support arrangements may need to change. You may need more support and a higher personal budget. Or your needs could have reduced, in which case you may no longer need a personal budget.

6.3 Support an individual to be at the centre of the review process:-

During the review process the individual should be at the centre of the review giving them respect, choice and participation in the whole process. Discussing the process fully before the actual review allows the individual to think about the best outcome for them at the end of the review.

The individual must have control in areas such as who supports them, what they do with their day, being listened to, and making decisions about their lives and we can support the individual making sure this happens during the review process.