Self Directed Support

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Self Directed Support Jim Pearson
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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.

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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

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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.

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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

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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)

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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

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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

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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

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Legislative Framework

• 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)

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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.

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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

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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)

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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.

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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.

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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 authoritys decision not
  to offer self-directed support.

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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.

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Accessing Self-Directed Support
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Managing an individual budget
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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 persons disability is
  challenging behaviour towards strangers.

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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 individuals own contribution,
  a contribution from the local authority, and
  money from funding streams such as the ILF which
  are not means tested.

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Useful web links

• http//www.ilf.org
• http//www.socialworkscotland.org.uk/index.php
• http//www.scotland.gov.uk/Resource/Doc/181224/005
  1499.pdf
• http//www.mentalhealth.org.uk/publications/?Entry
  Id576412
• http//www.scotland.gov.uk/Publications/2008/05/30
  134050/0
• http//www.selfdirectedsupportscotland.org.uk/

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Support Services in Glasgow and East
Dunbartonshire

• Glasgow Centre for
• Inclusive Living
• 117-127 Brook Street
• Bridgeton
• Glasgow
• G40 3AP
• Phone [phone]
• Email gcil_at_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 [phone] or 776 6342
• Fax [phone]
• Emaildirect.payments_at_eddpss.co.uk
• Website www.eddpss.co.uk