Transcript Personal Budgets - SEND

Personal Budgets - SEND
HEATHER M STACK
SEND CONSULTANT, HM STACK CONSULTING
MARCH 2014
Draft SEN Code of Practice - Section 7.12
 “A personal budget is an amount of money identified by
the local authority to deliver all or some of the provision
set out in an EHC plan. By having a say in the way this
budget is used, a parent or young person can control
elements of their support.”
Personalisation of Public Services
 Personal Budgets are a part of the personalisation of public
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services
An integral part of the co-ordinated assessment and
Education, Health & Care Plan process
Preceded by the Individual Budget (IB) Pilot Programme for
families with disabled children
Preceded by Personal Health Budgets (PHB) Programme
Mott MacDonald contracted to deliver Pathfinder Support
by Dept for Education
SEND Reforms
 Subject to Parliamentary approval of provisions in the Children
& Families Bill, all areas will need to implement the SEND
reforms from Sept 2014
 Services across education, health & social care need to work
together to place families & children at the centre of the
commissioning, assessment & planning process
 Pathfinder champion programme with run until March 2014,
scaling up new approaches to include whole areas, across 0 – 25
age range
 Next updates February 2014 of Devon SEND pathfinder (Version
3, Personal Budgets, December 2013)
Bills & Supporting Documents
 Children & Families Bill – clause 48
 Draft: SEN Code of Practice – section 7.12 Requesting a Personal
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Budget
Draft: Personal Budget Regulations
Consultation on transition to Education, Health & Care Plans
and the Local Offer
Support & Aspiration: a new approach to SEND 2.26 Giving
Parents Control
Draft Legislation on Reform of Provision for Children & Young
People with SEN – Section 26
DfE, In Control, SQW, Support and Aspiration: Introducing
Personal Budgets
Key Challenges
1. Implementing lessons learned from Pathfinders
2. Understanding local perceptions and strength of parental
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feeling towards reforms and PBs
Strengthening the role of key workers & Independent
Supporters
Gaining the involvement of CYP in their EHC Plans
Understanding and knowing the diversity and breadth of
provision from all sectors within a locality
SEND providers making clear a realistic costing of services
and provision shared with stakeholders
SEND Pathfinders – Personal Budgets
 20 Pathfinder sites – 31 Local Authority areas tasked to
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develop and trial –
An integrated assessment process;
A single, joined up, Education, Health & Care Plan;
Personal Budgets across education, social care &
health
Adult services
13 June 2013 – launch of a series of Pathfinder
Information Packs
Lessons from SE7 (Medway) Dec 2011
3 factors underpin the successful introduction of Personal Budgets
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Leadership and responsibility: addressing challenges,
removing barriers, informing staff, giving clear leadership
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Resourcing the work: giving time to resource the EHC timeline:
realistic and focused at the outset, 6 – 9 months for first group of
families
 Clarity about outcomes (define the change) and outputs
(concrete products or changes)
Lessons from Social Care – October 2012
 Debate over how PBs benefit different people in different ways
 The Office for Public Management, Essex County Council &
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user-led disability organization, ECDP, examined the impact of
PBs on the lives of people who use them (Oct 2012)
Differences in how budgets are used by different cohorts
Older people tend to prefer more traditional forms of support
Younger users favoured familiar people, often family members
PB holders of working age more likely to be creative to access
community services for personal development
Supply in some areas needs to catch up with demand
Evaluation of SEN Direct Payments – June 2013
 Across the 14 SEN DP pilot study sites –
 A total of 290 SEN DPs approved
 Over 270 covered home to school personal transport
 The others supported individual complex cases
 One area provided 7 direct payments for early years nursery
funding
 A low level of take up in the pilots driven by challenges and
complexities in the design & implementation of the DP.
 Over 50% of families invited to take part in the pilot chose not
to take up the offer of DPs but were keen to be involved in the
decision making process of support
Pathfinder Outcomes – Dec 2013 - Positive Outcomes
 Reinforces the importance of a person-centred approach
 Parents and young people have felt fully informed
 Parental fears allayed through discussion & planning processes
 Engagement with supportive Head Teachers seen as positive
 A phased approach to introduce the process
 Time spent working on the financial models and projections
 A different focus of conversation between the family, agencies
and the school/college
 Innovative solutions by empowering individuals to work
differently with families
 Close working with providers
Pathfinder lessons learned – December 2013
 DPs have meant some families operate as employers,
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contracting their child’s support
Need to comply with HMRC requirements
Not all families able to take on responsibility
A need for clear guidance on implications of managing the PB
Reality has been that many families seek support from
professionals to manage PB – an organized arrangement
LAs developing lists of preferred providers
Significant amount of work needed to develop the marketplace
to give families choice and control
The need for a phased approach crucial to its success
Main Challenges Ahead - December 2013
 A major culture change for families, the LA & providers
 Provider resistance a challenge
 Unpicking block contracts & developing the market place
 Building a robust resource allocation system
 Stimulating the private education market
 Developing more holistic wrap around support
 Enabling & supporting the culture shift to achieve a more
positive approach
 More case studies needed from a wider group of pathfinders
 Mott MacDonald (Version 3 – Dec 2013)
Local Concerns
 Public consultations: budgetary cuts & service
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revisions
The ‘Matrix of Need’ (Warwickshire Health & Social
Care)
Fear of diminishing services & high thresholds for
intervention to access services
Complexity of some service revisions
Heightened emotions, fear & anxiety
Battle mentality
Specialist Schools as a communication channel
Parental Voice & Anxiety
 “There
is an underlying concern that this...
is being driven by your need to prevent
parents and children from securing the
support they badly need in order to slash
your budget....”
 “It looks like services will just disappear
and that hardly any families will qualify for
personal budgets given how difficult you
have made it with your matrix...”
Twitter Comment @thelocaloffer
 “Where Local Authorities present #PersonalBudgets as
part of a rationalisation of services, alongside spending
cuts, there will be problems.”
 Jan 2014. @thelocaloffer
Parents, Young People, Schools & LAs
 Parents & Young People in the driving seat with PBs
 Represents a significant cultural change in relationships with
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schools and LAs
The ascendancy of advocates, key workers, parent partnership
groups & services
The importance of knowing the child & the family
A redistribution of control and lessening of the influence of LAs
Greater parental reliance on family & community wealth &
networks of support
A reduction in block commissioning of support as PBs become
part & parcel of new systems
Involving Families & Young People
 South East 7 – Pathfinder group (Medway, Kent, Surrey,
West Sussex, East Sussex, Brighton, Hove & Hampshire)
 A regular amount of money agreed by Children’s Services
to help children meet needs, hopes & aspirations...
 A need to think about what a child likes and enjoys, as well
as needs
 Parents encouraged to choose a friend to help create the
plan alongside an independent facilitator – reference to
the family’s social worker
Assessment & Planning Framework
In Control’s 7 Steps Plan
1. Need help
2. Making the most of existing resources (real wealth)
3. Making a plan
4. Agreeing the plan
5. Managing support
6. Living my life
7. Review and learn
Integrated Model of Assessment & Planning
(Southampton Pathfinder)
 Phase 1 – preparation & consideration (first
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assessment meeting)
Phase 2 – listen and understand (parental input,
home/school observations & visits)
Phase 3 – Analyse and synthesize (final assessment
team meeting)
Phase 4 – Agree and allocate
Phase 5 – Monitor and review (first review meeting)
Funding Personal Budgets
Components of a Personal Budget
1. Education
2. Health
3. Social care
4. At a school/Head’s discretion additional funding may
be contributed
 LAs and their partners are encouraged to develop a
single integrated fund from which a single PB can be
made available
Personal Budgets & EHC Plans
 Local Authorities prepare a Personal Budget if it identifies an amount
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as available to secure provision
The Education, Health & Care Plan may set out The amount of a personal budget
The sources of the contributing funds
Details of payments to be made to a child’s parent
The description of provision to which PBs may relate
When, how, to whom & on what conditions direct payments may be
made
When direct payments may be required to be repaid and the
recovery of unpaid sums
4 mechanisms for control of a Personal Budget
 An organised arrangements – LA retains management
& commissions support
 Third party/nominees – an individual or organization
manages the funds on behalf of parent/young person
 Direct payment – funds are paid direct to parent/young
person to contract, purchase & manage services
 A combination of the above
Addressing Needs & Seeking Outcomes
 Statement of SEN – 1996 Education Act – parallels
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with EHC Plans –
Part 1 – Sources of evidence – education & health
Part 2 – Statement of SEN
Part 3 – Objectives & educational provision
Part 3 – Resource allocation
Part 5 – Non educational needs – health & other
Part 6 – Non educational provision – travel
Opportunities for PBs - Jamie, Year 4
 Part 1 – Sources of
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evidence (of SEN)
SENCo/teacher/TA
Educational Psychologist
Speech therapist
CAMHS
HM Stack Consulting –
specialist services
Provision Mapping for PBs - Jamie
 ADHD – medication prescribed
 CAMHS involvement
 Parenting Project
 Anger management strategies
 Emotional resilience
 Listening skills
 Reading & literacy skills
 Friendship skills
 Gross & fine motor skills difficulties
Isabel
Dept for Speech &
language therapy
Educational
Psychology
CAMHS
Learning & Behaviour
Support Service
HM Stack Consulting
Hearing Impairment
Service
Provision Mapping for PBs - Isabel
 Ritualistic & anxiety driven behaviours
 Family history of Obsessive Compulsive Disorder
 Trichotilomania – discreet entity or part of more
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complex presentation
Friendship difficulties
Difficulties understanding & managing emotions
Vivid fantasy & imaginative life
Reading & literacy difficulties
Personal Budgets – Opportunities
 Personal Budgets create opportunities to  Meet presenting needs in a timely manner
 Give choice and control to parents & young people
 Direct services to providing support
 Meet stated outcomes in EHC plan
 Use resources effectively
 Create collaborations between sectors & services
 Ensure support interventions are not ‘tagged on’ in
isolation of the curriculum & the learning environment
Independent Supporters
 Government allocation of £30m available until March 2016
 Funding to cover costs of recruitment, management & training
 Anticipating 1,800 Independent Supporters, c 12 per each LA
 Council for Disabled Children (CDC) appointed to oversee & trial
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delivery methods
Individuals recruited & managed by Private, Voluntary & Community
sector (PVC) to provide advice & support for parents
To offer time-limited support & advice on personal budgets to
families
Independent from the LA but part of the offer of support that LAs
should make available
To work alongside Parent Partnership Services & Key Workers
 (last update 7th January 2014)
Hierarchy of Services & Support
 Universal services – local services, health & education
 Targeted services – CAMHS, children’s learning
disability team & others
 Community wealth – support groups & local services
 Real wealth – knowledge, experience & skills of family
 Specialist support services – additional & individual
needs over and above that which can be provided by
universal, targeted, community & family wealth
systems – the focus of the Personal Budget
Delivery Models
Universal
Services
Parental
Support
Child
Specialist
Services
(Personal
Budget)
Targeted
services
and
support
Expectations of Parents - Auditing Accounts
 Need for parents to keep a record of payments received via
direct payment & paid out to services
 A social worker, or other facilitator, will carry out regular audits
at pre-arranged times to look at paperwork –
 Invoices & bank statements to be kept safely for this purpose
 First review at 3 months and then at 6 monthly intervals to
consider whether EHC plan outcomes are being achieved
Schools & the SEND Journey
 Relationships with parents of children with SEND built up
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over a period of time
Gradual move to EHC Plans to replace Statements of Need
Children currently eligible for a statement of SEN or
Learning Difficulty Assessment
Children who are not yet of school age but likely to be
eligible for a Statement
Children who have both complex health & complex social
care needs
Promoting PBs to Hard to Reach Parents
 Lessons learned from Pathfinders indicate differences in
the way different cohorts take up and use Personal
Budgets
 A need to ensure that PBs serve the needs of all parents
and not just vocal, articulate, middle-class parents
 A need to ensure that efficient support is given to guide
parents through processes
 A need for schools to be vigilant to local changes in service
delivery, roles & opportunities in SEND management
The Double Funding Dilemma
 Commissioners must decide on funding approaches
with schools & parents
 What is to be provided through central or school
budget & what provided through a personal budget?
 Some health provision may be chosen by parents
through a PB – but may also be funded by school & LA
or local health service
 A need to avoid double funding to avoid detrimental
impact on provision & to make efficient use of
resources
Education, Health & Care Professionals
 Clinical psychologists
 Child & Adolescent Mental Health Services
 Community Paediatricians
 Community Support Workers
 Community Children’s Nurses
 Educational Psychologists
 Early Years Support Services
 Learning Disability Nurses
 Occupation Therapists & Physiotherapists
Education, Health & Social Care Professionals (2)
 Portage Home Visitors
 SEN Officer & Personal Advisors
 Social Workers
 SEN Co-ordinators
 Specialist Teacher Advisors
 Speech & Language Therapists
 Independent sector SEND consultants & advisors
 Consortiums of specialist providers & practitioners
 Community & Voluntary sector providers
Information for Parents
 Parents Guide to Personal
Budgets
 Case Studies
 E-learning
 Commissioners’ Guidance
 http://www.kids.org.uk
Key Challenges
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Implementing lessons learned from Pathfinders
Understanding local perceptions and strength of parental
feeling towards reforms and PBs
Strengthening the role of key workers & Independent
Supporters
Gaining the involvement of CYP in their EHC Plans
Understanding and knowing the diversity and breadth of
provision from all sectors within a locality
SEND providers making clear a realistic costing of services and
provision shared with stakeholders
Personal Budgets – An Overview by  HM Stack Consulting –
An independent consultancy service working with public, private
and third sector providers with and on behalf of children and
young people with SEND 0 – 25 years
[email protected]
Heather is also Founder of
 The Local Offer –
The first national brokerage service uniting the needs of parents,
schools, commissioners & providers of education, health & social
care services
[email protected] ~ www.thelocaloffer.co.uk