Transcript Active Listening

Personalisation
Personalisation means….
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Starting with the person as an individual with strengths, preferences
and aspirations and putting them at the centre of the process of
identifying their needs and making choices about what, who, how
and when they are supported to live their lives.
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Addressing the needs and aspirations of whole communities to
ensure everyone has access to the right information, advice and
advocacy to make good decisions about the support they need. It
means ensuring that people have wider choice in how their needs
are met and are able to access universal services such as transport,
leisure and education, housing, health and opportunities for
employment regardless of age or disability.
(Personalisation briefing, SCIE, 2009)
Beliefs for social care
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Disabled people are vulnerable and should be taken
care of by trained professionals.
Existing services suit people well – the challenge is to
assess people and decide which service suits them.
Money is not abused if it is controlled by large
organisations or statutory authorities.
Family and friends are unreliable allies for disabled
people and where possible should be replaced by
independent professionals.
Duffy, 2005, p10
Beliefs for self-directed support
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Every adult should be in control of their life, even if they
need help with choices.
Everybody needs support that is tailored to their situation
to help them sustain and build their place in the
community.
Money is most likely to be used well when it is controlled
by the person or people who care about the person.
Family and friends can be the most important allies for
disabled people and make a positive contribution to their
lives.
Duffy, 2005, p10
Valuing People (DH, 2001)
Four key principles:
 Rights
 Choice
 Independence
 Control
In Control 2003
Joint leadership of Mencap and the
Valuing People Support Team
 Resources from buildings and pre-paid
services to individuals
 Six local authorities responded to in
Control’s invitation to pilot (and fund) new
ways of working in their own areas.
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Spot the difference
Old ‘professional gift’ model:
 State uses the money it receives from taxes to slot people into prepaid services through the work of professional assessors and
gatekeepers
 Care manager identifies needs, then services, then funding
New ‘citizenship model’:
 Disabled person is at the centre of the process, is part of the
community and organises the support they need and want
 Individual identifies their needs, is given an indicative budget and
then plans provision to meet the identified needs: self-directed
support.
Seven steps to self-directed support
Set a personal budget
 Plan support
 Agree plan
 Manage personal budget
 Organise support
 Live life
 Review and learn
www.in-control.org.uk
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Setting the budget
Initial assessment screening to check
eligibility
 Completion of self-assessment
questionnaire
 Number of points scored is multiplied by
the price point to give the budget available
to meet the needs identified.
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Funding for Individual Budgets
Variety of existing funding streams:
 Adult social care
 Community equipment
 Independent Living Fund
 Access to Work
 Supporting People.
Government support for personal budgets
Demonstrated in four government publications in 2005:
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Independence, Wellbeing and Choice (Green Paper)
Pilots in 13 sites
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Improving the Life Chances of Disabled People (Strategy Unit Report)
Assessment and advocacy
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Opportunity Age (DWP report)
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Labour Party manifesto
Putting People First (2007)
Signatories:
 Six government departments
 National health and social care organisations
 Local government
‘The time has now come to build on best practice and replace paternalistic,
reactive care of variable quality with a mainstream system focused on
prevention, early intervention, enablement, and high quality personally
tailored services. In the future, we want people to have the maximum
choice, control and power over the support services they receive.’
(HM Government, 2007, p2)
Transformation agenda
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Based on Putting People First and guidance in local
authority circulars Transforming Adult Social Care (2008
and 2009)
System wide transformation aiming at personal budgets
for everyone receiving social care funding except in
emergency situations.
Social Care Reform Grant provides ring-fenced funding
for three years from 2008 to support local authorities to
make the changes needed.
Has prompted new Fair Access to Care eligibility criteria
guidance, with the consultation period ending in October
2009.
Expansion beyond adult social care
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Pilot of personal health budgets announced in
2009.
Health Bill 2009
Proposes provision for direct payments by health
authorities
£520m from health to local authorities
Children’s Services pilots
Other local and national government
departments
Social work’s contribution
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A preventative approach
The ability to work with complex situations and
with different agencies and sectors
The capacity to perform a wide range of tasks
including brokerage and advocacy
Flexibility and accountability
GSCC (2008)
Statutory role in seven steps
When a decision is made about the
amount of the personal budget
 When the support plan is agreed
(including ensuring the plan is safe and
that people have any necessary
representation)
 When the plan is reviewed
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New roles for social workers
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Advisers
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Navigators
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Brokers
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Service providers
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Risk assessors and auditors
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Designers of social care systems
Resistance from social workers
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Suspicion about government’s motives
Lack of training and information
Workload implications
Inadequate funding of direct payments and personal budgets
Concern that directly provided services and the people using them will become the
poor relation
Fears that service users will be left vulnerable to abuse or at risk of significant harm
Issues around exploitation of care workers and women
Concern that some people will be packed off with a personal budget because they
are seen as trouble-makers
Doubts about individuals managing their own support and budgets
PA recruitment difficulties
Desire to maintain professional status and role
Glasby and Littlechild (2009, p 131-132)
Managers’ concerns
All of the above, with emphasis on:
 Protecting in-house services
 Controlling expenditure through a traditional
gatekeeping role
 Safeguarding at the expense of rights and
responsibilities
 Protecting their resources from an increased risk
of fraud and financial abuse
A way forward
Ensure that:
 Social workers are involved in planning change
 Points of resistance are treated as indications
that important issues need to be tackled
 Implications for individual workers are
addressed
 Social workers have the skills and support
needed to work differently.
References
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Duffy, S (2005) ‘Will “in Control” at last put people in charge of their lives?’ Community Living, vol 18, no 4, pp 1013
Glasby, J and Littlechild R (2009) Direct Payments and Personal Budgets: Putting Personalisation into Practice
Bristol: The Policy PressGSCC (2008) (Digitised chapter on Blackboard)
The GSCC response to putting people first making it
happenhttp://www.gscc.org.uk/Policy/Consultations/ResponsePuttingPeopleFirst [ accessed on 1/12/09 SCIE
(2009)
Personalisation: a Rough Guide London: SCIE (See SCIE website)
Legislation, reports and guidance
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LAC (DH) (2008) 1 Transforming Social Care
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LAC (DH) (2009) 1 Transforming Adult Social Care
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HM Government (2007) Putting People First: A shared vision and commitment to the transformation of Adult
Social Care, London: HM Government
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DH (2001) Valuing people: a new strategy for learning disability for the 21st century. Norwich: The Stationery
Office
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DH (2005) Independence, Well-being and Choice, London: The Stationery Office
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DH (2006) Our Health, Our Care, Our Say, London: The Stationery Office
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DH (2009) Prioritising need in the context of Putting People First: A whole system approach to eligibility for social
care, London: The Stationery Office
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HM Government (2005) Opportunity age: meeting the challenges of ageing in the 21st century, London:
Department of Work and Pensions
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Prime Minister’s Strategy Unit (2005) Improving the Life Chances of Disabled People, London: Prime Minister’s
Strategy Unit