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Self-directed Support – Older People’s Service Providers EVOC thinkSpace 20 June 2014 1 Agenda • The nuts and bolts of how self-directed support is working in Edinburgh • Principles behind the new assessment process • How is it bedding down • Challenges/solutions, future thinking 2 Key messages 1 It’s a 10 year strategy with 6 years to go – that makes it a marathon not a sprint! 3 What we needed to have in place for 1st April Outcome focused assessment Support for informed choice Able to offer 4 options of SDS Indicative budget Promote a diverse market 4 Principles in SDS Act 5 Supported person must: • be as involved as they wish in their assessment and support • be provided with assistance to express their views and make informed choices Local authority must: • collaborate with people in respect of assessment and support • take reasonable steps to ensure people’s right to dignity and participation in the life of their community is respected The Person’s pathway 6 Key messages 2 It’s not only what you do the way that you do it is often more important 7 The Practicalities 8 The Council’s obligations in terms of assessment have not changed We still have a duty to: Assess people who present to us as appearing to have needs which the local authority should meet 9 Make provision available to meet any needs we have identified as being “eligible” Critical Substantial Eligibility Criteria Low Moderate • Worker’s professional decision based upon assessment • Must be recorded 10 What service users want from assessment 11 Assessment Approach Outputs • Person centred • Needs and abilities • Outcome focused • Eligibility • Conversational • Personal outcomes • Collaborative • Risks identified • Resources required 12 The Assessment Tool • • • • • • • • Electronic not paper based Gathers general details Identifies needs & abilities Identifies current supports Records views of others Records risks Considers the person’s level of capacity Generates a score based upon the professional judgement of the assessor • Identifies outcomes 13 Needs and abilities Needs and abilities rated in 7 domains and expressed as a numeric score: • • • • • • • 14 Personal support needs Nutrition Important decisions about my life Work and learning Leisure and community Caring for my family Risks to my wellbeing Needs and abilities continued • Tool should be used to record conversation not lead it • Free text with prompts 15 Funding Allocation System 16 Generating the score 17 Step 1 Needs and abilities expressed as a score Step 2 Quantify informal support Step 3 Quantify impact on informal carer Step 1 – Level of need 18 Assessment levels & bandings I do not need support I need total Support A 9.1 I am able to manage for myself 19 B C D 9.2 I do things I want to in my community. I need support to continue to do these A B C 9.3 I need support to do more in the community D A B C D 9.4 I need someone to support me closely to help me to make or maintain connections with friends, relatives and people in the community where I live Step 2 – Informal support Recorded for each domain and used to adjust the score 20 Step 3 – Impact on carer 21 The final score • The final score is arrived at by adding together: the scores for each domain adjusted to take account of informal care and the score for the impact of providing informal care on the carer 22 Measured approach Bandings • Rather than specific amounts Maximum amount • Limited to £500 per week (£26,000 per annum) initially People with complex needs • Deal with on a case by case basis Controls • Assessments approved by seniors • Ongoing monitoring 23 What people say they want from support planning How do I want to live my life As person centred as possible Worker knows “what’s out there” Same people involved to build trust Be creative If it’s not working who do I go to? 24 Support planning Purpose • Decide how support needs and outcomes should be met Collaboration • Person to have as much involvement as they wish, including deciding who should support them to produce their plan Scope • Not just about eligible needs and outcomes – but money is! Proportionate • Appropriate and sensible approach 25 4 options of Self-directed Support 26 Option 1 Direct Payment Option 2 Individual selects support and asks the local authority or a third party organisation to arrange Option 3 Local authority selects and arranges the support Option 4 Mix of options 1, 2 and 3 for different aspects of the person’s support Edinburgh approach to Option 2 27 ISF Process Supported Person Council 28 Provider Service delivery • Flexible • Person-centred • Directed by the individual as far as they wish and is appropriate • Choice, control and collaboration is not just for those eligible for the 4 Options of SDS 29 Reviews Outcomes Needs Support Plan SDS Option Reviewing and transitioning existing service users to SDS 30 Early indications … • Too early to get any really clear picture, but: ▪ some evidence that assessments are taking longer ▪ some examples of creativity ▪ some consistency issues being picked up by seniors and managers ▪ Need to train more staff more quickly 31 Challenges, opportunities and future thinking • Embedding SDS across whole staff group • Ensuring a proportionate approach • Fostering creativity • Collaborative approach to evaluation and monitoring 32 How does it feel to you? 33