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Self-directed support: national policy Jean MacLellan, Head of Adult Care and Support Division Emma Sinclair, Team leader of Self-Directed Support What is self-directed support • Money paid to people who use services to have more choice and flexibility; • Can be instead of (or in addition to) support services that a local authority would provide to meet assessed needs; • Ranges from personal care or short breaks to leisure activities; • Complements policies on Changing Lives and Independent Living; most radical aspect of personalisation Manifesto Commitments • We will do more to empower individuals and communities to have more control over their own lives and more choice in how their needs are met; • We will encourage the wider use of direct payments, particularly in groups where take-up has been low. We will also trial the development of individual budgets to extend the flexibility and choice of services available for people with a disability and who have an assessed need for care support; • We will extend direct payments to carers. So what’s the difference between direct payments and self-directed support? • A direct payment historically used social care monies to meet assessed social care needs; • Self-directed support makes it possible to use several funding streams such as ILF, health monies etc to meet wider needs and promote social inclusion. Evidence base • Riddell et al (2006) considered the effectiveness of implementation of self-directed support since enactment of Health and Social Care (Scotland) Act 2002 • Homer and Gilder (2008) A Review of Self- directed Support considered the experience of clients Main findings Homer and Gilder 2008 • Overwhelming majority of clients and informal carers had very positive experiences of using self-directed support funding… flexibility, control and choice were the main benefits reported. • The key enablers to facilitating growth at a strategic level were identified as effective leadership on the part of local authorities, a dedicated resource providing knowledgeable and skilled support to clients and the capability to apply consistent and appropriate lighter touch practices and procedures in the administration of funding rules. Riddell et al 2006 • Local authorities have not as yet shifted funds from traditional services into direct payments and there are anxieties that an increase in uptake of direct payments might destabilize existing provision. • Local authorities have major anxieties about financial accountability issues and social workers feel the paperwork associated with direct payments is onerous. What’s happening to improve uptake? • Ministerial roundtable – 3 June 2008 • Developing self-directed support strategy with recommendations for action; publish early 2009 • Key strand of strategy – 3 local authority test sites over 2 years; themes of cutting red tape, investing to save, leadership and training • Other areas of investment: research on personal assistant workforce; improved communication tools; support for service providers to adapt services; consideration of particular needs of client groups.
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