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Self-directed Support –Older People’s Service

Providers

EVOC thinkSpace20 June 2014

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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

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Key messages 1

It’s a 10 year strategy with 6 years to go – that makes it

a marathon not a sprint!

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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

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Principles in SDS Act

•be as involved as they wish in their assessment and support

•be provided with assistance to express their views and make informed choices

Supported person 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

Local authority must:

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The Person’s pathway

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It’s not only what you do the way that you do it is often more important

Key messages 2

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The Practicalities

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Assess people who present to us as

appearing to have needs which the local

authority should meet

The Council’s obligations in terms of assessment have not

changedWe still have a duty to:

Make provision available to meet any

needs we have identified as being

“eligible”

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Critical

Substantial

Low Moderate

EligibilityCriteria

• Worker’s professional decision based upon assessment

• Must be recorded

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What service users want from assessment

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Assessment

• Person centred

• Outcome focused

• Conversational

• Collaborative

Approach

• Needs and abilities

• Eligibility

• Personal outcomes

• Risks identified

• Resources required

Outputs

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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

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Needs and abilitiesNeeds and abilities rated in 7 domains and expressed as a numeric score:

• Personal support needs• Nutrition• Important decisions about my life• Work and learning• Leisure and community• Caring for my family• Risks to my wellbeing

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Needs and abilities continued• Tool should be used to record

conversation not lead it• Free text with prompts

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Funding Allocation System

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Generating the score

Step 1

Step 2

Step 3

Needs and abilities expressed as a score

Quantify informal support

Quantify impact on informal carer

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Step 1 – Level of need

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Assessment levels & bandings

I am able to manage for

myself

I need total Support

A A A BBB C DCC DD

9.1 9.2 9.3 9.4I do things I

want to in my community. I need support to continue to

do these

I need support to do more in

the community

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

I do not need

support

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Step 2 – Informal supportRecorded for each domain and used to adjust the score

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Step 3 – Impact on carer

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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

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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

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What people say they want from support planning

How do I want to live my life

Worker knows “what’s out

there”

Be creative

If it’s not working who do

I go to?

Same people involved to build

trust

As person centred as possible

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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

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Option 1

Option 2

Option 3

Option 4

Direct Payment

Individual selects support and asks the local authority or a third party

organisation to arrange

Local authority selects and arranges the support

Mix of options 1, 2 and 3 for different aspects of the person’s support

4 options of Self-directed Support

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Edinburgh approach to Option 2

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ISF Process

Supported Person

Personal Plan Terms

and Conditions

ProviderFramework AgreementCouncil

Supp

ort Pl

an a

nd

Fund

ing

Allo

cation

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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

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Reviews

Outcomes Needs Support

PlanSDS

Option

Reviewing and transitioning existing service users to SDS

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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

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Challenges, opportunities and future thinking

• Embedding SDS across whole staff group

• Ensuring a proportionate approach• Fostering creativity• Collaborative approach to evaluation

and monitoring

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How does it feel to you?