HEATHER M STACKSEND CONSULTANT, HM STACK CONSULTING

MARCH 2014

Personal Budgets - SEND

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 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) ProgrammeMott 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 48Draft: SEN Code of Practice – section 7.12 Requesting a Personal

BudgetDraft: Personal Budget RegulationsConsultation on transition to Education, Health & Care Plans and

the Local OfferSupport & 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 Pathfinders2. Understanding local perceptions and strength of parental

feeling towards reforms and PBs 3. Strengthening the role of key workers & Independent

Supporters4. Gaining the involvement of CYP in their EHC Plans 5. Understanding and knowing the diversity and breadth of

provision from all sectors within a locality 6. 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 develop and trial –

An integrated assessment process;A single, joined up, Education, Health & Care Plan;Personal Budgets across education, social care &

healthAdult 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

Leadership and responsibility: addressing challenges, removing barriers, informing staff, giving clear leadership

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 waysThe Office for Public Management, Essex County Council &

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 approvedOver 270 covered home to school personal transportThe others supported individual complex casesOne 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 approachParents and young people have felt fully informed Parental fears allayed through discussion & planning processesEngagement with supportive Head Teachers seen as positive A phased approach to introduce the processTime spent working on the financial models and projectionsA different focus of conversation between the family, agencies

and the school/collegeInnovative solutions by empowering individuals to work

differently with familiesClose working with providers

Pathfinder lessons learned – December 2013

DPs have meant some families operate as employers, contracting their child’s support

Need to comply with HMRC requirementsNot all families able to take on responsibility A need for clear guidance on implications of managing the PBReality has been that many families seek support from

professionals to manage PB – an organized arrangementLAs 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 & providersProvider resistance a challengeUnpicking block contracts & developing the market placeBuilding a robust resource allocation systemStimulating the private education marketDeveloping more holistic wrap around supportEnabling & supporting the culture shift to achieve a more

positive approachMore case studies needed from a wider group of pathfinders Mott MacDonald (Version 3 – Dec 2013)

Local Concerns

Public consultations: budgetary cuts & service revisions The ‘Matrix of Need’ (Warwickshire Health & Social

Care)Fear of diminishing services & high thresholds for

intervention to access servicesComplexity of some service revisionsHeightened emotions, fear & anxietyBattle mentalitySpecialist 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

schools and LAsThe ascendancy of advocates, key workers, parent partnership

groups & servicesThe importance of knowing the child & the family A redistribution of control and lessening of the influence of LAsGreater parental reliance on family & community wealth &

networks of supportA 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 help2. Making the most of existing resources (real wealth)3. Making a plan 4. Agreeing the plan 5. Managing support6. Living my life 7. Review and learn

Integrated Model of Assessment & Planning (Southampton Pathfinder)

Phase 1 – preparation & consideration (first 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 allocatePhase 5 – Monitor and review (first review meeting)

Funding Personal Budgets

Components of a Personal Budget

1. Education2. Health 3. Social care4. At a school/Head’s discretion additional funding may

be contributedLAs 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 as available to secure provision

The Education, Health & Care Plan may set out - 1. The amount of a personal budget2. The sources of the contributing funds 3. Details of payments to be made to a child’s parent4. The description of provision to which PBs may relate5. When, how, to whom & on what conditions direct payments may be

made6. 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 with EHC Plans –

Part 1 – Sources of evidence – education & health Part 2 – Statement of SEN Part 3 – Objectives & educational provisionPart 3 – Resource allocationPart 5 – Non educational needs – health & otherPart 6 – Non educational provision – travel

Opportunities for PBs - Jamie, Year 4

Part 1 – Sources of evidence (of SEN)

SENCo/teacher/TAEducational PsychologistSpeech therapistCAMHSHM Stack Consulting –

specialist services

Provision Mapping for PBs - Jamie

ADHD – medication prescribedCAMHS involvementParenting ProjectAnger management strategiesEmotional resilienceListening skillsReading & literacy skillsFriendship 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 behavioursFamily history of Obsessive Compulsive DisorderTrichotilomania – discreet entity or part of more

complex presentationFriendship difficultiesDifficulties understanding & managing emotionsVivid fantasy & imaginative lifeReading & literacy difficulties

Personal Budgets – Opportunities

Personal Budgets create opportunities to - Meet presenting needs in a timely mannerGive choice and control to parents & young people Direct services to providing supportMeet stated outcomes in EHC planUse resources effectivelyCreate collaborations between sectors & servicesEnsure support interventions are not ‘tagged on’ in

isolation of the curriculum & the learning environment

Independent Supporters

Government allocation of £30m available until March 2016Funding 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

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 availableTo work alongside Parent Partnership Services & Key Workers (last update 7th January 2014)

Hierarchy of Services & Support

Universal services – local services, health & educationTargeted services – CAMHS, children’s learning

disability team & othersCommunity wealth – support groups & local servicesReal wealth – knowledge, experience & skills of familySpecialist 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

Child

Universal

Services

Targeted services

and support

Specialist

Services (Personal Budget)

Parental 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 purposeFirst 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 over a period of time

Gradual move to EHC Plans to replace Statements of NeedChildren currently eligible for a statement of SEN or

Learning Difficulty AssessmentChildren 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 psychologistsChild & Adolescent Mental Health ServicesCommunity PaediatriciansCommunity Support WorkersCommunity Children’s NursesEducational PsychologistsEarly Years Support ServicesLearning Disability NursesOccupation Therapists & Physiotherapists

Education, Health & Social Care Professionals (2)

Portage Home VisitorsSEN Officer & Personal AdvisorsSocial WorkersSEN Co-ordinatorsSpecialist Teacher AdvisorsSpeech & Language Therapists Independent sector SEND consultants & advisorsConsortiums of specialist providers & practitionersCommunity & Voluntary sector providers

Information for Parents

Parents Guide to Personal Budgets

Case StudiesE-learningCommissioners’ Guidance

http://www.kids.org.uk

Key Challenges

1. Implementing lessons learned from Pathfinders2. Understanding local perceptions and strength of parental

feeling towards reforms and PBs 3. Strengthening the role of key workers & Independent

Supporters4. Gaining the involvement of CYP in their EHC Plans 5. Understanding and knowing the diversity and breadth of

provision from all sectors within a locality 6. 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 yearsheather@hmstack.com

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 info@thelocaloffer.co.uk ~ www.thelocaloffer.co.uk