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Personalised Support - Personal Budgets & Flexible Support
The document discusses the evolution and impact of personalized support and individual budgets for people with disabilities, emphasizing grassroots activism and the need for policy changes over the past 50 years. Key innovations and practices identified include individual service design and individualized funding, which have led to improved outcomes and reduced costs for service users. Challenges such as austerity and institutionalization persist, but there are emerging opportunities for transformation through community-focused approaches and effective advocacy.
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Similar to Personalised Support - Personal Budgets & Flexible Support
Personalised Support - Personal Budgets & Flexible Support
- 1. Personalised Support Personal Budgets& Flexible Support
- 2. 1. History 2. Innovations 3.Impact 4. Challenge 5. Opportunity
- 3.
- 4. • The bestway to think about personalised support is not by starting with government policy. • This is an ethical issue, which has been driven forward by radical grassroots action. • 50 years ago disabled people started demanding the right to be citizens. • Two generations of battle to close institutions and develop personalised forms of support instead. • Today there is still much to do…
- 5. Combine with lobbyingfor political and legal changes activist have created practical alternatives. For people with learning disabilities some of the most important include: 1. Individual service design, planning and policies 2. Managed personal assistants and shared management 3. Individualised funding (e.g. Individual Service Funds) 4. Supported decision-making and family leadership 5. Access to ordinary housing 6. Quality checking by people and families
- 7.
- 8. Recent survey of156 providers of personalised support helps reveal some of the key elements involved in providing personalised support.
- 12. WHAT IS…? NOT… Individualdesign slotting people into a placement Creative planning another ?@*&^ person-centred plan People/families make decisions it’s the organisation’s way or the highway Quality checking professional knows best Matching staff to people generic support roles Individualised policies organisational health & safety rules Full housing options we’ve got a lovely group home for you People/families recruit staff staffing is our business Individual budget protected money is a mystery Direct management possible their our staff, not yours
- 13. Not all personalisedsupport providers were using Individual Service Funds (ISFs) yet. However the organisations that had been using ISFs the longest are most likely to be doing all the key elements of personalised support.
- 15.
- 16. • Focus -The solution to one person’s needs doesn’t get muddled up with others • Creativity - You can create solutions around that person’s community and dreams • Trust - Everyone believes that the person’s budget is safe and changes benefit them
- 17.
- 19. Inclusion Glasgow workedwith people with complex disabilities, moving from institutions to individually designed support solutions in the community. Research on the work of Inclusion Glasgow demonstrated high levels of efficiency, improvements in people’s lives and lower costs over time. There was a 46% reduction in hours of support over a 5 years period.
- 24. Choice Support converteda block contract for 83 people into 83 personal budgets - managed by the organisation - ie. Individual Service Funds (ISFs). This work was associated with reduced costs and improved lives. Like many service providers, Choice Support were happy to accept short termination periods on that contracts - and the ability of people to end those contracts - instead of risky block contracts subject to tendering and procurement.
- 25. Choice Support converteda large block contract into 83 individualised services, with a saving of 28% over 3 years.
- 26. Social workers andsupport staff came to see the process as personally rewarding.
- 28. • Today GlasgowCouncil are threatening to put Margaret in a care home because her package of support is too high. • Her carers and independent citizens are being denied the right to advocate for Margaret.
- 29.
- 30. • Austerity andcuts to social care • On-going institutionalisation • Procurement and tendering practices • Lobbying by residential care industry • Fragmented advocacy movement
- 34. • In a3 month period 25.9% of inpatients had harmed themselves • 21.0% of inpatients had suffered an accident in the last 3 months • 22.2% of people had suffered physical assault in the last 3 months • Physical restraint had been used 34.2% of people in the last 3 months 11.4% had suffered seclusion in the last 3 months • 56.6% of people had been the subject of at least one incident involving self harm, an accident, physical assault against them, hands-on restraint or seclusion during the last three months • Antipsychotic medication used regularly or at least once in the last 28 days for 68.3% of the people in the units
- 36. …confused responsibility &liability
- 37. We still spendmost of out social care funding on residential care (but that is now dropping)
- 38. • Many charitiesunwilling or unable to campaign • Different disability groups competing • Government threatening behaviour (e.g. lobbying act and other restrictions on free speech) • Confusion about what kind of system people want to defend (e.g. residential care vs. inclusion) • System confusion (e.g. children vs adults; health vs social care) • Public and media ignorance
- 39.
- 40. • Some commissioners,like Dorset, see there’s a better way • Care Act 2014 and NHS personalisation supports the change • Limited funding can be used more effectively with creativity and focus on community connections • There is effective on-going pressure around ATUs etc. • Many providers want to break out of long-term block of framework contracts and be accountable to people.
- 42. Recent work inCalderdale has led to the use of ISFs becoming the main way that home care is provided. Over time this is encouraging more innovative and flexible support from service providers.
- 45. MOST IMPORTANTLY -to provide creative and flexible support to people as citizens is what people want and it’s much more fulfilling
- 47. 1. Get connected 2.Get informed 3. Learn from others 4. Share with others 5. Change the world
- 51. We learn incommunity
- 52.
- 53. Can you findways to collaborate today?
- 54. Join Citizen Networktoday Individuals can join FREE bit.ly/citizen-network-individuals Groups can join FREE bit.ly/citizen-network-groups
- 55.