Personal Budgets - SEND

1. Personal Budgets - SEND Heather M Stack SEND Consultant, HM Stack Consulting March 2014

2. 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.”

3. 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) Programme Mott MacDonald contracted to deliver Pathfinder Support by Dept for Education

4. 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)

5. Bills & Supporting Documents Children & Families Bill – clause 48 Draft: SEN Code of Practice – section 7.12 Requesting a Personal Budget Draft: Personal Budget Regulations Consultation on transition to Education, Health & Care Plans and the Local Offer Support & 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

6. Key Challenges Implementing lessons learned from Pathfinders Understanding local perceptions and strength of parental feeling towards reforms and PBs Strengthening the role of key workers & Independent Supporters Gaining the involvement of CYP in their EHC Plans Understanding and knowing the diversity and breadth of provision from all sectors within a locality SEND providers making clear a realistic costing of services and provision shared with stakeholders

7. 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 & health Adult services 13 June 2013 – launch of a series of Pathfinder Information Packs

8. 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)

9. Lessons from Social Care – October 2012 • Debate over how PBs benefit different people in different ways • The 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

10. Evaluation of SEN Direct Payments – June 2013 Across the 14 SEN DP pilot study sites – A total of 290 SEN DPs approved Over 270 covered home to school personal transport The others supported individual complex cases One 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

11. Pathfinder Outcomes – Dec 2013 - Positive Outcomes Reinforces the importance of a person-centred approach Parents and young people have felt fully informed Parental fears allayed through discussion & planning processes Engagement with supportive Head Teachers seen as positive A phased approach to introduce the process Time spent working on the financial models and projections A different focus of conversation between the family, agencies and the school/college Innovative solutions by empowering individuals to work differently with families Close working with providers

12. Pathfinder lessons learned – December 2013 DPs have meant some families operate as employers, contracting their child’s support Need to comply with HMRC requirements Not all families able to take on responsibility A need for clear guidance on implications of managing the PB Reality has been that many families seek support from professionals to manage PB – an organized arrangement LAs 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

13. Main Challenges Ahead - December 2013 A major culture change for families, the LA & providers Provider resistance a challenge Unpicking block contracts & developing the market place Building a robust resource allocation system Stimulating the private education market Developing more holistic wrap around support Enabling & supporting the culture shift to achieve a more positive approach More case studies needed from a wider group of pathfinders Mott MacDonald (Version 3 – Dec 2013)

14. 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 services Complexity of some service revisions Heightened emotions, fear & anxiety Battle mentality Specialist Schools as a communication channel

15. 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...”

16. 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

17. Parents, Young People, Schools & LAs Parents & Young People in the driving seat with PBs Represents a significant cultural change in relationships with schools and LAs The ascendancy of advocates, key workers, parent partnership groups & services The importance of knowing the child & the family A redistribution of control and lessening of the influence of LAs Greater parental reliance on family & community wealth & networks of support A reduction in block commissioning of support as PBs become part & parcel of new systems

18. 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

19. Assessment & Planning Framework

20. In Control’s 7 Steps Plan Need help Making the most of existing resources (real wealth) Making a plan Agreeing the plan Managing support Living my life Review and learn

21. 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 allocate Phase 5 – Monitor and review (first review meeting)

22. Funding Personal Budgets

23. Components of a Personal Budget Education Health Social care At a school/Head’s discretion additional funding may be contributed LAs and their partners are encouraged to develop a single integrated fund from which a single PB can be made available

24. 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 - The amount of a personal budget The sources of the contributing funds Details of payments to be made to a child’s parent The description of provision to which PBs may relate When, how, to whom & on what conditions direct payments may be made When direct payments may be required to be repaid and the recovery of unpaid sums

25. 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

26. 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 provision Part 3 – Resource allocation Part 5 – Non educational needs – health & other Part 6 – Non educational provision – travel

27. Opportunities for PBs - Jamie, Year 4 Part 1 – Sources of evidence (of SEN) SENCo/teacher/TA Educational Psychologist Speech therapist CAMHS HM Stack Consulting – specialist services

28. Provision Mapping for PBs - Jamie ADHD – medication prescribed CAMHS involvement Parenting Project Anger management strategies Emotional resilience Listening skills Reading & literacy skills Friendship skills Gross & fine motor skills difficulties

29. Isabel Dept for Speech & language therapy Educational Psychology CAMHS Learning & Behaviour Support Service HM Stack Consulting Hearing Impairment Service

30. Provision Mapping for PBs - Isabel Ritualistic & anxiety driven behaviours Family history of Obsessive Compulsive Disorder Trichotilomania – discreet entity or part of more complex presentation Friendship difficulties Difficulties understanding & managing emotions Vivid fantasy & imaginative life Reading & literacy difficulties

31. Personal Budgets – Opportunities Personal Budgets create opportunities to - Meet presenting needs in a timely manner Give choice and control to parents & young people Direct services to providing support Meet stated outcomes in EHC plan Use resources effectively Create collaborations between sectors & services Ensure support interventions are not ‘tagged on’ in isolation of the curriculum & the learning environment

32. Independent Supporters Government allocation of £30m available until March 2016 Funding 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 available To work alongside Parent Partnership Services & Key Workers (last update 7th January 2014)

33. Hierarchy of Services & Support Universal services – local services, health & education Targeted services – CAMHS, children’s learning disability team & others Community wealth – support groups & local services Real wealth – knowledge, experience & skills of family Specialist 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

34. Delivery Models

35. 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 purpose First review at 3 months and then at 6 monthly intervals to consider whether EHC plan outcomes are being achieved

36. 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 Need Children currently eligible for a statement of SEN or Learning Difficulty Assessment Children 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

37. 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

38. 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

39. Education, Health & Care Professionals Clinical psychologists Child & Adolescent Mental Health Services Community Paediatricians Community Support Workers Community Children’s Nurses Educational Psychologists Early Years Support Services Learning Disability Nurses Occupation Therapists & Physiotherapists

40. Education, Health & Social Care Professionals (2) Portage Home Visitors SEN Officer & Personal Advisors Social Workers SEN Co-ordinators Specialist Teacher Advisors Speech & Language Therapists Independent sector SEND consultants & advisors Consortiums of specialist providers & practitioners Community & Voluntary sector providers

41. Information for Parents Parents Guide to Personal Budgets Case Studies E-learning Commissioners’ Guidance http://www.kids.org.uk

42. Key Challenges Implementing lessons learned from Pathfinders Understanding local perceptions and strength of parental feeling towards reforms and PBs Strengthening the role of key workers & Independent Supporters Gaining the involvement of CYP in their EHC Plans Understanding and knowing the diversity and breadth of provision from all sectors within a locality SEND providers making clear a realistic costing of services and provision shared with stakeholders

43. 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.comHeather 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