Self-directed Support The Unpacking of Assessments SCOVI Conference 24 th June 2014 Suzanne Abbate

1. Self-directed Support The Unpacking of Assessments SCOVI Conference 24th June 2014 Suzanne Abbate

2. Welcome! • Provide an overview of the Act and brief historical context. • Confirm the principles and values of the Social Care (Self-directed Support) (Scotland) Act 2013 (“The SDS)Act”. • Help to demystify some aspects of self-directed support assessment • Consider some of the implications of the duties of Act for • practitioners • internal support services • partners • users of services By the end of this session participants will have: • Increased awareness of SDS values, ethos and principles • Increased awareness of the key duties in the SDS Act • An increased awareness of the implications of the key duties for their role/professional group

3. What is Self-directed Support? • An exciting and innovative approach to assessment and support planning that encourages collaboration and partnership with people. • Changes how we all do things and what we so to ensure people have more say in how formal support is designed and have control over how it is delivered. • Supported by new statutory duties, values and principles. • An opportunity for authorities, and those delegated to undertake SDS responsibilities to develop creative and more person centred systems and practices.

4. The Vision • The lives of people who require support are enriched through greater independence, control, and choice that leads to improved or sustained health and well being, and the best outcomes possible. • “Self-directed support should become the mainstream approach to the delivery of personal support. Building on the success of direct payments, every person eligible for statutory services should be able to make a genuinely informed choice and have a clear and transparent allocation of resources allowing them to decide how best to meet their needs. The choice should be available to all but imposed on no-one. “ Self-Directed support: A National Strategy, 2010)

5. Legislative and policy background

6. Influences: Independent living • The Independent Living Movement started in the 1970s • People wanted to be in control of their own care and support • Services weren’t fulfilling what was important to people • People wanted choice

7. Definition of Independent Living The 14 rights: • Full access to environment • Full access to transport • Technical aids and equipment • Accessible and adapted housing • Personal assistance • Inclusive education and training

8. The 14 rights (cont’d) • An income, including access to benefits for those unable to work • Equal opportunities for employment • Accessible information • Advocacy and self-advocacy • Counselling, including peer counselling • Accessible and inclusive healthcare • Communication, appropriate communication support • Civic participation

9. Co-production • To do “with not for” • Values/ Assets • Goal focussed. • Person and/ or carer as partner

10. Discussion • Think for a few minutes about what choice and control mean to you in how you live your life then • In pairs; share some of the themes where choice and control influence (and help)you in your day to day routines.“ • You have 5 minutes

11. The Self- Directed Support Values and Principles (for assessment, arranging support, for carers and supported people

12. Values and principles -their importance • Reassurance-The values and principles are already embedded in practice , we know this. • Drivers for change -They provide a powerful pathway for a shift in control and for innovation at all levels/ • Core and fundamental-give permission for enabling effective partnership and collaboration, different rules , better defined purpose.

13. What this means in practice ?

14. Personal outcomes and goals- a new language for assessment • Helps highlight the impact of any support put in place • People are motivated by what matters most to them • there are infinite ways of achieving outcomes that are both efficient and effective for people and for organisations.

16. Assessment for Personal Care A. I am able to meet my personal needs and do not require any support in this area B. I am able to meet my personal care needs with occasional (not every day) physical / gestural / verbal support to maintain independence but ensure essential care needs are met C. I need significant (every day) physical / gestural / verbal support from another to meet my personal care needs To have essential personal care needs met D. I need frequent (several times per day) intimate support to meet my personal care needs To have essential personal care needs met E. I need constant intimate support to meet my personal care needs • I do not require help to meet my personal care needs. I can attend to my needs by myself. I don’t regularly need support with things like going to the toilet, washing and dressing and mostly manage by myself. • I occasionally need help with personal care. I need someone to help me once a day. For example, someone to prompt me to take a shower or wear the right clothes. • I need support now and then with personal care. I’m OK for a while but need help with personal care every 3 or 4 hours. • I often need help with personal care during the day; I need someone to be there to help me every hour or so. • I need a lot of support with personal care (with washing and going to the toilet). I need someone else to help me at night - during the night - as well as during the day.

17. Assessment for Eating and Drinking • I don’t generally need help to eat or to drink. • I can prepare snacks and hot drinks, but need help to prepare a main meal. • I wouldn’t be able to make a snack for myself / or I need someone to help me to eat and drink. • I need lots of help to eat and drink, I need to be fed and given drinks or need to be supported to make sure I have enough to eat or don’t eat too much.

18. Assessments for Daily living I do not need support in this aspect of my life or I do not have my own tenancy and I am not planning on having my own tenancy B. I need occasional (once a week or less) support to run and maintain my home To maintain my tenancy and manage the day to day tasks involved in running a home C. I need regular (e.g. At least once a week) support to run and maintain my home To maintain my tenancy and manage day to day tasks involved in running a home D. I need frequent (several times per week) support to run and maintain my home To maintain my tenancy and manage the day to day tasks involved in running a home E. I always need significant (every day) support to run and maintain my home • I don’t need help with very much around the home • I need help weekly with some things around the home for example, I need some help with shopping, laundry, housework, managing finances, paying bills and general home maintenance • I need help a few times a week with some things around the home : I need help every other day with practical tasks as I can’t currently attend to these. • I need a lot of help every day and with most things around the home: I need lots of help with my shopping, laundry, housework, managing finances, paying bills and general home maintenance.

19. What do you think about SDS? In pairs/ at your tables take 5 minutes to discuss what you think SDS will mean for people who live with visual impairments or deafblindness.

20. What’s new? the six duties • We must have regard to the general principles stated the Act when carrying out assessment and the provision of support. • Power to provide support to carers(of adults) following carers assessment . • We have a duty to offer 4 choices to persons assessed as eligible for funded support to how that support is delivered: • Option 1 direct payment • Option 2 the person directs the available support • Option 3 the local authority arranges the support • Option 4 a mix of the above. • We must take steps to explain the ‘nature and effect’ of each option. • We must provide information, assistance and support – to express any views (how to manage the support and where to get help.) • We must, as far as is reasonably practicable, promote a range of providers and types of support (commissioning/procurement.)

21. Group Exercise Identify some of the benefits that this will bring for the people who require support You have 5 minutes

22. Any questions, comments or observations?

23. Who can be offered the 4 options? • The offer of the 4 options can be given to anyone who is eligible for social care funded support.This is only available after a full outcomes focussed assessment has been completedAND after alternative supports have been explored (natural supports, universals services, re-enablement support

24. Are there exceptions? • Local authority have discretionary powers to not offer option 1 and 4 in these circumstances: • People in Residential Care (Option 1) • Person whose safety is at risk (Option 1 or 4)

25. When will it start? • The Act commencedin April 2014 • The duties will apply from April to people new to the system • People already receiving services or who are “in the systems” must be offered the four options when their package is reviewed

26. How SDS fits with other legislation • The SDS Act does not replace any of our existing duties. • The SDS Act aims to complement and support other legislation. • There may at times be conflict between duties within other legislation that will require to be negotiated. • Protective duties will remain paramount. • SDS Act resonates strongly with Human Rights and Equalities legislation. • Statutory Guidance is available aims to support implementation and inform practice.

27. Adults with Incapacity Scotland Act 2000 Mental Health Care & Treatment Act 2003 Human Rights Act 1998 Social Work Scotland Act 1968 Children Scotland Act 1995 Adult Support & Protection Act 2007 Domestic Abuse Scotland Act 2011 Equalities Act 2010 Direct Payment Act 1996 Welfare Reform Act 2012 Children’s Hearings Act 2011 NHS & Community Care (Scotland) Act 1990 Community Care & Health Act Scotland 2002 Social Care (Self-directed Support) (Scotland) Act 2013 Patients Rights Scotland Act 2011 Disability Discrimination Act 1995 Housing Scotland Act 2010 National Assistance Act 1948 Public Service Reform Scotland 2010 Regulation of Care Scotland Act 2001 Chronically Sick and Disabled Person’s Act 1972 Protection of Vulnerable Groups Scotland Act 2007 Data Protection Act 1998 Education Scotland Additional Support for Learning Act 2009 Local Government in Scotland Act 2003 Freedom of Information Scotland Act 2002

28. In Summary • The majority of legal powers and duties will fall to local authorities. • Where a health board is discharging social care duties on a delegated basis the duties in the Act apply. • Duties and legally binding and cannot be ignored. • Self directed support, is intended to support, promote and protect human rights. • Support should be delivered in a way that supports choice and control. • Cultural and system change will be required to support successful implementation. • It is complicated but legislation, statutory and best practice guidance is there inform practice.

29. Useful links • Statutory Guidance & Regulations ‘The Social Care (Self-Directed Support) (Scotland) Act 2013’ – Scottish Government http://www.scotland.gov.uk/Publications/2013/11/3923 • Current eligibility for adults in Scotland http://www.scotland.gov.uk/topics/health/suphttp://www.careandhealthlaw.com/Public/LawDatabaseCasesDesc.aspx?IndexType=2&Id=171port-social-care/support/older.people/free-personal nursing-care/guidance • Self-Directed Support Scotland http://www.sdsscotland.org.uk/ • A Guide to Receiving Direct Payments (Scotland) NHS http://www.sehd.scot.nhs.uk/publications/grdps/grdps-01.htm • Disability Rights UK www.disabilityrightsuk.org • Belinda Schwehr – Legal judgments for England that can support SDS delivery in Scotland http://www.careandhealthlaw.com/Public/LawDatabaseCasesDesc.aspx?IndexType=2&Id=171

30. Thank you for your time, thoughts and attention today Please share your thoughts of today on flipchart