Self Directed Support in North Lanarkshire
Best Practice Guide
1 Contents
1. Introduction...... 3
2. SDS in North Lanarkshire ...... 3
3. Identifying Priority to Receive An Individual Budget ...... 5
4. Assessment Incorporating the Guided Self Assessment Tool ...... 7
5. Helping Someone Plan their Support - the 4 Options ...... 8
6. The Place of Carers in SDS ...... 15
7. Monitoring and Reviewing Support and Individual Budgets ...... 17
Appendix 1 - Membership and Role of Locality Enablement Groups ...... 19
Appendix 2 - Membership and Role of the Social Work Enablement Group .. 20
Appendix 3 - Children’s Guided Self Assessment (GSA)…..………………….21
Appendix 4 Adults Guided Self Assessment (GSA) ...... 39
Appendix 5 Planning My Support Leaflet ...... 52
1. Introduction
In April 2014, the Social Care (Self-directed Support) (Scotland) Act 2013 came into effect, as part of the Scottish Government’s ten year plan to implement self directed support for people, who need it. The legislation requires local authorities to make resources available in specified different ways but does not place the same duty on health services. The legislation indicates however, that NHS staff should adopt similar approaches in how they conduct assessment and planning when this is considered appropriate.
This document covers all legislative requirements in the Social Care (Self- directed Support) (Scotland) Act 2013, (SDS Act) and sets out what is meant by SDS in North Lanarkshire, in its wider meaning and specifically, what options are available to someone to choose how their support is provided, if their level of assessed needs are aligned to an appropriate priority and ongoing support is required for them to live in the community. The Service’s Assessment and Planning Procedures and Prioritisation Framework must therefore be borne in mind in particular since the Service’s outcome based framework to assessment and planning and approach to prioritising resources needs to be considered in conjunction with the SDS procedures. For example, someone, whose needs are deemed to be priority 4 will not receive ongoing support but may be given information, advice, sign posting to another service or a one off piece of practical assistance like a piece of equipment after completing a self assessment on the making life easier website (see below) etc.
This guide provides detailed information about how decisions are made and about the processes to be followed for individual funding to be agreed, made available to individuals, monitored and reviewed.
As noted above this guide does not stand alone as it overlaps with other national, local, legal, service, guidance and procedural requirements. Where appropriate these instances are referenced in the body of the guide.
2. SDS in North Lanarkshire
Originally the term SDS within North Lanarkshire Council Social Work Services meant that people using care and support services should have choice and control about the way in which their care plans were being delivered e.g. where they lived, with whom and by what provision. While these elements still remain, with the term “support” replacing “care”, over time the term SDS has evolved to mean a number of additional things. Largely for now SDS in North Lanarkshire still means giving people as much choice and control as possible in overcoming life difficulties which they face but it now extends to describe the framework in which this can be done and has associated attributes of promoting independence and social inclusion.
3 Information and knowledge are an integral part of giving people choice and control so part of SDS must be about making sure people have the right information to deal with issues affecting them. Good public information about “what’s “out there”, so people can find solutions for themselves, is supported by assets we have in North Lanarkshire. These include information about health and wellbeing and disability and the chance for people to complete a guided self assessment electronically, regarding daily living difficulties on the NLC website which is supported by the Integrated Equipment and Adaptations Service located in Motherwell, see http://www.makinglifeeasier.org.uk/ smartassist/northlanarkshire. Information about mental health and wellbeing and a range of information about community resources and facilities like how to pursue leisure pursuits, financial debt advice etc. is available via a council and NHS funded website called Elament – http://www.elament.org.uk. Other advice and information can be obtained from the Council website - http://www.northlanarkshire.gov.uk/, its First Stop Shops and public libraries and from ”Well Informed”, an information service provided by the Scottish Association for Mental Health (SAMH), which is also funded by the Council and of course from Social Work Service’s offices. Some information available through the media, described here, is not just about social support but about how people can keep healthy and well and deal with difficulties, which face us all from time to time.
As far as social work is concerned, there are a range of routes by which people may come in contact with Social Work Services – people refer themselves or are referred by family, friends or other people, or, as a result of a statutory response by social work such as adult protection, or mental health legislation etc. At this point, depending on the individual’s personal, family, community and financial resources, there should be a proportionate opportunity for them to choose to receive support in line with their own level of need and Social Work Service’s prioritisation framework, (see NLC Guide to Social Work Services: http://www.northlanarkshire.gov.uk/index.aspx?articleid=15788
For some people information or advice may be sufficient, others will need signposting to support sources, others will require some help to re-learn or develop personal skills or abilities e.g. cooking travelling independently etc. abilities which they may have lost or never had - re-ablement or enablement support, before the level of support they need can be properly assessed. Some people will need ongoing support which can be provided by using lower level supports such as locality support services and some people, who have complex ongoing needs will benefit from an identified individual budget which is available to meet their needs on a year to year basis. The SDS Act requires local authorities to ensure that people identified for funding are aware of the choices open to them regarding how they can choose to receive paid support and information about this is available across the Council and on the website.
Sometimes it is a carer who requires some support to maintain their caring role and some early intervention for a carer can in itself play a major role in using lower levels of support to assist the carer, rather than merely thinking about services for the supported person. Workers must be mindful of statutory
4 duties on the local authority to provide appropriate levels of support to carers. Carers should be encouraged to consider use of the “Carer’s Journey” see http://connect/index.asp?articleid=11136
3. Identifying Priority to Receive An Individual Budget
In North Lanarkshire there is a commitment to providing preventive and low level supports for people in order that they can maintain or improve their ability to remain healthy, well and as independent as possible in the community. When it becomes likely that someone needs more than advice, more than signposting, more than a short period of help, or more than some practical help like a piece of equipment to use at home, more than enablement/re-ablement or more than some lower level support, an individual budget may be what is required but we must first make every effort to maximise a person’s capacity before considering their longer term needs and their eligibility for an individual budget.
People come into contact with Social Work at different times and at points of their lives when they are experiencing a range of difficulty, e.g. as they become less able due to a health condition getting worse. For some people it will be evident at first contact that their needs are complex and likely to require ongoing support but others may find their difficulties have escalated over time. Someone with a long term condition may not be able to regain abilities which they have lost, despite short term engagement with services; or others receiving lower level ongoing support may find it difficult to continue with their current support arrangements. Whatever the position each individual faces, there may be a need to consider an individual budget either now or in the future.
Social Work Services resources are not infinite and a mechanism to make sure that there is an arrangement to allocate resources in an equitable and transparent manner is essential. The best way to do this across the Council area is for each geographic locality of NLC to identify people who need or will need an individual budget. There is a need to keep a central overview of this so that there is consistency across NLC and to assist strategic planning within the service.
Getting to know individuals either at early points of contact or following review of existing arrangements should assist in highlighting those people, who need to be considered for an individual budget. In each locality in NLC, there are Locality Planning Groups (LPGs) where multi agency consideration identifies people known to more than one service and who should be considered for some kind of support or resource. There are also regular reviews of people, who receive homecare, locality support services and integrated older adults support, who become known as likely to need an individual budget.
All of those, who should be considered as possibly needing considered for a financial award ought to be considered by the Local Enablement Groups, (LEG), which meets fortnightly in each of the six localities of NLC. These Local Enablement Groups are the place where priorities for planning and
5 agreement for planning using an individual budget are carried out. (See Appendix 1 for remit and membership of Local Enablement Groups.)
Some earlier initial assessment or review of existing arrangements should mean that the LEG should consider them, so long as the person’s needs meet Priority 1 or 2 and (subject to funding being available), Priority 3, in the Social Work Prioritisation Framework. Priority 4 needs should not be considered for an individual budget and should be met through signposting and redirection to other support available from social work funded supports provided by others such as peer support services or in universal or voluntary services.
When an individual is considered at the LEG, there are a set of questions and resultant actions which should follow. These are:-
a) Does the person meet Priority 1 or 2? - If so assessment and planning should follow the process for identifying an individual budget b) Does the person meet Priority 3, and is funding available? If yes, assessment and planning should follow the process for identifying an individual budget. If no, alternative arrangements must be considered to assist the individual. c) How quickly is an individual budget needed and until it is available for use, are supports available on an interim basis, or does something need provided meantime? Action may be needed or an assessment regarding sustainability of the person’s existing arrangements. d) When should the full assessment and support plan be completed? While some circumstances may require a lengthier period of planning, e.g. someone’s mental health is not stable and/or time in hospital is needed, this can take some time but generally eight weeks should be sufficient time for a full assessment and support plan to be complete. e) Are there any legal or other issues which may determine the person’s ability to use an individual budget? It is essential to consider if there are any Adults With Incapacity (AWI) or Adult Protection or potential fraud issues and if the person is capable of managing a budget, if they wish a direct payment f) Which social work budget should fund this particular person’s individual budget? Agreement should have been obtained, prior to the meeting about which budget is to fund the cost of the individual budget.
If the LEG believes that all of the issues above are satisfactory the assessment should proceed and a Guided Self Assessment completed within two weeks by the assessing worker.
6 4. Assessment Incorporating the Guided Self Assessment Tool
Any assessment which is likely to result in an individual budget award needs to include use of a Guided Self Assessment (GSA) tool. There are two separate GSA Forms, one for use in looking at children’s needs up until they are about to leave school and one for school leavers and adults.(The GSA Children Form is Appendix 3 and the Adult GSA Form is Appendix 4). These forms ask questions about different areas of someone’s life and are part of the process designed so that people with broadly similar needs for paid support get a similar individual budget award. The GSA is easy to understand, transparent in its use and not dependant on environmental factors or influences. Essentially the GSA is designed to give children and their families and/or adults a voice, which is recorded and must be considered by the assessing worker, who also records their views on the same form. The worker is not bound to accept the child and their family’s and/or the adult‘s own opinion about the answers to the GSA questions, as it is Social Work’s legal responsibility to complete the assessment. The worker should however welcome the focus which the GSA gives to the voice of the child and their family and/or adult being assessed and must give the views serious consideration.
There is no particular point during the assessment period where the GSA should be used in a routine fashion. Sometimes it is right for the worker to leave the form with the child and their family and/or adult for completion and sometimes the person and worker should do it together. How confident or able the child and their family and/or adult being assessed feels or is able to accurately reflect their needs in the form and how well the worker feels able to accurately give their opinion about the individual’s needs, will inform when to complete it. Obviously from the worker’s perspective, they need to know enough about the child and family and/or adult and their lives/life to answer the questions and help the child and family and/or adult think through how the questions fully apply to them.
Hopefully there can be agreement among those involved in completing the forms about how each question is answered. Ultimately however it is Social Work which has the statutory duty to complete the assessment and while the child and family and/or adult’s views will and should be heard, it is for the worker to determine the final decision.
There is a very considerable difference between the annual individual budgets which can be derived from using the two distinct GSA Forms. This reflects the fact that consideration of children’s age and stage and the role for which all family carers should be assumed to have responsibility and the fact that children are in education for a large part of their childhood, all must indicate that their need for paid support is reduced, in contrast to adults, whose circumstances are quite different.
Completing the GSA produces a resultant “score” which indicates a financial award of an annual budget. This budget may be increased depending on exceptional personal circumstances, which make this necessary. The budget
7 may also be reduced for an adult or young person about to leave school, whose budget has been identified by use of the adult RAS, where the adult’s or young adult’s family/household circumstances, are such that family members or other members of their household are assessed to be able to and capable of providing some of the person’s support or shared household tasks.
During an assessment there should be a full and wide ranging consideration of things which are important for the child and family and/or adult and what they hope for their life. Not only should the assessment be clear about what someone needs to keep them safe and well but what kind of life they would wish to have.
Social Workers speak about outcomes. Most outcomes are achieved by people themselves, or by their family, friends or others doing or assisting them to do something. There are some general outcomes which we all need to meet or have met for us – being safe and healthy, managing personal care and/or, the need to have housing and food. These are needs which everyone has but we all have other things unique to us, which we value or would wish to have. These areas of our lives are things like spending time with family and friends, taking part in social and/or recreational activities, travelling/holidaying, pursuing education and working etc. Which of these things are most important for us will vary depending on who we are and what our lives are like at that particular time.
What an individual budget should do is help children and adults achieve things which are both essential and important to their lives and can’t be met from their existing range of personal, family and wider resources. Identifying an annual individual indicative budget is the point at which planning can be done using the individual budget to set out a plan which shows in detail how and what it will be used to achieve with and for the person. For example what will the person, their family or paid supporters contribute and how and when will this happen etc.
When a GSA has been done this should be presented at the LEG for consideration, it is either endorsed or questions highlighted for consideration by the assessor. In cases where it may be necessary to award additional or lower funding, due to someone’s exceptional personal circumstances, this should be passed to the Social Work Enablement Group, (SWEG), which keeps an overview across the entire NLC area. (See Appendix 2 for details of role and membership of the LEG and SWEG.)
5. Helping Someone Plan their Support - the 4 Options
The 2013 SDS Act sets out requirements on how people must be advised about choices they are entitled to make in selecting the method by which they receive support. When someone has an indicative budget agreed at the SWEG, the allocated worker must visit the person to advise them of what the indicative budget is and explain the different ways in which the person can choose to have their support provided. The person should also be given a copy of a completed leaflet, (See Appendix 5), which should explain SDS and
8 show the amount available for planning and the name and contact details of the social worker leading on the assessment planning.
It is a requirement for workers to ensure that service users and/or their representatives/carers understand the options available to them. This does not just mean providing the descriptions contained in the legislation but rather a meaningful discussion with the person, which points out the implications of each of the options, in line with their own unique life circumstances.
There are four options available and workers must fully explain these options to the individual. The statutory guidance on options is set out in Section 8 of the guidance -
Section 8 of the Statutory Guidance states “After it has identified the person’s needs in collaboration with the adult, child/family or carer the authority is required to offer four options in relation to the relevant support identified at the assessment stage. The four options provided under the 2013 Act are:
Option 1 The making of a direct payment by the local authority to the supported person for the provision of support.
Option 2 The selection of support by the supported person, the making of arrangements for the provision of it by the local authority on behalf of the supported person and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of that provision.
Option 3 The selection of support for the supported person by the local authority, the making of arrangements for the provision of it by the authority and, where it is provided by someone other than the authority, the payment by the authority of the relevant amount in respect of the cost of that provision.
Option 4 The selection by the supported person of Option 1, 2 or 3 for each type of support and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of the support.
Section 8 of the Statutory Guidance on SDS states that all of the choices must be described to the supported person. A key challenge for the authority is how to relate the options to the supported person and how to make them “come alive” to the supported person. Information and support services and the relevant legal duties on information, support and advocacy play a vital role at this state……..”
In North Lanarkshire, irrespective of how someone chooses to have their paid support provided, this should start by having an assessment of need and
9 identified agreed outcomes. Whatever option is then chosen, should be designed to meet the identified agreed outcomes. It is important that workers understand and advise service users that whichever of the options are chosen, it will take a little time to establish a plan. As noted earlier, when people are in a crisis or going through frequent changes in their needs or are subject to re-ablement, this is not the time to make a choice about someone’s annual ongoing support arrangements.
Any support plan must reflect a detailed indication of by whom, what, how and when things are to be done to meet agreed outcomes. This is irrespective of whether the things to be done are hands on care, housework, help to socialise or whatever. The more essential or complex the thing to be done is e.g. giving someone essential medication, the more detailed the planning needs to be. This is particularly true if the support is to be done by a paid provider, who may rely on different people to deliver the plan. Equally however if support is shared between a family member and a paid provider, it is essential to detail who is doing what. While social workers should complete a personal outcome plan, a more detailed plan will often need to be done by the paid provider, setting out how specific areas of their role will be done e.g. moving and assisting someone, assisting someone to eat meals etc.
When workers are helping someone decide how they wish their needs to be met, they need to help the person understand that while their choice needs to be respected and supported/facilitated, there are some wide ranging considerations which need to be taken into account due to the social work service’s overriding need to meet its duty of care to the person. The following section seeks to assist workers discuss some of the factors they need to consider in each of the four options set out in the SDS Act.
Option 1 Direct Payments can give someone full control of how they use their money but people need to understand that with this choice comes responsibilities. Direct payments are the release of money to the supported person or another person acting on their behalf, to organise and pay for supports as agreed in a detailed support plan. Anyone acting on the supported person’s behalf must either be the parent of a child or, from the supported person reaching the age of 16 years, have the legal power to do so. The legal powers may be Financial Guardianship or Power of Attorney. Considering the capacity of the supported person should feature early on in the assessment process and be discussed in detail in relation to considering the four options. If a direct payment is likely to be preferred and the person lacks capacity then family members must be informed early in the process that financial guardianship will be needed. Direct payments offer the opportunity of employing personal assistants, an option not possible through any other route. Direct payments are also beneficial in the use of monies to achieve outcomes without the use of formal services, such as some or all of the resource being used for bespoke purchases. The Scottish Personal Assistants Employers Network (SPAEN) have been funded in North Lanarkshire specifically to support people considering this option through information, advice and assistance with employment law, contractual agreements, insurances and working practices of deployment and
10 management of personal assistants. If this option is preferred, the recipient of the direct payment will be responsible for four weekly returns outlining how the money has been spent and confirming it continues to be used as outlined in the support plan.
It is important that anyone considering a direct payment thinks through the pros and cons of this approach, particularly if it is used to pay for personal assistant/s, there are a lot of things to consider. Taking a budget as a direct payment could be compared to booking a holiday abroad by oneself through the internet rather than using a travel agent A legitimate registered travel company will make all the arrangements for you, get you home if there is some crisis and provide local support if you need it. On the down side you may have a restricted choice of when, where and how you travel and restricted choice of accommodation, as well as being more expensive. You can get a holiday cheaper usually if you book everything yourself but if things are not good when you get there or a crisis happens, it may be costly and difficult to resolve the difficulties you encounter and get home again.
Having a Personal Assistant does appeal to some people because they have real choice over who they employ and can sometimes pay less for the support they get but issues over attendance at work, sickness cover and dissatisfaction with performance can all be hard to manage. Never the less it does allow the supported person to recruit someone who they think meets the profile they wish e.g. a young person who likes outdoor activities etc.
When someone considers employing a family member in the capacity of a personal assistant, all of these potential difficulties are likely to be magnified and apart from that, it is likely to affect the nature of the relationship between the supported person and their personal assistant/close relative. On the other hand some people manage this well with no apparent conflict of interest.
Considerations in employing close family members For those, who consider having a close family member as a personal assistant, this may pose particular challenges to ensure that family relationships which exist do not close down wider social network opportunities and reduce the person’s chances of indicating that they are not happy with their support arrangement, (if this is the case). The potentially conflicted interests and loyalties of each party may pose a risk to some adults in this situation. The Scottish Government Statutory Guidance does support consideration of employing family members under stated circumstances. These circumstances are where:
There is a limited choice of providers The supported person has specific communication needs which make it difficult for another provider to meet their assessed needs The family member will be available to provide support at times when other providers would not reasonably be available The intimate nature of the support makes it preferable to the supported person that the support is provided by the family member
11 The supported person has religious or cultural beliefs that make the arrangement preferable to the supported person The supported person requires palliative care The supported person has an emergency or short-term necessity for the support There are any other factors which make it appropriate, in the opinion of the authority, that the family member provides the support.
The authority, the family member (i.e. the prospective personal assistant) and the supported person must all agree to the family member providing support. The family member must be capable of meeting the supported person’s needs via the employment arrangement (Note: the authority, with its statutory duty of care has to assess if the arrangement will meet the supported person’s needs)
A family member is not permitted to provide support if the authority determines that either the family member or the supported person is under undue pressure to agree to the arrangement, or where the family member is a guardian, continuing attorney or welfare attorney for the supported person. Best practice suggests that the supported person and the family member identified to provide support should both be seen on their own by the worker to assess their wishes on the matter. If either of the restrictions noted above apply this will prevents an employment arrangement happening, regardless of whether the other facilitating conditions apply.
Important additional information For those interested in pursuing a direct payment, they are encouraged to contact SPAEN (http://www.spaen.co.uk), the independent national organisation, which NLC partially funds. SPAEN can provide a whole range of advice and support as to how people can use a direct payment. There is a leaflet available from NLC, which explains how direct payments work. (See also Direct Payment Procedures See NLC Direct Payment Guidance)
Option 2 Selection of Support by the supported person may seem straightforward but there are considerations which the person and/or their carer need to understand. Social Work has a duty of care to the individual and has to ensure, that the person’s needs, can be safely and appropriately met. This will mean that the social work service must be satisfied that any provider organisation (including in house services), is appropriately registered with the Care Inspectorate, can meet the Council’s contractual standards e.g. has appropriate policies and procedures in place like adult protection, financial handling, appropriately trained staff etc. and that they can be party to signing a contract with the Council if they are not on the list of providers on the NLC framework, for the identified service to be provided. Workers should seek advice from the Planning and Quality Assurance Section at Social Work HQ, if there is any doubt about whether a provider organisation is on the framework for a specific form of support provision. In some instances providers will be new to NLC and even if they can meet the necessary criteria, regarding
12 registration with the Care Inspectorate, appropriate procedures exist etc. a contract, (service level agreement), will require involvement between Planning and Quality Assurance Section and the provider organisation. This means that people need to be alerted that a service will not start immediately on request and consideration must to be given to interim arrangements being put in place until this position is resolved.
In addition to contractual issues, the social work service must be satisfied that the person’s budget is used appropriately too and that it can meet the specified needs outcomes set out in the personal outcome plan. The provider will also need to provide a breakdown of how the person’s budget is being used for the service user. The allocated worker and finance section will need a financial breakdown of how the budget is being used, when requested, or routinely, on a quarterly basis. This latter condition applies to provider organisations on the framework and is both a financial check but more importantly for the service user, a chance to see if agreed needs and outcomes, which are set out in the support plan are being met.
Option 3 Selection of Support for the supported person. This option is limited to circumstances where someone knowingly and actively asks social work services to arrange their support, or where social work has legal authority to act on the person’s behalf. This can mean support being provided directly by social work services, e.g. social work’s homecare service, or by a provider selected by social work, e.g. a homecare provider or supported living provider on NLC’s social work provider framework.
For whatever reason someone’s support is arranged by social work, the same considerations about assessed needs and agreed outcomes must apply. At any given time, provider organisations will be in a higher or lower position to provide the necessary support arrangements and where workers are selecting a provider organisation for someone, this must be a provider organisation which is on the provider framework and agreed by the Locality Enablement Group (LEG), in advance of arrangements being discussed regarding service provision.
As noted earlier planning someone’s paid support by using an individual budget is different from the traditional model, where many solutions were described in service terms e.g. a set number of hours of support each day or week or, a set number of days or weeks of residential respite care per year. Following the description of the services being prescribed, the assessor tried to obtain permission to pay for the services specified. This resulted in fixed solutions being offered to people and this meant that they had little choice over what their support would look like.
If planning follows on from the identification of an individual budget, this creates the opportunity to consider the life outcomes, which someone needs and wishes to achieve using their personal strengths and attributes, family, financial and community resources and their individual budget as a supplementary resource, to add to their personal resources, to do important
13 things or have them done because they can’t do them from just their personal resources. These important things (outcomes) are those things that have been agreed during their assessment. Obviously the essential outcomes of keeping well, safe and healthy need to be met and the other outcomes like pursuing social and recreational opportunities identified in the overall support plan can be considered. Like any budget however just as all of us have a fixed budget made up from a salary, benefits etc, it is limited and we have to decide what we have to pay for and choose to use our budget to achieve. For example pay rent, food, electricity and use some of our budget to pay for a car on H.P. or save up for a holiday abroad etc. This often means that we need to make choices over what is most important and how we can achieve a balanced life from our budget. This is no different for someone who gets an individual budget to supplement their personal resources i.e. people need to choose how to get most from their total resources, a part of their resources being their individual budget.
Everyone who has ongoing support needs should have a completed personal outcome plan, which sets out aims identified for their lives. These aims/outcomes should have an identified support plan which indicates how this will be achieved i.e. the plan should agree what is to be achieved, who needs to do it, what needs to be in place and when and how the outcomes will be met. When someone has an individual budget, it should also show what things, which need paid will need some of the individual budget and how much this will be. (More detailed information on assessment and planning is contained in the Social Work Service Assessment and Planning Procedures.)
An illustration of how life outcomes, around achieving leisure opportunities, might for example, be where someone with an individual budget wishes to be able to see a film at a cinema once or twice each week and go to a football match every week too. If their budget cannot meet both of these costs every week, the person needs to find a way to make both affordable or perhaps plan to do one activity once each two weeks. Clearly if these activities involve paid staff accompanying them and having their entrance paid from the person’s own budget, there should be consideration of other ways of thinking about how this could be done, which would be more socially inclusive, less costly and more likely to be achieved. The way in which something can be done, how the person wishes to achieve it and some imagination or innovation about how things can be done all must be part of the planning considerations. For example use of a “season ticket” for either or both the cinema and football may be an aid to building on friendship and economic use of the budget if this is offered to a friend or acquaintance, who likes the cinema and/or football, to accompany the person to one of these events on a regular basis. This would build on community support rather than paid support and offer a wider circle of connections for someone who may have a restricted network of community connections. Alternatively, a person may choose to pay for a Sky television package to get access to football matches and a film channel. If they have this facility, it may well be that friends would be happy to watch football and films with them in their home. Watching television with a friend is a good option for some people and may be cheaper (using less of their individual budget) than
14 other ways of seeing football and films with friends. Thinking about how to achieve outcomes shouldn’t just be about paid staff.
An individual budget can be used in different ways, in line with the SDS Act. This means that people can receive money in the form of a service provided or funded by the Council, ask the council to purchase supports from a particular provider, take the budget as a direct payment or as a combination of all three of these options. The only restriction which NLC makes on the use of an individual budget is that it is legal, is not used for gambling, meets the agreed life outcomes for the individual, identified during their assessment or review and does not bring the council into disrepute.
The challenge for social work staff, service users and their families and provider organisations, is how to achieve all the benefits, which control of an individual budget can bring. For example, an adult may be fortunate to have accessible and appropriate family supports which deliver intimate bathing and other personal care support and would prefer to use part of their individual budget to pay for domestic support rather than have their family member do that at the expense of providing personal care. A family, who feel the need for a break due to the high level of support and care they provide a child who has complex disability, may use part of the child’s budget to pay for a close family member or friend to join them on a holiday, on the basis that they can spend some of the time relieving the parent/s of supporting the child all of the time while they are on holiday. This would both allow the child to be part of the family holiday but provide some respite for the parents for some of the time.
There are now numerous examples of how using money differently from purchasing traditional support in hours or days/weeks of respite can deliver good agreed life outcomes and as service users become more aware of their budget and how it can be used, there will be opportunities to do things better and differently, supporting greater independence and social inclusion. Irrespective of how the person uses their individual budget, it is important that they control how the money is spent and that they know what exactly their budget is being used to do.
6. The Place of Carers in SDS
The carer’s role is a critical one in informing, someone’s assessment of need, their hopes and aspirations and, where appropriate provide support, always remembering that the primary focus is the person, whose needs are being assessed. Often, carers have been the supported person’s advocate in their dealings with authority, provide direct care and support to the supported person and there is a strong bond and the carer wishes only the best for the supported person. Sometimes however carers and supported persons views differ, especially when the person’s needs have been met by the carer in a certain way for a long time. Recognising both sets of views and wishes can require considerable attention and discussion and needs confidence on the worker’s part to have been established.
15 Carers’ views should be respected and valued and where appropriate, the carer should be offered the chance to use the Carer’s Journey. The social work service meets the requirements of the legislation which highlights the need for carers to get support, advice, advocacy etc. and this is available through the various carer organisations which the Council supports in North Lanarkshire.
The additional resource, which carers often contribute to someone’s life experience, needs to be valued but also recognised when considering what effect this has on the supported person’s need for paid support if they are not able to meet all their own needs. Where carers are able and willing to make a contribution to someone’s support, it is reasonable to record this in any assessment and make this clear to the carer and supported person. Sometimes it is important that the supported person’s needs are willingly met by the carer but this means that it is harder for the carer to do some other things that the supported person needs done for them. In cases such as the carer being willing and able to provide personal care tasks but struggling to meet tasks such as cleaning or laundry, it may be best met by using part of the person’s individual budget to pay for washing laundry and ironing so the personal care can be done to both parties benefit. Equally, rather than using someone’s individual budget to pay for a residential care break to ease the burden on the carer, both parties may prefer to fund a third party’s costs to accompany them on a holiday or short break. Wherever possible the needs of both carer and service user should be considered unless there is a conflict of interest, when separate workers may be needed.
The SDS Act gives local authorities the power (not duty) to make payments to carers in their own right as one of the range of options available and which should be identified through the carer’s journey, e.g. advocacy etc. Since many of the things which carers think would help them in their role are already available for purchase through the supported person’s individual budget in North Lanarkshire. It seems reasonable to assume that most carers’ needs will be met by the budget allocated to the person for whom they are a carer. That does not preclude the fact that there may be some occasions when the carer has their own eligible needs over and above those of the cared for person which cannot be met within the individual budget. For example the ability to pay for laundry and ironing, to get support for a family break as noted above, for a piece of equipment or training for the carer etc. can all be appropriately purchased as part of the supported person’s support plan It is recognised that where a carer supports someone with assessed needs, but who has no individual budget available, there may be a need to consider a one off or annual small sum to assist the carer to continue to care. Any such case should be considered on a case by case basis through the Locality Enablement Group (LEG). In circumstances where a carer’s ability to provide the support needed for the support is affected by personal issues like frailty or health problems, this will be reflected in the supported person’s individual budget but if the carer is not able, because of having assessed needs for paid support themselves, this should be met through the carer having their own individual budget in their role of supported person not because they are simply a caring for someone.
16 7. Monitoring and Reviewing Support and Individual Budgets
There are some obvious steps which need to be taken in ensuring that someone’s support plan is working and their individual budget being used appropriately. The worker allocated to work with the service user needs to adopt the same considerations in general times irrespective of which one of the four options to receive support has been chosen. Regular direct contact with the supported person is a key element of any monitoring and continuous review of care management. The less access someone has to external contacts e.g. due to severe disability, limited verbal communication ability and wider family and social networks, means that direct contact is particularly important. The worker should also have regular contact with the support provider/s to ascertain their views on how the support is working. Obviously any concerns about someone’s support needs addressed at an early stage and not require a formal review.
Where someone has their budget managed for them by a provider organisation, the organisation will require to report quarterly on the use of the budget. Clearly this is an opportunity to consider whether identified outcomes are being met through the identified funding award e.g. if an outcome identified is for someone to have a regular break and this is not happening, why is this the case?
In the case of people receiving a direct payment, there are specific requirements which the person or their appointed budget holder e.g. guardian, must meet. This relates to providing information on a monthly basis to the worker for consideration on how the budget is actually being spent. While there is a need to do this every month, this is not just a financial review and does relate to outcomes being met. It is not a task for admin staff to check, it is for the allocated worker.
The Council is taking care to try to reduce the risk of fraudulent use of council funds and the guidance on Direct Payments explicitly asks staff to consider financial misuse as an important issue. Equally this consideration also needs to be given to budgets held by provider organisations to provide support. Any concern regarding misuse of funds must be raised immediately with managers.
Each person receiving ongoing support should have their support plan reviewed at least once per year. But sometimes this will be more frequent e.g. if a temporary plan is established with a view to reviewing expected changes to someone’s needs over a six month period. When it comes the right time to review someone’s support arrangements, the identified outcomes should then be the basis for considering how well the plan is/has been working and if the person’s level of needs has altered. The review should concentrate on the things which the plan set out to do and if it has achieved or is achieving the aims noted. If someone has different support needs after having the support provided, this may mean that their general circumstances have improved e.g. they are more confident and independent, or, they are less able to do things for themselves due to deterioration in health and/or their
17 plan needs adjusted. In the case of reviewing someone who has an individual budget, a new GSA should be completed again. This will help give a different perspective on their needs and any adaptation to the plan. In light of the outcomes achieved/not achieved and the new GSA score being agreed, this then will provide the opportunity to see how support may work for the next year planned on the new available budget and the experience of using the preceding year’s budget. Social work assessors and Locality Enablement Groups will have review dates flagged up three months before the end of an existing budget period – normally nine months into the current budget. This early notification is necessary to ensure that relevant information is gathered, a review (including a new GSA), discussion with the service user and other stakeholders about any need to adjust or change the support arrangements, a new support plan to be formulated and considerations submitted to the LEG, before the existing budget period ends, so that the new budget and plan can be put in place.
Of course plans which are not working should not wait until a formal review and new GSA is done. Ongoing review of the plan should be a task of the allocated worker from social work services and from any provider engaged in supporting the person. Minor changes to the plan should not require a full review to be carried out but major changes in the person’s life or if the plan is leaving the person at risk, will require a full review.
18 Appendix 1 - Membership and Role of Locality Enablement Groups
There is a Locality Enablement Group (LEG) for each of the six locality social work areas in North Lanarkshire. These localities are Airdrie, Bellshill, Coatbridge, Cumbernauld, Motherwell and Wishaw.
The Locality Social Work Manager (Community Care) is the chairperson for the LEG, with the Locality Social Work Manager Children Families as the co chair.
The full membership of the LEG is as follows –
Locality Social Work Manager (Community Care) : Chair Locality Social Work Manager (Children and Families) : Co-Chair Senior Social Worker Younger Adults and additional Senior Social Worker Designated Admin Officer Manager, Locality Support Service (Disability) Service Manager Younger Adults Service Manager/Senior Officer Children and Families Senior Officer Younger Adults Senior Officer Older Adults Other staff in line with locality and individual development needs of staff
The LEG will meet each two weeks on an agreed designated day and time.
The Group will be responsible for –
Ensuring the presentation of all potential new demand for consideration of assessment and planning using an individual budget now or in the foreseeable future Maintaining a register of planned future likely recipients of an individual budget for work to be started at an appropriate time Agreeing that planning to work with someone, who should have an individual budget can progress, or directing attention to other solutions which may be better at that stage Receiving completed GSA scores for all people being assessed or whose support arrangements are to be reviewed and a new/review GSA is to be done Identifying issues regarding budgets where exceptional circumstances apply, for the attention of the Social Work Enablement Group (SWEG) Receiving information on proposed support plans Identifying potentially “risky” or contentious issues regarding proposed support plans for consideration by the SWEG Collation of information and examples of issues and good practice which require to be addressed or shared with the SWEG – wider system
19 Appendix 2 - Membership and Role of the Social Work Enablement Group
The Social Work Enablement Group is a group which represent the Social Work Service across all six localities and regarding issues to moderating performance regarding the award and use of individual budgets.
The SWEG will be co-chaired by the Manager, Younger Adults and a designated Community Social Work Manager
The membership of the SWEG is as follows –
Manager Younger Adults Designated Community Social Work Manager 2 Service Managers (responsible for linking with the 6 LEGs) Resource Worker Younger Adults Social Work Accountant Locality Social Work Manager Rotated each 12 weeks Senior Social Worker (Rotated each 12 weeks) 2 Social Workers or other designated Assessors (involved in SDS work) – allocated for 1 meeting, in line with personal development needs)
The SWEG will meet each two weeks on an agreed designated day and time.
The Group will be responsible for –
Receiving minutes and update information from all 6 Locality Enablement Groups (LEGs) Providing a moderating role across all six localities in relation to financial awards and support planning Agreeing start date and amount of the payment of all costs and annual individual budgets for all those with an agreed budget Providing advice and suggested actions to LEGs on cases which suggested additions to the standard rate at which individual budgets are awarded – lower or higher due to exceptional circumstances Considering cases where it is believed the proposed arrangements may create a risk to the individual, the community, the Council or a provider, which should be acknowledged by the group and endorsed if appropriate Providing an NLC wide report after for localities and the SW Management Team each month regarding performance in terms of time scales, budget and quality of agreed and anticipated work Acting as a forum to identify and address issues or share information about good practice identified from LEGs, provider organisations, the public and other sources
20 Appendix 3 Self Directed Support
North Lanarkshire Guided Self Assessment for Children and Young People with a disability
Name of Child: DOB: Age:
Getting it Right for Every Child
Achieving Good Outcomes
Getting it Right for Every Child is an approach which has been introduced by the Scottish Government to apply across all services for children and young people to achieve better outcomes for children. To meet these outcomes, children need to be safe, healthy, achieving, nurtured, active, respected, responsible and included.
The child’s family, community and universal services of health and education will meet most of these outcomes most of the time for most children.
There will be times when some children will need additional support to achieve good outcomes. This support might come from targeted support, such as support for learning or specialist health services. Some children may require support from social services to achieve good outcomes.
When funded support is needed to achieve good outcomes
Getting it Right for Every Child recognises that children and their families are often best placed to know what kind of additional help would make the most difference. Self directed support is an opportunity for families to have control over some or all of the budget to deliver better outcomes for their child.
Not every child requires funded support to achieve good outcomes, and public money is only accessible in a limited number of cases. Funded support may be available if your needs have been assessed as Priority 1, defined as “Critical risk where serious harm or loss of life may occur”, or Priority 2 “Significant risk where harm may occur now or in the near future”
21 Self directed support
Self directed support is an approach which helps you to arrange support for your child in a way that is meaningful to your child and your family, and which keeps your child at the centre of the decision making. The guided self assessment helps you, your child and your child’s social worker to identify where the support your child receives from the family works well just now, and where extra support is needed. Where funding is available, a Resource Allocation System is used to identify how much money is available to you to plan your child’s support. Points are allocated at each section of the form according to the agreed score, and these points value results in an indicative budget being identified.
If it is agreed that a budget will be allocated, you will know from the outset how much money is available. How the money is to be spent is focused upon achieving good outcomes for your child. This means that the money can be used very flexibly and creatively to help your child to achieve these outcomes.
As you complete this guided self assessment, give consideration to the band which most appropriately describes your child and family.
Band Description Proposed annual award Family support The family is able to support the child age and stage appropriately £0
Band 1 Preventative support The family is able to support the child age and stage appropriately but this is £500 starting to have an impact on main family carers which low level intervention could help sustain
Band 2 Moderate support The family is able to support the child but to continue to do this they will need £2,500 some additional support
Band 3 Significant support The child has high support needs, the family is resilient and wants to achieve the £5,000 best for their child but without lots of support they are finding this increasingly difficult. Somebody needs to be with the child at all times.
Band 4 Exceptional support The child requires constant support from someone who knows the child well. £8,000 There is a high level of risk to manage which requires constant supervision during the day and night.
**Social work staff should refer to SDS Best Practice Guide for clarification about how to use this form**
22
Meeting good outcomes
1. Safety
It is important that your child is able to be safe. All children need help to be safe, and for most children the help they receive from their families and from people in the community, such as teachers, allows them to be safe as they grow up. The kind of help given varies according to the age of the child, and as children begin to do things more independently, this help often changes from direct care and supervision to the provision of advice and guidance to enable young people to learn to manage a level of risk.
Some children need additional help and support to be safe. If your child needs this kind of support, think about the circumstances when this is required. This support might be required for your child to be able to take some risks in order to develop risk taking skills; to avoid self-harm or accident; to make safe relationships; or to prevent someone else from being endangered.
Safe My view My family’s My social view worker’s view My family and friends help me to be aware of dangers and to feel safe. The support works just now and is right for my age. My family and friends help me to be aware of dangers and to feel safe. The support works just now and is right for my age. A bit of extra help for my family with this would make a difference to how they manage. I need a bit more help than expected for my age and stage of development I need help now and again to recognise dangers and to feel safe. I need my family, or my friends, or my teacher, or other people in my community to provide some extra help once or twice a week. I need help at all times to recognise dangers and to feel safe. I need my family, or my friends, or my teacher, or other people in my community to provide this help constantly. There is a high level of risk for me which needs to be managed. Someone who knows me well needs to constantly supervise me during the day and night
23 Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
24 2. Healthy
Everyone wants to have good health. Children and young people often need help and support to stay healthy, and to make good health choices. This may involve advice and support with eating a healthy diet, sleep, exercise, washing, toileting and skin care. It may also involve help to manage feelings and emotions.
For most children, this help is provided by their families, teachers and local health professionals. Some children need extra support to have a healthy life. If your child needs this kind of support, think about the circumstances when it is required. This might be needed if your child requires specialist health care, specialist support with his or her diet, or professional support to manage feelings, emotions or behaviour.
Healthy My view My family’s My social view worker’s view
My family, friends and local health staff help me to be healthy. This support works just now and is appropriate for my age. My family, friends and local health staff help me to be healthy. This support works just now and is appropriate for my age. A bit of extra help for my family with this would make a difference to how they manage. I need help which is more than would be expected for my age and stage of development. I need this help regularly to stay healthy and to manage my feelings from my family, friends, local health staff or people in my community. I need constant help to stay healthy and to manage my feelings and emotions. I need this help every day. I need constant support to stay healthy. I need this help from family, or from people who know me well and understand my complex needs in order to manage a high level of risk.
25
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
26
3. Active
Most people enjoy spending time doing something fun or interesting. For most children, the support they receive from their families, friends and other people in the community enables them to develop hobbies and interests, to go to fun places and to have new experiences.
For some children, additional support is required for this to happen. Some children need help with their mobility, with managing their behaviour as a result of a condition, with being aware of risks or with interacting with others. Some children need help to manage their feelings and emotions when they are with other people.
Active My view My family’s My social view worker’s view My family and friends help me to be active and to develop participate in hobbies, interests and to have fun. The support works just now and is appropriate for my age. My family and friends help me to be active and to develop participate in hobbies, interests and to have fun. The support works just now and is appropriate for my age. A bit of extra help for my family with this would make a difference to how they manage.
I need help which is more than would be expected for my age and stage of development. I need extra help regularly to pursue my interests and hobbies. I need this help to come from someone over and above the people in my family or community who would usually provide this I need extra help constantly to be involved in any hobbies, interests or fun things with my family or in the community. I need active help constantly whenever I am involved in any fun activities at home or in the community. This needs to be from my family, or from people who know me well and understand my complex needs.
27 Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
28 4 Nurtured
All children need a place where they can feel comfortable and safe, and where people really care about them. Most children are able to feel loved and secure within their families and wider circle of friends and community. For some children, this is more difficult because of family relationships, family breakdown, worries about parents and carers, or because there are circumstances which make it particularly difficult for the child and family to share feelings and to say what they need, such as earlier events or conditions such as autism.
Nurtured My view My family’s My social view worker’s view
My family and friends provide me with a place where I feel comfortable and safe and where I feel cared for. The support works just now and is right for my age My family and friends provide me with a place where I feel comfortable and safe and where I feel cared for. The support works just now and is right for my age. A bit of extra help for my family with this would make a difference to how they manage. A bit more help than is usual is needed for my family and I to feel happy and secure together.
We need regular help and support for my family and I to feel happy, safe and secure together
We need a great deal of help and support for my family and I to have a positive relationship with each other. We need support to express our feelings with each other in a positive way and to improve family relationships from people who know us well and have particular skills.
29
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
30
5. Achieving
Every child should have opportunities to learn and to have people who encourage them to do their best. For most children, the support and encouragement they receive from their family, friends, teachers and people in the community, such as youth club leaders, enables them to learn news and to have their achievements recognised.
Some children, however, require additional support over and above that which is appropriate for the child’s age in order to learn new things, and to be involved in opportunities to develop new skills. If your child needs this kind of support, think about the circumstances when it is required if your child is to develop knowledge, skills and achievements.
Achieving My view My family’s My social view worker’s view
My family and friends help me develop new skills and to learn things, and encourage me to do my best. The support works well just now and is right for my age.
My family and friends help me develop new skills and to learn things, and encourage me to do my best. The support works well just now and is right for my age. A bit of extra help for my family with this would make a difference to how they manage.
I need a bit more help than expected for my age and stage of development. I need help now and again to develop new skills and knowledge. I need my family, or my friends, or my teacher, or other people in my community, to provide some extra help every day.
I need extra help constantly if I am to achieve new things, and to develop my skills and knowledge. I need constant extra help in order to achieve new things and to develop new skills and knowledge. I need this help to be from my family or from people who know me really well and understand the complexity of my needs.
31
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
32
6. Respected
It is important that children are involved in decisions which will affect them as appropriate to their age and stage of development. Most children have someone they get on well with who listens to their opinions, ideas and anything they have to say. Children learn about respect from having someone who thinks they are special and who takes them seriously.
Some children need extra support to be able to express their views and for these views to be taken into account when decisions are being made about them. This might be because extra support is required for others to understand the child’s communication and for the child’s views to be meaningfully valued and considered.
Respected My view My family’s My social view worker’s view
My family and friends listen to my views, value my opinions and include me in decisions as appropriate to my age and stage of development. The support I receive works just now.
My family and friends listen to my views, value my opinions and include me in decisions as appropriate to my age and stage of development. The support I receive works just now. A bit of extra help for my family with this would make a difference to how they manage.
I need a bit more help than expected for my age and stage of development to express myself and for the adults in my life to understand my opinions and take account of these when decisions are being taken about my life. I need constant help to express myself and for the adults in my life to understand my opinions and take account of these when decisions are being taken about my life I need help all of the time to express myself and for the adults in my life to understand my opinions and take account of these when decisions are being taken about my life. I need this help to be from my family, or from people who know me really well and understand the complexity of my needs
33
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
34
7. Responsible
Growing up involves learning to take good decisions and make sensible choices. As children grow up, they need support to learn how to make good choices and to learn from the times when they make wrong decisions. Children often enjoy opportunities to do helpful, kind things for others. Most children receive this support, advice, guidance and encouragement from their families, friends and other adults in their lives.
Some children, however, require extra help to recognise good choices and to develop the confidence and knowledge they need to make good decisions and to behave responsibly towards others. They may require, foe example, extra support with understanding situations and others’ feelings.
Responsible My view My family’s My social view worker’s view
My family and friends help me to make responsible choices which are appropriate for my age, and support me if I make mistakes. The support I receive works just now. My family and friends help me to make responsible choices which are appropriate for my age, and support me if I make mistakes. The support I receive works just now. A bit of extra help for my family with this would make a difference to how they manage.
I need a bit more help than expected for my age and stage of development to make responsible choices and to learn from mistakes I make. I need constant help to make responsible choices and to learn from mistakes I make. I need help constantly to make responsible choices. This help needs to be from my family, or from people who know me really well and understand the complexity of my needs.
35
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
36
8. Included
Every child should feel accepted by the people in their lives and should have family and friends they can count on. They should have opportunities to enjoy the company of other people whom they like and to make real friendships. Most children have these opportunities within their families, communities and wider friendship groups.
Some children, however, need extra help to form friendships. This might be because of worries about how they will be treated by others, communication difficulties, mobility issues, lack of opportunities or confidence issues.
Included My view My family’s My social view worker’s view My family and friends help me to be included and to spend time with people of my choice. The support I receive works just now and is appropriate for my age. My family and friends help me to be included and to spend time with people of my choice. The support I receive works just now and is appropriate for my age. A bit of extra help for my family with this would make a difference to how they manage I need regular help which is more than expected for my age and stage of development to be included and to spend time with people of my choice. I need constant extra help to be included and to spend time with people of my choice.
I need constant and active help every time I wish to be included and to spend time with people of my choice. This help needs to be from my family, or from people who know me really well and understand the complexity of my needs.
37
Child’s comments
If the child has completed the workbook, or has provided views in another format, please note this here and attach the record of the views
Family’s comments
Social worker’s comments
38 Appendix 4
North Lanarkshire Council
Guided Self Assessment Questionnaire
Adults
Name Assessor Date of completion
**Social work staff should refer to SDS Best Practice Guide for clarification about how to use this form**
39 1. Meeting personal care needs
My View Assessors View A. I don’t generally need help and am largely independent with my personal care. For example,
I mostly manage by myself with things like going to the toilet, washing or dressing.
B. I occasionally need help with personal care; generally once each day. For example,
I need to be prompted to have a shower. I need some help to have a shower. I need help to pick the right clothes to wear. Sometimes my health becomes problematic and I go from not needing any support with personal care to needing help or reminders.
C. I need regular support with my personal care.
I need help to dress and undress. I need help in the shower or to bathe. I need help to go to the toilet. I usually manage my personal care by myself but often my health difficulties mean I sometimes need lots of help. I have problems with alcohol or drugs which result in me needing help with my personal care – sometimes a lot, but mostly none at all.
D. I need lots of help with my personal care.
I need lots of help with personal care throughout the day. I have specific routines with personal care that I need other people to help me follow.
40 I have complex personal care needs and those who help me need to know a lot about me.
E. I need an exceptional amount of support with personal care.
I need two people to help me with personal care. I need support throughout the night on most nights with my personal care. The people who help me with my personal care need to be trained to help me specifically.
41 2. Eating and Drinking (Nutritional needs) My View Assessors View A. I don’t need help to eat or to drink.
B. I need some help to eat or drink. I can prepare snacks and hot drinks for myself but would need support to prepare a hot meal. I can make my own meals but need some help with planning / preparation. I don’t usually need help to eat but as a result of problems with my health or difficulties with my lifestyle mean I need some help for a period.
C. I need a lot of help to prepare food and drink. I need significant support to make sure I don’t eat too much or too little. I need someone to cut up my food or to feed me. I can’t use the cooker / microwave and need support to prepare a hot meal. I often forget to eat and this is having an adverse affect on my health.
D. I need an exceptional amount of help to eat and drink.
I need specialist help with eating and drinking as a result of a risk of malnutrition / obesity. Others need to be trained to so that they understand how to support me specifically; I need to be fed via a nasogastric tube. I need someone to be with me when I am eating as I’m at risk of choking. I have a condition, for example, Diabetes, but don’t understand how to manage this to keep myself well.
42 3. Practical aspects of daily living My View Assessors View A. I can attend to the tasks of daily living according to my role within the home.
I am largely independent with most practical aspects of daily living.
B. I need some help with some things around the home.
I can usually attend to the practical aspects of daily living, but sometimes because of problems with health or addiction, I can be unable to for a period.
I can attend to my bills independently but require support to attend to the practical aspects of daily living.
I can attend to some housework tasks but require help with others.
C. I need a lot of help around the home.
I cannot attend to the tasks of daily living and require support to arrange or manage systems to pay my bills.
D. I need a significant amount of help in order to develop the skills required to independently attend to tasks of daily living.
I am developing the skills required in relation to the practical aspects of daily living but need significant support to become independent in this area.
43 4. Managing health conditions
My View Assessors View A. I am able to keep myself healthy and well;
I am able to highlight if I need to see a doctor or otherwise require support.
B. I need some support to stay healthy
I need routine support to take medication. I need support to attend regular GP appointments. I can let someone know that I don’t feel well.
C. I need regular support to maintain my health.
At times I need significant advice and support in relation addiction issues. Sometimes my mental health causes me problems and I need support from others. I can let people know if I feel unwell but need significant support to stay healthy
D. I need frequent support most days to make sure that I stay healthy and to maintain my health and well being.
I am unable to identify that have a problem with my health and rely on others to determine this.
44 E. I need specialist support to stay healthy.
I need specialist help with my health from someone who has been specially trained to support me. For example, I need subcutaneous medication / postural drainage / dialysis, etc. People who support me need to determine when I need medication. In the past I have decided to stop taking medication, for example in relation to my mental health, and this has led me to experience further problems.
45 5. Relationships and social inclusion My View Assessors View A. I am happy with the number of people in my life – friends, family and acquaintances.
I like seeing my family and / or friends I enjoy spending time with others as well as alone
B. I need help to keep in touch with the people in my life and go to the places I choose.
I have people in my life that I care about and need support to keep seeing them / to see them again.
C. I want to widen my circle of friends.
I want to develop new interests. I want to access good recreational opportunities or social learning opportunities, for example, leisure courses. It’s important that I have more people in my life who are not paid to be with me.
D. I’m very isolated and spend most of my time alone. I want to make new friends and do things I can’t do just now; I need help to do so.
I have very few relationships with people who are not paid to be with me. I have had little past experience of developing friendships. I plan to volunteer and will need significant support to do so.
46 6. Work and formal learning My View Assessors View A. I don’t need support in relation to work and learning.
I am already working or in education. I don’t wish to work or pursue formal learning at this point in my life.
B. I am working or at college/ university and need someone to help me sustain this.
I am in employment. I am participating in vocational classes at college or university. I need support to keep doing this.
C. I want to work or pursue formal learning and I will need additional help to access and sustain this.
I intend to gain employment or access formal learning. I am at the stage of actively pursuing employment, training or a vocational learning opportunity. I will need additional support to both access and sustain this.
D. I want to work or pursue formal learning and need significant help to do so.
I intend to gain employment or access formal learning. There are significant barriers to achieving this aim. The help I require is particularly complex.
47 7. Choice and Control My View Assessors View A. I can make choices and decisions and know how and when to seek advice.
B. I can make choices and decisions but don’t always know when to seek advice.
I can make some choices known, for example, where I want to live. I can make choices if information is presented to me in ways that make sense to me. I like to involve the people that care about me when making big decisions. It’s important to me to hear the views of particular people before I make decisions.
C. I can make some choices and decisions but sometimes people have to help me.
I can make some decisions, for example, what to wear or eat if presented with options. It is likely that I may be subject to Welfare Guardianship. I need significant help to understand and make choices about bigger issues, for example, what my support will look like or where I live.
D. Most choices and decisions are made for me.
Other people need make the most significant choices and decisions for me. It is likely that I will be subject to Welfare Guardianship. Both significant and day to day decisions about my life are made on my behalf even after every effort has been made to involve me.
48 8. Risk My View Assessors View
A. I understand the risks in my life and can manage these.
I appreciate that everyone’s lives involve an element of risk and I can manage the risks in my life.
B. I need some help to manage the risk, for example,
I need someone to check on me at times. Some equipment will help me be as independent as possible. Some adaptations to what my home looks like will help keep me safe. I need some support to develop strategies to keep me safe, for example, what to do if people come to my door / how to travel on public transport.
C. I need significant help to manage the risks in my life.
I don’t always realise that my behaviour puts me at risk and rely on others to identify strategies to keep me safe. There are times when the risks in my life increase as a result of addiction or mental health difficulties and my ability to manage them is compromised. I rely on other people to co-ordinate complex plans to help keep me safe.
D. I don’t understand many of the areas of risk in my life.
Strategies are in place so that I could summon assistance if I needed to, (eg in an emergency.) I need someone with me at home at times. I am able to spend periods of time alone in my own home but need others to be there consistently.
49 E. I need other people to be physically present most of the time to keep me safe.
I have no cognition of risk in most or all areas of my life and there are limited strategies available to keep me safe. I present serious risk to members of the public.
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9. Home and family life This part is about your day to day life and the role other people – like family and friends- play in your life.
My View Assessors View A. I live with my family, this suits us all, I don’t have any plans to change this in the next year. B. I live with my family at the moment and although we get on well this is something I am planning to change in the next year. C. I live with another person(s) – partner or friend(s)- this arrangement suits us, we enjoy doing something’s together and alone, my living situation suits me. D. I live alone, I spend some of my time with my family and friends, my living situation suits me. E. I live alone and I spend some of my time with my family and friends. My living arrangements don’t suit me anymore I plan to change this in the next year. F. I am planning at the moment to move to my own home and I don’t have or am not in touch with my family. Or My living arrangement suits me well and I don’t have or am not in touch with my family. G. I am planning at the moment to move to my own home. Contact with my family is difficult or has broken down completely. Or My living arrangement suit me well; contact with my family is difficult or has broken down completely.
51 Appendix 5 This leaflet is for people who have Option 1 North been assessed as needing support and where funding is available. It is You can take your budget as a Lanarkshire designed to give you more Direct Payment to purchase information about arranging your services or goods which will help Council support. you achieve your agreed outcomes.
You will already have contributed to Many people who use a Direct a Guided Self Assessment and your Payment to arrange their support worker will have confirmed the employ the services of a Personal Self Direct indicative budget available to you to Assistant. The Scottish Personal begin planning. There is space on Assistants Employer’s Network is Support the front of this leaflet for your an independent organisation which worker to note your indicative provides advice and support to budget. people considering using their budget in this way. Their contact Planning my There are 4 options for how your details are on the back of this support can be arranged. Your leaflet.
support worker will talk you through each Direct Payments allow for the option and will explain why if any of greatest flexibility and control over them are not available to you. individual budgets but carry the Name: most responsibility of all of the Further useful information on Self options. Directed Support in North Indicative Lanarkshire is available on the Your worker will help you think Budget: Council’s website: through which option will work best www.northlanarkshiresds.eg for you.
52 Option 2 Option 3 Useful contacts
You can ask a support provider to You can decide that you want the Scottish Personal Assistant manage your budget for you. This Council to design and manage what Employers Network (SPAEN) means that the provider will receive your support will look like. Tel No: 0845 601 1156 the budget on your behalf and will then E Mail: [email protected] provide or arrange your support. You will be actively involved in Web: www.spaen.co.uk planning your support and will have a This could be in the form of direct clear say in what would work for you. Advocacy Services support or the purchase of services or Your Voice Advocacy (up to 18 years) goods - so long as it will help you meet The Council would have the Tel No: 01236 700108 your agreed outcomes. Option 2 responsibility for identifying and E Mail: [email protected] cannot be used to employ Personal commissioning and/or providing Web: www.urvz.org Assistants, that can only be done appropriate support to help you meet through a direct payment. your agreed outcomes. The Advocacy Project (age18-64) Tel No: 0141 420 0961 You will have a direct say in what your Option 4 E Mail: [email protected] support looks like and be informed as Web: www.theadvocacyproject.org.uk to how your money is spent. The final option is a mixture of the first Equals Advocacy (age 65+) 3. Tel No: 01698 327772 This option allows you to have control E Mail: [email protected] over how your budget is spent without Some people might like to use this Web: www.equalsadvocacy.org.uk having the responsibility of managing a option to check out what works best for Direct Payment. them. Carers Groups Princes Royal Trust If you choose a provider the Council Workers Tel No: 01236 755550 or 0800 028 0287 does not currently have a contract with Name: E Mail: [email protected] some additional checks will be needed Contact Web: www.prtlcc.org.uk before your support can start. Details:
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