Impact – enabling short breaks for disabled children

Short Breaks and Personalisation: Policy and Practice

Thematic Workshop 1

Revised November 2012

Personalisation workshop 1What we hope to achieve

Participants should:

• Understand the policy context and how we have arrived at the current position

• Have assessed the readiness of their organisation to take personalisation forward

• Have an understanding of person centred planning and support planning

• Understand how personalisation can impact on families and local authorities (Providers are covered in a separate session)

• Have identified next steps in the personalisation process.

Agenda for the morning session

• A quick quiz - definitions and the law

• Some background - the policy context

• The experience of implementing a personalised service

• How prepared is your area for personalisation?

What is personalisation?

• “The process by which state provided services can be adapted to suit you.

• In social care that means everyone having choice and control over the shape of their support along with a greater emphasis on prevention and early intervention”

Department of Health

How did we get here?

• Disabled people’s movement, especially the Independent Living Movement in the 1980s and 90’s fought for direct payments

• The Woodlands Group (1976)

• Direct payments legislation introduced (The Community Care - Direct Payments - Act 1996)

• In Control Phase 1 2003-2005, Taking Control and Staying in Control

• Improving Life Chances for Disabled People (2005)

• D of H Adult Individual Budget Pilot Project 2005-2007 – IBSEN report

How did we get here? Part 2

• Putting People First 2007

• Lord Darzi – NHS review – recommended personalised approach

in healthcare 2008

• Personal Health Budget Pilot. Pilot started March 2009

• Children’s IB Pilot 2009-2012

• Special Educational Needs Green Paper 2010

Direct payments

• Introduced by the Carers and Disabled Children’s Act 2000

• The current law concerning direct payments for children can be found in section 17A Children Act 1989, this clause was inserted by the Health and Social Care Act 2011

• This legislation gives local authorities the power to offer a direct payment as long it continues to safeguard and promote the welfare of children.

Budget Holding Lead Professional (BHLP) • The approach was established following the publication Support for

Parents: The Best Start for Children, which made a commitment to support the increased personalisation of services through the piloting of BHLPs

• Based around the Team Around the Child (TAC) model

• It involved the allocation of low level funding to support the development of a child via: assessment; development of a support plan; costing and purchasing of services by the BHLP

Personal budgets

Vision for Adult Social Care: Capable Communities and active citizens 2010 Every adult in receipt of social care funding will have the opportunity to have a personal budget by 2013.

Putting People First 2007

A personal budget then only referred to money from local authorities. Now it can involve more than one source of money.

Information, advice and advocacy for all

Early intervention Low level services

Self-assessment Self-directed support Personal budgets

Neighbours Volunteers

What will change?

Personal Health Budgets Pilot Project The High Quality Care for All: NHS Next Stage Review Final Report (2008)

“ Over the next two years, every one of the 15 million people with one or more long term conditions should be offered a personalised care plan, developed, agreed and regularly reviewed with a named lead professional from among the team of staff who help manage their care.”

Start of the personal health budget pilots, as a way of giving patients greater control over the services they receive and greater choice over the providers from which they receive services.

“Continuing and developing the personal health budget pilot programme, both extending existing sites and encouraging proposals for additional sites in 2011/12. The learning from the pilot programme will inform wider rollout in 2012. Personal budgets will allow greater integration between health and social care at the level of the individual and give people more choice and control over their care. “

People receiving continuing healthcare support from the NHS will have the right to ask for a personal health budget, by April 2014 (subject to the evaluation).

Rt Hon Andrew Lansley M.P. Sec of State for Health, Oct 2011

White Paper Liberating the NHS 2010

Key Findings from Children’s Individual Budget Pilot Sites

The over-arching conclusion appears to be that while the pilots have achieved much and demonstrated what can be done (there were many successes), there is still a need to refine some elements of the delivery process.

The Main Lessons

• The requirement of dedicated resources

• The willingness of a range of families to engage with IBs

• The challenges of resource allocation

• The importance of support planning

• The challenge of engaging health and education services

• practice is less developed around engaging young people

The Impact on Families

The survey and focus group evidence from parents clearly demonstrates an increased sense of choice and control after the pilot.

In particular:

• Improved access to social care services

• A shift in the types of services that they use

• Greater satisfaction with the services they received

• That these findings occur independently of increases in a family’s budget allocation

The IB pilots were awarded an additional year of funding to explore how education and health based funding could be incorporated into an Individual Budget for families with disabled children during 2011-12.

Children’s individual budget pilots

A cautionary note.....

• It must be remembered participation was optional and so pilots worked with those that were willing but working with a wider, potentially less willing group of parents requires further testing.

• The pilot sites all faced difficulties in generating change outside their own service areas.

• Cross sector working is more likely to be delivered if there is a clear expectation of what should be offered.

• Resource allocation is likely to remain a prominent issue

• Idea of a single personalised plan from early childhood to old age

• Give parents the option of a personal budget by 2014

• Recruit a set of pathfinders to test the best ways to provide a personal budget to children with SEN and/or disabilities, linked to the new plan, building on findings from the current IB pilots and the Getting a Life programme.

SEN Green Paper - Support and aspiration

Furthered its commitment to the personalisation of services for families with disabled children and now the draft legislation

The continuing move to Personalisation in the draft legislation on the reform of the provision for children and young people with special educational needs

• Person centred planning underpins the idea of personalisation and the education, health and care plan

• The idea of a local offer is so children and families can access a range of provision in the community (Information and advice, prevention)

• If a child has a education, health and care plan, there is a requirement to prepare a personal budget if asked to do so by child’s parent or young person

Recent developments- issues arising from the draft SEN legislation• Appears to be a more narrow definition of personal budgets in the draft

legislation –

S26 (2) implies that personal budgets can be made available to secure a 'particular provision’

S26 (3) states that regulations may make provision about the description of provision to which payments may (and may not) relate.

Some Issues to resolve

• How local authorities will develop a range of provision which families can buy and what support they will provide to people with personal budgets.

• How the single plan will look at each stage

• The idea of a single assessment – has it been shelved?

• Whether we can retain the flexibility of personal budgets as they have developed to date

• Is there still hope for bringing funding streams together?

Agenda for the afternoon session

• 7 Steps of Self Directed Support – Presentation and Group Discussion Including feedback (10 minutes)

• Resource Allocation System - Presentation

• Principles of Person Centred Planning and support planning

• Group work: Scenarios to consider person centred planning and processes for making it happen

• Identifying next steps and key actions to take forward