Personal Budgets SEND HEATHER M STACK SEND CONSULTANT

Personal Budgets - SEND HEATHER M STACK SEND CONSULTANT, HM STACK CONSULTING MARCH 2014

Draft SEN Code of Practice - Section 7. 12 �“A personal budget is an amount of money identified by the local authority to deliver all or some of the provision set out in an EHC plan. By having a say in the way this budget is used, a parent or young person can control elements of their support. ”

Personalisation of Public Services �Personal Budgets are a part of the personalisation of public services �An integral part of the co-ordinated assessment and Education, Health & Care Plan process �Preceded by the Individual Budget (IB) Pilot Programme for families with disabled children �Preceded by Personal Health Budgets (PHB) Programme �Mott Mac. Donald contracted to deliver Pathfinder Support by Dept for Education

SEND Reforms � Subject to Parliamentary approval of provisions in the Children & Families Bill, all areas will need to implement the SEND reforms from Sept 2014 � Services across education, health & social care need to work together to place families & children at the centre of the commissioning, assessment & planning process � Pathfinder champion programme with run until March 2014, scaling up new approaches to include whole areas, across 0 – 25 age range � Next updates February 2014 of Devon SEND pathfinder (Version 3, Personal Budgets, December 2013)

Bills & Supporting Documents � Children & Families Bill – clause 48 � Draft: SEN Code of Practice – section 7. 12 Requesting a Personal Budget � Draft: Personal Budget Regulations � Consultation on transition to Education, Health & Care Plans and the Local Offer � Support & Aspiration: a new approach to SEND 2. 26 Giving Parents Control � Draft Legislation on Reform of Provision for Children & Young People with SEN – Section 26 � Df. E, In Control, SQW, Support and Aspiration: Introducing Personal Budgets

Key Challenges 1. Implementing lessons learned from Pathfinders 2. Understanding local perceptions and strength of parental 3. 4. 5. 6. feeling towards reforms and PBs Strengthening the role of key workers & Independent Supporters Gaining the involvement of CYP in their EHC Plans Understanding and knowing the diversity and breadth of provision from all sectors within a locality SEND providers making clear a realistic costing of services and provision shared with stakeholders

SEND Pathfinders – Personal Budgets � 20 Pathfinder sites – 31 Local Authority areas tasked to develop and trial – �An integrated assessment process; �A single, joined up, Education, Health & Care Plan; �Personal Budgets across education, social care & health �Adult services � 13 June 2013 – launch of a series of Pathfinder Information Packs

Lessons from SE 7 (Medway) Dec 2011 3 factors underpin the successful introduction of Personal Budgets � Leadership and responsibility: addressing challenges, removing barriers, informing staff, giving clear leadership � Resourcing the work: giving time to resource the EHC timeline: realistic and focused at the outset, 6 – 9 months for first group of families � Clarity about outcomes (define the change) and outputs (concrete products or changes)

Lessons from Social Care – October 2012 � Debate over how PBs benefit different people in different ways � The Office for Public Management, Essex County Council & user • • • -led disability organization, ECDP, examined the impact of PBs on the lives of people who use them (Oct 2012) Differences in how budgets are used by different cohorts Older people tend to prefer more traditional forms of support Younger users favoured familiar people, often family members PB holders of working age more likely to be creative to access community services for personal development Supply in some areas needs to catch up with demand

Evaluation of SEN Direct Payments – June 2013 � Across the 14 SEN DP pilot study sites – � A total of 290 SEN DPs approved � Over 270 covered home to school personal transport � The others supported individual complex cases � One area provided 7 direct payments for early years nursery funding � A low level of take up in the pilots driven by challenges and complexities in the design & implementation of the DP. � Over 50% of families invited to take part in the pilot chose not to take up the offer of DPs but were keen to be involved in the decision making process of support

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

Pathfinder lessons learned – December 2013 � DPs have meant some families operate as employers, contracting their child’s support � Need to comply with HMRC requirements � Not all families able to take on responsibility � A need for clear guidance on implications of managing the PB � Reality has been that many families seek support from professionals to manage PB – an organized arrangement � LAs developing lists of preferred providers � Significant amount of work needed to develop the marketplace to give families choice and control � The need for a phased approach crucial to its success

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

Local Concerns �Public consultations: budgetary cuts & service revisions �The ‘Matrix of Need’ (Warwickshire Health & Social Care) �Fear of diminishing services & high thresholds for intervention to access services �Complexity of some service revisions �Heightened emotions, fear & anxiety �Battle mentality �Specialist Schools as a communication channel

Parental Voice & Anxiety � “There is an underlying concern that this. . . is being driven by your need to prevent parents and children from securing the support they badly need in order to slash your budget. . ” �“It looks like services will just disappear and that hardly any families will qualify for personal budgets given how difficult you have made it with your matrix. . . ”

Twitter Comment @thelocaloffer �“Where Local Authorities present #Personal. Budgets as part of a rationalisation of services, alongside spending cuts, there will be problems. ” �Jan 2014. @thelocaloffer

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

Involving Families & Young People �South East 7 – Pathfinder group (Medway, Kent, Surrey, West Sussex, East Sussex, Brighton, Hove & Hampshire) �A regular amount of money agreed by Children’s Services to help children meet needs, hopes & aspirations. . . �A need to think about what a child likes and enjoys, as well as needs �Parents encouraged to choose a friend to help create the plan alongside an independent facilitator – reference to the family’s social worker

Assessment & Planning Framework

In Control’s 7 Steps Plan 1. Need help 2. Making the most of existing resources (real wealth) 3. Making a plan 4. Agreeing the plan 5. Managing support 6. Living my life 7. Review and learn

Integrated Model of Assessment & Planning (Southampton Pathfinder) �Phase 1 – preparation & consideration (first assessment meeting) �Phase 2 – listen and understand (parental input, home/school observations & visits) �Phase 3 – Analyse and synthesize (final assessment team meeting) �Phase 4 – Agree and allocate �Phase 5 – Monitor and review (first review meeting)

Funding Personal Budgets

Components of a Personal Budget 1. Education 2. Health 3. Social care 4. At a school/Head’s discretion additional funding may be contributed �LAs and their partners are encouraged to develop a single integrated fund from which a single PB can be made available

Personal Budgets & EHC Plans � Local Authorities prepare a Personal Budget if it identifies an amount as available to secure provision � The Education, Health & Care Plan may set out 1. The amount of a personal budget 2. The sources of the contributing funds 3. Details of payments to be made to a child’s parent 4. The description of provision to which PBs may relate 5. When, how, to whom & on what conditions direct payments may be made 6. When direct payments may be required to be repaid and the recovery of unpaid sums

4 mechanisms for control of a Personal Budget �An organised arrangements – LA retains management & commissions support �Third party/nominees – an individual or organization manages the funds on behalf of parent/young person �Direct payment – funds are paid direct to parent/young person to contract, purchase & manage services �A combination of the above

Addressing Needs & Seeking Outcomes �Statement of SEN – 1996 Education Act – parallels with EHC Plans – �Part 1 – Sources of evidence – education & health �Part 2 – Statement of SEN �Part 3 – Objectives & educational provision �Part 3 – Resource allocation �Part 5 – Non educational needs – health & other �Part 6 – Non educational provision – travel

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

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

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

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

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

Independent Supporters � Government allocation of £ 30 m available until March 2016 � Funding to cover costs of recruitment, management & training � Anticipating 1, 800 Independent Supporters, c 12 per each LA � Council for Disabled Children (CDC) appointed to oversee & trial delivery methods � Individuals recruited & managed by Private, Voluntary & Community sector (PVC) to provide advice & support for parents � To offer time-limited support & advice on personal budgets to families � Independent from the LA but part of the offer of support that LAs should make available � To work alongside Parent Partnership Services & Key Workers � (last update 7 th January 2014)

Hierarchy of Services & Support �Universal services – local services, health & education �Targeted services – CAMHS, children’s learning disability team & others �Community wealth – support groups & local services �Real wealth – knowledge, experience & skills of family �Specialist support services – additional & individual needs over and above that which can be provided by universal, targeted, community & family wealth systems – the focus of the Personal Budget

Delivery Models Universal Services Parental Support Child Specialist Services (Personal Budget) Targeted services and support

Expectations of Parents - Auditing Accounts � Need for parents to keep a record of payments received via direct payment & paid out to services � A social worker, or other facilitator, will carry out regular audits at pre-arranged times to look at paperwork – � Invoices & bank statements to be kept safely for this purpose � First review at 3 months and then at 6 monthly intervals to consider whether EHC plan outcomes are being achieved

Schools & the SEND Journey �Relationships with parents of children with SEND built up over a period of time �Gradual move to EHC Plans to replace Statements of Need �Children currently eligible for a statement of SEN or Learning Difficulty Assessment �Children who are not yet of school age but likely to be eligible for a Statement �Children who have both complex health & complex social care needs

Promoting PBs to Hard to Reach Parents �Lessons learned from Pathfinders indicate differences in the way different cohorts take up and use Personal Budgets �A need to ensure that PBs serve the needs of all parents and not just vocal, articulate, middle-class parents �A need to ensure that efficient support is given to guide parents through processes �A need for schools to be vigilant to local changes in service delivery, roles & opportunities in SEND management

The Double Funding Dilemma �Commissioners must decide on funding approaches with schools & parents �What is to be provided through central or school budget & what provided through a personal budget? �Some health provision may be chosen by parents through a PB – but may also be funded by school & LA or local health service �A need to avoid double funding to avoid detrimental impact on provision & to make efficient use of resources

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

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

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

Key Challenges 1. Implementing lessons learned from Pathfinders 2. Understanding local perceptions and strength of parental 3. 4. 5. 6. feeling towards reforms and PBs Strengthening the role of key workers & Independent Supporters Gaining the involvement of CYP in their EHC Plans Understanding and knowing the diversity and breadth of provision from all sectors within a locality SEND providers making clear a realistic costing of services and provision shared with stakeholders

Personal Budgets – An Overview by � HM Stack Consulting – An independent consultancy service working with public, private and third sector providers with and on behalf of children and young people with SEND 0 – 25 years heather@hmstack. com Heather is also Founder of � The Local Offer – The first national brokerage service uniting the needs of parents, schools, commissioners & providers of education, health & social care services info@thelocaloffer. co. uk ~ www. thelocaloffer. co. uk