Self Directed Support in Scotland The Story so

Self Directed Support in Scotland: The Story so Far Mark Han-Johnston EVOC ‘SDS - are we there yet? ’ Thursday 28 th September 2016

Who are Self Directed Support Scotland • Self Directed Support Scotland (SDSS) is a national membership organisation • We are a User-Led, Disabled People’s Organisation (DPO) (A majority of our Board Members are disabled people from disabled person’s organisations) • We are part of the Independent Living Movement in the UK • We actively promote Independent Living by supporting, working with and championing the aims of Self Directed Support disabled people's organisations (SDS-DPOs)

What we do: • Raise awareness of Self Directed Support and the principles behind it • Promote the Social Model of Disability and the philosophy of the Independent Living Movement • We develop resources, materials and training for our member organisations • Research best practice, identify examples of good practice in SDS and report back to member organisations and others • Provide a national campaigning voice for member organisations • Work with other local and national organisations and agencies • We also work with Local Authorities, NHS Health Boards and Health and Social Care Partnerships / Integrated Joint Boards to raise awareness of SDS practise and implementation

The picture across Scotland

Implementation of Self Directed Support: • SDS 10 year National Strategy (2010 – 2020) • Social Care (Self-directed Support) (Scotland) Act 2013 • Statutory Guidance to accompany the above Act (March 2014) • Created new expectations in the delivery of social care • Central themes of personalisation, co-production and an outcomes focus • Created new legal duties for Local Authorities (eg ‘facilitate the person’s dignity and participation in the life of the community’; offer the 4 options; signpost)

Scottish Government Statistics for SDS: 2014 - 2015 Implementation • The best estimate of an implementation rate suggests that clients who made a choice represented 20% of all social care clients in 2014 -15 (80% no choice made? ) • The implementation rate was higher amongst younger clients (aged under 65) than amongst older clients (aged 65+) Client Analysis • The best estimate of the breakdown of SDS option choices in 2014 -15 is: 13% Option 1; 9% Option 2; 75% Option 3; and 3% Option 4 • The vast majority (88%) of clients aged 65+ chose Option 3, whereas under 65 s were more likely to choose Option 1 or 2 Expenditure • At least £ 250 m of expenditure was budgeted for social care clients who had made a choice regarding their services and support in 2014 -15 (20% of the all people? ) • On average, Option 3 care packages were of a lower value than Option 1 or Option 2 packages (Lower value = lower cost? )

This Report also highlights: • Only 20 out or 32 Local Authorities could give figures for the number of people on each of the 4 options of SDS • For 37% of people recorded on option 3 – it was not known what type of need their service was meeting (eg Housing, Personal Care etc) • There is an assumption that people on option 1 made a choice for this – which SDSS research has shown is not always the case • Different Local Authorities have different definitions of what constitutes an Option 2 service • There is no comparison between the amount of money spent on social care services prior to SDS implementation – no way of knowing if more or less is being spent • There is no comparison with the number of people eligible for social care funded support before SDS implementation

Where SDS is working well in Scotland: ? • There is no systematic way to know • There is not enough evidence to say that good practise is embedded in SDS implementation • It is not possible to say that Local Authorities meet their statutory duties under the SDS legislation • There are examples of good practise – certain teams / individuals etc • There is far more evidence of SDS not working as intended across the whole of Scotland

Weather Forecast for SDS: There may be trouble ahead • There has been some stormy weather • It’s likely to get wetter • There will be a few gales • There are some bright spots on the horizon

Some of the Issues that people face

(1) Postcode Lottery: • You may receive a different level of service and support depending on where you live • You may receive more money as a budget under Option 1 in one place, and less in another (But your needs are the same) • There may be varying degrees of understanding of SDS in different places • Some people may not even be told of SDS • It may be difficult to move to another area and get the same level of support

(2) Challenges to accessing SDS: • Lack of awareness of SDS • Lack of training for Local Authority staff on SDS • People being given incorrect information – dissuades people from applying for SDS • Reductions in Local Authority budgets – the on-going reduction of people’s care packages / budgets • Stricter interpretation of eligibility criteria – and applying this to Support Plans and activities people choose to undertake • Lack of a transparent and open system for allocating an appropriate budget to meet identified needs • Inequality of access to SDS for different groups of people • Local Authorities not undertaking assessments timely - if at all (for SDS and Carers)

(3) Challenges when receiving SDS: • People being given incorrect information • Lack of effective co-ordinating and communicating service provision between Education, Health, Housing and Social Work • Difficulty in getting jointly funded packages of care under SDS • Lack of access to Independent support (from Disabled People’s organisations and advocacy) • Difficulty getting agreement to use budgets flexibly and being risk positive • Lack of an Option 2 choice

It’s no longer them and us – it’s just us’ Collaborative Practise in Assessment Research • ‘The relationship between the assessor and the assessed person is the foundation – it’s so important. It needs good communication – especially good listening – and honesty. Processes and systems should be built around this and enable it, rather than getting in the way. ’

It’s no longer them and us – it’s just us’ Findings: • A climate of openness was created when people can come together to review SDS • Assessors are experiencing differing degrees of financial pressure • In practise, people using SDS and practitioners experiences differ significantly because of this financial pressure • The relationship between people using SDS and the assessor has come under strain because of the financial pressure • Assessors can struggle to be honest with their employer about the reality of SDS implementation

It’s no longer them and us – it’s just us’ Conclusions: • Introducing SDS at a time of austerity has put pressure on front line practitioners – who are encouraging people to make choices but are also being asked to cut people’s budgets • There is variation in the quality of workers practice • The ‘system’ created to deliver SDS is a major issue in preventing the delivery of SDS • It is possible to work in holistic, creative, preventative ways which reduce cost, prevent crisis and delay deterioration (Co-production)

SDS in Edinburgh: Some of the challenges: • Guiding people to block contracted services first • Not funding alternative therapies and counselling • Not paying for activity costs • Not being able to choose the gender of the person supporting you • Pushed to move to Option 1 if service identified is not satisfactory in some way • Activities in Support Plans being ‘reassessed’ against eligibility criteria • SDS not being for certain groups (eg homeless)

The Overall Challenge:

Support, information and further advice: SDS Information and Support Services across Scotland: • www. sdsinfo. org. uk Self Directed Support Scotland (SDSS): • www. sdsscotland. org. uk Not-for-profit support providers in your local area across Scotland: • www. searchforsupport. org SDS National Guides • (for service users, carers and practitioners) www. guidance. selfdirectedsupportscotland. org. uk Scottish Government and SDS: • www. selfdirectedsupportscotland. org. uk

Contact details: • Mark Han-Johnston: • Capacity Building and Resource Co-ordinator • Self Directed Support Scotland Norton Park 57, Albion Road Edinburgh EH 7 5 QY • Tel: (0131) 475 2625 • Mob: 07775 065653 • Email: mark@sdsscotland. org. uk

Thank you for listening: