Simon Duffy explores what we're learning about the Personalised Support at an event for Dorset County Council. This event was also the first event to explain the role of Citizen Network.
4. • The best way to think about personalised support is
not by starting with government policy.
• This is an ethical issue, which has been driven
forward by radical grassroots action.
• 50 years ago disabled people started demanding
the right to be citizens.
• Two generations of battle to close institutions and
develop personalised forms of support instead.
• Today there is still much to do…
5. Combine with lobbying for political and legal changes
activist have created practical alternatives. For people with
learning disabilities some of the most important include:
1. Individual service design, planning and policies
2. Managed personal assistants and shared management
3. Individualised funding (e.g. Individual Service Funds)
4. Supported decision-making and family leadership
5. Access to ordinary housing
6. Quality checking by people and families
8. Recent survey of 156 providers of personalised
support helps reveal some of the key elements
involved in providing personalised support.
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12. WHAT IS…? NOT…
Individual design slotting people into a placement
Creative planning another ?@*&^ person-centred plan
People/families make decisions it’s the organisation’s way or the highway
Quality checking professional knows best
Matching staff to people generic support roles
Individualised policies organisational health & safety rules
Full housing options we’ve got a lovely group home for you
People/families recruit staff staffing is our business
Individual budget protected money is a mystery
Direct management possible their our staff, not yours
13. Not all personalised support providers were using
Individual Service Funds (ISFs) yet. However the
organisations that had been using ISFs the longest
are most likely to be doing all the key elements of
personalised support.
16. • Focus - The solution to one person’s needs doesn’t
get muddled up with others
• Creativity - You can create solutions around that
person’s community and dreams
• Trust - Everyone believes that the person’s budget
is safe and changes benefit them
19. Inclusion Glasgow worked with
people with complex disabilities,
moving from institutions to
individually designed support
solutions in the community.
Research on the work of Inclusion
Glasgow demonstrated high levels
of efficiency, improvements in
people’s lives and lower costs over
time. There was a 46% reduction in
hours of support over a 5 years
period.
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24. Choice Support converted a block
contract for 83 people into 83
personal budgets - managed by the
organisation - ie. Individual Service
Funds (ISFs).
This work was associated with
reduced costs and improved lives.
Like many service providers, Choice
Support were happy to accept short
termination periods on that contracts
- and the ability of people to end
those contracts - instead of risky
block contracts subject to tendering
and procurement.
25. Choice Support converted a large block contract into 83
individualised services, with a saving of 28% over 3 years.
26. Social workers and support staff came to see the process as
personally rewarding.
27.
28. • Today Glasgow Council
are threatening to put
Margaret in a care home
because her package of
support is too high.
• Her carers and
independent citizens are
being denied the right to
advocate for Margaret.
30. • Austerity and cuts to social care
• On-going institutionalisation
• Procurement and tendering practices
• Lobbying by residential care industry
• Fragmented advocacy movement
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34. • In a 3 month period 25.9% of inpatients had harmed themselves
• 21.0% of inpatients had suffered an accident in the last 3
months
• 22.2% of people had suffered physical assault in the last 3
months
• Physical restraint had been used 34.2% of people in the last 3
months 11.4% had suffered seclusion in the last 3 months
• 56.6% of people had been the subject of at least one incident
involving self harm, an accident, physical assault against them,
hands-on restraint or seclusion during the last three months
• Antipsychotic medication used regularly or at least once in the
last 28 days for 68.3% of the people in the units
37. We still spend most of out social care funding on residential
care (but that is now dropping)
38. • Many charities unwilling or unable to campaign
• Different disability groups competing
• Government threatening behaviour (e.g. lobbying act
and other restrictions on free speech)
• Confusion about what kind of system people want to
defend (e.g. residential care vs. inclusion)
• System confusion (e.g. children vs adults; health vs
social care)
• Public and media ignorance
40. • Some commissioners, like Dorset, see there’s a better
way
• Care Act 2014 and NHS personalisation supports the
change
• Limited funding can be used more effectively with
creativity and focus on community connections
• There is effective on-going pressure around ATUs etc.
• Many providers want to break out of long-term block of
framework contracts and be accountable to people.
41.
42. Recent work in Calderdale has led
to the use of ISFs becoming the
main way that home care is
provided. Over time this is
encouraging more innovative and
flexible support from service
providers.
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45. MOST IMPORTANTLY - to provide creative and
flexible support to people as citizens is what people
want and it’s much more fulfilling
46.
47. 1. Get connected
2. Get informed
3. Learn from others
4. Share with others
5. Change the world