Doing It Your Way - In Controldoing it your way' worcestershire... · with learning disabilities in...

Doing It Your Way

AUTHORS: JennY PItts, VIVIen soaVe and John Waters

The story of Self-Directed Support in WorcestershireIn 2008 a group of people with learning disabilities in Worcestershire took control of their support. February 2009

2 Worcestershire County Council | In Control Partnerships

The story of Self-Directed Support in Worcestershire

It’s great to see how Worcestershire County Council has responded to the opportunity to transform their current system into a system of Self-Directed Support. Again we see that, when they

have more control, people can achieve better lives and build stronger communities.

Worcestershire have made smart investments of time and effort in:

✱ leadership – getting great people to lead the necessary changes

✱ real entitlements – giving people a budget they can control

✱ focused support – making sure people have the right support to control their budget

✱ communication – making sure people understand what’s going on

✱ learning – understanding what has changed and what it all means.

Thanks to all those who have helped make this project happen and who have helped us develop and shape it with their support. In particular: Worcestershire’s Learning Disability

Partnership Board, Choice and Control Board, British Institute of Learning Disabilities, Mencap, LivesthroughFriends and In Control for their continued support. Thanks too to some key individuals: Martin Cattermole, Stephen Chandler, Vivien Soave, Caroline Tomlinson, John Waters and Keith Smith and the ‘Doing It Your Way’ team.

Welcome

Acknowledgements

This commitment to both learning and to sharing that learning is critical to the on-going development of Self-Directed Support. For Self-Directed Support has never been a top-down innovation imposed by central government - instead it has been embraced and shaped by local authorities like Worcestershire who can see that it is the way to improve the lives of local citizens.

So, a big thank you to the people of Worcestershire – it’s great to see what you have achieved and thank you for giving In Control the chance to share your learning with the wider community.

Simon DuffyCeo In Control Partnerships

Most of all, I would like to thank the families and individuals who have been part of this project and who have stuck with it and shared their learning, their frustrations, their celebrations and their successes with us.

Thank you

Jenny Pitts‘Doing It Your Way’ Development Manager

Worcestershire County Council | In Control Partnerships 3


Foreword Worcestershire County Council was recently named the most improved local authority in the country. This reflects our determination to serve all local citizens well. We see it as our

duty to constantly improve and, when it comes to assisting those in our community who may be in particular need because of age or disability, then we know we have an added responsibility.

So I am particularly delighted to introduce this report that describes our endeavours to implement Self-Directed Support, a new approach to social care that allows disabled people to control their own support through a personal budget. Self-Directed Support places each and every person who needs our support at the heart of what we do. As you will see from the report, we have achieved a great deal during the last year and we have led the way nationally. We are rightly proud that our learning disability service has been a pioneer of this new approach.

We believe passionately that people with learning disabilities in Worcestershire have a right to be full and active members of our communities, contributing to and being actively involved in all aspects of life in the county. The work described here offers us an approach that ensures that the Local Authority can play its part in working towards fulfilling this commitment.

The report clearly shows the resourcefulness and creativity that local people and their families can draw on when we recognise and value their roles as equal partners. I would like to extend my personal thanks to all the staff and local people involved in this work, in particular those who shared their personal experiences.

Councillor Philip Gretton Cabinet Member for adult and Community services and Co-Chair of the Worcestershire Learning Disability Partnership Board

‘Doing It Your Way’The story of Self-Directed Support in Worcestershire



Introduction In 2005, a report was published describing an exciting development in social care. The report was the record of two years of work by In Control, a partnership set up by the Department of Health, Mencap and six local authorities. In the report In Control described how 60 people with learning disabilities across six local authorities had taken control of a personal budget to organise and buy their own support.

This account of how people worked with their family to develop individually tailored packages of support included some very impressive outcomes for those who took part and seemed to offer some exciting opportunities for wider change. A subsequent evaluation of In Control’s ongoing work showed similarly exciting findings. Nearly 200 personal budget recipients were surveyed:

✱ More than half (55%) reported that they spent more time with people they wanted to be with.

✱ The majority (77%) reported improvements in their quality of life since starting Self-Directed Support.

✱ Nearly two thirds (63%) reported that they took more part in and contributed more to their communities.

✱ Almost half (47%) reported improvements in general health and well-being since starting Self-Directed Support.

✱ The majority (72%) reported that they had more choice and control in their lives since starting Self-Directed Support.

✱ More than half (59%) said that they had more personal dignity since starting Self-Directed Support.

In Control’s work soon gained a lot of interest and started to influence national policy. The approach came to be known as Self-Directed Support.

In their reports, In Control recognised that, while their early work was very interesting and appeared to offer an affordable and helpful innovation, there was clearly still much to learn about how to better organise our social care system. This report is our contribution to that learning.

Self-Directed SupportAs in most parts of the country, services for people with learning disabilities in Worcestershire have traditionally been based around buildings: care homes, respite units, day centres and the like. People who need support are assessed and, if they are seen as eligible, they may be allocated a ‘place’ in one of these services. The whole system of social care is effectively shaped around the professional assessment process and a small set of established services.

Self-Directed Support starts from a very different place. The starting point is not services but the individual, their family and their community. Self-Directed Support is underpinned by a belief that disabled people and their families have both the capacity and the right to control the support they need to live full and active lives.

Instead of just placing a person into an existing service, Self-Directed Support is designed to allow the person and their family as much control of their support as is possible. To do this, it draws on existing good practice such as person-centred planning, and introduces some new elements such as a personal budget and a resource allocation system.

A resource allocation system (RAS)The RAS takes the form of a simple self-assessment questionnaire that lets people know early on in the process how much money is available to them from the local authority to fund their support. It also clearly states the intended outcomes of their support plan. The RAS gives an indication of the maximum amount of money that should be in someone’s personal budget and what it must achieve.

The personal budgetA personal budget is the money made available to an individual to develop a support plan. The money can be held by the person, their representative, a social care provider or by the local authority. The important thing is that the person and those close to them have control of the money. Knowing how much money is available and what outcomes must be achieved, the person and their family can take control of the personal budget and plan how it is used. Once the person or those closest to them has developed a plan, the local authority is then asked to approve the plan and arrange payment. This important check provides a mechanism through

‘It has made my son’s life better and given me peace of mind’.



1. MoneyIf people are to direct their own support, it is important to be clear early about how much money is available to use in a support plan and the outcomes it must be used to achieve. To do this, the local authority must develop a resource allocation system (RAS).

2. Making a support planIf people are to have support that is personal to them, there needs to be a good plan describing what that support will look like and what it will achieve. It is important that the person and those close to them lead this planning process.

3. Agreeing the planAs the local authority is making money available to fund the support plan, it is reasonable that the authority should want to agree how that money is used. The local authority also needs to ensure it is happy with any risks the person may be choosing to take.

4. Organising moneyOnce the money and the plan are agreed, the person needs to be in control of the money so they can direct their support. There are different ways this can be achieved. Taking the cash directly is not right for everyone.

5. Organising the supportNow that the budget is under the control of the person, they can arrange for the support to be delivered. This can involve such things as buying equipment or recruiting staff.

6. Living lifeWhen people are supported in ways and at times that are right for them it is possible to live a full and active life.

7. Seeing how it workedIt is important to take time to look at how well the plan has worked and to show what the money has been used to achieve.

Self-Directed Support is broken down into seven steps

which the authority is able to meet its wider social and financial responsibilities.

Approaching social care with the seven-step process shown above seems to have a number of potential benefits:

✱ The full cost of a support plan is known to the person and they have a vested interest in ensuring that money is spent well.

✱ Each step can be led by the person or those in their family, drawing on support from professionals only if needed and desirable. This means professional staff are able to dedicate their time towards those who most need their help.

✱ As the money is set early on and in a transparent way, people can draw on a range

of other support systems (friends, family, community) free from the fear that the local authority may withdraw its help if they do.

✱ As people have control over the money, they are able to choose existing services or design their own bespoke support. They can avoid being slotted into services that are not able to meet their unique needs. This leads to innovation.

✱ Social workers can avoid acting as ‘gatekeepers’ of the public purse (a role that the current system of social care requires of them). This is important as it allows social workers to form trusting relationships and to help people they serve to plan creatively.

✱ As resources are allocated on an individual basis, it is easier to ensure that people get resources that match their level of needs.

2. Making My Plan

3. Getting My

Plan Agreed1. My Money: Finding

Out How Much6. Living My Life5. Organising My

Support7. Seeing How

It's Worked

£

4. Organising My Money

£Agent?



What we set out to achieve: The Worcestershire Learning Disability Partnership Board is a multi-agency group that includes statutory organisations, local providers, people with learning disabilities and family carers. The Board is charged with coordinating the delivery of support to people with learning disabilities in the county.

The Partnership Board was aware from the responses to surveys and consultation events that many people with learning disabilities in the county wanted to change how they lived, how they were supported and what they did in the day. People with learning disabilities and their families were saying they wanted opportunities to lead ordinary lives and have support geared around them. So, when In Control published its report, there was a natural desire to see if having a personal budget could help local people achieve the changes they were saying were needed.

While the prospect of personal budgets seemed attractive, we knew that, before deciding to make personal budgets available to everyone using social care in the county, we should first test out the approach locally. In 2007, we resolved to test personal budgets and see if we could implement them locally using an approach that worked for us. We knew that, if successful, the personal budgets could radically transform the whole system of social care in the County, so we needed to make sure we took our early work forward in partnership with a range of key stakeholders, including people with learning disabilities, their families, local providers and voluntary organisations.

With this in mind, Worcestershire’s Learning Disability Service, the British Institute of Learning Disabilities and Mencap came together to form a new partnership called ‘Doing It Your Way’. The project was supported by the Partnership Board and Worcestershire County Council’s ‘Choice and Control’ programme. It was hoped that, by working across a range of organisations, the learning from early work would be shared widely.

How we organised ourselvesThe Doing It Your Way partnershipIn April 2008, the Doing It Your Way partnership was formed to provide independent advice and guidance and to help local people make best use

of their personal budgets. The team was designed to be arm’s-length from the County Council and was selected to bring expertise in relation to:

✱ person-centred thinking and planning ✱ the family and carer perspective ✱ housing ✱ work and volunteering ✱ welfare rights (including Independent

Living Fund) ✱ young people leaving schools and colleges ✱ community development.

Workers in the team were employed across the different partner organisations. The team included both new and existing posts funded either by the Learning Disability Development Fund or from the Learning Disability Service core budget. Having partners from outside the local authority was felt to be a good way of bringing the right expertise to the project and giving people access to independent guidance and support. To ensure learning from the project informed changes within the County Council it was decided that the Project Development Manager should be a member of the Learning Disability Senior Management Team.

Things the team didWe shared information and helped people get together The first job of the new team was to let people know they were there, what they could offer and to let people know about Self-Directed Support and personal budgets. The team did this through a range of different ways including:

✱ an information pack ✱ information sessions for carers ✱ newsletters

An informAtion shAring session



✱ In Control DVDs ✱ information events ✱ specific sessions targeted at carers from

black and minority ethnic communities ✱ informal evenings for people to come

together socially and share information, ideas and experiences.

All this activity was funded through Carers Grant from the County Council and money from the Partnership Board. Looking ahead, it is planned that a Service-user Link Worker will join the team to develop and share easy read information about Self-Directed Support. The post will also be linked to self-advocacy groups throughout Worcestershire.

We told people how much money they had to spend on their support In order to create personal budgets, we needed a way of telling people how much money they could spend on their plan. This meant we needed to develop a resource allocation system (RAS). We wanted our RAS to:

✱ reflect the nature and level of people’s needs and take their family circumstances into account

✱ be open and transparent so people felt the RAS offered a fair deal

✱ be consistent and allocate similar funding levels to those with similar needs

✱ be affordable for social care budgets so that we could continue to make personal budgets available to people over time.

To create the resource allocation system we followed the approach In Control had developed. This involved undertaking a desktop exercise to analyse the needs and costs associated with a group of people currently using social care services. We used this information to allocate a financial value to each point in the self-assessment questionnaire. Then, by totalling the

points scored, it was possible to give each person an indication of the total maximum amount of money that would be available to achieve the outcomes identified. The questionnaire looked at a number of outcomes that the budget should be used to achieve:

After we had used the questionnaire for a time we made some changes taking into account feedback from carers and community team members.

We helped people plan The team had two people who were experienced person-centred planning facilitators. They supported people and their families to develop a support plan using their personal budget. Some of the people who had personal budgets chose their existing social worker to help them plan and the Doing It Your Way team provided support, advice and guidance where needed.

We organised network meetings to bring people together so they could share ideas and information. Many people taking part said that they found this thinking and planning together very helpful. When we held a stakeholder event to review our work many family carers stressed the value of having independent help to develop their support plans and the importance of accurate and up-to-date information.

People took control of their personal budget We wanted personal budgets to be widely available so, having told people about Self-Directed Support, we responded to people who

✱ a life that I can control ✱ to be as healthy as it is possible for me

to be ✱ to keep relationships that are important

to me and make new ones too ✱ to be part of my local community ✱ to be able to engage in activities that

are meaningful to me ✱ to be able to take risks and be safe ✱ to be financially secure/ stable and

choose how I spend my money ✱ to contribute in some way and do

regular work ✱ to be able to express myself and be

treated with respect ✱ to be able to choose where I live and

whom I live with.

‘The personal budget has been hugely beneficial to our and our son’s lives. We can see our son enjoying the activities and having such a cross section of things he enjoys and also things we know will give him an opportunity to mix with others, learn new skills and enjoy himself and be supported by people he and we know and trust’.



People used their budgets to help them get on with living their life:

Donna’s storyPrior to having a personal budget, Donna lived for nearly 30 years in a residential care home and was increasingly unhappy living with lots of other people in a large group. Donna values her own space and wants things to be ‘just so’. Like many of us, it is very important to Donna that she chooses who to spend her time with. Living in a communal setting, it was very difficult for Donna to make these choices. This led to frustration and to Donna being labelled as displaying ‘challenging behaviour’ which was increasingly managed by medication. Driven by Donna’s sister, a plan was agreed whereby Donna would become a tenant in her own home. A personal budget meant that Donna could have complete choice and control over who supported her. Donna was actively involved in the recruitment of personal assistants, making her wishes very clear. ‘If she liked someone she would make them a cup of tea and if she didn’t she would show them the door – it really was that blunt!’

came forward. Some people came to us as a result of wanting or needing to change their current service, and some (mainly those who were leaving school) approached us for the first time. Social workers in the community teams also helped identify people who might want a personal budget. Interestingly, two people came forward for the first time from black and minority ethnic communities. (Uptake of traditional services from within these communities is generally low. )

By January 2009, there were 73 people with a Personal Budget allocated to them, of which 46 have their plans agreed and are spending their money. The group comprises 44 men and 29 women with a wide range of needs.

To ensure personal budgets worked for a wide group of people we made sure the money could be held in a range of different ways. We paid money directly to the person. We paid money to family or friends. Some people asked the local authority to hold the money. Independent social care providers also held money as personal budgets for people.

Budget Type PeopleDirect to the person 3

Payment to representative ( family or friends)

28

Professional (held by local authority) 13

Provider (independent social care provider)

20

Nobody chose to have their budget held by a broker or in the form of a trust. Many people chose a variety of the above options to hold their personal budget.

We helped people organise their support We wanted to make sure that help was available from a range of different people and organisations. So the County Council funded a training course for people from a number of agencies and roles to become accredited support brokers with the

National Brokerage Network. As part of the training, people worked closely with one individual to help them develop their plan and organise their support. So for some of the people, the trainee support broker became the person who helped them develop a support plan. People on this training included:

✱ social workers ✱ family carers ✱ advocates ✱ day service staff ✱ independent sector provider staff.

Who took up personAl budgets



Donna’s sister manages her budget for her and manages the small team of personal assistants. Donna loved going to her day service where she spent time with a small group of friends, so this remained in her support plan, though the attraction of other opportunities has meant Donna now spends less time at the centre. Donna has now become a volunteer with a local charity shop and, with her support workers, travels around Evesham collecting charity bags. She is well known in her neighbourhood and her local community and loves doing new things and meeting new people. Her circle of friends has grown considerably since she has had her personal budget. New opportunities are opening up for her all the time to do ordinary things without her needing to pay for a service.

During the last six months, Donna and her sister have shared their experiences at national and local events and Donna’s self-confidence and esteem have noticeably increased as she takes an active role in these events. Her medication has reduced and her physical health has improved. Donna is more active and spends time doing the things she enjoys. It has been a rollercoaster ride to get to where she is, but the change in Donna is described by her sister as ‘remarkable’. She says: ‘I now get to spend quality time with Donna rather than rushing round to the care home every time she needs my help. If I want to see my sister I can simply pop round for a cup of tea and visit her in her own home. I worry about her less than I did when she was in a professional care environment.’ It has not all been plain sailing but Donna is most definitely making up for lost time and is living her life in the way that is absolutely right for her.

James’s storyLike any other young man of 25, James wanted his own life and it was time for him to leave home and have his own place. This is difficult enough for anyone, but James’s profound and multiple disabilities meant there were a few more hurdles to overcome. James’s parents knew that they wanted him to have a home and not a ‘placement’. They wanted support that was right for him and meant he could lead his own life having fun, being out and about and socialising.

His parents found out about shared ownership and embarked on the journey to enable James to part-own his own specially adapted bungalow. A home was vital, but so was good care and support. A personal budget seemed to offer James and his parents the control and flexibility they needed. James moved into his bungalow in June 2008 with a team of support workers paid for through his personal budget. James’s parents decided that a mixture of staff employed by a local agency and his day service, which James enjoys, would be the ideal arrangement. There is enough flexibility for James’s mum to support him once a week and some weekends and the money saved goes towards other things that enhance his life. For example, James loves wildlife but in the winter months is vulnerable to the cold so webcams have been set up in bird boxes in his garden which he can watch in his living room – ‘bringing the outside in’, as his mum puts it.

The support provider that employs the staff is paid directly by James’s parents who manage his personal budget. James is actively involved in choosing his staff and he wants people who enjoy the same things as him and he wants to ‘click’ with them. His parents feel in control and even though they are not directly paying for his day service, they feel their relationship with the service has changed as they are seen more as ‘customers’. Using assistive technology, James’s mum can check if his support worker



has arrived, giving her peace of mind. James has taken to his new home ‘like a duck to water’. She remains anxious as a parent and is no less involved. But she is able to take a rest from all the hands-on caring and, for the first time in 26 years, is able to go out to work. The lives of James and his family have changed enormously and having the control of a personal budget has given them the confidence to enable him to develop his own life.

Ruby’s storyRuby has lived in her own sheltered bungalow for 20 years and leads a full and independent life, being very involved in local self-advocacy groups. She

used to have support from an agency that was funded by Supporting People but this was not working well for Ruby. Her support workers wanted her to do the housework and some of the jobs she found difficult. Due to her arthritis, jobs like changing her bedclothes and holding the vacuum cleaner were quite painful for her. Ruby leads a busy life and has a part-time job. But her support was not flexible and the workers would not come at times that suited her. If she was not in when they wanted to come, she lost those hours of support.

As part of the Doing It Your Way project, the local Supporting People team agreed to free up the funding for a small number of people to see if they could find better ways to be supported through a personal budget. Ruby was therefore given the control to get the support that she wanted and needed. With her budget Ruby has employed her own cleaner who has a key to her house. She can now go to meetings and come back to a clean house! It has cost her less, but Ruby is getting the support she needs in the way she wants it and in a way that means she doesn’t have to change her lifestyle.

We evaluated our work When we came to evaluate the project we were aware that there was a lot of interest in Self-Directed Support across the country and our work would be of national interest. We wanted to listen to the views and experiences of people who had personal budgets, their families and the staff who had helped them.

Different questionnaires were used for three different groups: people with a personal budget, family carers, and staff. The questionnaires were designed to find out what difference personal budgets had made to different aspects of people’s lives.

The questionnaire for personal budget holders asked about whether personal budgets had affected peoples lives in a wide range of areas.

Results from the personal budget holders questionnaires:

To review the impact of personal budgets we:

✱ sent out questionnaires to people with a personal budget, to family carers and to community team members

✱ had a big event with everyone involved. Over 90 people came and took part in workshops looking at key things that were important to people

✱ asked a user-led organisation called ‘Time4People’ to talk in more depth to some people

✱ looked at people’s support plans to find out what things people were buying and how they were organising their personal budget.

Area of life Better Same Worse

Health 14 8 0

Feeling safe at home 6 15 0

Felling safe out and about 10 12 0

Control over support 16 5 0

Social life 16 6 0

Dignity in support 14 9 0



Results from the family carers questionnaires:

do you feel your financial situation has changed as a result of the person you care for having a personal budget?

What effect has the personal budget had on your capacity to have a social life or follow leisure activity?

What effect has the personal budget had on your own mental and physical wellbeing ?

What effect has the personal budget had on the level of choice and control you have over the important things in your life?

What effect has the personal budget had on the relationship you have with the person you care for? What effect has the personal budget had on your quality of life?

What effect has the personal budget had on other significant relationships (family and friends) in your life ?

What effect has the personal budget had on your capacity to undertake paid work?

to what extent do you now feel you have the support you need to continue caring and remain well?

in the work to develop the support plan for the person you care for, how far would you say you felt you were an equal party with expertise to contribute?



The questionnaire for family carers looked at areas that had been identified as significant in the national carers strategy. The questionnaire asked about the effect of the personal budget on the life of the carer in the following areas:

✱ financial situation ✱ support to continue caring and remain well ✱ quality of life ✱ mental and physical wellbeing ✱ capacity to have a social life or follow leisure

activity ✱ undertake paid work ✱ relationship with the person cared for ✱ relationships with other significant people ✱ level of choice and control over the

important things in your life. The questionnaire for staff looked at how personal budgets had affected various aspects of their working life including:

✱ making a positive difference to people’s lives

✱ helping people plan creatively ✱ getting the right amount of help to people ✱ getting help to people in a timely way ✱ using your own skills and knowledge ✱ allocating resources fairly ✱ helping people to maintain existing support

networks ✱ supporting people to take an active part in

their community

✱ managing risks ✱ supporting people to take control and make

choices about their lives ✱ developing support that is tailored to the

needs of an Individual ✱ staying motivated in your own work.

Time4People findingsIn addition to the data from questionnaires, a family-led organisation, Time4People, spoke to people in detail. Information was collected through a combination of personal visits, telephone and written comments. Views were also captured in a seminar with over 30 family carers at a large stake holder event. Some key learning emerged from this work:

✱ Some people (those with easy internet access) found it easier than others to understand the process and to find out about Self-Directed Support.

✱ There is good information there if you can get it.

✱ Carers welcomed the opportunity to talk to other carers in plain English about real life experiences rather than theoretical situations.

✱ The level and quality of knowledge and advice offered by transitions workers and social workers was variable and not always available to everyone.

results from the stAff questionnAires



Things that people found unhelpful included:

✱ abbreviations and specialist terminology ✱ an air of ‘being the professional’ ✱ cancelled appointments ✱ infrequent visits ✱ information packs could be simplified ✱ need for better information about local

services (people had to learn as they went along). There is no single place where this information is provided

✱ the length of time that it was taking to start and complete professional assessments.

Things that people found helpful included:

✱ access to telephone support (once the right person had been identified)

✱ the Access Centre (for those not currently receiving adult services)

✱ In Control and the Doing It Your Way team (especially Link Worker role)

✱ flyers and information packs (once people had got them)

✱ Support Planning and Review website http://www.supportplanning.org/ (examples of how a plan could be put together)

✱ the learning days, information events and workshops (though some people felt overwhelmed and needed more time to reflect and absorb information)

✱ talking to other people who had taken control and been through the process was overwhelmingly reported to be the most useful way of understanding Self-Directed Support

✱ home visits from brokers, providing suggestions of creative ways to use the personal budget

✱ being helped to develop support plans (by a range of different people). More of this type of support was highlighted as a ‘must have’.

Some people were happy their social worker put a plan in place for them. A few others knew exactly what they wanted and were confident enough to make it happen. One person with a personal budget knew exactly what she wanted to change but needed support to make it happen. There was a request for family workshops to help with forms, benefits, legal issues, staff training and so forth.

The overall sense from the Time4People evaluation was that, while the journey was not trouble-free,

the outcomes showed that people can have great lives by making real choices if they are given the opportunity.

To read the full findings, visit: www.time4people.org.uk

As part of the evaluation, a learning event was held with a large group of stakeholders. People with personal budgets took part in a seminar to reflect on what was working and what was not working.

Best things about having a personal budget: ✱ ‘being in control - having the power and

flexibility to get the right support’ ✱ ‘planning my dreams and being able to

do the things I want to do’ ✱ ‘able to move house and choose the

person I want to live with’ ✱ ‘getting support with what I need such

as cooking, household chores, shopping, going to the gym’

✱ ‘helped me move into my own flat’ ✱ ‘able to do activities and stay with mum

and dad’ ✱ ‘support to be a volunteer for the

National Trust’ ✱ ‘planning to get my own computer’ ✱ ‘meet new friends / meet new groups of

people’.

What could be better? ✱ ‘Doing It Your Way packs need to be

easy-read’ ✱ ‘finding/ recruiting support staff:

agency taking a long time to get back or find the right person’

✱ ‘financial assessment should be done before you are told your budget’

✱ ‘people are having to wait a long time for the Adult Care Assessments’.



Some family members and individuals involved in the project formed a new local community group, Time4People. The group works to support the development of communities where people who need support are included as valued citizens. The group supports local people to have choice and control over their support by providing information and advice. They intend to work with organisations to help make social care more personalised and to help vulnerable or disabled people develop lasting networks of support in their communities.

How people spent their moneyAs part of the evaluation we reviewed all the support plans. Some clear themes emerged so we counted occurrences of each type of activity. The results from this count are shown here. It was interesting to note some people (13) still continued to use a traditional day centre for part of their week. Many looked elsewhere and employed people to do different things: a significant number (9) chose to employ family or friends; 14 used some of their budget to provide a break for family members caring for them. No-one spent money on a traditional respite service and only one person used money for residential care.

Leisure was the largest activity area: of the 34 people who spent some of their personal budget on ‘leisure’, 21 used money for health and fitness-related activity (including gym, swimming, sports club, golf, rambling).

As well as buying ongoing support, people spent their money on a range of interesting things, including:

✱ adaptations to the home ✱ broadband internet access ✱ help with cleaning and ironing ✱ holidays ✱ hot tub ✱ a mobile phone ✱ guitar lessons.

How much personal budgets costAs well as looking at the outcomes for people and how they had decided to use their personal budgets, we also needed to look very closely at how much money was being made available to people.

Developing a simple picture of how much personal budgets cost when compared to traditional services is complicated because: the group of people who took up personal budgets was not ‘typical’ of those people who use learning disability services in the County; the group featured a very high proportion of young people leaving school and, in recent years, this group has tended to have much higher support costs than average. As well as this, money for support is available through multiple funding streams: Independent Living Fund , Health , Social Care, and Supporting People. This means it is difficult to know what to compare the cost of personal budgets with. Therefore, our comparisons for those who had not previously

WhAt people spent their money on

Supporting people with a personal budget has felt more like social work as it should be. The allocation of funding up front is vital so that people can plan in an informed way. Personal budgets have opened up opportunities that are not available through traditional ways of care planning. There is more creativity and, I believe, better use of money. As a social worker, it has changed my working relationship with families. My role has been more about supporting families to find information, reassuring, guiding, passing on knowledge and enabling them to take as much control as they feel happy with whilst also managing risks. The result is: families have far more ownership of the chosen support arrangement and more confidence to adapt it over time.

Jeanne hooper, Worcestershire Learning Disability Community team

Account from social worker



choice and control that personal budgets offer is available to an increasing number of people across the County. We will seek to make personal budgets available to people with a range of needs, older and disabled adults alike.

We have recently launched a new programme, ‘Choice and Control’, that will drive forward our learning from the Doing It Your Way project . This programme recognises the expertise that sits with disabled people and their families and so we will continue to support the development of family leadership and seek ongoing opportunities for individuals, regardless of their disability, to share their experiences and learning with us.

We are immensely proud of what has been achieved through this project and very grateful to the families and individuals who have worked with us to help us learn from their early experiences.

Eddie Clarke Director of adult and Community services

used adult services were based on informed estimates of how much the local authority would otherwise have spent meeting those individuals’ needs. Using this approach can only offer a broad indication of the financial implications of Self-Directed Support.

Comparing the costs of personal budgets to an estimated or known cost of traditional services for each individual showed that, of the 73 people with allocated budgets, 23 people were allocated about the same as we would have expected traditional services to cost, eight cost more and 42 cost less. For the eight who cost more, this reflected a change in their living arrangements (for example, a move out of the family home to their own home with bespoke support, or a move out of a block-funded residential service). The average personal budget cost was £560 per week, the average estimated or known traditional cost was £670, meaning the personal budget cost was some 16% lower.

AverAge costs

cost of personAl budget vs trAditionAl costs

ConclusionThe social care system in England is changing. Central government has set all local authorities an ambitious agenda for change over the next three years. Personal budgets sit at the heart

of this transformation. As you will have seen, we have learned a lot about what it takes to ensure personal budgets are available to people who need support, and we have seen the difference they can make to people’s lives.

As we look to the future, we know that personal budgets and Self-Directed Support will be at the heart of what we do. They offer the Local Authority a way of working in much closer partnership with local organisations, local people who need support and their families. So we are delighted that the Learning Disability Partnership Board has continued to support the Doing It Your Way team as this will mean many more people who will be eligible for a personal budget can have the help and guidance they need to make full use of the opportunity.

In the coming months and years we will work with local people to ensure that the increased

Worcestershire Learning Disability ServiceAdult & Community ServicesCounty HallSpetchley RoadWorcesterWR5 2NP

Tel: 01905 728878Email: [email protected]: www.worcestershire.gov.uk/learningdisabilities

in Control Partnerships Tel: 0121 708 3031 Email: [email protected] Website: www.in-control.org.uk

This report is an account of our work and the things we believe we have learned by implementing Self-Directed Support in Worcestershire. The findings are not intended to represent the results of an academic study. Rather they are a critical self-evaluation of our progress to date. The findings represent our best attempt to understand and report the things people have said to us about their experience of taking control of a personal budget.

Having evaluated our work we noted:

✱ an increase in people living in their own home (tenancy and home ownership)

✱ a strengthening of family relationships ✱ an increase in volunteering and work-related

activity ✱ increased economic security for the family and

the person ✱ an increase in family carers feeling they have a

life of their own ✱ an increase in carers’ ability to have paid work ✱ improved health and wellbeing for both carers

and people with learning disabilities.

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