1. What is Self-directed Support?

Self-directed Support is Scotland’s mainstream approach to social care. Self-Directed Support (SDS) puts the person at the centre of the support planning process. It enables people, carers and families to make informed choices about what their social care support is and how it is delivered.

It’s not an add on or a separate way of doing things, since the 2014 Act it is the legal way in which all social care must be delivered. What Self-directed Support does is ensure that people who are eligible for support are given the choice and control over how their individual budget is arranged and delivered to meet their agreed health and social care outcomes.

  1. Who can access SDS?

People who are eligible for support for their health and social care can direct their own support. The Social Care (Self-directed Support) Scotland Act places a legal duty on Local Authority social work departments to offer everyone receiving social care 4 options as to how that care is delivered.

  1. I thought SDS was only for disabled adults. Is this true?

It isn’t. Children in need of support, older people – people who need social support – can access SDS

  1. How do I get Self-directed Support?

If you already get support but do not feel that you have experienced choice and control over how that support is delivered your next review of your support plan should give you the opportunity to discuss this with your social worker/practitioner.

If you don’t already receive social care, but feel that you or a friend or relative are in need of some help, you can do two things, firstly you can contact a local advice and information service who can advise you on your next steps. It may be that there are community supports which would meet your needs. However, if you feel that more formal support is necessary, get in touch with your local council social work department to discuss an eligibility assessment.

There are lots of organisations who offer support and information, some of these can be found here http://www.sdsscotland.org.uk/members/

  1. What are my options if I am deemed eligible after my social work assessment?

Local authorities as of 2014 now have a legal duty to offer people eligible for social care four options on how to use their personal budget. The four options are: (1) a Direct Payment (a cash payment); (2) an Individual Service Fund (a budget held by the local authority and allocated to a provider of your choice); (3) the local authority arranges support on your behalf; or (4) a mix of these options for different types of support.

  1. How can it benefit me?

Many people are satisfied with receiving services that are arranged by their local authority; this is option 3 and as long as the person has made an informed decision about this then this is perfectly fine under the new legislation. However, there are a lot of people who could really benefit from having choice and control over the support they receive, such as having support staff visit them at times of their choosing or enjoying the consistency of care that can come from employing your own personal assistants or even the flexibility of using your budget to purchase services that meet your needs more creatively and individually than the services provided by the local authority.

  1. Can Guardians or Attorneys request and receive SDS?

Yes. These persons can consent on behalf of someone, if the client lacks capacity. The Council would have to conclude, in its assessment, that the person with assessed need has, after every attempt to support them, no capacity to make a decision to receive Self-Directed Support.

  1. Do all guardians get awarded the same powers?

No, at the point of applying to the court for financial or welfare guardianship, the supported person’s solicitor can seek specific powers and authority proportionate to the role. For self -directed support this can be minimal but specific powers.

Financial guardianship may include for example:

 claiming and receiving self-directed support in order to purchase care services appropriate for the adult

 employing a personal assistant

 contracting with a care provider and paying for services and care using self-directed support payments

 arranging for employer’s liability insurance on the adult’s behalf.

 

Welfare guardianship may include for example:

 having access to confidential documents or information about the supported person that the supported person would have had if they had capacity

 consenting or withholding consent to medical treatment

 opening, reading, attending to and replying to mail (paper, electronic or otherwise) on behalf of the supported person

 taking the person on holiday, excursions or outings or authorising someone else to do so

 making decisions about the social or cultural activities the person may pursue.

 

  1. Who does the guardian account to?

Most financial guardians are expected to report to the Office of the Public Guardian (Scotland) and submit specific financial records. With self-directed support, financial guardians and those with welfare powers are only required to report to the local authority.

  1. Who should consider appointing power of attorney?

Anyone can appoint a power of attorney at any time, so long as they have the capacity to do so. Everyone at some time in their life will need to use health or social care services. While we hope people can make informed choices throughout their lives, we know that unexpected events can result in capacity being impaired or lost.

Appointing someone, while you have capacity, to act on your behalf in the event you lose capacity means that:

 you can appoint someone who you know has your best interests at heart and who can advocate for you as they know you

 you can plan in advance and make decisions for your future should you become unable to express these for yourself.

 

We support power of attorney as a preventative measure to Guardianship.

Would a family carer with welfare guardianship require financial guardianship powers if the supported persons care and support was to be managed by a support service (option 2)?

Financial guardianship would only be required where the person was managing the supported person’s budget (option 1).



  1. I am happy with the support I have – do I have to take change anything?

No-one needs to take control of their budget if they don’t want to. Opting to remain on Option 3, traditional services is still making a choice.

SDS allows everybody to choose the way their support is provided but no particular option should be imposed on anyone.

  1. Can I get help to decide?

Yes, you can get support to help make choices from a local support organisation, which can help with a range of issues, such as general employment practice, payroll or peer support.

There are lots of organisations who offer support and information, some of these can be found here http://www.sdsscotland.org.uk

  1. Is SDS not just about cuts?

SDS is the way we deliver social care now; it's about giving people a better life; supporting people to think how they would like to lead their lives and giving them the chance to control that. It is not about cuts, everyone assessed as needing social care will be assigned a budget, SDS is about how that budget is best used, not the amount allocated. 

  1. What can I do if I think my budget is not enough?

If you think the money you are offered is not enough, you do not have to accept it. You can dispute the amount offered. You will need to discuss with your council what will happen while your complaint is being worked on. You can accept the individual budget if you want, while your complaint is being dealt with. If you do not want to do this while your complaint is being considered, you can choose to get arranged services instead.

  1. Where’s the money going to come from to pay for Self-Directed Support?

There is no new money for SDS. If SDS could only happen when large amounts of new funding become available, it is unlikely that it would happen at all. So the money will come from that which social services are already spending on social care. However, a better focus on outcomes will mean that this money is better spent in a way that works for each individual.

  1. What responsibilities will I have?

Self-directed support offers you much more flexibility, but managing it is also a responsibility. An important part of SDS is that a person can take on as much or as little responsibility they want depending on the options they choose.

  1. Can someone, other than the assessed person, receive and / or manage the payment?

Yes – Parents of, or those with parental responsibility for, children under 16 (or in some circumstances under 18). Guardians/Attorneys of adults over 16 and certain persons included by Scottish Government guidance (this would include members of circles of support, user-controlled trusts, independent living trusts or certain individuals providing assistance), all at council discretion.

  1. Where can I go to buy the services I need?

You can make arrangements yourself and employ your own staff and they will report directly to you. Or you can buy services from an agency, a private service provider or voluntary organisation.

Some people have a contract with a service provider to provide any emergency cover they may need should any problems arise.

  1. Can I buy services from my council?

Yes, you can buy services from any council provided it agrees to sell its services to you.

  1. Can I buy short breaks (respite)?

Yes, respite is a short break which is to act as a positive experience for the person with support needs and the carer, where there is one. The term includes a wide range of different services of limited duration. The common factor is not what service is provided, but its purpose. Respite can be offered in a wide variety of settings, including breaks in residential homes, respite-only units (e.g. specialist guest houses), breaks in the home of another individual or family who have been specially recruited, breaks at home through a support worker or sitting service, or holiday type breaks.

  1. Can I use self-directed support for 'Free Personal Care'?

Yes, if you are eligible for free personal care and wish to use self-directed support to buy personal care services at home you will not be asked to pay part of the cost of these services.

  1. Will service users have to pay for the services they receive through SDS?

To receive any service from your council you will be assessed financially (means tested) to see whether you should contribute some money to help pay for it. Your council will charge you in the same way that it charges people it provides arranged services to.

  1. If I move from one council area to another will I still get the same level of support and will I be charged the same contribution?

Not necessarily. If you move to another council you will be asked to complete an assessment. Each council will assess your level of support in the local community care context, and may therefore ask for a different level of contribution or offer a different level of support. If you are not happy with your payment see question below.

  1. How accountable will individuals be for the use of the money?

You will be accountable. The Support Plan and the Individual Contract together say what you agree to do with the money – they form a contract. Any big changes must be agreed with the council.

  1. Will it affect benefits?

Receiving money for support does not affect benefits.

  1. If it all goes wrong, what happens?

There is no guarantee that any kind of support will work for someone. This is no different with Self-Directed Support. But, there is a lot of flexibility with Self-Directed Support, so you can make big changes. If having this kind of control really doesn’t suit someone, they can use the ordinary council arrangements of care planning and commissioning by choosing Option 3.

  1. When can my council refuse to offer me SDS?

 If a person is assessed as not requiring any social care services then they will not be offered the 4 SDS Options. However, the council still has a duty to offer advice and information about community supports which might meet your needs.

 A small number of individuals may also be excluded because, for example, they are subject to certain criminal justice orders. Your social worker will be able to tell you whether your circumstances exclude you from self-directed support.

A council may also may not allow you to purchase services from your preferred provider if they believe the provider will not meet your health and social care needs.

In the case of direct payments a council may withhold payment if they suspect the recipient of financial mismanagement.

Currently, the council may also withhold a direct payment if the person is unable to consent (due to mental incapacity) to having a direct payment and they do not have a guardian or attorney in place who can consent on their behalf.

  1. Who do I complain to if I am not happy with the service?

If you are not happy with any action, decision or apparent failing of the local council you should use the local council complaint procedure. You may find that an independent mediator can help solve the difficulty. If this is not successful then you can go to the Scottish Public Services Ombudsman who will look into your complain independently.

If you are not happy with the service being provided you should inform your social worker and the provider or personal assistant involved. If the service is registered a complaint can be made to the Social Care and Social Work Improvement Scotland (SCWIS).

Local support services can provide information and advice about how to conduct a complaint.

  1. My Council have advised me that I am not eligible to receive any help with my Social Care, what do I do now?

Every Local Authority has a budget to provide social care to the individuals in their locality who need it most and they must ensure that this budget is administered fairly. The Scottish Government’s guidance on Self-directed Support states that local authorities must be sure that the resources they allocate to a person are sufficient to meet their assessed needs. When delivering social care services local authorities are required to adhere to the following key principles as outlined in the national Self-directed Support Strategy:

 

  • Councils should invest an appropriate amount of funding in effective preventative and universal services
  • Services should meet the needs of funded clients and the wider population, thus helping to prevent the escalation of needs
  • Councils should be transparent with users at every stage. This should include their financial assessment and charging policies
  • Councils should also involve their local provider organisations in developing their commissioning plans

 

If you disagree with your local authority’s assessment of your eligibility for social care support then you should use the local authority appeals process to appeal their decision. The Scottish Government cannot intervene in individual cases.

Self-directed Support is about the four options but it's also about prevention, community and well-being, not being eligible for financial support should not be the end of the road, you should be offered advice and information about unpaid community supports which could meet your outcomes.

  1. Now that I’m getting SDS, my Council are charging me for services I never had to pay for before. Why is this?

Some Local Authorities have made changes to their charging policies following the enactment of Self-directed Support which has resulted in people being charged for services. The Self-directed Support Act does not include any specific duties or powers on charging, and does not make any amendments to existing charging powers or duties. Charging policies continue to be a matter for individual local authorities and if you feel you are being charged unfairly you should contact your local social work department. The Scottish Government cannot intervene in individual cases.

  1. I have asked my Council if I can use my Direct Payment to make a purchase and they have refused. Can they do this?

Self-directed Support has been developed as a way of giving individuals more flexibility, choice and control over the support services they receive. However, local authorities have a responsibility to ensure that the resources allocated to an individual are used to meet their agreed personal outcomes. If you are attempting to make a purchase which the local authority feels will not help towards achieving your agreed outcomes then they may refuse this purchase. If you feel that this decision is unfair and that this purchase will help you achieve your outcomes then you should contact your local social work department to discuss.

  1. Can Option 1 (direct payment) be used to purchase a care home service?

No, the legislation currently places restrictions on the use of option 1: direct payment.

The regulations state that direct payments are not to be used to fund residential accommodation (care home) for a period of more than four consecutive weeks in a period of 12 months.

This restriction also reflects the Care Inspectorate’s definition within the Public Services Reform (Scotland) Act 2010 of a care home service as “a service which provides accommodation, together with nursing, personal care or personal support, for persons by reason of their vulnerability or need”.

The legislation does not however restrict the use of option 2, 3 or 4 when people move into care home services. We would very much like to see providers of care homes working with people to manage their own personal budget and as such, controlling their care and support on a day-to-day basis (option 2). Irrespective of the funding source or arrangements, we expect all care providers to be familiar with the principles of self–directed support and the importance of choice, control and personal outcomes.

  1. Can a person use option 1, 2, 3 or 4 when living in supported accommodation?

Yes, where people live in supported accommodation, sheltered housing or other accommodation that is not registered as a care home, people can and should be offered all four options.

The self-directed support legislation refers to residential accommodation. In respect of the legislation, residential accommodation means a care home and as such option 1 would not be available to people moving into a care home, however options 2, 3 and 4 can and should be offered.

Where any accommodation is provided with nursing or personal care, or personal support, this arrangement would be defined as a care home service. As such, providers of accommodation also wanting to offer personal care and support need to ensure that this is not a condition of the tenancy or occupancy agreement. The care arrangements then would be registered as a care-at-home support service. This way the supported person is able to select an alternative support service or their own personal assistant under option 1.

Accommodation provided together with a housing support service is not considered to be a care home due to the lack of personal care and support, and as such these arrangements can be a condition of tenancy/occupancy.

This has been the position of the Care Inspectorate and the Scottish Government since regulation of housing support and support services (care at home) commenced.

  1. I was getting support before and have now been re-assessed and am receiving Self-directed Support but the Council have made cuts to my budget which I now feel doesn’t meet my needs. What can I do?

In implementing Self-directed Support Local Authorities must comply with their duty of care under section 12A of the Social Work (Scotland) Act 1968. Local Authorities must be sure that the resources they allocate to a person are sufficient to meet their needs and any provision or assistance should be based on a detailed and outcomes-focussed social care assessment. Any change in an individual’s support should be clearly explained to them.

The Self-directed Support Act does not affect the level of resource provided to a person under each of the four options and there is no single approach to resource allocation prescribed on the face of the Act, nor any single method recommended by Scottish Government. However, local authorities must ensure that the approach taken to the allocation of resources is both fair and transparent.

If you disagree with the budget allocated to you following your assessment then you may wish to appeal the decision using your local authorities appeal process, more information on which can be found by calling your local social work department or visiting their website. The Scottish Government cannot intervene in individual cases.

  1. I would like to receive a Direct Payment to employ a family member as my personal assistant. Is this allowed under SDS?

You may be able to employ a close family member as your PA if:

 

  • you are unable to find a care agency or employ a PA who can deliver the services you need
  • you have special communication needs
  • your cultural or religious needs can only be met by a family member
  • you and your social worker/care worker agree this is appropriate.

 

However, if you want to employ a family member your council must agree to this arrangement. You should think very carefully about employing a family member who lives in the same house as you, as it will be difficult to separate the times when they are your employee and when they are delivering unpaid care. For further advice and assistance you should contact your local social work department.

  1. What are the Care Inspectorate’s expectations of personal assistants supporting people while they are using a registered service?

 

Where an individual employs a personal assistant and also uses a registered care service such as a support service – day care, we would expect that:

 the responsibilities of the personal assistant and the care service staff are clearly defined, recorded and understood

 where the personal assistant is conducting tasks along with the care service staff, such as lifting and transferring the person using the service, that relevant training has been undertaken

 the person employing the personal assistant can assure the manager of the care service that their personal assistant is posing no risk to other people experiencing care. For example, they can confirm PVG membership or police checks.

 

  1. If a family employs a personal assistant to support their child, can the personal assistant provide care and support in their own home and the family’s home?

The definition of childminding excludes someone who “looks after the child wholly and mainly in the parents’ home”. Therefore, the Care Inspectorate would have no role where a personal assistant supports a child in the child’s family home.

However, where a personal assistant uses their own home to mainly or wholly look after the child, we would consider this to be a childminding service. We will consider this to be childminding when more than 20% of the contracted time is spent in the personal assistant’s own home.

  1. Personal assistants - what is a sole and private arrangement and when would registration be required?

We recognise how important the support of personal assistants is to people and would not want to register personal assistants unnecessarily. However, where a personal assistant is providing a defined care service, the law requires that we register, inspect and offer assurance to the public.

 

The criteria below sets out when we would consider a care service to be operating:


A personal assistant providing a defined care service has a private arrangement with one of more supported people and:

 would make arrangements for another person to undertake the support in their absence, including the details of the support required and hours of support

 may pay the person replacing them or may be aware of arrangements for person to be paid by the supported person

 employs others directly to cover for them or work as a cooperative covering each other

 would be aware of appropriate insurance being in place, tax arrangements and so on.



A non-regulated personal assistant


Has a private arrangement with one or more supported people and:


 Would not make arrangements for individual/s to cover for them when sick/on leave


 May provide details to supported people of other people who may be able to provide support but is not responsible for this.


 Would have no responsibility or interest in the arrangements reached by

 

  1.  What degree of flexibility does the Care Inspectorate have when applying the legislation and regulations?

The Care Inspectorate has a duty to ensure that care services operate within the law and  expect appropriate registration. They require care services to develop person-centred support plans, keep records of support and conduct reviews. If they employ staff, the Care Inspectorate also expect care services to fulfil the duties of an employer, training and supervising their staff.

Where the Care Inspectorate can use their discretion is by being proportionate and recognising that some services provide less intensive care and support than others, for example telecare services.

  1. Do care services managing supported people’s budgets on their behalf (option 2) require to be registered with the Care Inspectorate?

The need for registration depends on the nature of the service and not the funding arrangements. There is no requirement for services to be registered in order to support people with their personal budget (option 2) unless the provider is offering a care service as determined by the legislation.

  1. Do cooperatives, micro-enterprises and collectives need to be registered?

Sole and private arrangements do not require to be registered as care services. These arrangements may include the employment of personal assistants . A personal assistant may work for more than one individual and an individual may employ more than one personal assistant however, this is still classed as sole and private arrangement. The supported person must be in charge of their arrangement, make their own choices, contingency arrangements and so on, and not be led by the personal assistant.

Where a group of personal assistants work together to support each other and provide holiday and sickness cover for each other, this may fall under the definition of a care service and registration may be needed. (See 35 above.)

Cooperatives, micro-enterprises and collectives would only require to be registered if they were providing a specific care service.

  1. What is the Care Inspectorate’s role when an individual uses mainstream community services?

 

If someone receives their self-directed support from a registered care service to use mainstream community services for example, to attend social activities, the Care Inspectorate would have an interest in the care and support arrangements being provided.

However, if the supported person uses an unregistered service, they would only have an interest if a registered service has enabled the supported person to use the community service unaccompanied. This is because the Care Inspectorate would want to ensure that the service has completed a risk assessment and provided the necessary support and advice to enable the person to attend the activities they choose.

 

  1. How do the Care Inspectorate balance risk prevention and risk enablement?

While the Care Inspectorate expect care services to protect people from avoidable harm or abuse, everyone has the right to make choices that may involve an element of risk. This may include people travelling independently to the shop, managing their own medication or money, developing friendships with members of the local community, and being supported to attend community facilities by unpaid workers or friends or family of support workers.

The Care Inspectorate focus on the positive experiences and outcomes that these potentially risky activities will afford the individual but they do expect providers to have carried out risk assessments. Risk assessments are not to prevent these activities taking place, but to enable them to take place by putting in necessary supports in order that people can achieve their personal aspirations.

 

  1. Who scrutinises the work of personal assistants?

 

The supported person by employing a personal assistant is ultimately responsible for their own support, as the ethos of self-directed support intends.

Local authorities and health and social care partnerships supporting a person to obtain Option 1 and employ a personal assistant should give advice and guidance about practical issues such as safe recruitment, PVG checks, training, the need for insurance and a duty to ensure that public money is spent appropriately. However, local authorities and health and social care partnerships are not accountable for the personal assistant or their day-to day-work, as they are not the employer despite being the provider of the funding.

The local authority or health and social care partnership has a duty of care to advise, support and intervene as necessary if they identify someone using self-directed support to be vulnerable.

While personal assistants are an unregulated workforce, the support provided by local authorities and health and social care partnerships would form part of the Care Inspectorate’s strategic inspection and scrutiny.




 

 

 

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