Talk given to senior managers in Aberdeen on the nature of self-directed support and the challenges of effective implementation.

1. Self Directed Support
Dr Simon Duffy ￭ The Centre for Welfare Reform ￭
Aberdeen ￭ 18th July 2012 ￭

2. Dr Simon Duffy
• 22 years working on reforming welfare
systems, especially with people with learning
difficulties and their families
• Invented Individual Budgets, RAS, SDS and
Keys to Citizenship.
• Works to support innovations in the design of
the welfare state to promote citizenship,
family, community and fairness.

3. Centre for Welfare Reform
• The welfare state is a good thing,
• Its just designed wrong
• Based on 1945 thinking
• Needs to promote citizenship, family and
community
• Needs to be fairer

4. Key messages
1.SDS is about citizenship
2.SDS is not Direct Payments
3.Keep it simple and clear
4.Include everyone in it
5.Build on your assets

5. 1. SDS is about citizenship

6. Above all, I think the idea of
citizenship should remain at the centre
of modern political debates about
social and economic arrangements.
The concept of a citizen is that of a
person who can hold their head high
and participate fully and with dignity in
the life of their society.
Professor Jeremy Waldron

8. System spends
people’s money for
them on things
they wouldn’t buy
for themselves

9. The Spectrum of Services
£200,000
£150,000
£100,000
£50,000
£0
Specialist Placements 24 Individual Support
Group Homes Specialist Day Services
Residential Colleges Nursing Homes
Residential Homes Individual Day Supports
Day Services Adult Placements
Outreach Supports Domicilary Care
Residential Respite

10. Numbers using services
400
320
240
160
80
0
Specialist Placements 24 Individual Support
Group Homes Specialist Day Services
Residential Colleges Nursing Homes
Residential Homes Individual Day Supports
Day Services Adult Placements
Outreach Supports Domicilary Care
Residential Respite

11. Expenditure
£15,000,000
£11,250,000
£7,500,000
£3,750,000
£0
Specialist Placements 24 Individual Support
Group Homes Specialist Day Services
Residential Colleges Nursing Homes
Residential Homes Individual Day Supports
Day Services Adult Placements
Outreach Supports Domicilary Care
Residential Respite

12. The balance
8%
92%
Segregated Services
Community Services

13. Recent developments
• International developments
• Scottish export to England
• Interesting innovations
• Radical policy changes

16. Place N Change
6 Sites Phase I Report 60 -18%
17 Sites Phase II Report 128 -9%
13 Sites IBSEN Report 203 -6%
Northants 17 -18.7%
City of London 10 -30%
Worcestershire 73 -17%

17. but some real problems too
1.Hidden services, hidden budgets
2.Increasing bureaucracy & control
3.Poor engagement with community
4.Growing inflexibility
5.Poor use of service providers
nevertheless, momentum continues...

18. 2. SDS is not Direct Payments

19. But it really should build on
Direct Payments

20. Not Direct Payments,
because
1. It’s about entitlements - not cash
2. It’s about the right point of control
3. It’s about supporting decisions
4. It is not about employing staff
5. It is for everyone

21. clear entitlements - up-front

22. different ways to control a budget

23. returning to the values of social work

24. personalised solutions

25. universal system

26. Implementation should build
on expertise of Direct
Payments workers and
support systems

27. 3. Keep it simple and clear

28. 1. Entitlements - clear and quick
2. Rules - minimal
3. Systems - simple and efficient

29. Don’t Razzle - use simple tiers
or existing budgets

30. right to be a citizen
“I have a right to live my life in a way that
1. Independent living - full access to makes sense to me”
ordinary life
right to enough
“I have a right to enough support and a
2. Entitlement support to achieve right not to be over supported”
citizenship
“I have a right to make decisions about
right to be in control how I live my life and to be supported by
3. Self-determination
of our own lives people who know me and love me to
make those decisions for and with me”
rules & systems “I have a right to be told clearly and
simply how the system works and how
4. Openness should be clear and any rules affect me; including how much
fair money I am entitled to for my support”
“I have a right to use my money in any
free to use our way that helps me to live my life;
5. Flexibility
money as we see fit including the freedom to take risks, make
mistakes and learn from them”
“I have a responsibility to share with
we should share
6. Learning others what I have learnt works for me
what we are learning and what doesn’t work for me”
“I have a right and a responsibility to use
we should each
7. Contribution my skills, talents and knowledge to play a
make a contribution full part as a citizen in my community”

31. Avoid layering systems on
systems, like
Sedimentary rock

32. SDS Processes
Support Planning
RAS
Care Management
Protection/Safeguarding Responsibilities
Annual Reviews
Joint Assessment Processes
Eligibility Criteria & Resource Panels
Care Planning
Monitoring Systems
Comprehensive Assessments
Mental Capacity Law
Social Care Law for Children and Adults

33. Who is the best planner?
Indi vi dual
Fami l y/Fri ends 17%
23%
Provid er
Broker
Soci al Worker 12%
13%
34%
N = 801

34. Who is the best organiser?
Indi vi dual 9%
16%
Fami l y/Fri ends
Provid er
Broker
Soci al Worker 17% 31%
N = 774 28%

36. 4. Include everyone in it

37. social workers

38. schools

39. Jonathan’s story
For the 3 years before 150 days in hospital -
responding to problems with breathing.
In the 3 years after leaving hospital he has spent
only 2 nights in hospital - for elective dental
treatments.
Personalised learning - on the job - 2 City & Guilds
Qualifications.
Saving NHS, LA & Education
•Over £100,000 in hospital stays
•Over £300,000 in residential care costs
•Over £100,000 of funding contributed by the LSC

40. services

41. use Individual Service Funds

42. advocacy

43. people

44. The real innovators are
disabled people & their families
John O’Brien

45. 5. Build on your assets

47. Real Wealth

48. from push to pull economics

49. flexibility creates efficiency

50. We need to recognise the Real
Wealth of our communities
Work with what you’ve already got

51. communities are not products

52. New money, training, jobs often
becomes a distraction
The real change is cultural -
playing by a new set of rules

53. You can’t start playing a new
game incrementally...
you must stop playing cricket
and start playing rugby...
even if (to begin with) you
don’t feel very competent.

54. For more information go to
www.centreforwelfarereform.org
These slides are © Simon Duffy 2012 ￭ Publisher is The
Centre for Welfare Reform ￭ Slides can be distributed subject
to conditions set out at www.centreforwelfarereform.org ￭