Putting People First frequently asked questions
- What is Putting People First?
- What is personalisation?
- What do you mean by Self Directed Support (SDS)?
- What do you mean by personal budget?
- I keep hearing about individual budgets. What is the difference between that and a personal budget?
- What is included in a personal budget?
- Who can get a personal budget?
- How will people sort out everything to do with a personal budget?
- What help is out there to manage a personal budget?
- Will services continue to be provided in the same way?
- Will there still be social workers?
- Will these changes put more pressure on carers?
- What is support brokerage?
- How will people find the Personal Assistant (PA) to support them?
- What can people spend their budget on?
- Not everyone we work with can make all their own decisions or manage their own budgets; who will help them?
- Personalisation may increase the risk of abuse. How will we keep people safe in this new way of working?
- How will we strike a balance between respecting people's rights to more choice and control with the responsibility to keep people safe?
- There is at present no requirement for Personal Assistants to be registered or Criminal Records Bureau checked. Are there any plans to change this?
- Self Directed Support looks fine as long as everything is going well in someone's life, but what if they have a crisis and need extra services or help?
- What happens if someone chooses to do something risky or unsafe with their personal budget that leaves them without the support they need?
- Don't carers already have enough to worry about without the additional stress of helping manage a personal budget?
What is Putting People First?
Putting People First sets the future direction for adult social care. It means:
- people who use social care services will have more choice and control in their life
- better support for carers
- making sure the right help is provided at the right time before people reach crisis point
- people who use social care services having an up front allocation of money so they know how much they will have to spend on support
- support that is tailor-made to meet needs
- a range of excellent, high quality services provided by skilled staff
- easy access to information, advice, support and advocacy
What is personalisation?
Personalisation is the process of enabling a person to be more in control of the services they receive whether funded by adult social care or by themselves. It is about the individual being the best person to know what they need and how those needs can be successfully met because of their understanding of their strengths, needs and preferences.
Personalisation recognises that with the right support, advice and information people can often make their own decisions about what they require to meet their needs and to achieve their goals.
What do you mean by Self Directed Support (SDS)?
Self-directed support is the term used to describe how people are able to design the support or care arrangements that best suit their specific needs. It puts people in the centre of the planning process, and recognises that they are best placed to understand their own needs and how to meet them.
Through self-directed support people are able to direct and control how the money available to meet their support needs is spent, with a greater emphasis on people using personal budgets to build on their own support networks such as family and friends.
There are seven steps to Self Directed Support:
- Your support needs
- Design your support plan
- Getting your plan agreed
- Organising your money
- Organising your support
- Living your life
- Has your plan worked
Visit our Self Directed Support page for more information.
What do you mean by personal budget?
A personal budget is the amount of money given to a person who has been assessed as eligible for support from adult social care. This will mean that for the first time people will know upfront how much is available from the Council to meet their assessed needs. A personal budget will give people more choice and control over how their budget is spent.
I keep hearing about individual budgets. What is the difference between that and a personal budget?
An individual budget is the same as a personal budget, but also includes other sources of funding. The government tested individual budgets in 13 Local Authorities and the funding included:
- Social care
- Equipment
- Disabled Facility Grants (such as large adaptations)
- Supporting People (support with housing)
- Access to work
- Independent Living Fund
But the pilots only had limited success in bringing all the funding into one pot of money. We will be working closely with other funding sources such as Independent Living Fund and Supporting People to make sure that people get everything they are entitled to. We will be working on how we can move towards one pot of money, but that will take time.
What is included in a personal budget?
For the time being the personal budget will only include social care funding.
Who can get a personal budget?
From September 2009, in Plymouth we will be offering personal budgets to all existing clients. By April 2010 we will have all the processes we need in place to make personal budgets a reality for new and existing service users. To become a service user people have to be assessed as eligible for council support under Fair Access to Care.
How will people sort out everything to do with a personal budget?
It will be up to each individual to decide how much or how little control they want over their personal budget. Some people will still want the Local Authority to look after the money and buy the support they need. Others might want to direct how their money is spent, but not have to manage the budget, and there will be advice available about organisations who can manage the budget on a person's behalf. There will be people who want to take complete control over their budget and manage and arrange their own support. Managing a budget through a cash payment is called a Direct Payment.
What help is out there to manage a personal budget?
Right now, you can get help with things from a Direct Payment Support Service called A4E. They can help with sorting out things such as:
- finding a personal assistant
- payroll for people who have a Direct Payment.
We are looking at developing more services to help people manage their own personal budgets – so watch this space. Often this is called support brokerage.
Will services continue to be provided in the same way?
People will continue to receive the care and support they need. The aim is to give people more choice and control of services and how they are provided.
We will be developing new options and opportunities for people to personalise how they receive care. This will involve changes to the types of services and how they are provided in the future. We'll offer these new options to people as they become available.
Will there still be social workers?
Yes. They'll take on new roles and ways of working, but will continue playing an important part in people's support.
Will these changes put more pressure on carers?
Supporting carers, including young carers remains a top priority. We aim to help people continue caring for as long as they choose to do so. We understand its important carers are not disadvantaged by these changes. Keeping carers informed and involved will be an important part of the process.
What is support brokerage?
It is about the help some people will need to work out what their choices are, what support or care is right for them and where to buy the services or activity.
How will people find the Personal Assistant (PA) to support them?
Firstly, people receiving support do not have to become employers. But if a PA is right for them and their circumstances, the person can advertise and recruit their own PA. If they need support with this, then they get help from A4E the Direct Payments Support Service. We are also looking at how we could support care providers to offer PA agency services as we know that many people do not want the worry of employing their own staff but still would like a PA service.
What can people spend their budget on?
We are looking to offer guidance about this, but how people will spend their budget and what they will want to buy will be as varied as the individuals themselves. Broadly, we know that what the person chooses to buy must meet their agreed needs and outcomes, be safe, legal and affordable.
Not everyone we work with can make all their own decisions or manage their own budgets; who will help them?
Who helps them now? For some people it will be a family member or carer who manages their affairs and this does not have to change with a personal budget. For others we are able to offer an advocate through new investment we have made this year into advocacy services. The Mental Capacity Act applies under self directed support as it does now.
Personalisation may increase the risk of abuse. How will we keep people safe in this new way of working?
There is no evidence to indicate that personalisation may increase the risk of abuse, there are always risks for vulnerable people from a variety of sources.
In the recent individual budgets pilots 15 per cent of people chose to have a complete change of service provision whilst 35 per cent opted for a mix of their existing services and recruited personal assistants or arranged other services themselves. It is, however, important to stress that the current system of service delivery is not without risk. The evidence from the individual budget pilots and from international studies does not demonstrate a significant increase in abuse with the use of Direct Payments.
How will we strike a balance between respecting people's rights to more choice and control with the responsibility to keep people safe?
Safeguarding adults is about promoting people's rights to make choices and have control over their own lives. This can involve assessing with the people concerned the type of risks they are taking and what can be done to reduce those risks, the principles of personalisation encourage this approach.
There is at present no requirement for Personal Assistants to be registered or Criminal Records Bureau checked. Are there any plans to change this?
The Association of Directors of Adult Social Services have asked the government to ensure that local authorities are able to offer everyone the option of checking Criminal Records Bureau (CRB)/Independent Safeguarding Authority (ISA) registration. However, as the law stands at the moment a person using Direct Payments does not have to use a CRB checked or an ISA registered person if they choose not to. Legislation is coming into force in 2010 that will require ISA registration for those providing care to children and vulnerable adults.
Self Directed Support looks fine as long as everything is going well in someone's life, but what if they have a crisis and need extra services or help?
We will always need to support people in a crisis. Putting People First is not just about personal budgets: it is about the NHS and Local Authority working together to develop joined up rehabilitation and recovery services during periods of crisis. Part of our medium term plan is to develop a wider range of more joined up prevention and early intervention services. During the next six months we will be monitoring how people with personal budgets manage crisis situations so we can develop guidance for care managers.
What happens if someone chooses to do something risky or unsafe with their personal budget that leaves them without the support they need?
We are ensuring that we write clear policies and guidance for both staff and service users and their families about how to plan support properly.
Don't carers already have enough to worry about without the additional stress of helping manage a personal budget?
We will make sure that support to manage personal budgets is not just available to service users but their carers, friends and family as well. Not everyone who has a personal budget will want to have a Direct Payment.