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For Christmas 2023, we are sharing our #12DaysOfSelfDirectedSupport with twelve top tips for Self Directing your Social Care and Health support.

You can reference this as a complete tool kit for Self Directing your own support or you can select the sections which apply to your own personal circumstances.

Day 1: Your Rights

For people at the beginning of the process of accessing Health and Social Care Support, a good place to begin is to learn about their rights.

The Care Act 2014 is the legal framework which governs the provision of Health and Social Care in England. Visit the .gov website for a range of Factsheets about the Care Act to find out more.

Day 2: Assessment

Everyone has a right under the Care Act 2014 to request an assessment for Adult Social Care support if they believe they have eligible needs. Carers can also request their own assessment for support under the Care Act.

Read our Information sheet about #eligibility to help prepare for a Care Act assessment.

Day 3: Personal Budget

Everyone who has been assessed as having eligible Social Care needs has a right under the Care Act 2014 to request a Personal Budget in order to #SelfDirect their support.

A Personal Budget is a way of choosing how your support will be paid for and managed. It gives you the level of control you want over how your support is planned, organised, provided and paid for.

Read our past blog article about #ChoiceAndControl which shares a real life example of a situation where a #PersonalBudget could make a real difference to someone’s #Outcomes.

Day 4: Personal Health Budget

If you have received a #ContinuingHealthCare assessment, and have been deemed to have #eligible needs, you may be entitled to a #PersonalHealthBudget to #SelfDirect your support.

A Personal Health Budget is a way of being in control of, paying for and managing your own Health support. It gives you the level of control you want over how your Health support is planned, organised and provided.

You can choose to receive the budget as a payment to a bank account or you can ask a #ThirdParty organisation to manage the budget and make the arrangements on your behalf.

Read this fact sheet from NHS England for more information.

Day 5: Circle of Support

If you are choosing to #SelfDirect your own support, a good place to start is to think about the people who are important in your life, who are great at helping you, spending time together and who understand you really well. These are the people who you might want to involve in planning your support, exploring your options and helping you to make new connections in your local community. We sometimes refer to this group of people as a ‘Circle of Support’.

Watch our explainer video with Mollie to find out more about #CirclesOfSupport

Day 6: Advocacy

Sometimes, people who are choosing to #SelfDirect their own support might need some help with expressing their wishes and preferences to ensure that their assessment and support plan is #PersonCentred

The person is entitled to an advocate under the Care Act 2014 legal framework. There are several different types of advocates who can help, depending on the type of issue or support required:

-Care Act advocate

-NHS complaints advocate

-Mental Capacity advocate

-Mental Health advocate

-Independent advocate

Voiceability have some excellent information on their website, including an explainer video about #Advocacy

Day 7: Support Brokerage

Sometimes, people who are choosing to #SelfDirect their own support might want to work with somebody independent of the Local Authority or NHS to explore their options, talk about their ideas and hopes for the future and put their support in place. This is where working alongside an Independent Support Broker can be really helpful in opening up ideas, options, possibilities and solutions for the person, and keeping the momentum going so that the person receives the support they want to achieve their outcomes.

To find out more about #SupportBrokerage watch our explainer video

Day 8: Dreams

In the process of thinking about the future, making plans and organising support; Dreaming is an important part of listening to the person in order to understand what is important and to explore ideas which help the person to experience a good life, based on what they have shared about their dreams.

We have a simple template available to download for #free from our website, with an explainer video to support conversations about ‘Dreams’.

You might also be interested in watching our webinar on ‘Dreams’

Day 9: Explore your options

Once the person has had opportunity to learn about their rights, think about how they want to receive and manage the budget for their support, it’s time to explore options for how the person wants to live their life and how they would like to receive support to do that.

It’s not just about looking at a ‘directory of services’ available in the local area. It’s about starting with the ideas the person has expressed about their life and their future, and then exploring possibilities about how the person could be supported to achieve these outcomes. It might not just be about what is available locally, but about exploring about how to make something happen which does not exist yet. #SelfDirectedSupport is a mechanism which supports this approach, and allows the person to tailor their support in a way which makes sense for them.

The Person’s #CircleOfSupport might also offer to get involved in exploring opportunities and making connections for the person. The person might use some of their budget for paying for support, but some of these opportunities and connections may be relationship-based and without a financial cost attached.

Here are some tools and templates which could assist with this process, and are #free to download from our website.

Day 10: Build connections

Once the person has had explored their options for activities and support, and expressed what they would like to do, the next step is to actively start building connections with people and places the person is interested in. .

The Person’s #CircleOfSupport can offer support with this process (in making introductions) or the person might want to build connections independently.

A tool which could assist with identifying the people and places where the connections need to happen is called ‘The fifth circle’ and it is #free to download from our website (along with an explainer video about how to use it).

Day 11: Support Planning

Once the person has had explored their options for activities and support, built connections in their local community and expressed how they would like to be supported, the next step is to develop a clear #SupportPlan with all of this information, showing where each activity or form of support is sourced from, any associated costs, and the source of funding which will cover the cost of this. An itemised and costed Support Plan can be shared with the person’s social worker or care co-ordinator if funding agreement is needed. This is what a #SelfDirected Support Plan should cover.

The person can say if they want to employ their own #PersonalAssistants to support them or if they want to use an agency to provide support. They can say how they want to receive their budget (if they are eligible) to pay for their support, and they can decide how they want their budget to be managed. This information can all be included in the Support Plan.

At Imagineer we follow the #SevenCriteria for developing a Support Plan:

  1. What is important to the person?
  2. What does the person want to change or achieve?
  3. How will the person be supported?
  4. How will the person use their budget?
  5. How will the person’s support be managed?
  6. How will the person stay in control of their life?
  7. What are the steps to making the plan happen?

By covering all of the information in the #SevenCriteria questions, we can be confident that a comprehensive and effective support plan has been developed in #Coproduction with the person and anyone involved in helping them to make decisions.

Our webinar ‘Introduction to Support Brokerage’ covers some of these key ideas.

Our #free template series ‘Getting the support right’ also has some helpful tools which you can download to use for working out the content of the Support Plan.

Day 12: Make it happen!

Once the person has developed their #SupportPlan and received agreement from Social Care or Health funders, it’s important to keep the momentum going so that the plan is actually put in place. This is where working with a #SupportBroker can be really helpful to coordinate who is going to do what, and creating an action plan which everyone involved agrees to and is held accountable for.

Our #free template series ‘Making it happen’ has some helpful tools which you can download to use for implementing the Support Plan.

We hope you find it useful!

We talk about being person-centred in social care, but what does this mean in the context of supporting people with learning disabilities or autistic people to leave a long-stay hospital or assessment and treatment unit?
When we talk to leaders in adult social care they openly admit “we can do better for people” with regards to community support and getting a good life.

So how can we do better?

One national project, Small Supports, is providing some answers and raising some questions about how we support people and commission services differently.
Personalisation and being person-centred is at the heart of this project, with twelve sites nationally supporting the growth of small providers. Amanda (from the Team at Imagineer) has been involved in developing Small Supports projects in a number of areas.

What are Small Supports?

Small Supports are small, local organisations who work with people with learning disabilities and/or autism, who have experienced difficult or traumatic life events and who need a different approach to support them to leave hospital.

These new providers will focus on putting the person in the driving seat by building strong relationships with them and their family and circle of support. Fundamental to this is their willingness and ability to listen deeply to the person, their aspirations and hopes
for their future and then to help them choose and plan what a great life looks like for them. Conversations about support and risk follow that.

Why small?

The belief is that remaining small enables the leaders of the organisation to keep in touch with everyone, the people being supported, their families and those providing the support. Small is also very much about quality. Building strong relationships of trust with the individuals they support and their families, the commissioners and the community teams is vital to ensuring quality continuous support. Being able to ‘touch the sides’ of the organisation means that when challenges arise and changes are needed they can be spotted early and acted upon quickly.

Being small and local also means the leaders and paid supporters in the organisation are rooted and engaged in their community. They are able to build links with the person to their community based on their assets and strengths.

People are therefore able to contribute to society and build relationships outside of their family and paid support, something Small Supports strongly advocates. Focusing on individual’s aspirations and building intentional relational networks with and for the
person means that anything becomes possible, including friendships, finding love, getting a job, being a good neighbour and regaining health and happiness. Whilst these things may not seem like a great ask for most people, for many people who have lived for years in locked environments these important life experiences may feel out of reach. Small Supports is aspiring to change this by putting the person at the centre of the decision making in their life including focusing on what a good life looks like for them.

How does Support Brokerage fit in?

This is where quality Support Brokerage fits in. Being able to use a personal budget in the form of a direct payment, third party health budget or individual service fund offers a way to use creative and strengths based approaches to build a support plan directed by the person and their family. Every person has unique strengths, assets, gifts and skills and these are the starting point for building a dynamic support plan with the person in the driving seat. Looking at the person’s aspirations first, instead of a ‘one size fits all’ approach to buying support services; a personal budget enables the person to be directing their plan and how they want to spend their money so that the support wraps around them. The provider is there to support the individual and broker services as directed by the person. This will look very different for each person. Support Brokerage enables this bespoke and highly creative approach to designing a support plan which makes sense to the person; and drawing on all of the other strengths, connections and resources available to the person which can help to make their plan a reality..

Why Personal Budgets?

What Small Supports organisations learnt was that compromising on control and aspirations is when things start to go wrong. Using an individual service fund or a personal health budget enables the person to be in control, supported by their family and the provider. This type of personal budget offers flexibility like a direct payment.
Recognising that daily life is not on a schedule, is not predictable and is not the same every day. The person, their family and network supported by their provider can flex the support around the person’s choices and changing needs and if something unexpected comes up, they can adapt. This is not necessarily the case with a commissioned or managed budget (sometimes referred to as a ‘notional’ budget), where they might have to ask for a social care review to change the support plan, which may not happen immediately.

An individual service fund (ISF) is where the person and their family might like the idea of directing their support and being in control but don’t want the responsibility of managing the finances, staff and payroll. The provider or a third party helps them work out how to spend their budget and create their support plan and is accountable for it on their behalf; while the person remains in control of their support.

How can you get involved?

People who have successfully established their new Small Supports organisation tend to be people who have a background in providing or commissioning services.
Some are people with lived experience and family members, some are learning disability nurses, commissioners or social workers. However, they are bold and compassionate leaders committed to human rights, who understand the value of their community, aspire to provide high quality, local support and plan to remain small but sustainable- not supporting more than 5 people in their first year.

All Small Supports sites are actively looking for brave values-driven people who want to explore with them how to set up their own dynamic citizen-focused great Small Supports organisation. They will need to be tenacious, pro-active, flexible, good at problem-solving and passionate about making a difference and supporting people to live a great life.

Peter’s story

Here, Peter shares some of his story about caring for his young adult son who has Profound Mental and Physical Disabilities.

Tell us about the person who you care for. How old are they? What sort of things do they need help/care with?

He is now 20 years old with profound mental and physical disabilities. He needs 24/7 care, 2:1 during the day with a sleeping shift over night

How much of your time each day/week do you spend caring for your family member?

Actually very little, but only because we have fought to get a Personal Health Budget (PHB) which has transformed the lives of the whole family. It is hard to manage and administer – but worth it.

Do you ever get a break from caring? If so, what sort of things do you like to do when you have a break?

As above, we now have time breaks. I am now a PhD student looking into PHBs

If you could have better support as a family carer, what sort of things would make life easier for you and your family?

PHBs are great, but there is no support for you run them. This support is what is needed.

How Imagineer can provide support to carers like Peter:

  • Imagineer can provide Information, Advice & Guidance to help carers like Peter to understand the Personal Budget or Personal Health Budget process; and understand their rights within that process
  • Imagineer can support with exploring options and providing assistance for developing a Personal Health Budget support plan to meet the person’s assessed needs
  • Imagineer can provide support to family carers and their family members during meetings with Health and Social Care professionals (such as Multi-disciplinary team [MDT] meetings)

At Imagineer, we work alongside unpaid family carers in many different ways; but one of the key ways that we can assist is by providing Support Brokerage.

If you are interested in receiving assistance from one of our Support Brokers, please contact us: info@imagineer.org.uk to request a call-back for an informal discussion, or a referral form.

For more information about Carers Week 2021, visit: Carersweek.org

People we work with often ask ‘What supports wellbeing?’

The Care Act 2014 has an emphasis on Wellbeing and therefore it is a key aspect of all assessment and planning work in Health and Social Care.

In the practice of Independent Support Brokerage and Person-Centred Planning, we often talk about the concept of ‘purpose’.

However, it’s often missed in the health & social care process as an integral element of a person’s life- so why should we place such emphasis and importance on it?

Research study on purpose and mortality

A recent study conducted in the USA in 2019, followed 6985 adults over the age of 50 to identify a link between life purpose and all-cause mortality rate.

This is huge. This provides evidence which connects a person having a clear purpose in life; with their well-being.

How does Independent Support Brokerage link to the concept of purpose?

Stories of how Support Brokerage has enabled people to pursue their sense of purpose:

Jenny was living in a cramped home with parents as an adult, with no sense of future direction. Through accessing Independent Support brokerage, Jenny was able to move into her own home, employ her own support team using a Direct Payment, and set up her own business.

Billy was facing a future after school which was very lonely and isolated, and without any particular direction. With some Support Brokerage input, Billy  became involved in what was going on in his local community, joined local clubs and began speaking at events about inclusion.

Nicky was a lady in her mid-40s. She had been placed in a home for older people because that was the only provision ‘available’ to her, which could meet her complex support needs. The home was out of area- far away from her family and the community she knew well. With input from a Support Broker and key family members, Nicky was able to develop a plan to move into her own home back in her local community. Her family helped her to recruit & manage a team of Personal Assistants using her Direct Payment, which enabled her to be close to her family and back with her relationship networks and connections.

Are you interested in finding out more?

Imagineer offers a range of training & mentoring services to support the knowledge and practice development of practitioners; and also to help people to know and understand their rights.

Consider signing up for our ‘Quick bite for lunch’ webinars which explore practical ideas taken from Independent Support Brokerage. These practical approaches can be embedded within your practice.

Subscribe to our mailing list to be kept up to date with what we’re doing.

About us:

Liz Leach-Murphy Founder of Imagineer Development CiC

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

Follow us on twitter: @imagineercic

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Leaders and decision-makers within the health and social care sector generally grasp (and subscribe to) the concept of Personalisation and Self-Directed Support; but often feel ‘stuck’ in relation to the systems, structures and processes that they are required to work within.

Having a simple lens by which to review policy and practice could be a catalyst for real and lasting change.

Let’s explore this in a little more detail.

Independent Support Brokerage is an approach which strongly aligns with the theory of self-determination and was first developed by families of people with complex needs, called the Woodlands Parents’ Group in British Columbia, Canada in the 1970s.

When the person is in the driving seat of their own life, amazing things can happen; and solutions and opportunities can be discovered which were not even considered through the narrow lens of commissioned provider services and statutory provision from Health and Social Care. Elements of Support Brokerage exist in many different models and approaches, but authentic and truly Independent Support Brokerage is rooted in a wide range of Person-Centred Practice and Strengths-Based Approaches such as:

Some of the barriers and challenges presented by the current Health and Social Care system include:

Our experience as practitioners of Independent Support Brokerage has shown that many of these barriers and challenges can be overcome when the following conditions are present:

The mechanisms and legal structures enabling these conditions to be present already exist, and it is happening in small pockets around the UK. 

So why isn’t it happening everywhere? There is a growing groundswell of momentum towards the radical transformation of the welfare state. The Health and Social Care sector forms one part of the puzzle. There are many refrains of ‘Coproduction’, ‘Personalisation’, ‘Strengths-Based Approaches’ and ‘community development’ being sung by different groups wanting to see change.  If we gather our voices together collectively and sing as a choir; we could weave our harmonies together to create a symphony of citizenship, inclusion and equal rights for all. 

Do you want to join the chorus?

Further reading: What does ‘good’ look like?

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