Self-defined training needs of Direct Payment holders


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Really useful analysis from Wiltshire CIL on the training needs of Direct Payment holders. Well worth a look to help inform DPULO training offers.

For further info, email clareevans@wiltshirecil.o

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Self-defined training needs of Direct Payment holders

  1. 1. The Self-Defined Training Needs ofPeople who use Direct Payments and Personal Budgets in Wiltshire in 2011. Wiltshire CIL delivers training to disabled people Report of the Survey Results by Clare Evans January 2012
  2. 2. Published by: Wiltshire Centre for Independent Living, Learning and Research Centre Devizes 2012Author Clare Evans to whom any correspondence about this publication should be sent:- 2
  3. 3. CONTENTSForeword and acknowledgements 4Introduction 5Methodology 5Characteristics of respondents in table 6Findings 7Discussion 10Policy and practice recommendations 12References 13 3
  4. 4. FOREWORDWe hope this small piece of research will be used to inform the development ofsupport service design and specification for direct payment users and alsoinform the wider personalisation agenda nationally. In conducting this researchwe have been concerned to follow an “emancipatory” approach throughout sodisabled people have led the process from the point of identifying the need forit to publicising its availability and developing an action plan based on thefindings. Thanks are due to all the disabled people who have been involved inthis process including the 100 people who responded to the survey.Whilst only a small research project, we hope the results will be of interestboth locally and nationally to all those seeking to move forward thepersonalisation policy.Our thanks are also due to a number of other people who assisted in theresearch process: to Mel Pow and Louise Farrant, social work students onplacement, who collated the survey results and represented them virtually inpreparation for analysis, to Janette Moore and Diane Zeitzen for furthercollation of results, to Ruth Evans for professional research advice and PollyHannan for cover design.Clare Evans Chair of WiltshireCILGeraldine Bentley Director of WiltshireCIL January 2012 4
  5. 5. The Self-identified training needs of Direct Payment & PersonalBudget users in Wiltshire in 2011IntroductionThis report discusses the results of a survey conducted by Wiltshire Centre forIndependent Living from October to December 2011. The aim of the survey wasto ask direct payment users to identify the workshop training they consideredwould be useful to them, both in managing their own self-directed support and inleading a full independent life in the community.In carrying out this training needs analysis we had the clear purpose ofgathering information to use in planning the training disabled and older peoplewanted in our first training programme in 2012. The training needs analysis ispart of a strategy we are currently pursuing which also includes looking forfunding to put on training events free of charge for disabled people. Thistraining programme, the first provided in Wiltshire since the inception of directpayments in 1997, will be delivered by disabled trainers and mentors through ½day workshops and will be free at the point of delivery with travel costs paid.The national policy of Personalisation in Putting People First (2007) and theincreasing emphasis on self help and peer support (2010) makes this research ofsome interest nationally, particularly in relation to rural areas. The surveyresults reveal that some direct payment users were interested in receivingtraining delivered by their peers to enable them to manage their directpayments more effectively. Peer-led training provided in a safe environment maybe a cost effective way of supporting users to manage their direct paymentsand lead fulfilled lives in the community. The results also demonstrateemployers desire for training for their personal assistant employees at a timewhen this part of the social care workforce is increasing.After an overview of the methodology used in this research the results of thesurvey are given and there follows a discussion within the policy context andpolicy and practice recommendations are made.MethodologyOur awareness of the need for this research grew from informal commentsmade by direct payments users at Wiltshire CIL direct payment peer supportgroups across Wiltshire about their training needs. We have been committed tousing an emancipatory approach at all stages of the research. The research wasled by an experienced disabled researcher who uses self-directed support.Other disabled people were involved in the survey design. 5
  6. 6. 1037 questionnaires were distributed in hard copy to users and carers listed byWiltshire Council as using direct payments, including a small number of peopleinvolved in a pilot on personal budgets. Freepost envelopes were provided toreturn questionnaires and recipients were encouraged to contact Wiltshire CILoffice if they required the questionnaire in another format or requiredassistance in completing it.100 completed questionnaires were returned to the Wiltshire CIL office andthe information was collated by 2 social work students on placement fromWiltshire College and by the researcher’s personal assistants. The draft reportwas circulated to disabled people and allies for comment.Table 1 shows the profile of 100 respondents.Table 1PROFILE OF 100 RESPONDENTS TO TRAINING QUESTIONNAIRELength of Time on Direct Not at Less 1-3 years 3 yearsPayments all than + 1 year 12 11 44 33Gender of Respondents Male Female 26 53Age of Respondents 20-35 36-50 Over 50 10 18 60Ethnicity of Respondents White White Black Asian British Other British 82 0 1 1Impairments of Respondents Phys LD MH Old Hearing Sight Imps Issues Age Imps Imps Probs 46 17 11 16 13 9Notes1. Not all respondents answered all questions2. Some respondents had more than one impairmentSome comments implied family carers were completing the form in their ownright as well as others completing them on behalf of the person they cared for.This reflects the fact that some family carers received a direct payment in 6
  7. 7. their own right to give them a break from care work. There was no question toidentify the numbers of family carers receiving direct payments in thequestionnaire. 12 of the 100 respondents reported that they were not currentlyusing Direct Payments. This may be because they had recently stopped usingdirect payments or had been circulated with the questionnaire in error. Theirresponses have been excluded from this report and the results are thereforebased on the responses of 88 current direct payment users.FindingsThe questionnaire results show a number of findings relating to the trainingneeds that direct payments users identified. Over two thirds of respondents(68%; 60 out of 88) identified at least one workshop they wished to attend.Those who responded came from all adult age groups, all impairments anddiffering lengths of time that they had been using direct payments.The Workshop that most direct payment respondents felt would be useful, 35out of 88 (40%) direct payment respondents, was “Dealing with Problems asthey Arise”. More older people (42% over 50’s) chose this workshop comparedwith Direct Payment Respondents generally. This suggests it was a workshopvalued by experienced direct payment users and older people who still neededassistance when new problems arose.23 (26%) direct payment users wanted to attend workshops on Planning &Support and the majority of these respondents (13) had been using directpayments for between one and three years. This suggests that peoplerecognise, after receiving direct payments for a year or more, thatopportunities to learn about planning that support etc. would enable them to usedirect payments more effectively. A larger proportion of people with learningdifficulties (25%) and with mental health issues (25%) were interested in thisworkshop compared to direct payment users with other impairments since theseimpairment groups represented only 18% and 8% of the overall sample ofrespondents.18 people out of 88 (20%) requested a workshop on accounting for expenditure,suggesting that a proportion of direct payment users were concerned about thereturns they had to complete for their direct payment and wanted more controlover their own budgeting.30 (34%) of the direct payment users did not want training. 14 were keen topoint out the reasons why it was not practical. Some reasons related todifficulties in attending workshops while others felt there was no need forthem. 7
  8. 8. For example some respondents said: “Sorry very elderly and restricted in travelling.” “As the person being cared is bed bound, this is not relevant.” “None at present as I only use money for day centres at present.” “Filled out by partner/carer – our direct payments are very simple and we do not need any further help. Thank you very much for offering further support.” “Housebound – I am 99 years old.”Figure 1 Percentage of respondents who require training in identified areas 45 40% 40 35 30 26% 25 20% 20 18% 14% 14% 15 10 6% 5 0 Dealing with Planning and Accounting Managing Recruiting Choosing an Running a Problems Support for Pas Pas Agency Payroll that Arise ExpenditureAs Figure 1 shows, the other 4 workshops we proposed (Recruiting PA’s,Managing PA’s, Running a Payroll and Choosing an Agency) were requested bysmaller numbers of respondents.Respondents were offered a choice of 4 workshops that were not directlyrelated to direct payments – Assertiveness and Speaking Up, Becoming a 8
  9. 9. Volunteer, Taking Part in Local Area Boards and How to Influence Social Care.Compared with other training offered, there was less interest in these apartfrom How to Influence Social Care. The second most popular workshop forDirect Payment users overall was How to Influence Social Care which wasselected by 28 out of 88 (32%). This suggests respondents using directpayments still sought to influence general social care policy although they didnot now receive direct services. Those choosing these other workshops were 14(16%), 11 (13%) and 6 (7%) respectively. Despite the development of localism inWiltshire the opportunity to learn to participate in this by direct payment usersappears not to be seen as a priority.We also asked direct payment users if they would be interested in WiltshireCIL running training for the personal assistants they employed. 22 respondentsidentified they would value this, whilst 45 replied they would not. 1A further question about, “Is there anything else you want to say about yourtraining needs etc?” brought comments from those who recognised the value ofWiltshire CIL providing training and others who had wider support and trainingneeds:- “I am confident I can contact you when my needs grow i.e. Alzheimer’s help, lifting etc. I just do not have the time or energy for classes.” “I have received direct payments from you but have no idea where to go for help.” “More training on benefits/direct payments.” “Appreciate the availability and scope.”Respondents were asked about practical arrangements for training workshopssuch as the choice of day of the week, time of training and geographicallocation. Respondents were equally divided about whether training should be inthe morning or afternoon but only 4 identified evenings as the most convenient.These responses may be an indication that those Direct Payment users workingfull time did not constitute many of the survey respondents. Tuesday was seenas the most convenient day for training although some respondents chose eachweekday but only 5 people felt they would prefer training on a Saturday.Respondents expressed preferences for a number of locations for trainingworkshops, with Devizes as the most popular (21 respondents, 24%), followed by1 There is no record of the number of direct payment recipients who choose to employ personal assistants sowe do not know what proportion of PA employers this number represents. 9
  10. 10. Trowbridge (17 respondents, 19%) and Chippenham (13 respondents, 15%). Forpractical reasons, it is unlikely that we would be able to offer training in theother locations requested by less than five respondents.Direct payment users were asked how they would travel to training, and weregiven the choices of taxi, car, bus, link community driver and on foot. Somerespondents pointed out that arriving by wheelchair was also an option.43(49%) respondents replied they would travel by car with other means oftransport being chosen by less than 10 (11%) people each so public transport wasnot seen as a viable option. This reflects the reality of rural areas where thelack of public transport means people need to use cars to travel. Only 9respondents said they would need taxis to attend training workshops.Respondents were also asked if there were any other areas they would likesupport from Wiltshire CIL about. These responses fell into 3 categories:equipment needs, advocacy support such as “making complaints in the case ofpoor service” and issues directly related to Direct Payments such as“redundancies”.DiscussionThere is increasing emphasis in the personalisation policy on the importance ofencouraging those needing social care support to receive their personal budgetas a direct payment to give maximum choice and control. One important issuerelevant to this is consideration of what range of support to direct paymentsusers is required in order to enable them to use their direct payments aseffectively as possible.In the 1980’s and 1990’s when only a few disabled people were able to negotiatefirst, indirect payments and then from 1997, direct payments, to purchase theirown support, support services were usually run by local centres for independentliving the roots of which were founded in the Independent Living Movement inBerkeley, California. This philosophy shaped the pattern of support serviceswith an emphasis on peer support and using the “lived experience of disabledpeople” in delivering quality of service. The pattern of these services wasexplored fully by Barnes and Mercer. (2006)In the last 10 years the growth in the market of direct payment users has ledto the development of more variety of service provision of direct paymentsupport services with the increased involvement of national commercialorganisations and charities. These have often been chosen by local authorities ina tender process on the grounds of cost. 10
  11. 11. A more recent trend is for local authorities to add a sum to each individual’sdirect payment to purchase the kind of support they wish from within thecommunity. Whilst this trend is philosophically attractive because it gives adirect payment user the maximum choice of support services and is also cheaperfor the local authorities who do not need to resource the infrastructure of asupport service, it seriously disadvantages local disabled people’s organisationsseeking to tender in this market. Such organisations often lack theinfrastructure of larger national organisations funded from other sources. It isalso questionable whether the individual direct payment user can exercise fullconsumer choice at a time when he/she is at crisis point as is often the situationwhen first being offered local authority social care resources.Meanwhile recent studies about the value of peer support provided by disabledpeople’s organisations and the Think Local, Act Personal publications highlightthe value of support (OPM 2011) (DOH 2010). The OPM evaluation of directpayments in Essex showed that more people moved effectively to directpayments when supported by a local organisation of disabled people than by thelocal authority. However there needs to be more exploration of the differentkinds of peer support which can be provided within disabled people’sorganisations and their appropriateness at different stages of each directpayment user’s journey.In Wiltshire CIL we are developing the following peer support services fordirect payment users:- • A peer support group network across Wiltshire. • A volunteer peer mentor service. • A peer influenced online information resource. • A peer delivered training programme.The survey findings reported here clearly demonstrate the need for peertraining amongst other peer support services.A consequence of the growth in direct payments has been a growth in the use ofpersonal assistants directly employed by disabled people and there is concernthat this new section of the workforce should have opportunities for learningrelevant skills and career progression. The recently published DOH Framework(2011) explores this subject further but does not consider the possibleadvantages of training being provided by disabled people’s organisations. Suchtraining is a sensitive issue for individual employers who are concerned thattheir staff should assist them as they wish and who may find training 11
  12. 12. threatening if delivered by an unknown external organisation. Local disabledpeople’s organisations have credibility with disabled people and are able todesign courses embedded in disability equality as well as incorporating practicalskills PAs may need such as “Manual Handling”.The Cardiff Coalition of Disabled People who provide the local direct paymentsupport service, have developed and obtained accreditation for a 6 sessiontraining course for personal assistants which they are able to run at regularintervals (Goodwin 2011). Their experience shows the need for local authorityassistance in providing extra financial support to direct payment users to enablethem to support staff to attend the training whilst also employing anotherpersonal assistant to have the support they need during the duration of thecourse. The survey findings reported here suggest there is a demand for such acourse to be developed in Wiltshire.Policy and Practice RecommendationsNational• The value of training for direct payment users by disabled peers in organisations of disabled people should be recognised and funded as part of support for direct payment users.• Further research is needed into the different kinds of peer support disabled peoples’ organisations can provide to direct payment users and its effectiveness including the role that can be played by peer training.• Disabled people’s organisations are trusted by direct payment users as places to provide personal assistants’ training. Therefore Skills for Care and the Department of Health should support disabled people’s organisations wishing to do so, and enable them to gain national accreditation for training for personal assistants at NVQ level 1 qualification.• Local authorities should be encouraged to commission training from centres for independent living for direct payment users and make financial support available to enable direct payment users to release personal assistants to attend accredited courses of training.Wiltshire• The need for peer training to support direct payment users should be recognised by the local authority and built in to any plans to support direct payment users. 12
  13. 13. • The travel cost for direct payment users to attend training in Wiltshire rural county, should be met by the local authority.• Wiltshire Centre for Independent Living should develop a programme of training for direct payment users to start in spring 2012.• Wiltshire Centre for Independent Living should begin a dialogue with Skills for Care staff to develop an accredited training course for personal assistants as soon as possible.ReferencesBarnes C. and Mercer G. (2006) Independent Futures Creating user- leddisability services in a disabling society. Policy Press, Bristol.Department of Health (2007) Putting People First: A Shared Vision andCommitment to the Transformation of Adult Social Care, Department of Health,London.Department of Health (2010) Putting People First: Planning together – peersupport and self-directed support London:Department of HealthDepartment of Health (2011) Working for personalised care: a framework forsupporting personal assistants working in adult social care. Social CareWorkforce Policy, Adult Social Care Workforce Department, Department ofHealth, LeedsGoodwin A. Personal email correspondence (2011) Awetu and Cardiff and ValeCoalition of Disabled PeopleOffice for Public Management (2011) Briefing papers 1 – 4 findings from thesecond round of a three year longitudinal study in Essex London ECDP/OPMOffice of Disability Issues (2011) Independent Living Strategy Support planningand brokerage. London Office of disability IssuesThink Local, Act Personal Partnership (2011) Think local act personal; asectorwide commitment to moving forward with personalisation and community –based support London ; Think Local Act Personal PartnershipThink Local, Act Personal (2011) Re-thinking support planning: Ideas for analternative approach London: Think Local, Act Personal Partnership 13
  14. 14. Other publications available from Wiltshire CIL • Quarterly newsletter • Annual Reports • Publicity leaflets: • What We Do • ‘How’s it for you?’ Peer Mentoring Scheme • Support to those funding their own care & support, and their carers • Peer Support Group Network for Direct Payment Users and Personal Budget Holders • How you can help These can be downloaded from our website are available in other formats by request from 01380 725400 or Unit 1, 11 Couch Lane, Devizes, Wiltshire SN10 1EB Charity no. 1120611 Company no. 5480761 ©WiltshireCIL 2012 14