Self Directed Support in Northern Ireland Dr Simon Duffy ￭ The Centre for Welfare Reform ￭ Belfast ￭ 27th June 2012 ￭
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.
Key messages1.Make SDS your own2.SDS is not Direct Payments3.Keep it simple and clear4.Include everyone in it5.Use your Real Wealth
international progress, butno panaceas...• Scotland, England, Australia, US, Europe...• much we can learn from the developing world• Challenge is to learn from others• ...and do better
Place N Change6 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%
real problems in England1.Hidden services, hidden budgets2.Increasing bureaucracy & control3.Poor engagement with community4.Growing inflexibility5.Poor use of service providersnevertheless, momentum continues...
think about citizenship...Above all, I think the idea ofcitizenship should remain at the centreof modern political debates aboutsocial and economic arrangements.The concept of a citizen is that of aperson who can hold their head highand participate fully and with dignity inthe life of their society. Professor Jeremy Waldron
System spendspeople’s money forthem on thingsthey wouldn’t buyfor themselves
Find your own language!Do it the Northern Irish way
1. Entitlements - clear and quick2. Rules - minimal3. Systems - simple and efficient
Don’t RAS - use simple tiers or existing budgets
right to be a citizen “I have a right to live my life in a way that1. Independent living - full access to makes sense to me” ordinary life right to enough “I have a right to enough support and a2. 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 by3. 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 how4. 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 share6. 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 each7. Contribution my skills, talents and knowledge to play a make a contribution full part as a citizen in my community”
Avoid layering systems onsystems, likeSedimentary rock
SDS Processes Support Planning RAS Care ManagementProtection/Safeguarding Responsibilities Annual Reviews Joint Assessment Processes Eligibility Criteria & Resource Panels Care Planning Monitoring Systems Comprehensive Assessments Mental Capacity LawSocial Care Law for Children and Adults
Jonathan’s storyFor the 3 years before 150 days in hospital -responding to problems with breathing.In the 3 years after leaving hospital he has spentonly 2 nights in hospital - for elective dentaltreatments.Personalised learning - on the job - 2 City & GuildsQualifications.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
New money, training, jobs oftenbecomes a distractionThe real change is cultural -playing by a new set of rules
You can’t start playing a newgame incrementally...you must stop playing cricketand start playing rugby...even if (to begin with) youdon’t feel very competent.
A rabbi asked his students how theycould tell when the dawn had come andmorning prayers could be said. Onestudent responded by saying, “Whenyou can see the sheep on the hill.”Another suggested that one can tellthat the dawn has come when a personis able to distinguish between a fig treeand a grapevine. “No,” said the wiseone. “It is dawn when you can look intothe faces of human beings and youhave enough light within you torecognize them as your sisters andbrothers.”
1. What are people’s rights2. How to take the fear away3. Good places to extend SDS
Key themes for citizens:1. Choice - what suits me2. Equality - full participation in life3. Freedom - it’s what I decide4. Self-determination - the right to be in control5. Person-centred - it’s about me, my plan, my life and my community6. Control - I’ve got the right to change my mind, without permission
Key themes for professionals:1. Use real stories - pivotal impact2. Citizens are your best champions - in their own communities and beyond3. Take a leap of faith - start it, talk about it, use it4. Keep it simple5. Involve citizens in the system redesign6. Encourage and engage real communities7. Working with community assures sustainability
Good places to go next:1. Full implementation - regionally2. One set of rules for NI3. Build on work of Southern Trust4. Share user success stories5. Focus on the positive impact in local economy6. Promote sharing, training & awareness raising7. Be clear and up-front now8. Keep it simple9. Promote by experience and example10. Clear leadership and dedicated person in post11. Use reviews in special schools