self directed support cpa

SELF DIRECTED SUPPORT

OPTIONS AND OPPORTUNITIES WITHIN CARE PLANNING

TRISH STOKOE

CSIP –SOCIAL INCLUSION

South West Regional Development Centre

07768421669

trish.stokoe@hotmail.co.uk

Sue attends the day centre and the clinic.She has 5 friends she sees at outpatients or the day centre.

Employment

Education

Volunteering

Arts and Culture

Faith communities

Family & neighbourhood

Sport & exercise

Services

People can become very isolated

Too many questions and not enough answers How can adults with mental health problems

secure the same opportunities for social participation and access to services as the general population ?

What more can be done to enable adults with mental health problems to enter and engage within community life ?

and so on …,

RecoveryWhat does ‘recovery’ mean for an

individual?

“…of changing one’s orientation and behaviour from a negative focus on a troubling event, condition or circumstance to the positive restoration, rebuilding, reclaiming or taking control of one’s life.”

NIMHE Guiding Statement on Recovery (January 2005)

What does recovery mean for a system designed to provide support to people?

Focus on people rather than services.Monitoring outcomes rather than performance.Emphasising strengths rather than deficits or dysfunction.Educating people who provide services, schools, employers, the media and the public to combat stigma.Fostering collaboration between those who need support and those who support them as an alternative to coercion.Enabling and supporting self-management, promoting autonomy and, as a result, decreasing the need for people to rely on formal services and professional supports.

NIMHE Guiding Statement on Recovery (January 2005)

Direct Payments are …,

Money given directly to people to meet their assessed social care needs

The result of campaigning by Disabled People for greater choice and control in their lives

Improving the life chances of disabled people Prime Minister’s Strategy Unit, DWP, DH, DfES, ODPM (2005) Improving the Life Chances of Disabled People – January London: Cabinet Office

A means to an end:Recovery and Independent Living or Enabling people to live their life as they would want

“Ultimately every locality should have a single community based support system focussed on the health and well being of the local population. Binding together local Government, primary care, community based health provision, public health, social care and the wider issues of housing, employment, benefits advice and education/training. This will not require structural changes, but organisations coming together to re-design local systems around the needs of citizens.” (“Putting People First 10th Dec 2007 Local Government Association, NHS, ADASS

Environment Home Hospital Intermediate Home + support

GOAL Reduce risk of admissionIncrease planning for

admission

Maximise focus on return to home

Maximise dignity & self-respect

Reduce risk of re-admission to hospital or care home

Increase rate of return to home

Reduce risk of re-admission

Maximise health & well-being

STRATEGIES Develop ‘passports’Involve family and friendsMaking plans transparentShare good information on

health and risk

Maximise recovery from shock - regain confidence and prepare for return to control

Maximise control - ward routine - mealtimes - patient participation - self-medication

Maximise relative contribution

Planning changes to home and support

District NursingVirtual budgetConstruct a person-centred

approachInformation on efficacyTherapy serviceslink to friends, neighboursenvironmental assessment

Support planning to stay well

Professional help to train family, friends and supporters

working with family and housing environment

crisis emergency planningMH capacity plan

LEVERS Practice-based commissioning

Local Area CoordinationSome people with

Individual Budgets already

NHS State funded... Payment by results

Increased focus on electives

Early clarification of community entitlements (including Individual Budgets)

Virtual Individual Budgets for health & therapy services -

Use of non-recurring budgets and grants

Environmental adaptationsTax, income solutions for

families

Individual BudgetContinuing Health Care

fundingPooled Budgets

The Challenge Ahead

Some areas for Action!

•A standard option within CPA

•Commissioning that facilitates this

•Pro-active approach from managers, based on the guidance, research and ministerial statements

•Well informed and well supported Care Co-ordinators

•Adequate Payments support services•Information and support to people eligible to use mental health services and carers