Reports on 'In Control', a project led by Mencap which aims to put people with a learning disability in control of their own lives through the power of self-directed support. The initiative aims to empower people with learning disabilities to personalise their own support and put them in charge of their finances. The project is being tested in six areas across England.
Reports on 'In Control', a project led by Mencap which aims to put people with a learning disability in control of their own lives through the power of self-directed support. The initiative aims to empower people with learning disabilities to personalise their own support and put them in charge of their finances. The project is being tested in six areas across England.
Subject terms:
independence, learning disabilities, personal budgets, self-directed support, social care provision, financing;
King's College London. Social Care Workforce Research Unit
Publication year:
2013
Pagination:
181
Place of publication:
London
Jobs First was a Department of Health demonstration project which ran from April 2010 to October 2011. This project aimed to test out the use of Personal Budgets combined with non-social care funding streams to increase the number of people with moderate to severe learning disabilities in paid employment. It also combined a focus on personalisation and increased employment, both of which remain important elements of central government policy as highlighted in the White Paper on adult social care ( ‘Caring for our future’, 2012). Five local authority adult services departments participated: Herefordshire; Leicester City; London Borough of Newham; North Tyneside; and Northamptonshire. Each aimed to select a cohort of 20 people with learning disabilities, eligible for adult social care, who were judged to have moderate to severe learning disabilities for whom assessments, reviews and support plans were to be refocused on employment. A comparison group of 20 people, who received standard services, was matched in terms of demographic variables and level of learning disabilities. The Department of Health commissioned this independent evaluation, to investigate whether and how Jobs First made a difference to employment outcomes for people with learning disabilities; and to Identify organisational and practice developments that support this goal. This report presents findings on the methods and sample descriptions; contextual factors to Jobs First implementation; professional attitudes to the employment of people with learning disabilities; attitudes and experiences of people with learning disabilities and their family carers; the process and practicalities of arranging employment related support; job coaching and employment brokerage with people with learning disabilities; the impact of Jobs First on local authorities; working with other departments and agencies to support employment of people with learning disabilities; funding supported employment; and employment outcomes and views of employment. This research supports other findings about the positive impact of employment for people with moderate to severe learning disabilities and, most clearly, about the value of good quality supported employment services as being the key to getting and keeping paid work. The report is accompanied by a summary report, easy read summary report, and a document about research tools used.
(Edited publisher abstract)
Jobs First was a Department of Health demonstration project which ran from April 2010 to October 2011. This project aimed to test out the use of Personal Budgets combined with non-social care funding streams to increase the number of people with moderate to severe learning disabilities in paid employment. It also combined a focus on personalisation and increased employment, both of which remain important elements of central government policy as highlighted in the White Paper on adult social care ( ‘Caring for our future’, 2012). Five local authority adult services departments participated: Herefordshire; Leicester City; London Borough of Newham; North Tyneside; and Northamptonshire. Each aimed to select a cohort of 20 people with learning disabilities, eligible for adult social care, who were judged to have moderate to severe learning disabilities for whom assessments, reviews and support plans were to be refocused on employment. A comparison group of 20 people, who received standard services, was matched in terms of demographic variables and level of learning disabilities. The Department of Health commissioned this independent evaluation, to investigate whether and how Jobs First made a difference to employment outcomes for people with learning disabilities; and to Identify organisational and practice developments that support this goal. This report presents findings on the methods and sample descriptions; contextual factors to Jobs First implementation; professional attitudes to the employment of people with learning disabilities; attitudes and experiences of people with learning disabilities and their family carers; the process and practicalities of arranging employment related support; job coaching and employment brokerage with people with learning disabilities; the impact of Jobs First on local authorities; working with other departments and agencies to support employment of people with learning disabilities; funding supported employment; and employment outcomes and views of employment. This research supports other findings about the positive impact of employment for people with moderate to severe learning disabilities and, most clearly, about the value of good quality supported employment services as being the key to getting and keeping paid work. The report is accompanied by a summary report, easy read summary report, and a document about research tools used.
(Edited publisher abstract)
Subject terms:
learning disabilities, employment, personal budgets, financing, personalisation, eligibility criteria, adult social care, attitudes, qualitative research, research methods;
Purpose – There are major pressures on social care funding for people with learning disabilities. It is unsustainable to continue working in the same way. The need to promote independence and prevent the need for social care for people with a learning disability is urgent. The purpose of this paper is to highlight key issues, stimulate debate and strengthen the evidence base. Design/methodology/approach: The paper takes evidence from research, literature reviews, statistics and policy debates. It illustrates key points with case studies. The argument for change has been developed in discussion with key stakeholders including the chief executive of a leading self-advocacy organisation. Findings: Demand is increasing whilst funding is reducing. Policy, practice and evidence on prevention of the need for social care for people with a learning disability are underdeveloped. Nevertheless, there are many examples of good practice, and of emerging opportunities for local partnerships to work together to build a new approach. Research limitations/implications: Research on the benefits and costs of prevention of social care for people with a learning disability is underdeveloped. There is a need to extend the evidence base on the range of interventions and their effectiveness. Originality/value: The paper argues for a step change in culture, practice and the focus of research.
(Publisher abstract)
Purpose – There are major pressures on social care funding for people with learning disabilities. It is unsustainable to continue working in the same way. The need to promote independence and prevent the need for social care for people with a learning disability is urgent. The purpose of this paper is to highlight key issues, stimulate debate and strengthen the evidence base. Design/methodology/approach: The paper takes evidence from research, literature reviews, statistics and policy debates. It illustrates key points with case studies. The argument for change has been developed in discussion with key stakeholders including the chief executive of a leading self-advocacy organisation. Findings: Demand is increasing whilst funding is reducing. Policy, practice and evidence on prevention of the need for social care for people with a learning disability are underdeveloped. Nevertheless, there are many examples of good practice, and of emerging opportunities for local partnerships to work together to build a new approach. Research limitations/implications: Research on the benefits and costs of prevention of social care for people with a learning disability is underdeveloped. There is a need to extend the evidence base on the range of interventions and their effectiveness. Originality/value: The paper argues for a step change in culture, practice and the focus of research.
(Publisher abstract)
Subject terms:
personalisation, learning disabilities, personal budgets, adult social care, social inclusion, policy, financing, costs, social care provision;
The author reports on 'In Control', which provides self-directed support for people with learning difficulties, whilst seeing the social care system from the perspective of the service user. Users are told their annual funding entitlement so they have the information to devise their own support plan. The article includes details of how 'In Control' made an impact on one service users life.
The author reports on 'In Control', which provides self-directed support for people with learning difficulties, whilst seeing the social care system from the perspective of the service user. Users are told their annual funding entitlement so they have the information to devise their own support plan. The article includes details of how 'In Control' made an impact on one service users life.
Subject terms:
learning disabilities, personal budgets, person-centred care, self-directed support, service users, social care provision, empowerment, financing;
A pilot to increase service users' say over how their needs are met has been welcomed. The new system will enable people with physical disabilities, learning difficulties to have more say over how money spent on services for them would be used through 'individual budgets'. Looks at how this will change the nature of social work and commissioning.
A pilot to increase service users' say over how their needs are met has been welcomed. The new system will enable people with physical disabilities, learning difficulties to have more say over how money spent on services for them would be used through 'individual budgets'. Looks at how this will change the nature of social work and commissioning.
Subject terms:
independence, learning disabilities, mental health problems, personal budgets, physical disabilities, social work, commissioning, financing;
This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations. This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia. Overall, the evidence suggests positive effects of individualised funding with respect to quality of life, client satisfaction and safety. There may also be fewer adverse effects. There is less evidence of impact for physical functioning, unmet need and cost effectiveness. The review finds no differences between approaches for the Adult Social Care Outcomes Toolkit (ASCOT), self-perceived health and community participation. Recipients particularly value: flexibility, improved self-image and self-belief; more value for money; community integration; freedom to choose who supports you; social opportunities; and needs-led support. Many people chose individualised funding due to previous negative experiences of traditional, segregated, group-orientated supports. Successful implementation is supported by strong, trusting and collaborative relationships in their support network with both paid and unpaid individuals. This facilitates processes such as information sourcing, staff recruitment, network building and support with administrative and management tasks. These relationships are strengthened by financial recognition for family and friends, appropriate rates of pay, a shift in power from agencies to the individual or avoidance of paternalistic behaviour. Challenges include long delays in accessing and receiving funds, which are compounded by overly complex and bureaucratic processes. There can be a general lack of clarity (e.g. allowable budget use) and inconsistent approaches to delivery as well as unmet information needs. Hidden costs or administrative charges can be a source of considerable concern and stress. Staff mention involvement of local support organisations, availability of a support network for the person with a disability and timely relevant training as factors supporting implementation. Staff also highlight logistical challenges in support needs in an individualised way including, for example, responding to individual expectations, and socio-demographic differences.
(Edited publisher abstract)
This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations. This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia. Overall, the evidence suggests positive effects of individualised funding with respect to quality of life, client satisfaction and safety. There may also be fewer adverse effects. There is less evidence of impact for physical functioning, unmet need and cost effectiveness. The review finds no differences between approaches for the Adult Social Care Outcomes Toolkit (ASCOT), self-perceived health and community participation. Recipients particularly value: flexibility, improved self-image and self-belief; more value for money; community integration; freedom to choose who supports you; social opportunities; and needs-led support. Many people chose individualised funding due to previous negative experiences of traditional, segregated, group-orientated supports. Successful implementation is supported by strong, trusting and collaborative relationships in their support network with both paid and unpaid individuals. This facilitates processes such as information sourcing, staff recruitment, network building and support with administrative and management tasks. These relationships are strengthened by financial recognition for family and friends, appropriate rates of pay, a shift in power from agencies to the individual or avoidance of paternalistic behaviour. Challenges include long delays in accessing and receiving funds, which are compounded by overly complex and bureaucratic processes. There can be a general lack of clarity (e.g. allowable budget use) and inconsistent approaches to delivery as well as unmet information needs. Hidden costs or administrative charges can be a source of considerable concern and stress. Staff mention involvement of local support organisations, availability of a support network for the person with a disability and timely relevant training as factors supporting implementation. Staff also highlight logistical challenges in support needs in an individualised way including, for example, responding to individual expectations, and socio-demographic differences.
(Edited publisher abstract)
Subject terms:
choice, direct payments, disabilities, evidence-based practice, financing, health care, independence, intervention, learning disabilities, personal budgets, quality of life, resource allocation, self-directed support, social care, systematic reviews;
This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations. This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia. Overall, the evidence suggests positive effects of individualised funding with respect to quality of life, client satisfaction and safety. There may also be fewer adverse effects. There is less evidence of impact for physical functioning, unmet need and cost effectiveness. The review finds no differences between approaches for the Adult Social Care Outcomes Toolkit (ASCOT), self-perceived health and community participation. Recipients particularly value: flexibility, improved self-image and self-belief; more value for money; community integration; freedom to choose who supports you; social opportunities; and needs-led support. Many people chose individualised funding due to previous negative experiences of traditional, segregated, group-orientated supports. Successful implementation is supported by strong, trusting and collaborative relationships in their support network with both paid and unpaid individuals. This facilitates processes such as information sourcing, staff recruitment, network building and support with administrative and management tasks. These relationships are strengthened by financial recognition for family and friends, appropriate rates of pay, a shift in power from agencies to the individual or avoidance of paternalistic behaviour. Challenges include long delays in accessing and receiving funds, which are compounded by overly complex and bureaucratic processes. There can be a general lack of clarity (e.g. allowable budget use) and inconsistent approaches to delivery as well as unmet information needs. Hidden costs or administrative charges can be a source of considerable concern and stress. Staff mention involvement of local support organisations, availability of a support network for the person with a disability and timely relevant training as factors supporting implementation. Staff also highlight logistical challenges in support needs in an individualised way including, for example, responding to individual expectations, and socio-demographic differences.
(Edited publisher abstract)
This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations. This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia. Overall, the evidence suggests positive effects of individualised funding with respect to quality of life, client satisfaction and safety. There may also be fewer adverse effects. There is less evidence of impact for physical functioning, unmet need and cost effectiveness. The review finds no differences between approaches for the Adult Social Care Outcomes Toolkit (ASCOT), self-perceived health and community participation. Recipients particularly value: flexibility, improved self-image and self-belief; more value for money; community integration; freedom to choose who supports you; social opportunities; and needs-led support. Many people chose individualised funding due to previous negative experiences of traditional, segregated, group-orientated supports. Successful implementation is supported by strong, trusting and collaborative relationships in their support network with both paid and unpaid individuals. This facilitates processes such as information sourcing, staff recruitment, network building and support with administrative and management tasks. These relationships are strengthened by financial recognition for family and friends, appropriate rates of pay, a shift in power from agencies to the individual or avoidance of paternalistic behaviour. Challenges include long delays in accessing and receiving funds, which are compounded by overly complex and bureaucratic processes. There can be a general lack of clarity (e.g. allowable budget use) and inconsistent approaches to delivery as well as unmet information needs. Hidden costs or administrative charges can be a source of considerable concern and stress. Staff mention involvement of local support organisations, availability of a support network for the person with a disability and timely relevant training as factors supporting implementation. Staff also highlight logistical challenges in support needs in an individualised way including, for example, responding to individual expectations, and socio-demographic differences.
(Edited publisher abstract)
Subject terms:
systematic reviews, disabilities, learning disabilities, intervention, health care, social care, evidence-based practice, personal budgets, financing, quality of life, direct payments, resource allocation, choice, independence, self-directed support;
Community Living,|Emprise International Training and Consultancy
Publication year:
2002
Pagination:
48p.
Place of publication:
Bury St. Edmunds
Direct Payments should be regarded as the first step towards a system in which all the functions are allocated logically and clearly, avoiding conflicts of interest. Systems which follow this model, generically termed Individualised Funding (IF), already exist. Some fifty programmes are under way in several countries. Evaluations of these programmes are only now emerging, but reveal outcomes that are strikingly positive. Although the evidence is not, as yet, conclusive, there are also strong indications that a comprehensive IF system would be more effective in supporting selfdetermination, especially for people with learning difficulties, than the current Direct Payments provision. The development of Direct Payments into a comprehensive system of Individualised Funding would involve: permitting people who require support services, and wish to use IF, to develop and cost their own support plans, reflecting their own life aspirations ( this would replace community care assessment); creating a system in which the limitations of public funding are balanced against the requirements of the individual through a process of open negotiation between the person and the council, based on the plan prepared by the individual; providing funding to individuals who require assistance in developing their plan, so that they are able to purchase this help from a source that is independent of Social Services and service providers, and who is accountable solely to the disabled person; ensuring that help is available to people who receive IF in the administration of their funding, and, if required, in meeting the legal responsibilities as employer of personal assistants; encouraging the development of a market of support provider agencies who are willing and able to provide services tailored to the requirements of individual IF recipients; and authorising and funding an agency in each locality to regulate the supply of independent service brokers, and to provide an access point for people requiring brokerage services.
Direct Payments should be regarded as the first step towards a system in which all the functions are allocated logically and clearly, avoiding conflicts of interest. Systems which follow this model, generically termed Individualised Funding (IF), already exist. Some fifty programmes are under way in several countries. Evaluations of these programmes are only now emerging, but reveal outcomes that are strikingly positive. Although the evidence is not, as yet, conclusive, there are also strong indications that a comprehensive IF system would be more effective in supporting selfdetermination, especially for people with learning difficulties, than the current Direct Payments provision. The development of Direct Payments into a comprehensive system of Individualised Funding would involve: permitting people who require support services, and wish to use IF, to develop and cost their own support plans, reflecting their own life aspirations ( this would replace community care assessment); creating a system in which the limitations of public funding are balanced against the requirements of the individual through a process of open negotiation between the person and the council, based on the plan prepared by the individual; providing funding to individuals who require assistance in developing their plan, so that they are able to purchase this help from a source that is independent of Social Services and service providers, and who is accountable solely to the disabled person; ensuring that help is available to people who receive IF in the administration of their funding, and, if required, in meeting the legal responsibilities as employer of personal assistants; encouraging the development of a market of support provider agencies who are willing and able to provide services tailored to the requirements of individual IF recipients; and authorising and funding an agency in each locality to regulate the supply of independent service brokers, and to provide an access point for people requiring brokerage services.
Subject terms:
learning disabilities, personal assistants, personal budgets, self-determination, service brokerage, social services, social care, social care provision, accountability, assessment, carers, care planning, direct payments, financing;