I have the power

Users sit in the driving seat when choosing services as part of a pilot scheme in which social workers become facilitators. Natalie Valios reports on In Control7 step process

If the adult care green paper Independence, Well-Being and Choice brought to the fore social care values of supporting service users, what set the ball rolling? The answer may lie with the In Control programme, a concept of self-directed support that sees the social care system from the perspective of the service user and puts them in control.

“Self-directed support is the system that we want to change towards and move away from the current social care system,” says Simon Duffy, director of In Control.

With In Control users are told their annual funding entitlement so they have the information to devise their own support plan. Although having an individual budget is an important step, users would not be in control of their lives if there were no system of self-directed support.

Duffy says: “If you know what your individual budget is, but in practice you could still only receive the existing domiciliary care service or a place in a care home, what benefit is there to having an individual budget?”

In Control radically changes what social workers do. “In the present system it is assumed that the social worker assesses somebody and develops a care plan based on the money available,” Duffy says. “This reinforces the rationing role of the care manager. The user doesn’t know what they are entitled to financially so they can’t lead the support planning. This is disempowering and undermines creativity.

“But that relationship changes once users are given information about their funding. The social worker becomes the facilitator, helping them think through how they want to use the money.

“We think this is the future – not just for people with learning difficulties,” says Duffy. “Sixty local authorities have now joined In Control and are working in this way with older people, people with mental health problems, physical disabilities and sensory impairments.”

West Sussex – one of the six councils to pilot the scheme – focused on people with high support needs, profound disabilities and challenging behaviour. All six authorities were asked to find 15 people.

In West Sussex, eight people are now using In Control, seven of whom live in the family home. Five others have money allocated, a support plan ready and are waiting for suitable housing to become available before they move out of residential care.

Two others dropped out of the scheme, one because the family felt managing the money would be too difficult, the other because she chose to live with her boyfriend in a supported housing scheme where the package was unsuitable.

Clare Brittain, county manager for services for adults with learning difficulties, says: “All the people we work with have severe complex needs so they can’t use direct payments. They have an indirect payment that is paid to an agent who acts for them. In all cases that has been a family member.”

The result is that users can live more like the rest of us – and it has been a positive experience for social workers too, as Brittain explains: “They use their skills in empowering people to have more choice and control. The support plans that people write are very personal and reflect their hopes and aspirations.

“From my perspective that’s one of the main values that I believe in as a social worker – that we are enabling people to achieve. They have all made quite close relationships with the families they are working with. Social workers sometimes feel constrained when ticking too many boxes and following tight procedures.”

West Sussex has now set itself a target of 60 more people using In Control in 2006-7, about 40 of whom are expected to come through children’s services.

Brittain says: “For us it should be the first option for people coming new to the service or if there is a change of need.”

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