Personalisation: self-directed support in West Sussex

With more than 700 people on self-directed support packages, West Sussex Council is at the forefront of the personalisation agenda.

The authority was one of 13 pilot sites to trial individual budgets in 2006 and 2007 to prepare for a national rollout. IB project lead Jane Goldingham says, although there was trepidation about what was involved, it was an exciting time “because this was something that could offer real opportunity for customers”.

Goldingham and project manager Ruth Corden took up their posts in January 2006 and a governance structure was set up. Goldingham says: “One of our hardest tasks was scoping the project due to the level of transformation required and support from the Care Services Improvement Partnership (CSIP) was essential – they organised network meetings, gave us headline targets and signed off our initial project plan we worked with them to develop tools and materials.”

They decided to work with three operational teams. “It was essential to choose teams that were stable and enthusiastic about change,” says Goldingham.

They met to discuss the scoping of the pilot with these teams and other main stakeholders – voluntary and independent sector providers. As their plans became clearer, the team expanded and two full-time development workers (one focusing on operational issues, the other on policy), a part-time worker (whose role included generating user involvement), as well as part-time support and finance staff were recruited.

Selection

With more staff it was possible to start briefing the three teams who began to identify individuals they thought would be interested in piloting IB. Goldingham says: “The people selected initially were those who were interested in taking more control over the support they received or those who weren’t entirely happy with the services they were receiving so might be interested in a new approach.”

Simultaneously the IB team had to do a lot of work trying to scope each of the funding streams. Goldingham says: “We found streamlining self-assessment wasn’t easy because of the complexities involved within the different streams. We had already made progress with aligning Supporting People and direct payments funding and were keen to start with them we had lots of discussion about integrating grants for community equipment services and disabled facilities with OT colleagues. Again CSIP support was crucial – they helped us work through a lot of problems.”

The IB team, together with practitioners, started by testing the In Control programme with older people and found it needed to be adapted its development is continuing.

There are many elements that contributed to the pilot’s success. It was necessary to have a lot of regular small team meetings to discuss issues, challenge terminology and thinking. Supporting staff was key, and development workers ran briefing sessions covering issues that arose as the project moved forward. It was also critical to get the views of users, staff, carers and stakeholders along the way. Indeed, increasing customer choice and control can be difficult for some staff. West Sussex’s executive director of adults’ and children’s services, John Dixon says: “The enormous cultural shift required to reform social care into an enabling system away from one of paternalism cannot be underestimated and is something that we have given a high priority.”

Empowering

And what about user satisfaction? West Sussex ended up with about 100 people using IB, including Stephen Page, a wheelchair user with multiple schlerosis, who found the effects of switching to IB immediate. “I had help from the Independent Living Association in Worthing. Straightaway I was involved in the process of recruiting a PA, I could be as involved as I wanted to be, which I found enormously empowering.”

Overall he’s delighted with the flexibility of IB. “It’s been amazing because I have lots of things I’m still interested in and IB means I can still do those things. I have been able to continue writing my poetry, run poetry workshops, pay for someone to take me out to the theatre or the opera I wouldn’t be able to do those things without IB support.”

While the final DH report has yet to be published, the government is clear that expanding choice and control is the direction of travel, a sentiment Dixon shares. “The pilot has been a great success and has demonstrated a real potential to transform the lives of disabled people. Hearing people speak of ‘having the world opened up to them’ through having a personal budget brings home the positive change that self-directed support is having it.”

The findings from the two-year pilot is expected to be released by the Department of Health later in the year.

What works

● Identifying customers and carers willing to share their stories. This is a powerful way to deliver and get the message across to the public, staff and providers.

● Team managers and champions in each team who recognise the potential of personal budgets and are empowered to find solutions.

● Bringing the “market” along with you on the journey.

● Willingness to reflect, learn and change, and sharing experiences with other local authorities.

 More on individual budgets

This article is published in the 26 June issue of Community Care magazine under the headline ‘The world opened up’