Self Directed Support
North Lanarkshire Council · 15 November 2022
Back to Adult Care and Social Work Committee — 15 November 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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PO51.1 Self-Directed Support North Lanarkshire Council Report Does this report require to be approved? ☐ Yes ☒ No Ref DF/KM Date 15/11/22 From Diane Fraser, Head of Adult Social Work Services E-mail murdochk@northlan.gov.uk. Telephone Executive Summary This report sets out our approach to Self -Directed Support (SDS) locally and provides an update to committee on our SDS Transformational agenda. Promoting choice through Self-Directed Support (SDS) continues to be the national and local approach to ensuring that people who require support can exercise maximum choice and control around how they are supported. Locally, our approach to SDS starts with the person and their personal resources, wider family and friends, community resources and community solutions, as well as targeted supports or services. This approach reflects that SDS is everything that is available that helps someone live their life. Our approach means that people can choose and arrange some or all of their own support instead of having it chosen and arranged by other people. For many people who come into contact with our services locally, information, advice and signposting may be all that is required. For others with more significant ongoing complex need, an individual budget may be required. Our Social Work Information System currently reflects approximately 14,000 people open to Social Work with 1,600 people currently in receipt of an individual budget. It has been almost ten years since the passing of the Social Care (Self-Directed Support) (Scotland) Act 2013. The Independent Review of Adult Social Care was published in 2021, and with the ongoing developments with a National Care Service there is likely to be ongoing substantial changes to Scotland’s Social Care landscape. North Lanarkshire’s strategic direction will continue to be informed by developments at National level including the revised SDS Strategy. The improvements to implementing SDS is a local priority which will influence the way in which people will receive care and support. Our transformational SDS agenda is being developed to reflect the current landscape and to allow us to evolve as we move forward. Economic conditions mean that public sector budgets will always feel constrained while the need for services is likely to continue to grow. Therefore, it is important that we look to anticipate and, where possible, prevent need before it arises. Adult Care and Social Work Committee
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Our transformational SDS agenda incorporates our approach to support for unpaid carers and this update will be provided via a separate report. Recommendations It is recommended that the Adult Care and Social Work Committee: i. Note the content of the Report ii. That an update is provided as the Transformational SDS Strategy is developed and implemented. The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities (13) Improve preventative approaches including self-management Ambition statement and giving people information and choice over supports and services 1. Background 1.1 The Social Care (Self-Directed Support) (Scotland) Act 2013 was implemented on 1 April 2014. The Act aims to ensure that care and support is delivered in a way that promotes people’s choice and control over the support they receive whilst respecting the person’s right to participate in society. 1.2 The Strategic Commissioning Plan identifies three key priorities: • People should be in control of the care they receive, and it should meet their needs • People are supported to maintain their independence and manage their care needs • People are supported and helped to avoid preventable conditions. 1.3 The Independent Review of Adult Social Care was published in 2021, and with the ongoing developments with a National Care Service there is likely to be ongoing substantial changes to Scotland’s Social Care landscape. At a national level the SDS Strategy is being refreshed. 1.4 We are committed to retaining and strengthening our approach to Self-Directed Support and further embedding this ethos within our practice and our systems. With the level of change required given the scale of transformation envisaged we will require continued strong leadership and commitment from all staff to develop and embrace a whole system change.
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2. Report 2.1 We are developing a transformational agenda within our SDS strategy which will review and reflect on our current approach to SDS and ensure that we have a clear approach directing the way forward. The local strategy is at an early stage of development, and we are seeking membership from a variety of stakeholders. Our strategy will be co-produced and reflect the unique contribution and perspective of our members. 2.2 The local strategy board will facilitate ongoing discussions with service providers, those in receipt of support, carers/families and other stakeholders regarding the future shape of our local social care and support framework which ensures that we remain responsive to the changing needs and aspirations of North Lanarkshire’s residents. 2.3 Our transformational SDS agenda has an emphasis on building greater community capacity to support earlier preventative approaches and proactive planning. We have a number of initial workstreams identified that will link directly into the new strategic board and inform future workstreams that will be developed. Workstreams 2.4 Our approach will involve development and training across Health and Social Care, support organisations, community organisations through the Third Sector Interface and local communities. Our current SDS training and associated materials including our guided self-assessment (resource allocation tool for individual budgets) will be reviewed involving the above stakeholders and the revised training will be co- produced and delivered widely. 2.5 We have commenced staff engagement sessions to ensure that we are fully reflecting the current views, feelings, and concerns of the teams who will be delivering on much of this strategy. The feedback from the sessions will inform future development and training going forward which will be tailored to the needs of the team at this time. To deliver on the strategy Social Workers have to be empowered to practice in creative and innovative ways which allow people to have greater choice and control in their own lives. 2.6 In line with the ambition statements guiding the Partnership an early intervention and prevention approach will have a focus on increasing the awareness of and use of technology enable care. We will be working alongside our own technology leads as well as provider organisations who currently offer bespoke technology enabled care solutions and responder services. 2.7 To ensure that people have access the right information at the right time from our website, public information, and marketing materials we will be undertaking a review of this and updating the information available. 2.8 Our provider framework has grown over the past 2 years meaning that people should be able to choose from a larger number of support organisations who have contractual arrangements with Health and Social Care NL.
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2.9 To support the sustainability and continuing growth of providers we will continue to work closely with them whilst developing a more consistent approach to working together, promoting development opportunities, increasing capacity, and supporting investment. In turn this will empower people to have increased choice, control, and flexibility over the supports and services they access. 2.10 The workstreams outlined as well as future developments will inform the strategy. This will be reported on in future updates. 3. Measures of success 3.1 Evidence of new SDS training and materials being delivered across Health and Social Care, support organisations, community organisations through the Third Sector Interface and local communities. 3.2 Increase in the engagement in training and the feedback from this in terms of the impact. 3.3 Evidence of a consistent and understood approach to SDS which will ultimately improve the quality of information, advice, guidance, and support provided to those engaging at any entry point. 3.4 Evidence of increased confidence in social work practice via more creative and innovative support. 3.5 Evidence of reduced number of people planning support in a crisis with more preventative intervention being reflected. 3.6 Increased use of technology enabled care and bespoke technology solutions. 4. Supporting documentation 4.1 Appendix 1 – Terms of Reference SDS Transformation 4.2 Appendix 2 – What is Self-Directed Support Diane Fraser Head of Service Adult Social Work
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? An equalities impact assessment will be undertaken as the transformational plan progresses. As the implementation and delivery of SDS will be to a range of groups it is important to do determine whether any of these groups will be impacted. If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☒ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? There is no budget detail contained within this report, However, the SDS budget is regularly monitored and reviewed through a series of meetings with the budget holder and finance . This needs to be monitored closely due to the increased in demand in social care support and the transition from time and task to outcome focussed. However, there are a range of controls in place to ensure robust management related to the allocated costs of support packages. 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts have been discussed and agreed with People and Organisational Development? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic Solutions? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? The approach set out in this report is in line with the principals set out in The Social Care (Self-Directed Support) (Scotland) Act 2013. 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data?
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Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Where the impact identifies a requirement for technology, has an assessment been carried out (or scheduled) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? The programme board and implementation group oversee all aspects of this transformational plan including developing a communication plan. There is a need for communication with key stakeholders in the delivery of Self Directed Support. 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? There is a risk that demand for service become greater than the allocated budget. A robust process has been implemented to ensure effective budget management is in place.
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Appendix 1 Terms of Reference – SDS Transformation Note: This Terms of Reference will be kept under regular review. As the workstream progresses this document will continue to be updated on roles, responsibilities, and assurance processes. Purpose The group’s purpose is to ensure the delivery of Self-Directed Support in line with Scottish Government policy. We will do this locally in line with the 5 key priorities which are: 1. Improve economic opportunities and outcomes. 2. Support all children and young people to realise their full potential. 3. Improve the health and wellbeing of our communities. 4. Enhance participation, capacity and empowerment across our communities. 5. Improve North Lanarkshire’s resource base. The group’s remit is to deliver a clear position statement and strategy on Self Directed Support. The group will have a particular focus in identifying, assessing and managing risk. This includes four weekly meetings, that may branch off to small, working groups to support the progress of this agenda. Aims Work stream aims are to: • Explore ways to ensure supported people, carers/family and staff all contribute to ensure effective, safe and outcome focused approaches • Understanding levels of accountability • Managing expectations and dispelling myths. • Identify what resources are available to enable people to live as independently as possible. • Raise awareness and increase the use of Technology which promotes independence and minimise risk. • Develop a culture of self-evaluation; reflection; shared learning; build on best practice • Ensuring practice remains in line with national guidance and local policy. • Source tools that support practice improvement and achieving outcomes • Explore opportunities to measure impact and celebrate success The group will support the development of self-directed support across North Lanarkshire. There will be eight working groups: Working Group Lead 1. Reviewing the guided self-assessment Claire Leslie 2. Carers Morris Howat 3. Public Information and Marketing Lisa Barbour/ Claire Leslie/Kerry Murdoch 4. Performance Information Lisa Barbour/Laura Astrauskas/Kerry Murdoch 5. Training Helen Marie Bolton/ Claire Leslie 6. Commissioned Services Ray McDonald 7. Universal Services Morris Howat/ Linda Rice
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8. Complex Care Linda Rice 9. Technology Lisa Barbour/Laura Astrauskas/Kerry Murdoch The standard agenda items on each working group will be: • Risk • Public Protection • Engagement and Participation The facilitator will maintain links with the other work streams across North Lanarkshire and provide feedback to the group as appropriate. Accountability and Reporting Arrangements The group facilitator will be Andrea Breen, Manager, Adult Services and a group member will be cover if required. The group will report progress through the SDS Transformational Programme Board. The members of the group are responsible and expected to: participate in session discussions; review documents shared; carry out assigned tasks between sessions; adopt a solution focused approach; become an agent and champion of change; seek feedback from wider groups; capture examples of good practice, share learning & feedback and support the implementation of solutions required to enhance Self Directed support. The group will provide an update report on progress and any matters that require escalation through the Adult Support and Governance Group. Suggested Membership The Manager, Adult Services will chair the group. Andrea Breen Senior Manager Adult Services Maria Williamson Senior Manager Quality Assurance Lisa Barbour Service Manager Adult Services Morris Howat Service Manager Adult Services Linda Rice Service Manager Adult Services Helen Marie Bolton Service Manager Adult Services Claire Leslie Senior Officer Adult Services Ray McDonald Senior Officer Quality Assurance Kerry Murdoch Resource Worker Adult Services Laura Astrauskas Resource Worker Adult Services
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What is Self-Directed Support? Appendix 2
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Self-Directed Support Contents List 1. Introduction 2. Assessment, Planning and Review 3. Universal Services 4. Making Life Easier 5. Technology 5.1 Community Alarms Redesign 5.2 Equipment and Adaptation Service 6. What are Community Solutions? 7. Self Help 8. What are Locality Support Services? 9. Non-Traditional Respite 10. Disability Information Officer 11. Integrated Day Service 12. Carers Engagement and Participation 13. Carers Guided Self Assessment 14. Four Options 15. Transition Planning 16. Advocacy 17. Public Information
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1. Introduction The Social Care (Self-Directed Support) (Scotland) Act 2013 was implemented on 1 April 2014. The Act aims to ensure that care and support is delivered in a way that promotes people’s choice and control over the support they receive whilst respecting the person’s right to participate in society. 2. Assessment, Planning and Review Assessment: Your assessment is a conversation about your needs and how these impact on your wellbeing, independence, and daily living. Your assessment is led by you, and it is important that it captures information that is important to you and that reflects you as a person individually as well as part of a family or community. If you have a carer, family member, or loved one who you would like to be involved in contributing to your assessment their views can also be recorded. Your assessment will reflect things you want to achieve- these are referred to as outcomes. The worker undertaking your assessment will engage with you over a period of time to gather this information and this will be recorded, and a copy of the assessment provided to you. To request an assessment, please complete the online contact form or contact your local social work office. Planning: Following your assessment a plan will be complete which will identify what advice, signposting, and/or support is required for you to achieve the outcomes identified in your assessment. Planning is essentially supporting you to think about the things that are important in your life, the things you want to achieve (your outcomes) and the support required for you to achieve your outcomes. Planning will also consider the resources you have available to you including your own strengths and assets, your natural networks like friends, family, neighbours, and community. Review: Reviews are carried out annually however can be convened at any point if there is a change in circumstances or it is felt that there would be benefit in reviewing support prior to the annual review. The purpose of a review is to discuss the progress being made towards your induvial outcomes as identified in your plan. The review will consider if the support plan is enabling you to make the progress towards your outcomes and if not the reasons for this will be explored and changes can be made to your support plan. Reviews are also about acknowledging and celebrating the outcomes you have achieved over the year and reflecting the impact of this success in your support going forward. Within North Lanarkshire there are 3 commissioned Carer Support Organisations: • NL Carers Together (Information, advice, signposting service and carer advocacy) • Lanarkshire Carers (Carer Support, Short breaks service and a range of other carer support options) • Action For Children Young Carers Support Project Lanarkshire Carers provide: A carer training programme Short breaks Bureau
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Adult Carer Support Plans BAME Career Support Legal Clinics Lanarkshire Carers Call Virtual Drop in Service Carer Well -Being support Carer Activities and events Carer Card and Carers Space Support to young adult Carers We also fund or support a range of condition specific, age specific, or issue specific carer support organisations, as well as organisations who can support carers as part of their wider remit. As examples, we fund PAMIS, Hope for Autism, Huntington’s Association, Parkinson’s Self-Help Group and many others. We regularly consider further options aimed at enhancing preventative and \ or anticipatory approaches. The NL Disability Forum and Equal Say Advocacy received funding from Scottish Govt through Support in the Right Direction (SIRD Funding) and offer an advice and signposting service (NLDF) and advocacy around SDS (Equal Say) respectively. We have used some of our SDS Transformational Funding, provided by the Scottish Government, to fund two further projects. Bazooka Arts were awarded £10, 000 and on the strength of that, were able to secure significant additional external and further internal funding to deliver a participatory arts project- aimed at promoting health and well-being, including carer health and well -being. We also awarded SOL £20,000 and following that, w SOL secured a further £159,000 of BIG Lottery Funding – for a project aimed at using technology to tackle isolation and loneliness. Whilst the SOL project was initially geared towards supported people, a number of carers have given feedback about how much the project has helped them. SDS Transformational Funding was also used to fund two internal posts, aimed at maximising the impacts of preventative approaches, enhancing our approach to SDS and having a focus on assistive technology, health, well-being and recovery and support to unpaid Carers. All of the above is aimed at anticipatory and \ or preventative approaches to support and maintain unpaid carers. However, where an Adult Carer Support Plan (ACSP) identifies unmet caring related carer need, that cannot be met through the range of supports described above, a Carer GSA can be agreed. In line with the Partnership Statement agreed between Lanarkshire Carers and both South and North Lanarkshire Councils: In situations where there is likely low or moderate carer need – Lanarkshire Carers can progress\ facilitate the ACSP. Likely substantial or critical carer need, and \ or where the cared for person is known to SW, then SW can progress\ facilitate the ACSP.
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Should the ACSP identify carer related caring needs that can’t be met through the range of options above, then it’s probable that a Carer Guided Self-Assessment would be agreed. In line with prioritisation, our resource allocation is as follows: Low level needs -unlikely that a budget would be agreed and more likely that ongoing casework, advice, signposting, information and so on would help meet needs. But, if it made sense to agree a carer budget – to stabilise a situation, or as a one off to help prevent the need for greater resourcing being required at a later date, a carer budget could be agreed, at SW discretion. Moderate Level needs – as above. Again at SW discretion, and likely that carer support as described above, rather than a budget would help meet needs. Substantial - caring related priority carer need. Critical - caring related priority carer need. 3. Universal Services Universal Services are those things that are generally available within in the community to everyone. Universal Services are things like libraries, gyms, leisure centres, health centres, information services, volunteer centres, citizens advice centres and so on. All of these can all play a role in supporting health, well-being, citizenship and social inclusion – through meeting personal outcomes and \ or providing opportunities, information, advice or signposting to other forms of support. Information and knowledge are an important part of ensuring that people can exercise choice and control around the issues affecting them. So, part of Self-Directed Support (SDS) is about making sure that people can access the right information. It is important that up to date public information is widely available - so that people can find solutions for themselves. Information can be about how to keep healthy and well, or about opportunities, or social connections. It could also be about sources of help - for things like how to deal with financial difficulties, welfare benefits or how to access social and recreational resources. All of these are needed for a community to support its citizens. Having a wide source of solutions which people can choose to make use of, enhances their personal responsibilities as citizens and is at the heart of self - directed support. 4. Making Life Easier What is Making Life easier? Making Life Easier is an online resource offering information, professional advice and direct access to services and support. Who can use it? Anyone who lives in North Lanarkshire can use the service for themselves or for someone they care about. For more Information If you need further information, support to access the website or you wish to make a general enquiry about our services, please email makinglifeeasier@northlan.gov.uk
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Visit the website https://www.makinglifeeasier.org.uk/ 5. Technology Technology Enabled Care (TEC) is the umbrella term that is used to describe how technology can be used to support your health and wellbeing and enable you to live safely and independently at home. Technology enabled care has continued to develop and advance over recent years with new bespoke technology solutions widely accessible. The range of technology available is extensive and varies from alarms, monitors, and sensors, to the use of digital assistants such as Alexa, or an App on a mobile device. Many of the technology options can be easily integrated into your home environment. How can technology help you? For some people using technology replaces the need for support from an individual whilst still increasing independence and reducing risk. Technology can be used in a variety of ways including: • It can alert others if you need support, for example, if you have a fall or feel unwell • allow you to control your home environment, for example to close your blinds, turn your tv on/off, or control your heating/lighting • Prompt or remind you with tasks such as taking your prescribed medication • keep you connected to friends, family, and your community How can we help you access technology to support you at home? We may recommend and provide some assistive technology following a community care assessment . To request an assessment, please complete the online contact form or contact your local social work office. The technology flat In North Lanarkshire we have an innovative project within Allershaw Tower, Gowkthrapple, Wishaw to showcase how technology can promote safety, wellbeing and independence within the home. A team of staff are available by appointment to demonstrate how technology can be used within your home environment and to allow you to see how this could be used in your home or the home of someone you know. For a YouTube demonstration video of the flat please go to: Assistive Technology Flat Demonstration North Lanarkshire - Making Life Easier For more information or to arrange a visit to the flat please contact: assistivetechnology@northlan.gov.uk
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5.1 Equipment & Adaptation Service The service provides equipment and adaptations for people living in North Lanarkshire, as well as NHS Lanarkshire equipment to South Lanarkshire residents. The range of equipment and adaptations we provide includes items such as assistive technology, sensory impairment items, commodes, standard walking items, stairlifts, external rails and banisters, ramps and bathroom adaptations. When you no longer need your equipment or your equipment needs repaired Contact the Equipment and Adaptation Service for more information on collection, uplift and repair of equipment. 5.2 Community Alarm Service Redesign North Lanarkshire currently offers a telecare/community alarm service which operates 24/7 365 days per year and provides a response to the most vulnerable within the community. The two aspects of this service are initial telephone response through our alarm receiving centre and if required by one of our responders visiting a person’s home to provide assistance. The telecoms infrastructure used to deliver telecare services in Scotland is changing from analogue to digital. This opens up a range of new possibilities and opportunities for service delivery and gives us an immediate opportunity for the community alarm service to be reviewed. We want to ensure that we continue to deliver a well-rounded service that can be an asset to the organisation and most importantly to the people in our communities. We need to identify if the community alarm service needs to be modernised and we need to know that the call handling, management of alerts and the delivery of response services are all adapted and attuned to the new digital environment. From early September 2022 we will be asking staff from all areas of the organisation to be involved in this exciting opportunity to give input to focus groups. If you would like to be involved or would like to nominate staff please let us know assistivetechnology@northlan.gov.uk. We aim for this work to be completed by Spring 2023 and a business case with findings submitted to the senior leadership team for consideration. 6. What are Community Solutions? Community Solutions is a community led, health and social care programme operating across North Lanarkshire. It is focused on building communities where people can have full, independent lives. The programme has been in place since 2013 and is a partnership between:- • Health and Social Care North Lanarkshire (HSCNL), • Voluntary Action North Lanarkshire (VANL), the local third sector interface; and • the vibrant community and voluntary sector of North Lanarkshire.
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What is the aim of Community Solutions? Community Solutions aims to improve people’s quality of life and wellbeing by taking action which: • strengthens social connection and support, helping to reduce isolation and loneliness; • promotes equality and human rights and reduces inequalities. through services and activities developed in partnership and delivered by the community and voluntary sector. How does Community Solutions work? Community Solutions is an effective and active example of co-production: a true partnership between people, communities and services. There are two approaches: • The Locality Approach: where local communities and organisations work together to create development plans and direct funding based on local need; • The Thematic Approach: larger, North Lanarkshire-wide projects focusing on specific and identified needs, such as community transport; physical activity, hospital discharge support 7. Self Help For some people information or advice may be sufficient, others will need signposting to support options and others might require some reablement or enablement intervention, before the level of support they need can be determined. In all instances, the expectation is that people try to fully explore the range of information, advice and signposting options that are readily available through Universal Services, before considering whether there is any need for a greater level of support through statutory support services. 8. What are Locality Support Services The locality support services are part of the community care teams and of North Lanarkshire Council’s SDS portfolio. We offer personalised, self-directed support to adults who have a disability or long-term health condition in their local community. What is the aim of Locality Support Services. • To deliver flexible support that is personalised and self-directed to adults who live in North Lanarkshire who have a disability or long erm health condition • To Support people to have better, safer, independent lives through assessment and planning, and review. We support people to be more independent, access health services, education, employment, technology, be active in their communities and work towards outcomes identified by people themselves. • To deliver regular, planned respite, during the day to unpaid carers; endeavouring to ensure that we meet their needs while providing person centred care and support.
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How does Locality support services work? • People who use our service experience high quality professional support and care which is flexible throughout the week, including evenings and weekends. • Our staff are appropriately qualified and experienced with opportunities for career development and progression. • North Lanarkshire’s six locality support services are each registered with the care Inspectorate; each participate in quality assurance reporting that ensures we meet the standards and requirements set by Scottish government, and that we continually look at ways of improving the service experience for our service users and their families. • We are part of HSCP in Lanarkshire and our work is informed by the identified national and local health and social care outcomes • We are involved in local planning groups/consortiums which agree where investment in community is required. 9. Non-Traditional Respite The new NTR framework came into being on 1 December 2021. This resulted in clear contractual arrangements around the provision of respite in the community. Under this framework, respite consists of a ‘short sharp’ period of support for people who continue to live in their own homes, arranged around each person and their carer’s individual needs and outcomes. Flexible support for a period of up to 12 weeks can be arranged quickly and directly by operational teams. The aim here is that the provision of short periods of respite will assist in reducing the impact of crisis or unexpected situations involving carers and will also support assessment processes. In-House Services Home support How we support people to live independently and safely in their own homes One of the ways in which we help people to live independently is through our support at home service. The services provided depend on the individual needs of the person requiring support and take account of all other resources available. These are services that are provided in your home. If you are referred for a home support service you will have an assessment to determine what you need support with. The best way that we can assess you is to work closely with you in your home to explore what you can do for yourself. We will involve your family and other natural supports to help us to assess what you need help with to increase your independence. We use a reablement approach which means that a small team of support workers will support and encourage you to re- learn or re-gain skills and confidence through the provision of a wide range of personal and practical support. The period of time this team will work with you can range from 4 – 6 weeks. At the end of this period of support we will undertake a review to determine whether or not longer-term support is required.
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Free personal care Since 1 July 2002, people aged 65 and over have been entitled to free personal care. Nursing care is provided free to nursing home residents of all ages. On 1 April 2019, the Scottish Government introduced 'Frank's Law'. This means adults under the age of 65 may also claim free personal care if they are assessed as needing support. Frank’s Law is so named after the campaign led by footballer Frank Kopel’s widow Amanda. Personal care covers things like bathing and hair washing, assistance with eating or with medication, and help with getting up and going to bed. Support at home - a guide to our services Services that are provided in your home Social work services in North Lanarkshire have three key objectives to improve care and support for all service users. These are- - that more people are supported at home rather than within institutional care - that people receive faster access to services - that people receive better quality of services and have a positive experience. What services are available? • Home support- this service may be available to you if you are assessed as having specific longer-term needs. This support may be delivered by NLC home support service or by an Independent Home Support Provider who are commissioned to deliver services on behalf of Social Work Service. • Reablement service- this service will support you to re-learn or gain new skills and confidence to support yourself. This service will also work with other professionals to assess if you require support longer term. • Intensive support service- this is a service which can provide support to people who are at the end of their life and wish to remain at home. This service can also support you or your carer if you experience crisis and just need some short-term support within your own home. • Integrated rehab team- This is a team of professionals, for example an occupational therapist or physiotherapist, who will visit you at home and provide advice, support or order aids or equipment that will enable you to be independent and be safe within your home. They work closely with Home support providers to ensure that any service you receive is personalised and meets your needs. 10. Disability Information Officers We have two disability information officers who provide a comprehensive information, advice, and support service for disabled people, carers, all staff and the local community. Officers can provide support to owner/occupier applicants who are assessed for grants and eligible under ‘Additional Assistance’ criteria. Eligibility criteria: when the service user, their family or carers are unable to obtain estimates or complete the application themselves.
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How is the service accessed? Requests either come from health and social care staff following an assessment or from members of the public who have completed a guided self-assessment for equipment through Making Life Easier website. To request an assessment from Health & Social Care Contact your local Social Work Office 11. Integrated Day Services Integrated day services involve staff from health and social care working together to provide care and support for older people. The service may provide support through our outreach respite at home service or at an integrated day service centre. The service aims to enable people to remain independent in their communities for as long as they are able to do so. We recognise that older people often have complex and overlapping needs that require support, care and treatment from a range of professionals at the same time. We actively encourage carers to be involved in developing and providing support for the person on an individualised basis. There are six integrated day service centres available with support and meal provision at each of them. There is currently a charge, but this will be discussed with you at the assessment stage. How is the service accessed? Access is through a formal assessment of your support needs, carried out by a social work or health professional. For more information Contact your local Social Work Office 12. Carer Engagement and Participation There are a range of ways in which carer interests are represented locally. These include the funded carer agenda and campaigning function from North Lanarkshire Carers Together, as well as direct support through Lanarkshire Carers. There is a Carer Support Network which seeks to meet and address collective, and individual carer related needs locally, offers a shared interest forum and has an overall remit of supporting carer needs. A Carer Strategy Implementation Group also previously met within North Lanarkshire. However, the impact of COVID, the need for a local strategy refresh and imminent legislative changes around supporting carers means that this group will need to be re-established, perhaps with a different role and remit and work is currently underway to progress this. A Carer Forum also meets regularly and is an integral element of engagement and participation processes.
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13. Carer Guided Self-Assessment The Carer GSA (Guided Self -Assessment) was introduced in 2018, to offer individual Carer budgets subject to certain priority need and eligibility criteria being met, following the completion of an Adult Carer Support Plan (ACSP) The headings for the Carer GSA were agreed nationally, with discretion on eligibility criteria and budget amounts left to local negotiation and discretion. After consultation with stakeholders, national eligibility criteria were adopted, and the 12 set budget amounts noted above were agreed: Carer Budgets can be used flexibly to meet agreed outcomes, so long as they are used legally, meet agreed outcomes, do not constitute gambling nor bring NLC into disrepute. Any support put in place to meet assessed carer need flowing the completion of an ACSP cannot be charged for – charges must be waived. Any adult Carer Can request an ACSP and Social Work staff have a responsibility to offer an ACSP when assessing a cared for person. Young Carers can request a Young Carer Statement Current Position There are approximately 50 carer budgets in place at present, agreed through a Carer GSA and reviewed annually. Whilst this number of budgets may appear “low” relative to the number of unpaid carers locally (conservatively estimated at around 40,000), the figure can also be viewed as a testament to the range and variety of supports available to unpaid carers locally – through universal services, community solutions, targeted services or supports, carer specific commissioned organisations, and \ or support to the cared for person that also meets the carer’s needs. Planned eventual end point and timescale With an estimated unpaid Carer population of around at least 40,000 carers locally, it is imperative that we support unpaid carers to support the cared for person for as long as is reasonable and appropriate. It is reasonable to anticipate that the number of Carer budgets will increase over time. Ideally the majority, if not all, unpaid carers could complete at least the part of the ACSP relating to Future Planning, as that facilitates detail of the cared for person’s needs, interests and so on, should anything happen to the unpaid Carer. We need to undertake work to progress this, along with mapping \ profiling demography, to better inform future planning and potential financial demand around unpaid Carers. The challenge will be around how we balance supporting a large number of carers a little bit, including preventative approaches as well as support those carers most in need more, whilst seeking to ensure that preventative approaches positively impact on reducing need. 14. Four Options Under the Social Care (Self-directed Support) (Scotland) Act 2013 there is a duty to offer four options to the supported person upon how they use their individual budgets. Offering the options in this way aims to promote choice, personal control, and flexibility. These principles apply across children, adults and carers who are eligible for individual funding.
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The four options are: Option 1: A direct payment, this is when the local authority /health and social care partnership (HSCP) gives money to the person for them to arrange their support plan and arrange payment for these themselves. For a child under 16 this will be paid to parents or a carer with parental responsibility. For all adults this will be paid to the person themselves or an attorney or guardian. Direct Payments offer the person the greatest amount of control over their funding. Option 2: This is when the person has full involvement within their support plan and how their funding is arranged without having to take a direct payment. This option enables the person to design and choose support options while having the local authority/ HSCP arrange payment for this for them. Option 2 offers the person a great deal of choice and control over their social work support and funding. Option 3: This is when the person is unable or doesn’t wish to be involved in the arrangement of their support. This option is when local authority/ HSCP develops the support plan and arranges payment for this on behalf of the person. In planning this option, the social work staff will consider any past wishes and knowledge of the person. Option 4: A mix of the first 3 options for different aspects of the person's support. The local authority/HSCP have a duty to discuss the nature and effect of the 4 options provided to the person planning with their funding. This means that social work staff should explain what each of the 4 options will mean for the person. This applies both in terms of the general impact of the options, that is the varying degrees of flexibility and control associated with each option, general guidance and advice on what it means to have your support arranged on your behalf or to direct your support. It also means the specific impact for the supported person, i.e. what the different options might mean for the person given their own circumstances, assets and circles of support. A collaborative approach to discussing the budget and options is essential. 15. Transition Planning Health and Social Care North Lanarkshire (HSCNL) have a dedicated team of social workers whose role it is to co-ordinate support with and for people who are leaving school and have additional support needs and who will need support to plan for leaving school and beyond. The transition planning team are based within the adult headquarters team and work across localities. Their role is to link with all the young people whose needs should be considered in this way aiming to ensure a as smooth a transition from secondary school as possible. Working closely with The Scottish Transitions Forum and ARC Scotland, in their principles into practice work across Scotland, HSCNL work to the ethos that ‘Transition is a critical and formative experience for young people and their parents and carers. It should be viewed as a process that unfolds over several years, and not a single ‘event’ such as leaving school’. Principles-into-Practice- 2021_full-document- (1).pdf. Working with partners in North Lanarkshire education and families and NHS Lanarkshire the aim of the Transition Planning team is to implement the seven principles of good transitions set out by the
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principles into practice work for each person with additional needs leaving school in North Lanarkshire: Principle 1: Planning and decision-making should be carried out in a person-centred way We ensure young people are at the centre of their transitions planning. We have a shared understanding and commitment to person-centred approaches across all services. We ensure young people have a single plan. Principle 2: Support should be co-ordinated across all services We have a co-ordinated approach to transitions in our local authority area. Our learning and development opportunities include an understanding of all aspects of transitions. We evaluate transitions in our area. Principle 3: Planning should start early and continue up to age 25 We begin planning from age 14 and it is proportionate to need. We have joint approaches to assessment between children and adult services Our transitions planning and support continues to age 25. Principle 4: All young people should get the support they need We have an understanding of the number of young people who require support and levels of unmet need. We provide support for those who do not meet eligibility criteria for funded social care support. Our planning and decision- making is done in partnership with young people and their carers. Principle 5: Young people, parents and carers must have access to the information they need We provide information that clearly states what young people are entitled to during transitions. We provide information that shows what support is available. We provide information that is inclusive of different communication needs. We provide information that uses common and agreed language. Principle 6: Families and carers need support We support family wellbeing needs. Advocacy is available at the start and throughout transitions. Principle 7: A continued focus on transitions in our area We have a plan in place to support continual improvement. We share our learning and learn from others. 16. Advocacy The role of an advocate in health and social care is to support a vulnerable or disadvantaged person and ensure that their rights are being upheld in a healthcare context. Health and social care advocacy means supporting people who are unable to ensure their best interests are being recognised. Advocacy Support enables individuals to have their views, wishes and opinions heard. In 2021 North Lanarkshire Council Health and Social Care Partnership, alongside colleagues from NHS Lanarkshire, tendered for the provision of advocacy services. The existing age banded, rather than condition specific commissioning model was retained, as it was found that this approach worked well, referral processes were clear, and increasing numbers of people accessed advocacy each year. The advocacy services available in North Lanarkshire are as follows:
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• Equals Advocacy Partnership for adults aged 65 and over • The North Lanarkshire Advocacy Project for adults aged 16-65 • Who Cares? Scotland for children and young people The importance of advocacy being available during the transition from child to adult and from adult to older adult services is key to our ambition that the right support at the right time and plasce is available and that when services are required, that these are accessible to all. Advocacy services are flexible to accommodate those within transitional phases of their lives. This delivery model is expected to promote continuity and to best meet the needs of people using advocacy services. In addition to the three core independent advocacy services, the undernoted are also offered: Shelter (Housing Advocacy Service) is a small but valued service, providing third party advice on complex housing issues to advocacy providers, and when necessary, one-to-one professional advocacy. The local worker also participates in and provides guidance to local housing and other relevant forums. North Lanarkshire Carers Together offers advocacy provision for carers. Advocacy is one of the many services that NLCT offer carers across North Lanarkshire. Other care group, condition specific or interest groups may also offer a degree of representation or advocacy in relation to people accessing or using their services. 17. Public Protection A fundamental objective of North Lanarkshire Health and Social Care Partnership is that the people who live in North Lanarkshire are safe. The Partnership along with other public agencies have statutory duties in respect of public protection. This includes the support and protection of both children and adults. This applies to the general population of North Lanarkshire regardless of whether or not someone receives support from or is known to Social Work. For more information on public protection please visit: Public protection | North Lanarkshire Council