Is support planning working?
Care and support planning is part of the self-directed support process, but is not always done well.
At TLAP, we want to understand better the current state of practice and look at creative and diverse ways of looking at personal budgets, to see where people are having a better experience of support planning.
We’ve recently visited places where support planning isn’t all being carried out in the statutory sector, but by other people and organisations. Is this improving people’s experiences?
Why might the system be stuck?
It feels as if the system isn’t working as it should.
- Direct Payment uptake as one indication has been static - at around 28% of all community-based support provided for the last three years.
- There seems little appetite to support the wide range of choices and high degree of control envisioned in the Care Act. It may be that social workers don’t feel they have the scope, flexibility or management backing for undertaking the type of care and support planning that helps people to make the most of the resources available.
- Another indicator is the kind of support being put in place; it is largely home care, residential respite to help carers get a break, and supported living; services that some might call a ‘traditional offer’. In fact expenditure rose marginally on these types of support between 2016-17 and 2017-18.
Despite this, there has been a high degree of excitement and enthusiasm across the country about asset or strengths-based social work practice, and rightly so. That may be fabulous around assessments, but what’s happening when developing care and support plans?
If strengths-based practice is being lovingly rolled out, we would see a proliferation of new types of support flourishing everywhere. This would mean an explosion in the uptake of Direct Payments or a scramble to get an Individual Service Fund option in place. And that isn’t really happening.
Glimmers of hope
At TLAP, we are taking a closer look to understand the current state of practice in the care and support planning part of the self-directed support process. We think there are glimmers of hope out there, where small scale, but solid evidence tells us best practice might be found. For a number of reasons, they may not necessarily be within statutory assessment services – there is scope within the Care Act to ask others to undertake care and support planning.
As the TLAP Policy Advisor for self-directed support, I went on a ‘road trip’ with members of the National Co-production Advisory Group -NCAG for short. We spoke to people and organisations involved in care and support planning.
We visited five places –Wiltshire, Bournemouth, Cornwall, West Sussex and Huddersfield - and now want to share our findings with you. Over the next few months we will be publishing these case studies to shine a light on the places, locations and organisations we’ve explored.
One key aspect we are interested in is the degree of detail that the statutory care and support plan contains. We’ve found a repeated sticking point has been the high degree of precision that long term plans lock people into - in terms of price, timings and tasks. Of course this can be for years as some people don’t have an annual review of their care and support plans. Since things change for people, plans should be updated on a regular basis.
Maybe we haven’t got things quite right, and need to rebalance. At TLAP we’ve updated Making it Real, our resource that defines from the perspective of people accessing services and the organisations that support them what good care and support looks like.
There are some specific I and We statements about care and support planning:
- “I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.”
- “We have conversations with people to discover what they want from life and the care, support and housing that will enable this, without restricting solutions to formal services and conventional treatments.”
- “We tell people about person-centred approaches to planning and managing their support and make sure that they have the information, advice and support to think through what will work best for them”
Our series of case studies, called ‘stories of success’ will highlight the places where these statements are being brought to life.
We’d like to hear from you about whether you agree with our analysis, and whether you too are Making it Real with respect to care and support planning. Maybe you’d like us to shine a light on your practice if you think others should hear about it? If so, we’d like to hear from you.