General Questions on Self Directed Support

Q: What are a local authority's duties in respect of Self Directed Support?

The local authority's duties are:

• Duty to have regard to the general principles of collaboration, informed choice and involvement as part of the assessment and provision of support.
• Duty to take reasonable steps to facilitate the person's dignity and participation in the life of the community.
• Duty to offer the 4 Options to the supported person .
• Duty to explain the nature and effect of the four options.

Q: What other local authority duties complement their Self Directed Support duties?

These duties are:

• Duty to assess needs for a community care service
• Duty to safeguard, support and promote the wellbeing of children
• Duty to identify carers' needs and support carers
• Duty to promote social welfare
• Duty to make inquiries 

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Q: What happens if I have had an assessment carried out but I am not eligible for care and support services?

If you have received an assessment and you are not eligible for care and support services you will be signposted to agencies who will be able to support you to access community resources.  If, however, you feel that your needs have changed since your last assessment you can ask for a new assessment to be undertaken.

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Q: Are there restrictions on who can be offered the 4 Self Directed Support options?

There are times when the obligation to discuss and offer the 4 options does not immediately apply:

• When a person is presenting in crisis
• When it is premature to make an assessment about a person's longer-term need for support, for example when people are working to maximise their capability through re-ablement or intermediate care.
• When a person's chaotic lifestyle needs to be stabilised before their longer-term support needs are considered

As soon as it is decided that the individual will be provide with stable ongoing-support, the authority must offer the 4 choices.

In addition, there are circumstances where local authorities are not required to give the opportunity to choose a direct payment:

• When a local authority has previously terminated a direct payment
• When the granting of a direct payment is likely to put the safety of the supported person at risk
• When the 4 options are not discussed or agreed to, the practitioner will record this in assessments and support plans.
• When considered planning to meet future needs is required, for example, to facilitate a discharge from hospital

Q: Is my Direct Payment only to be used for employing Personal Assistants or contracting Self-Employed Workers?

Becoming an employer is only available to those who select option 1 but their direct payment can also be used to purchase other goods and services that might otherwise be available under options 2-4 for example, purchasing services from a registered care provider.

Q: What happens If I don't like how my chosen option is working for me and want to select a different option? 

If you are not wholly comfortable with your SDS option and what your care delivery arrangements involve then you should contact your social work practitioner to discuss the other options that are available to you.

Q: Can I employ a member of my family to support me?

In certain circumstances, it may be agreed that you can employ a family member to provide your care and support:

• There is a limited choice of service providers who could meet the needs of the individual.
• The individual has specific communication needs which mean it will be difficult for another person or provider to meet those needs.
• The family member will be available to provide support which is required at times when providers would not reasonably be available.

There are other factors which make it appropriate, in the opinion of the local authority, for that family member to provide support.

Careful consideration should be given to the possibility of employing a family member who lives in the same house as the individual as it can be difficult to separate those times when they are delivering paid care and other times when they are providing unpaid care and natural supports.

• The intimate nature of the care required makes it preferable to the individual that it is provided by a family member.
• The individual has religious or cultural beliefs which make the provision of care or support by a family member preferable.
• The individual requires palliative care.

The individual has an emergency or short-term necessity for care. 

Q: Can Brokerage Agencies be used as a source of Personal Assistants or Self-Employed Workers?

Different Brokerage Agencies (a broker) will have different business models, but a common feature will likely be the supply of staff, goods or other services that individuals want to employ, purchase or use. An arrangement or management fee for sourcing the staff, goods or other services will be charged and this fee will be in addition to the costs of utilising those actual resources.

Careful consideration must be given to a broker's operation in respect of undertaking regulated activity and being appropriately registered with the Care Inspectorate as a care service (Public Services Reform (Scotland) Act 2010).  If there is any uncertainty about this then the Care Inspectorate should be contacted for further advice and guidance in case, there are grounds for them to investigate whether the broker is operating outwith the required statutory registration.

West Lothian Council require that any selected agency who will be delivering personal care and support must be appropriately registered with the Care Inspectorate. To help clarify whether a broker should be categorised as an agency it may be helpful to take the following considerations into account:

• Do they have public liability insurance and does this cover the carers that they supply?
• Do they have an appropriate and up-to-date portfolio of policies and procedures relating to the delivery of care and support?
• Do they have their own support plan and risk assessment documentation with appropriate training and guidance for the carers on how to complete these?
• Do they provide ongoing direction or control to the carer in respect of the needs of the cared-for person?
• Do they accept responsibility for ensuring that the care that is delivered in their name meets the national health and care standards?
• Do they monitor and continuously improve the quality of the care and support that is provided?
• If the quality of care is not to the required standard, do they manage the desired practice improvement from the carer?
• Do they recruit, select, induct, train, support and supervise the carers?
• If the supplied carer is ill or absent from work for some reason, does the broker supply additional carers at no additional cost?

Answering 'yes' to most of these questions would enable the broker to be categorised as an 'agency' however it is likely that they will then have passed the regulated activity threshold and as such should have an appropriate Care Inspectorate registration. 

What can I spend by individual budget on?

There are lots of things you can spend your budget on to help you meet your personal outcomes. Some examples of what you may wish to use this budget for:

Support for a provider, local authority or a personal assistant.

• Different supports to help you live well such as help to do your shopping or to do cleaning around your home.
• Specialist supports to help you stay fit and healthy. This could be, for example, a personal trainer or a gym membership.
• Membership of a group or activity that helps you connect with people in your own local community.
• Things to help you in work or learning new skills.
• Technology or equipment that helps you meet your goals (and any maintenance of this).
• A holiday or a short break.
• You can choose to pool your resources with a friend to pay for a joint item (like a trip to an event for example)

The are many other possible uses for your budget, however you should know that this budget must be used to meet or support you to meet the outcomes in your support plan and all funds must be used for legally appropriate activities and support.