A Short Guideto Transforming Care

North East LincolnshireCare Trust Plus

Introduction...............................................................................................................3The Vision for the Future of Health & Social Care.....................................................4Some of the National Challenges Facing Society......................................................5Some of the Challenges Facing Society in North East Lincolnshire..........................6The Traditional Social Care System...........................................................................7The Care Trust Plus Transforming Care Programme ...............................................8The Care Trust Plus 4 Areas of Transformation........................................................9What Will Transforming Care Deliver for the People of North East Lincolnshire?...10More Choice & Control Through Self-Directed Support ..........................................11What is a Self-Assessment Questionnaire?.............................................................12What is a Support Plan?...........................................................................................12What are Personal Budgets?....................................................................................13What are Direct Payments?......................................................................................13Personal Health Budgets.........................................................................................13Who Can help?.........................................................................................................14Lives & Aspirations - Amelia’s Story........................................................................15Lives & Aspirations - Andrew’s Story.......................................................................16Lives & Aspirations -The Walking Project................................................................17Lives & Aspirations - The Kick Start Project............................................................18Carers Support Services..........................................................................................19How Will We Be Developing Personalised Support for Carers?..............................20Lives & Aspirations - Carers Stories........................................................................21How to be Involved in Transforming Care ..............................................................22For More Information...............................................................................................23

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The Care Trust Plus askedcommunity members, carers, staff,the Council and commissioninggroups what Transforming Carewould mean for them in 2011.

Follow the speech bubbles to readwhat they said…

Contents

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Care Trust Plus Transforming Carewww.nelctp.nhs.uk/transformingcare

George Hardwick Foundationwww.georgehardwickfoundation.org

Saying It Allhttp://sayingitall.nelctp.nhs.uk

In Controlwww.in-control.org.uk

Department of Healthwww.dh.gov.uk

Care, Support, Independencewww.careandsupport.direct.gov.uk

Contact theTransforming Care TeamFor more information about TransformingCare, to find out if you may be eligible forSelf-Directed Support, or to receive acopy of this guide in large print, easy read,Braille or Makaton, contact:

Transforming Care TeamNorth East Lincolnshire Care Trust Plus1 Prince Albert GardensGrimsbyNorth East LincolnshireDN31 1HTTelephone: 01472 625300E-mail: transformingcare@nelctp.nhs.uk

Acknowledgements & ReferencesPutting People First: A Shared Vision and Commitment to the Transformation of Adult SocialCare (December 2007), NHS Next Stage Review Final Report (June 2008), In Control, Officefor National Statistics, Emerson & Hatton - Estimating Future Needs Demand for Support forAdults with Learning Disabilities in England (2004), PANSI Prevalence Data on DisabledPeople Permanently Unable to Work (2001).

For More Information

Useful Websites

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Would you like to be involved in thedevelopment of Transforming Care?

The Experts by Experience AdvisoryGroup welcomes people withdifferent needs and backgrounds,who are accessing the Care TrustPlus adult health and social careservices, including carers.

Members of the group meet toprovide their views, ideas and workin partnership with the Care TrustPlus, to develop Transforming Care.

For more information about theExperts by Experience AdvisoryGroup and how to become involved,contact the Transforming CareTeam.

How to be Involved inTransforming Care

Geoff LakeDirector of Integrated

CommissioningCare Trust Plus

Transforming Care is about“Making your own decisions about yourown life, in your own way and being well

advised, with good information. It’s aboutbeing in charge of your own destiny.” The Transformation of Care is a

diverse, challenging programme andwill have a great impact on the careand support services that people canexpect to receive.

Continued improvements in publichealth, developments in medicine andchanges in society, means we areliving longer. People are telling usthey want more control and choice inlife and the risks they take. They alsowant adult social care services to caterfor a wider variety of health and careneeds, with a greater focus onapproaches that encourage people'sindependence and well-being, helpinga person to live at home for longer.

To meet the changing needs of societyand offer more personalised care andsupport, every part of England is nowworking towards transforming thecurrent health and social care system.

The Care Trust Plus is the first of itstype in the country and hasresponsibility for the commissioning ofHealth and Adult Social Care Servicesin North East Lincolnshire. We nowreplace the former North EastLincolnshire Primary Care Trust, aswell as inheriting responsibility for themanagement of Adult Social Carefrom North East Lincolnshire Council.

The Care Trust Plus is uniquely placedto develop Transforming Care, as wehave much greater co-ordinationbetween health and social care.

We also have agreater opportunityto co-ordinateaction plans totackle the widerareas of health and well-being, suchas education, employment, housingand lifestyle.

Our Short Guide explains theDepartment of Health vision for anational Adult Health and Social CareTransformation Programme and whywe need to make changes to thecurrent care system. We describe theCare Trust Plus Transforming CareProgramme and what this will deliverfor the people of North EastLincolnshire.

The Transformation of Care is a veryexciting opportunity, which we aredeveloping and implementing over thenext 2 years. In doing so, we will beworking very closely in partnershipwith members of the public, carers, theCouncil, voluntary and private sectororganisations, our staff and volunteersand most importantly, by listening towhat is really important to people whoneed care and support services andenabling them to be involved in everystep of our journey.

We hope you enjoy reading this ShortGuide to Transforming Care

Jane Lewington, Chief ExecutiveNorth East Lincolnshire Care Trust Plus

Jane Lewington

Dear Reader

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Introduction

The NHS and Social Services over the last 60 years,has provided an important service to us all at timesof basic human need, when we are at our mostvulnerable and need that extra bit of care. Itcontinues to be available to everyone, wheneverand wherever we need help, however, in today'ssociety, people have much higher needs andexpectations.

To create a more modern service for the GeneralPublic, the Department of Health laid out its vision inDecember 2007 for the future of social care, inrelation to a national Putting People First,Transformation Programme Agenda for Adult SocialCare.

The Putting People First Agenda recognises how oursociety is changing. People want more control anda say in the design of their care packages, whichimprove their health, well-being and ability to stayindependent for as long as possible. People wantsupport when they need it, they expect it quickly,easily and in a way that fits into their daily lives.

Putting People First is incorporated into the CareTrust Plus Transforming Care Programme and is ashared vision and commitment, to ensure thatpeople who need adult social care services and theircarers, have more choice and control over the careand support they need. Every local authority area inEngland is developing the Putting People FirstAgenda over the next 2 years, to improve the healthand well-being of its local community.

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The NHS Next Stage Reviewwas led by Health Minister andSurgeon Lord Darzi, to plan forthe next 10 years of the NHS inEngland. Lord Darzi's reviewinvolved a large consultationwith patients, the GeneralPublic, NHS employees, healthand social care staff, LocalAuthorities and the voluntarysector throughout the UK, tounderstand what they thoughtwas important in changing theway care and support servicesare delivered.

Lord Darzi's aim is to create anNHS that delivers world-classquality of care to everyone - aworld-class quality of care thatis tailored to a person's specificneeds and local circumstances.

The Lord Darzi NHSNext Stage Review

The vision for the future of health and social care aims to ensure that people:n Have the opportunity to fulfil their potential.n Have more choice, control and are helped to live the best possible quality of life,

irrespective of a disability or illness.n Retain respect and dignity.n Stay healthy and recover quickly from illness.n Live independently, live with or look after their family.n Can participate and are treated as active and equal citizens in society.

The delivery of the Transformation Programme means local authorities will be workingclosely with their partners, health and social care employees, independent, voluntary andprivate sectors, the General Public and in partnership with people needing care, theirfamilies and carers.

The Vision for the Future of Health & Social Care

Lord Darzi says it’s about

Giving moreclout to patients,

more say topatients.

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Lives & Aspirations

Yvonne cares for her motherYvonne has cared for her mother forthe last 3 years and recentlyregistered for the Carers EmergencyAlert Card. Yvonne said; "I had oftenworried about what would happen tomum if I were suddenly taken ill or inan accident. Registering for the AlertCard was really easy and I now havepeace of mind and reassurance, thatin an emergency mum will besupported."

Yvonne also benefits from thediscount card and thinks thediscounts are great. She commented;

"Just yesterday I used the card toclaim my carers' discount. Carerswho haven't registered for the AlertCard should!"

Mary cares for her husband JohnMary loves being in the fresh air, outin the garden watching the birds.However, Mary feels that as she isgetting older and has less time due toher caring responsibilities, she isunable to manage to keep the gardentidy and weeded.

It was identified during Mary’s carer’sassessment, that support wasrequired with the gardening, to allowher to have a break and enjoy someleisure time.

Mary received a Direct Payment tosupport her with gardening. Marysays; “It’s great as it’s one less thing toworry about and in summer, I can stillenjoy my garden without worryingabout trying to do it myself.”

Joan cares for her son CraigJoan's son Craig has mental healthproblems. Joan's caring role hasaffected her health and she hasrecently suffered a heart attack and 2strokes. Joan also has 3 otherchildren.

Joan received a Direct Payment to gofor a long weekend break to Scotland.Joan commented; "If I hadn't had themoney to help me go to Scotland fora weekend, I might have run away.Caring can be very stressful, it was awell needed break."

Carers Stories

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n Access to Self-Directed Support toensure that support meets aperson's needs and preferences.The increased use of DirectPayments will be promoted.

n Self-assessment and PersonalBudgets for carers will beintroduced, to encourage thedevelopment of individual, flexibleand creative support to carers.

n Development of more personalised,flexible breaks for carers, to helpcarers continue to enjoy their lifeoutside their caring role.

n Development of home care, sitting,befriending and other services toprovide the person being supported,with a service that is tailored to theirpersonal needs. Services willinclude activities inside and outsidethe home, giving the carerconfidence that the person theysupport, is having a personalised,enjoyable experience.

n Access to information and adviceservices. A well informed carer hasgreater choice and control over thedecisions they make and servicesthey may wish to use.

How Will We Be DevelopingPersonalised Support for Carers?

Carers"We have accessible, meaningful

information in areas such asbenefits, transport, educational,

employment, social andrecreational opportunities"

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n Improvements in healthcare,medicine and changes in societymean we are living longer.Children with complex needs aresurviving into adulthood. Thediversity within local communitiesis also increasing as we all havedifferent needs and wants.Society needs to recognisepeople's aspirations and desire tolive life as fully as possible.

n People have higher expectationsof what they need to meet theirown personal circumstances,wanting greater control over theirlives and the risks they take.

n People want dignity and respectto be at the heart of any servicethey receive, they want access tohigh-quality services and supportcloser to home at the right time.

n People want care services to takeinto account a range of needswith greater focus on methods toprevent illnesses, getting help atan earlier stage of an illness orproblem, to enable people toremain independent for as long aspossible.

North East Lincolnshire Council“We are led by community aspirations.

We are closer to ourcommunities.”

Some of the National Challenges Facing Societyn Life expectancy has increased,

doubling the number of olderpeople since 1931. Between2006 and 2036, the number ofpeople over 85 in England will risefrom 1.055 to 2.959 million.

n The number of people withdementia in the UK wasapproximately 560,000 in 2007and is expected to double in thenext 30 years, meaning demandfor care and support will increase.

n The number of people aged 50and over with learning disabilitiesis expected to rise by 53%between 2001 and 2021.

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n The North East Lincolnshirepopulation is estimated to increase12.21% by 2031 - from 158,900 in2006 to 178,300 in 2031.

n The number of people over 65 isgoing to grow at a faster rate thanthe rest of the UK. By 2017, it isestimated that North EastLincolnshire will have 33,000 peopleaged over 65 years. The proportionof those aged over 85 is expected todouble by 2028.

n The increased growth of our elderlypopulation and a lower estimatedbirth rate, will mean there are feweryounger people, to meet the supportneeds required, to help the oldergeneration stay independent.

n By 2015, 2,384 adults aged 18-64are predicted to have a learningdisability.

n The number of people with aphysical disability who arepermanently unable to work is alsorising, with an estimated total of2,654 males and 1,655 femalesaged 16-64 by 2015.

Care Trust Plus“We constantly develop

more flexible services to makethem more attractive to

service users”

Some of the Challenges FacingSociety in North East Lincolnshire

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SPECIMEN

Carers Support ServicesA carer is someone of any age wholooks after a child, relative, partneror friend in need of help becausethey have an illness, disability, frailty,or a substance misuse problem. Thecare they provide may be personal,emotional or supervisory and isunpaid.

Caring can be a very positiveexperience, but for many carers itcan lead to a number of health,social and economic problems. TheCare Trust Plus aims to help carerscontinue caring and to have a lifeoutside of the caring role, includingwork, education, leisure and training.

Carers have the right to anassessment of their own needs,either through a joint assessmentwith the person they care for, orthrough a separate carer'sassessment. Support plans enableaccess to an increasing range ofservices, including advice andinformation, support groups, training,a carers emergency alert,befriending, counselling, holistictherapies, Direct Payments, sittingand respite services.

The transformation of health andsocial care applies equally to carers.Carers also have the right toexercise greater choice, control andflexibility in how they are supported.We have started to move away fromreliance on support services, suchas respite care in residential settingsand traditional sitting services, whichare often limited in the type ofsupport given and the flexibility ofwhen it is delivered.

The Carers Emergency Alert CardService gives carers thereassurance, that in the event of anemergency or personal crisis, aCarer's Emergency Plan isimplemented. This ensures theperson being cared for continues tobe supported, while their carer isunable to do so.

Carelink operate a dedicated 24hour Carers Alert Phone Line.Eligible Carers can register with theservice, which will provide them witha Carers Emergency Alert Card anda Carers Emergency Plan.

The Carers Emergency Alert Cardalso acts as a recognition card,giving Carers the opportunity toclaim discounts at local businesses,services and leisure facilities.

Carers"We now have carer input into decision-

making. We can access information,training and equipment that we need to

provide the care required."

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The Kick Start Project is a 5 a sidefootball team group which runsweekly at the Grimsby Institute, toallow people with mental healthdifficulties, to play football in asafe and fun environment.

Physical activity can often greatlyhelp to improve a person'sphysical and mental well being.Direct Payments have been usedto pay for the coaching, venue,footballs, bibs and to contributetowards transport.

Group members who meet andpractise a range of skills as well asparticipating in mini 5 a sidefootball matches, have improvedtheir confidence, physical fitnessand developed friendships.

The group is led by a sportsdevelopment officer and coaches.

A Mental Health OccupationalTherapist and Community MentalHealth Nurse also take part in thesessions.

The use of Direct Payments hasbeen vital in developing andkeeping the project running for thebenefit of its group members.

A member of the group said;"Physically, it has improved mystrength, speed and stamina. I feelhealthier from participating and amvery pleased with it. Mentally, ithas improved my motivation,confidence and willingness toparticipate within a groupenvironment. I also get greatenjoyment from the experience."

The Kick Start Project has led to itsmembers playing in a mental healthfootball league across the Humberand Yorkshire. Their team name is‘Humber Hotspurs’ and somemembers are studying a level 1certificate in coaching football.

The Kick Start Project

Lives & Aspirations

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The traditional social care system and management of a persons care andsupport needs follows a rather standard process.

The current system starts with a professional assessment of a person's needs bya care manager or social worker. Once the assessment has been completed, thecare manager or social worker will then look at which needs are being met byother care and support services.

The care manager or social worker then creates a care plan, which describes howa person's social care needs are going to be met. Care and support services arechosen from a standard list of services, which have been selected and bought bythe local authority. These services may not always meet the personal needs andpreferences of the person, nor does it allow any control over decisions about thetype of care a person feels will best meet their needs.

The total costs of the support in the person's care plan will depend on the type ofservices that are selected, however, people are often not made aware of thecosts involved in providing their care and support services.

So why does the current care management system need to change?

n Traditional social care relies mainly on socialworkers or care managers to make decisionsabout a person's care needs, rather than giving aperson control and a say over their supportarrangements.

n People cannot be imaginative in choosing thesupport they need.

n There is little or no encouragement for the personneeding support, or their family to contribute infinding care and support solutions.

n People are often slotted into services that are notalways personal to their needs and aspirationsfor their life.

n People do not understand what amount of moneyis available to spend on their care.

The Traditional Social Care System

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The Care Trust Plus is fully committed to delivering the Putting People FirstTransformation Programme and changing the traditional social care system, toenable people to have more choice, control and be supported to live asindependently as possible. The Care Trust Plus recognises that real change, canonly be achieved through the involvement of people who need care and supportservices and their carers, at each stage of transformation.

Over the last year, the Care Trust Plus has been working closely with peopleneeding care and support services, carers, the General Public, partnerorganisations, the Council, and health and social care staff and volunteers, to agreea vision for the future of adult health and social care services in North EastLincolnshire.

We agreed the following statement communicated the shared aspirations of people,for the future of health and social care:

What Does This Mean?

n The needs, wants and aspirations of people will come first. All of our workwill be led by what local people tell us is important to them and we will listen tothe needs of local people, to make sure we can provide the best care and supportservices.

n People will have more choice and control to shape and buy their own careand support services. People will not have to fit into existing services, they candevelop their own personal care package, with help from family, friends or theCare Trust Plus.

n Local services will be of a high quality, to improve people's experience ofcare. We will continuously measure and check how effective services are, inimproving people's health and well-being.

People using health and social care servicesand carers, told us they wanted to use thisstatement to represent an identity for theTransforming Care Programme. Together,we designed the Transforming Care logo.

The Care Trust Plus is focusing on 4 keyareas of Transformation, to achieve the rightresults for people, ensure care servicesbecome more personalised to people’sneeds and to improve their quality of life.

The Care Trust Plus Transforming Care Programme

‘Transforming Care - my care, my way’

A Walking Group Project was setup by the Mental HealthHomelessness Service. A numberof people using the serviceshowed a keen interest in longdistance walking, to help toimprove their mental and physicalhealth and be part of a worthwhileactivity. Many people with amental health illness experiencelong periods of low self-esteem,anxiety, loneliness and feelinginsecure.Group members wanted tocomplete the Swaledale Walk, a34 mile walk in the YorkshireDales, over 3 days. The groupapplied for Direct Payments topay for their walking trip, whichincluded the cost of hikingequipment, travel andaccommodation and the supportcost for 2 workers to lead thegroup.The walking experience greatlybenefited the group members byimproving their self-esteem,confidence and motivation. Onemember explained how it hadhelped him to overcome anxietyproblems. He found the contactwith the natural environmentcalming and relaxing. On hisreturn, he felt more confident andable to socially engage, not onlywith other people but withservices. He is now walkingregularly and hoping to startvoluntary work.

The Walking Project

Lives & Aspirations

Another member reported thathis anxiety problems caused bya build up of energy, haddisappeared, as the exercisehad helped him to releaseenergy and control his anxiety.He now leads a more activelifestyle and is fitter and morefocused. He sees walking as hismain hobby.The whole team gained somevaluable skills, such as teambuilding, navigation, mapreading and planning skills.They now find it easier to makefriends and enjoy social activitieswith other people.With the help of Direct Payments,the group made very positivesteps towards their recovery, bygaining care and support whichwas personal to their needs andaspirations.

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Andrew’s Story

Lives & Aspirations

Andrew is 23, lives with his familyand depends on his mother tosupport him when he does anyactivity outside the home. Andrewenjoys being busy and meeting hisfriends when he attends theGrimsby Institute for two hours aweek, he also likes using thecomputer, being on a mixer deskand taking his dog for a walk withhis mother.Andrew was unsure what hewanted to do after he completedhis course at the Grimsby Instituteand was referred by his tutor todevelop a Person Centred Plan.Before making his plan, Andrewmet with a Person CentredPlanning Facilitator to talk aboutwhat he wanted to do in the future.

Andrew chose to have his planmeeting at the Institute so hissister, her boyfriend and hismother could be present.Following the development ofAndrew's plan, he is now learningballroom dancing, he goes bowlingorganised through the Foresightorganisation and is saving somemoney for a holiday. Andrew andhis friends were also taken to anightclub in Hull, which was a nicenew experience for Andrew.Andrew's plan continues to bereviewed and he is consideringDirect Payments, to supporthobbies and activities outside thehome.

The Care Trust Plus 4 Areas of Transformation

1. Universal Services are our general supportservices, available to everyone locally such astransport, leisure, health, education, housing,community safety and good access to informationand advice. Everyone should be able to access thissupport, information and advice easily andeffectively, to maintain their health and well-being,make choices over their daily lives and be activemembers of their community.

2. Early Intervention andPrevention means support isavailable for people who need alittle more help at an earlystage, to stay independentfor as long as possible,such as support to recoverfrom a long term illness,help to gain training, orreturn to work after abreak.

3. Choice and Controlis about enabling peopleto choose who deliverstheir care and support andhow and when their care isprovided. This also involvesproviding the right informationand advice, to help people makedecisions about the servicesavailable. People need to be confidentservices are safe, reliable and suitable to buy.Access to advocates must also be available forpeople who need help to express their support needs.

4. Social Capital is about development of the localcommunity, enabling people to experience thesupport, care and friendships that come fromrelationships with others. Everyone should alsohave the opportunity to be part of their community,where they can have a voice and influence decisionsthat affect their life.

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Create a ‘no wrong door’ policy, sothat if an organisation or person youfirst contact does not have theinformation you need, they will makesure your details are given to thecorrect organisation, or person whocan offer you help and support.§ Improve people’s whole experience

of care and support services and givepeople the confidence, that servicesare of high quality and safe.§ Encourage and support people’s

personal needs and requirements fortheir independence, well-being anddignity.§ Ensure local services are available

to everyone, such as transport,education, leisure, health, housing.These services are important ineveryone’s lives and we will work tomake sure that barriers which stoppeople using everyday services, areremoved.§ Give more choice and control to

people who use services, carers andtheir families, over planning anddesigning their care. Encouragepeople to influence and be involved indeveloping future care services.§ Focus on preventing illness and

health problems and make suresupport is available for people whoneed more help at an earlier stage, tostay independent for as long aspossible. This includes the use ofequipment in the home, help to safelymaintain the home, support to exercise,training to gain a job, or return to workafter a break.

What Will Transforming Care Deliver for thePeople of North East Lincolnshire?

With your co-operation, our Transforming Care Programme seeks to:

§ Introduce a Personal Budget foreveryone who is eligible for publiclyfunded social care. Encourage andhelp people to do their own self-assessment.§ Focus on ways to build a

combined health and social carebudget, by testing the use andbenefits of offering Department ofHealth Personal Health Budgets.§ Provide easy ways for people to

access information and adviceabout care and support servicesavailable locally, from a range ofdifferent organisations and agencies.§ Provide personalised support to

carers including self-assessments,Personal Budgets, flexible breaks,improved training and opportunitiesfor carers.§ Create new roles for health and

social care workers to support thenew system of care. Increase staffknowledge of health conditions andproblems, by providing more trainingand learning opportunities.

Care Trust Plus“We are adventurous and innovative.

We are integrated and everyoneis moving in the same direction.”

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Amelia’s Story

Lives & Aspirations

Amelia is a 93 year old lady living alone, supported by a homecare package and a supportive family. Amelia was admitted intohospital, she had facial injuries after a fall from wandering outsideher front door into the street. Amelia was diagnosed with vasculardementia, which can cause short term memory loss.

Before hospital admission, Amelia received daily morning andteatime calls, to make sure she had taken medication and hadeaten. Family were worried about her discharge home and herability to stay at home safely.

To help with the discharge from hospital assessment, the Just Checking MonitoringSystem was discussed with the family. The Just Checking System is an on-linemonitoring system used to support people with dementia. It creates a chart of activityof a person living alone and charts can be accessed on the Internet. The familydecided to install the Just Checking System and following her discharge fromhospital, they monitored Amelia's activity from the on-line charts.

At first, the charts showed Amelia was up and active for long periods during the night,having spent a lot of time between the kitchen and the lounge. She was not settled,constantly moving around her property. She was also going out into her back gardenduring the evening, but not throughout the night. However, 6 days after Amelia'sdischarge, the charts began to show she was beginning to settle at night, havingslept in her bed for periods of time and did not wander outside her front door.

Amelia's family were so pleased after 10 days use of the Just Checking System, theyhired one from Just Checking at a cost of £16.50 per week.

Amelia's daughter said; "I would highly recommend this system to anyone with anelderly relative, who is concerned about their welfare, whilst living in their own home.It has shown us what her normal routines are, when she goes to bed and gets up.We can see if she has had a restless night and then be more prepared for her to betired or agitated the next day. The system is easily installed and the Website is easilyaccessible to anyone who is given a log-in and needs to see the charts of activity,making it safe and secure."

The Just Checking System gave Amelia's family peace of mind about her safety,providing important information they could not have gained if the system was not inplace. It showed how a person with vascular dementia can become disorientatedwhen taken out of their own home.

1. Social Worker/Care Manager

A Social Worker or Care Managercan help a person to:

§ Complete the Self-AssessmentQuestionnaire.

§ Put together a personal SupportPlan and budget.

§ Arrange for any of the Care TrustPlus registered care services tobe provided.

§ Review a person’s care andsupport.

§ Find answers to any questions theperson may have.

2. Advocates

An Advocate is someone who isindependent and can help a personsay what they want, to secure theirrights, represent their interests andgain the services they need.

3. Support Brokers

A Support Broker is someone who istrained to help a person look at,choose and set-up their programmeof support.

4. Voluntary and CommunityOrganisations

In North East Lincolnshire there aremany Voluntary and Communitygroups that support people withdisabilities, older people and thosewith a mental health condition bygiving advice and information as wellas practical day-to-day, or one-offassistance.

5. Friends and family may also beable to help

A person can involve their friendsand family as much or as little asthey wish, in planning and buyingtheir support. Family and friendsmay also be involved in providingcare and support to the person.

Who Can Help?

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Commissioning Groups“We offer advice, support and

information to people usingunregulated services andthose who are funding their

own care”

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More Choice & Control Through Self-Directed Support

The new system of care is called Self-Directed Support, which aims to change how thetraditional social care system works, by giving people greater choice and control over theirsocial care needs. The Care Trust Plus is developing this new system over the next 2 years.

There are 7 stages of Self-Directed Support:

Step 1 - Money - Finding Out How MuchSelf-Directed Support starts with a short Self-Assessment Questionnaire, in which aperson's responses indicate what care and support they may need. (See page 12) This ispart of the Care Trust Plus assessment of need. Once the questionnaire is completed, theCare Trust Plus decides whether the person is eligible to receive social care help and ifeligible, how much help should be offered. If not eligible, the Care Trust Plus will offerinformation and advice, or referral onto other organisations. Social care and support isoffered in the form of a Personal Budget, which is the amount of money the Care Trust Plushas decided it should spend on meeting the person's social care needs. (See page 13)

Step 2 - Developing the Support PlanA Support Plan is developed to explain how the person will spend their Personal Budget,to make improvements to their life. The Support Plan can be made by the person needingsupport, or with help from family, friends, a social worker or care manager. (See page 12)

Step 3 - Getting the Plan AgreedThe Care Trust Plus has to agree the Support Plan - the amount of the support needed andthe costs of the support in the plan. The Care Trust Plus will check the person's care andsupport goals and ambitions are safe and once agreed, the person will be given theirPersonal Budget.

Step 4 - Organising the MoneyA person can take as much control as they want over the money in their Personal Budget.The money can be paid to the person, or someone can manage the money on their behalfsuch as a friend, family member, a Trust, a care manager or other professional.

Step 5 - Organising the SupportA person can organise their support in a way that is suitable to them and is encouraged toset up their own care and support arrangements. If unable to manage by themselves,friends, family or the Care Trust Plus can help. Information and advice will be madeavailable, to help a person choose and buy the most appropriate support.

Step 6 - Living LifeA person can use services to meet their care and support needs, but can also use themoney within their Personal Budget to gain help from local people, friends, or buysomething that would help improve their life, such as a gym membership or a holiday.

Step 7 - Seeing How it WorkedThe final step involves monitoring and reviewing the Support Plan, to check the PersonalBudget is working and to show the money is being used properly. A person can also saywhat they wish to do next, or make changes to the Support Plan.

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If a person has been assessed asbeing eligible to receive care andsupport by the Care Trust Plus, theywill be given a Self-AssessmentQuestionnaire to complete.The Self-Assessment Questionnaireis used by the Care Trust Plus tounderstand what support a personmay need and to identify the risks toa person, if help were not provided.The assessment is also used to workout a person’s Personal Budget.The Self-Assessment Questionnaireis a tick box question and answerform. It is designed to make a personthink about different areas of their lifeand what level of care and support isneeded, to achieve maximumindependence.The Self-Assessment Questionnairecan be completed alone or with thehelp and advice of a care manager,social worker, friends or family.Each question asks the person toestimate the level of support theymay need, what they find difficult andwhat they can do for themselves. Ithelps to identify a range of issuesthat may have an impact on theperson’s life. The assessment helpsa person record their own supportneeds as they see them.Each of the answers in the Self-Assessment Questionnaire is given acertain number of points and eachpoint is given a monetary value. Thepoints are added together to give theperson a Personal Budget.

The Support Plan is developed oncethe person has been advised of theamount of money they have withintheir Personal Budget. The SupportPlan can be completed by theperson or with the help of friends,family, a social worker or caremanager.The Support Plan should look allareas of a person's life. Thisincludes their care, support andwell-being, what is working and notworking for them.It should identify what they would liketo change, to help them live the bestpossible quality of life and how theywould like to receive care andsupport services.A Support Plan can be developed inmany ways such as drawn picturesor diagrams, presentations andDVD’s. Some people choose to talkabout their ideas to someone elsewho writes them down. The SupportPlan does not have to becomplicated, it can be as detailed orsimple as the person desires.

Community Members“We have a point of contact,

that person helps us through thewhole process or will always know

who is helping us at anypoint in time.”

What is a Self-AssessmentWhat is a Self-AssessmentQuestionnaire?Questionnaire?

What is a Support Plan?

What are PersonalBudgets?

What are DirectPayments?A Direct Payment is an amount ofmoney given to a person to buy theservices they have been assessed asneeding. The payment is made as analternative to regular services providedby the Care Trust Plus.

A Direct Payment can be used by aperson to pay for their own support,either by employing someonethemselves, or buying support throughan agency.

A Direct Payment cannot be used to buygoods or services from the Council orCare Trust Plus. A person can howeverchoose to receive their support in partby a Direct Payment and in part by theCare Trust Plus.

A Personal Budget is a sum of moneyprovided to a person needing care, whichenables them to have more choice andcontrol to develop a package of supportservices, that meet their personal needs.A Personal Budget lets people know theamount of money available to spend ontheir care, allowing them to plan how theywant to achieve their care and supportgoals, to improve their quality of life.

There are few limits on how PersonalBudgets can be used. People areencouraged to be creative in choosing thetype of care and support they want tomeet their needs and aspirations. Aperson may choose to use some servicesprovided by the Care Trust Plus, or buygoods and services from other people ororganisations using cash from DirectPayments.

Personal Budgets are often used to buydomestic home help to cook, shop, cleanand gain personal care such as washing,dressing and going out. These servicescan be gained by hiring a care agencysupport worker, or by employing aPersonal (care) Assistant to work for theperson. Personal Budgets are sometimesused to buy holidays, leisure activities,driving lessons, computer equipment, tobecome a member of a gym or football club.

In the future, everyone eligible for publiclyfunded help with their social care needs,will have a Personal Budget.

Personal Health BudgetsThe Department of Health announced aPersonal Health Budget PilotProgramme in January 2009, to be ableto offer people a combined health andsocial care budget.

The aim of a Personal Health Budget isto give people even more choice andcontrol over their personal carepackage. People would be able todevelop a Health and Social Care Planthat considers all areas of their well-being, health care and social care needs.

The Care Trust Plus is a pilot site fortesting the benefits that can be gainedfrom offering Personal Health Budgets,to people needing care and support inNorth East Lincolnshire.

Community Members"We will be more in control of ourlives and destiny. We will feel likevalued members of the community."

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