At the heart of self directed support is the idea that you are the best person to say what is right for you. We would like to help you to take as much control over your care and support as you feel comfortable with.

If you’re a user of mental health services and have a problem with ongoing personal care and support with daily living as well as your mental health issues, your care coordinator will help you to work out what your individual social care needs are and calculate the cost to meet those needs. If you are eligible for financial support, Buckinghamshire County Council will contribute towards the cost of your care. You can then choose how to meet your needs in an appropriate way that is agreed by us.

The idea behind contributing towards the cost of your care, instead of providing you with services directly, is that the government wants you to be in charge of how your support is arranged and to have maximum control over how the money is spent.

However, you can also choose to let your care coordinator arrange your social care support for you if you do not wish to be in charge of your own support.

If you or your representative have trouble understanding any of this information and want help please contact your care coordinator or your mental health team to discuss this further.

Am I eligible for Self Directed Support?

• Self Directed Support and Personal Budgets are for meeting your Social Care needs.
• This is support you may need to manage everyday things such as shopping, housework, getting out and about.
• To qualify for Self Directed Support you need to have Critical or Substantial Social Care Needs based on the Fair Access to Care Criteria.

Because Buckinghamshire County Council have to provide services within set budgets, we have to make sure that we use resources as effectively as possible and in a fair and consistent way. The government has issued national guidelines to help us to do this.

All councils apply the same criteria for deciding on eligible social care needs for adults. These eligibility criteria are called the “Fair Access to Care Services guidance”. Your care coordinator will use them to decide who we can provide services to.

There are four bands:

• Critical needs
• Substantial needs
• Moderate needs
• Low needs

Each band has a list of risks against which needs are assessed. In Buckinghamshire we are able to provide care and support if your needs are assessed as either Critical or Substantial

Find out more about Fair Access to Care Services (PDF)

Your care coordinator will work with you to identify whether you have social care needs as part of your CPA assessment.

1. Assessment

In Buckinghamshire we use the Self-directed Assessment Questionnaire (SAQ) to work out if you are eligible for support. The self directed assessment questionnaire (SAQ) asks about your life, what kind of support you need and, most importantly, what you want to achieve. It’s been designed to be simple to complete and is made up of 8 main questions. Your care coordinator will work with you to fill this out. Each question has a choice of answers so you can discuss with your care coordinator which one best fits you. You may also ask people who know you well to help with the questionnaire. These could be your family, your friends, an advocate or anyone else you’d like to help.

When working out whether you are eligible, we have to take account of the help and social support you are already receiving from your family and the local community.

If a friend or family member provides care for you, please tell them they have a right to an assessment as well.  The carers assessment will look at how we can help them to care for you.

Your care coordinator will arrange for a carers assessment to be carried out with your carer.

If we assess any of your needs as ‘critical’ or ‘substantial’, you will be eligible for help from Buckinghamshire County Council to cover the cost of your social care needs.

Currently, we cannot offer services to you if we assess your needs as ‘moderate’ or ‘low’.

Your social care needs and eligibility criteria will be reviewed six monthly as part of your CPA assessment.

If it is not possible to offer you services your care coordinator can advice you of any local organisations that may be able to help you.

2. Notional Budget

Once you have worked with your Care Coordinator to complete the Self Directed Assessment Questionnaire and you are eligible for support we will then calculate how much we think it will cost to meet your social care needs. To do this we use a calculator called a Resource Allocation System (RAS). This will tell you what the cost of your care is likely to cost so that you are able to begin to plan your support. We call this a Notional (or estimated) Budget.

So we can provide services to as many people as possible, Buckinghamshire County Council has to charge those people who are able to pay for their social care support. If you are eligible for social care funding your care coordinator will refer you for an assessment of your financial situation to work out how much you have to contribute towards the cost of your care.

Buckinghamshire County Council does not charge for after care services provided under Section 117 of the Mental Health Act 1983   (Section 17 of the HASSASSA Act 1983)

For further information on financial assessment and the Council’s Charging Policy please follow the following links:

https://www.buckscc.gov.uk/sites/bcc/adult_social_care/paying_for_care.page

Non residential care charging policy (PDF 123KB)

Find out more about paying for your care: Looking after your assets – paying for your care (PDF 446KB)

3.  Support Planning

A support plan shows how you want to get the support you need to have the life you want. It’ll say how you would like to spend your personal budget to meet your eligible social care needs. For further information about support planning click here.

4. Agreeing your Support Plan

If you have social care needs and the Council is contributing towards the cost of your support then we must agree your support plan before you receive your personal budget. If you are using your own money, we won’t need to agree your support plan.

5. Managing your Personal Budget

You can take as much control as you want over the money in your personal budget. However, if it is not appropriate for you to manage your personal budget or do not wish to manage it yourself, your care coordinator can help you to manage it on your behalf. For further information on managing your budget click here.

6. Reviewing how it is going

Your support plan will be reviewed after 12 weeks to see how it is working. It will then be reviewed as part of your regular CPA review.

In between reviews, you might find that some of your support needs change. This could be for a number of reasons, e.g. you have gained some independence, your mental health has improved or got worse, or your informal support has changed. You’ll need to tell us if this happens so that your care coordinator can help you work out how to change your support. You may need to make some changes to your support plan or complete a new assessment questionnaire so that you continue to get the right amount of money to pay for your support.

You can choose to do your support plan yourself or get help from your care coordinator, your family and friends or from somebody who has your best interests at heart (an advocate).

If you are using your own money, we won’t need to agree your support plan. However, if you are entitled to social care funding we are obliged to check and agree the amount of support you have identified that you need and the cost of this support. To be agreed your support plan should:

1. Be legal
2. Be sustainable (so that it continues to provide ongoing support)
3. Not put you (or anyone else) at risk
4. Not be used to fund services which can be provided by another source (such as the NHS)
5. Meet your needs in the most cost effective way (so it gives value for money)

Your plan for your social care support should talk about you and how the support you’d like will meet your needs and outcomes. It should also show how you’d like to arrange your support so that you stay safe and well. Your care coordinator will work with you to make sure these plans are reflected in your mental health Care Plan.

Your support plan needs to be agreed by your care coordinator and the council. If you are not happy with our decision you can discuss this with your care coordinator and ask for your support plan to be reviewed.

There are a number of ways you can arrange your support. You can choose to recruit your own personal assistant for example. Alternatively, you may want to buy support from a company or have some support from your family and friends. You can also choose to let your care coordinator arrange your support services for you if you do not wish to have the responsibility of arranging your own support.

Advice and information about recruiting staff, as well as advice on training and employment is currently provided in Buckinghamshire by:

The Direct Payments Advisory Service
24 High Street
Prestwood
Buckinghamshire
HP16 9ED
Telephone 01494 862489
Telephone/Fax 01494 865368

Whatever type of support you decide to have, you can have help to set it up. Your care coordinator will be able to advise you about your options and where to get further help from.

Direct payments and different ways of managing your personal budget

If the Council is contributing towards your budget, we can provide the money to buy some or all of the social care support you need using Direct Payments. Advice and information about managing a direct payment is provided in Buckinghamshire by:

The Direct Payments Advisory Service
24 High Street
Prestwood
Buckinghamshire
HP16 9ED
Telephone: 01494 862489
Telephone/Fax 01494 865368

Currently there are five ways of managing a direct payment and you can choose which is the best way for you.

A direct payment can be managed by:

Payment card

This works like a debit card. It is issued by the Royal Bank of Scotland and is designed to be used by people who get Direct Payments. The card replaces paper cheques or cash based systems. It removes the need to open a bank account and makes it easier to buy services and to manage and monitor accounts. Your care coordinator will be able to tell you more about this.

Someone can act on your behalf

A nominated person can look after the money and take responsibility for making payments., This person should be recorded in your support plan and in your budget agreement as your agent. They will then hold the payment card in their name.

An independent voluntary organisation/community broker

A voluntary organisation can hold the council’s financial contribution on your behalf. The Council’s current arrangement is with the Direct Payments Advisory Service (DPAS). They will always put you at the centre of any decisions made and will have the authority to buy and manage your support. They will have to record how they spend this money and show they have only used the money to pay for what has been agreed in your support plan. This is a called a third party payment.

Over the next few months Buckinghamshire County Council will be looking at additional ways your personal budget can be managed and details will be made available as soon as possible.

Managed by a Trust

This is made up of three or more people, known as Trustees to manage someone else’s money. This commitment is written up into a Trust Deed. The deed creates the legal duties and responsibilities for the Trustees. All Trustees are individually named and must sign the document with an independent witness for verification. The deed needs to clearly reflect the purpose for which it has been created and the power of the trustees.

Managed by Buckinghamshire County Council

If you do not want to manage your personal budget and would prefer your care co-ordinator to arrange all your support, then they will manage your budget on your behalf.

Buckinghamshire County Council will then use the organisations they already have contracts with to provide your care and support to meet your social care needs.

Find out more about Direct Payments in Buckinghamshire: Direct payments factsheet (PDF 90KB)

Find out more information about the payment card: Payment cards (PDF 115KB)

Some of these questions were asked by people who use mental health services and their carers at information events that have been organised by the Self Directed Support Service User and Carer Reference Group in Buckinghamshire.

1. Who will be able to have a personal budget?

Self directed support with personal budgets will be made available to mental health service users who are eligible for social care support. Eligibility for social care support will be based on an assessment of need using Fair Access to Care Services criteria (FACS). Only people eligible under FACS will be able to have a personal budget.

Fair Access to Care Services (FACS) is a national guidance from the Department of Health on eligibility for social care services. FACS identifies eligibility based on levels of need: critical, substantial, moderate and low. Buckinghamshire’s policy is to provide services to meet critical and substantial levels of need. FACS criteria should apply to all social care services.

The assessment carried out by the assessing practitioner of a community mental health team will establish the individual’s eligibility for social care money under FACS.

2. Does anyone not get allocated a budget?

Only people who have been assessed as not being eligible for Social Care Services will not be allocated a personal budget, however not everyone chooses or will be able to receive their allocated budget as a direct payment, in some instances the council or a third party will help to manage the money.

3. How can we ensure that the person being assessed can be supported by their family member or friend who knows the real situation?

The person themselves can decide who they want to be present at their assessment. If the person lacks capacity to partake in their assessment, the family’s views will be taken into account as part of the assessment.

4. My needs change; sometimes I’m well, sometimes I’m not. Sometimes I need services, sometimes I don’t. How will SDS support me?

Your care co-ordinator will assist you with your support plan, which will take into account that your needs may fluctuate at times. Receiving a personal budget under SDS should be able to give you more flexibility for times when you need increased support.

5. Having not had services for a while, how do I access an assessment?

If you are known to the Mental Health Services you can phone your CMHT and ask for an assessment. However if you are not known to services you will need to go to your GP in the first instance, who will need to work with you to decide whether a referral to the CMHT is appropriate at this time.

6. Will all mental health and physical disabilities be able to be taken into account?

The assessment under SDS will be integrated into your CPA assessment and will therefore be able to take fully into account all your health and social care issues including any physical disabilities you may have. If you require a specialist service from another service you will be referred to this as appropriate.

7. Can I have my needs as a carer assessed?

Yes, all carers are entitled to an assessment in their own right. Speak to your care coordinator about arranging a carer’s assessment.

Back to Topic headings

Personal Budgets

8. Can a personal budget be used for health care services?

No. A personal budget can only be used for social care services. It is illegal to spend social care money on health care services. You need to be assessed as eligible for social care services in order to get a personal budget. The assessment may be carried out by a social worker, a community psychiatric nurse or an occupational therapist who works for one of the Community Mental Health Teams. Sometimes they are also called care co-ordinators.

9. How can you tell what’s a social care service and what’s a health care service?

In mental health services, social and health care services can seem interlinked. The practitioner carrying out the assessment of need will be able to advise on what is a social care service and what is a health care service. Social care services are provided to people to achieve social care outcomes like increasing someone’s independence or well being. Health care services are provided to people to achieve health outcomes like meeting a medical need or achieving better mental health.

10. When will Self Directed Support with Personal Budgets be implemented in mental health?

The Self Directed Support with Personal Budgets for people who are using mental health services in Buckinghamshire is due to be fully implemented by September 2011, which means that by then all new service users and all existing service users are expected to have a personal budget.

If you are currently in receipt of a service you will be assessed for Self Directed Support at your next CPA review.

11. Will everyone have to have a Personal Budget even if they don’t want them?

Everyone with an eligible social care need will eventually have a personal budget. However you can engage with self directed support as much or as little as you would like to. Everyone still has the option to ask their care co-ordinator to continue to arrange all support services for them or they arrange some or all of their support themselves. It’s the individual’s choice. No one is forced to take on more choice and control.

12. Will personal budgets mean carers have to provide more support?

Personal budgets should not result in increased demands on carers. The assessment will take into account how much support a carer is willing or able to provide. However, under Self Directed Support, the service user has the option to employ somebody they already know and pay them for the service they provide via a direct payment. The only rule is that the chosen person does not live at the same address, otherwise they would not be entitled to payment under Self Directed Support.

13. What can people spend their personal budget on?

There is no list of the kinds of services users can spend their personal budgets on as this will be different for everyone. Therefore your support plan will be agreed on an individual basis. Your support plan must meet your eligible assessed needs.

Your support plan must be:

1. legal
2. sustainable (so that it continues to provide ongoing support)
3. Not put you (or anyone else) at risk
4. Not be used to fund services which can be provided by another source (such as the NHS)
5. Meet your needs in the most cost effective way (so it gives value for money)

Your plan for your social care support should talk about you and how the support you’d like will meet your assessed needs and outcomes. It should also show how you’d like to arrange your support so that you stay safe and well. Your care coordinator will work with you to make sure these plans are reflected in your mental health Care Plan.

Your support plan needs to be agreed by your care coordinator who will submit it for approval. If you are not happy with our decision you can discuss this with your care coordinator and ask for your support plan to be reviewed. Once your support plan has been agreed your personal budget will be made available to you.

14. Will there be an annual uplift to the budget?

No. Your needs will be reviewed at least annually and any adjustments would be made then.

15. Who can look after my personal budget if I don’t feel able to do this myself?

You can nominate an agent of your choice to receive your Personal Budget as a Direct Payment on your behalf (for example: spouse, son, daughter, sibling) by allowing them to be second card holders of the pre payment card – the method used for giving people their Direct Payment.

If you do not have anyone willing to do this you can ask the DPAS (Direct Payment Advisory Service) to receive the money on your behalf into a managed account. This will not mean that you are handing over choice and control to another person just that someone else will be receiving the Personal Budget and managing it for you. You can also ask your care co-ordinator to arrange the support directly for you, in which case you wouldn’t have to manage either the budget or the care arrangements.

Back to Topic headings

Direct Payments and Charges

16. How do Direct Payments fit with Self Directed Support?

Direct payments are one way in which you can receive a personal budget as part of self directed support.

These are payments made to a person directly so they can arrange their own support, buying services from providers or employing their own staff. Although direct payments were available to you before the implementation of Self Directed Support, you will now have the possibility to spend your direct payment with a lot more choice and control on services that are able to meet your assessed needs e.g. by employing a Personal Assistant. You can receive part or all of your personal budget as a direct payment. Those people who do not feel comfortable to arrange their own support can choose to let their care co-ordinator continue arranging all or part of their support for them.

17. Is there support available to help people manage their direct payments?

Yes. In Buckinghamshire the council contracts DPAS (Direct Payments Advisory Service) to help people set up and manage their direct payment. DPAS can provide you with advice, support and information about recruiting staff, as well as advice on training and employment. DPAS also provide a payroll service for paying a personal assistant if you want this.

The Direct Payments Advisory Service
24 High Street
Prestwood
Buckinghamshire
HP16 9ED
Telephone 01494 862489
Telephone/Fax 01494 865368

Whatever type of support you decide to have, you can have help to set it up. Your care coordinator will be able to advise you about your options and where to get further help from.

18. How will charges work with Self Directed Support?

As soon as possible after the assessment of need, a financial assessment will be carried out. This will provide information to decide how much, if at all, a service user should contribute to their personal budget. People who ask the council to arrange their support will receive invoices (monthly bills) for their contribution. If the individual chooses to receive a direct payment, their payment will be reduced by the amount they are assessed as needing to contribute.

19. Will there be a limit to the financial contribution I may have to make?

You will have to undergo a financial assessment to determine whether you have to make a contribution to your care and this varies with each individual. However, we would never ask anyone to contribute more than the actual cost of care. A personal budget is not classed as a personal income; therefore it would not affect your benefits.

20. What is the monitoring process to justify how direct payment money has been used?

The preferred new method of getting a Direct Payment in Buckinghamshire is the Payment Card. This is a debit card issued by the RBS (Royal Bank of Scotland). With the Payment card the Council can monitor the account online. The card holder can register on line to view their account.

Service users are required to keep receipts of their payments in case the Council needs to check that the Direct Payment has been used correctly.

The RBS will also send regular Statements to the service-user so that they can check their expenditure.

For further information on the payment card please follow this link:https://www.buckscc.gov.uk/assets/content/bcc/docs/adult_social_care/payment_card.pdf

Back to Topic headings

Support Planning and Putting things in Place

21. Will Self Directed Support mean I have to change the services I currently get?

No. You do not have to change your service if you are still eligible for support and are happy with the support you receive.

22. Will new services be available for people to buy using their Personal Budgets?

As use of personal budgets increases, the market of social care services is likely to change as people choose different kinds of services. However, these changes will not happen overnight. The commissioning team within social services are looking at the social care service market and are working with providers to encourage new and more flexible services.

23. Who will be available to help people with planning their support?

The person’s care co-ordinator who has completed the assessment can help as can a carer, family and friends or an advocate. In Buckinghamshire, the person will in the future be able to get involvement and support from a “broker”. This is a person who specialises on helping people to do their support planning by helping them to find out what services are available and how it is best to spend their personal budget. Buckinghamshire County Council are currently in the process of developing this brokerage service.

24. Will carers be involved in the development of support plans?

Yes if they want to be. Carers are also offered a carers assessment to look at their needs.

25. Can people change their support plans?

Yes. You should ask for a review and can do this at any time if you feel your needs have changed and/or your support no longer meets your needs.

26. Do people have to have a Direct Payment to access different kinds of services?

Currently there are some restrictions on what services the council can buy. This means people receiving direct payments may find they are able to access a wider range of support than what is available through the council.

27. What happens with Self Directed Support if someone needs urgent help?

If someone needs urgent help, this might not be the best time for them to think about self directed support. In this case, we can arrange services on a temporary basis and then discuss self directed support with them at a later date when they are more able to consider this.

28. Where can I get a personal assistant from?

You can employ somebody you know as a personal assistant as long as they do not live at the same address as you. If you don’t know anyone you could employ as your personal assistant, the Direct Payments Advisory Service (DPAS) can assist you to find one. They will provide support to place an advert, shortlist and interview people. They will also provide help and guidance around all other aspects of employing somebody directly i.e. insurance, tax and payroll.

29. Who is responsible for CRB checks and checking references for Personal Assistants?

If you are employing someone privately you can ask the Direct Payments Advisory Service (DPAS) to complete CRB checks on the person you wish to employ. DPAS will also carry out any reference checks for you if requested and will assist with any or all of the recruitment process.

30. If I opt for a direct payment to employ people myself, who is responsible for sorting out National Insurance, liability insurance and tax?

It is your responsibility as an employer to ensure that any payments due to the inland revenue are made.

The DPAS (Direct Payments Advisory Service) can assist you to set this up. Your care co-ordinator can refer you to this service.

31. If I employ a personal assistant and they go off sick, what happens then?

Your care co-ordinator will help you to complete your support plan. Your support plan will have to take into account what will happen in situations when your personal assistant is off sick or on annual leave.

32. Can I pay family members to carry out the care for me?

Yes you can as long as they are not family members living in the same house as yourself. Any arrangements would have to demonstrate that they are in your best interest.

33. What if I do not want the hassle of arranging my own care?

You can ask your care co-ordinator to arrange your services for you.

34. How can you buy something that isn’t available yet e.g. how can we ask agencies to cater for our needs at certain times if they still run on the same system as before with the same staff situation? How will they be able to cater for us under SDS e.g. if people ask to be seen at the same time?

Under SDS providers may need to change how they operate or you may need to change your provider to one that can better meet your needs.

35. Will I get enough money via direct payment to keep my present care agency?

This is not guaranteed. It depends on the rate your agency is charging and whether they are willing to negotiate an affordable hourly rate with you.

36. What happens if the amount assessed does not match your current provision which meets your needs? Would you have to top up and if so what happens if you don’t have the funds to do so?

When you are assessed your personal budget will be calculated to enable you to meet your current needs. If you choose to use a provider that is more expensive than your personal budget can meet, then you are able to top up the difference. The council has the duty to meet your assessed needs in the most cost effective way and within the resources available to them.

37. What happens when a private agency wants to increase the cost?

All requests for increased costs would have to be negotiated with the provider by you or someone who can negotiate for you. If your personal budget is inadequate to meet your eligible care needs then you would have to discuss this with your care coordinator.

38. Can additional services be paid for from an Agency on top of the agreed services set out in the support plan?

Yes you can purchase additional care yourself.

Back to Topic headings

Risks and Keeping you safe

39. How will the quality of care be monitored if people are arranging their own care?

Your care co-ordinator will check with you at your review that your needs are being met and that you are satisfied with the care you are receiving. If you are experiencing any problems with your care in between reviews you can contact your care co-ordinator or your local Mental Health Team.

40. Will Self Direct Support mean that people are put at more risk?

No. People’s support plans will identify any risks and how these will be managed. The support a service user receives will be reviewed regularly to make sure this continues to meet their assessed needs and any risks are managed.

Safeguarding procedures will apply whether the service user chooses to arrange their own support or they ask the council to arrange their support on their behalf.

41. Money given to people could result in an unsafe situation if that person has a mental health episode. What safeguards will be in place for this?

Cash given to someone would be in the form of a direct payment which should only be spent on the support identified in that person’s support plan. How a direct payment is spent is monitored through regular financial statements provided by that person or someone acting on their behalf, like a carer, relative or a friend. If a direct payment could put someone at risk, this would be considered as part of their care plan. It would also influence the decision to make a direct payment available to someone.

42. Who is going to regulate the carers that will be available to us, how can we make a good choice? What info will be available to us about agencies/carers to enable us to make a good choice?

Care agencies are regulated by the Care Quality Commission (CQC). Information about care agencies can be found on the CQC website www.cqc.org.uk or you can phone them on 03000616161. If you are employing your own carers through a direct payment they are not regulated as such but this will be discussed at your review with your care co-ordinator.

If you are employing carers privately then DPAS (Direct Payments Advisory Service) will be able to give advice and assist you with safe recruitment practises, which will include taking up robust references and undertaking CRB checks. Your care co-ordinator will refer you to DPAS.

43. Who will help if I have problems with my care?

If you are having problems with your care you can contact your care co-ordinator or your Community Mental Health Team.

Where can I get more information?

Leaflets

• Self Directed Support Buckinghamshire (PDF)

Buckinghamshire

Annual report of the Buckinghamshire SDS service user and carer reference group (PDF)

Bucksinfo – a web directory of over 1500 clubs and societies, voluntary and community services and activities in your area.

Buckinghamshire County Council:
County Hall
Walton Street
Aylesbury
HP20 1UA

Telephone: 01296 383204
Email: customerservices@buckscc.gov.uk.
Careline (to report mistreatment): 0800 137915
Out of hours emergency: 01494 675802

Buckinghamshire County Council have put together links to further information on self directed support on their website.

In Control

A national organisation that works to promote SDS and personal budgets. Their website has a large amount of easy to read information.

In Control Support Centre
Carillon House
Chapel Lane
Wythall
West Midlands
B47 6JX

Telephone: 0156 482 1650
Fax: 0156 482 4260
Website: https://www.in-control.org.uk
Email: admin@in-control.org.uk

Department of Health

Department of Health Website information on Social Care:https://www.dh.gov.uk/en/SocialCare/index.htm

• The Government’s White Paper that initiated self directed support Putting People First 2007:https://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081118
• Government White Paper Our health, our care, our say 2006:https://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4127602
• Good practice guidance on person centered planning: Personalisation through Person-Centred Planning
• Fair Access to Care Services – Department of Health:https://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_113154
• Choosing Recovery – Towards Personalisation in Mental Health:https://www.hscpartnership.org.uk/workstreams/personalisation/per_resources.aspx

We are not responsible for the content of external websites.