Back in June in the post From In Control to Citizen Directed Support I suggested we all have a go at coming up with 100 words at answering the question ‘What does Citizen Directed Support Mean to us?’.
The officers of City and County of Swansea have really engaged in this and came up with a range of definitions for personalisation and Citizen Directed Support, thanks to them for these 100 word definitions.
Personalisation to me means the incorporation of a number of concepts. Enabling, empowering are two but behind that is ensuring that people have enough information to make an informed choice without constraint. It also means that people have the right to give the right away to trusted others. Not everyone wants responsibility and we cannot thrust it upon them. The very fact that people are touched by our services means that they have needs that they are unable to deal with at the time. Personalisation suggests that we assist in enabling people to address these needs in whatever way is right for them.
‘Citizen Directed Care allows and encourages individuals to have greater control over the services they need to obtain the independence, well-being, social interactions and autonomy which they want. It allows and enables individuals to take a greater degree of personal responsibility for their lives and lifestyles and to choose how they will engage with agencies or others to deliver services in ways which will meet the outcomes which are best for them. It will enable individuals to understand their rights and entitlements, whilst also recognising the constraints imposed by society and the responsibilities of being a citizen.’
- A fundamental shift from a consumerist model of care to a model of co-production
- Capacity building within the community, and building individual social capital within these communities (interdependence)
- A move from individuals being recipients of a service to active participants
- The outcomes agenda, individual budgets or direct payments alone will not ‘transform’ social care and a more fundamental cultural shift is required
- This will require understanding and sign up from politicians, senior and middle managers, staff and service users and their families
- Understand the changes that need to occur throughout the Commissioning Process
- It will require a change in roles for professionals and front line staff
- A change to how we perceive risk as an organisation, a change to how we contract and understand and manage performance
- A change to how we allocate and manage budgets
- Key phrases; feeling in control and having shared responsibility, having choice, flexibility and responsive services.
Personalisation should mean exactly that. As an authority we should be prepared to develop a range of solutions and options for people to have support and take action from the individual discussions we have with people. People will vary on the levels of choice and control they aspire to and how they direct their own support and we need to respect that. Many will have their primary focus on improvements to the reliability, consistency and quality over the sorts of services they already receive and we need to achieve this while fostering a culture that allows for innovation for those who wish.
Personalisation is finding out what matters most to service users and carers and using this knowledge to make a positive difference to their lives. It supports their interdependence and well being, through a relationship centred and collaborative approach to the achievement of personal outcomes, in a manner which values and respects everyone concerned.
This requires:
- A common understanding of outcomes
- A commitment to social justice and equality
- Increased service user and carer control
- Supportive risk management
- Working within the context of families and communities
- Making the best possible use of all resources, including those within families and communities
- Supporting frontline staff and volunteers
Personalisation is putting the service users with their family and carer(s) back in the centre by self assessing or co-assessing holistically. It’s about the ethos that the individual/customer knows best, allowing/enabling people to shape and control their own services – thereby their life. It’s about putting more resources into prevention and reablement, making people part of their community and vice versa. Transparent allocation of resources to provide a full range of services, developing the marketplace, making choice real. Access and inclusion where citizens have equal rights and opportunities. It’s about supporting better health and social care outcomes by seeing images of possibilities by good support planning. Give staff and users permission to do it differently, not prescriptions.
- Individuals are supported to have as much control over their support planning as they choose or are able to manage, through a range of methods such as individual budgets or use led services.
- They are equally helped to become part of mutually supportive communities which they have investment in and influence over.
- Agencies deliver services to individuals achieving explicitly agreed individual outcomes.
- They also actively support communities to build their capacity for collaboration and mutual assistance.
- Explicit shared systems of communication exist between individuals, community groups and agencies to support collaborative decision making and local adaptation.
The Wales Alliance for Citizen Directed Support is now picking up this approach and are building on the work to create a shared definition for Citizen Directed Support across Wales. You can find out about their work at their website at www.wacds.org.uk
