26th February 2020 | News

Since 2014 local authorities in Scotland have had a legal duty to offer those eligible for social care four options about how their care and support can be delivered. As well as offering these options, local authorities must also be able to offer support to help people make informed choices about how this happens.
 
What does Self-Directed Support aim to achieve?
The aim of Self-Directed Support is to help people live better lives by making sure that:

• Disabled people have the same freedom and choices as others at home, at work or in the community
• People get the kind of support they want, where and when they want it
• People get support at the right time, before a crisis or emergency happens
 
Who can access Self-Directed Support?
Self-Directed Support is available to people receiving long-term support following a formal social care assessment. It is intended for people with longer term, relatively stable and predictable needs for support. These could include needs associated with:

• frailty
• cognitive impairment such as dementia
• learning disability
• some long-term conditions
• physical disability
• a person who has needs that may be episodic but there is some degree of predictability e.g. mental health problems
• a child with disabilities requiring longer term support

The four options for Self-Directed Support
• Option 1: Direct payment
The local authority decides how much can be spent on support. It then makes the payment directly to the supported person who is responsible for arranging and paying directly for the care or support. The individual can buy support from a care organisation or employ someone to provide the care.

Direct payments were introduced to provide more independence, flexibility and choice for those who use services.

• Option 2: Support chosen by the individual, arranged by the local authority
The local authority decides how much can be spent. The individual chooses the support they would like and the local authority arranges it and pays for it.
 
• Option 3: Support chosen and arranged by the local authority              
The local authority decides how much can be spent on support. The individual then asks the local authority to choose, arrange and pay for the support. 
 
 Option 4: A mixture of options 1, 2 or 3 for each type of support
The local authority decides how much can be spent on support. The individual chooses which types of support they want to pay for and organise directly and which they want the local authority to do.

[Taken from the Scottish Government’s A Guide to the Self-directed Support (Scotland) Act 2013]

What can the money be spent on?
Anything in a support plan which will meet outcomes that have been agreed with the person requiring the support.

Under the terms of the 2013 Act, local authorities must provide a variety of sources of support, whichever option the individual chooses. Providers of support can include:

• in-house (local authority) providers; 
• local authority trading companies;
• arm‘s length independent organisations (ALMOs); 
• voluntary sector (not for-profit) providers; 
• private sector (for-profit) providers;  
• social enterprises; 
• small and micro-providers;
• user-led providers; 
• employee owned co-operative providers; 
• independent support organisations;
• personal assistants
 
What has happened so far?
In a report published by the Scottish Government in 2018, it was estimated that 70% of social care clients were given a choice over their support and services in Scotland in 2016-17. At least £539 million was budgeted for Social Care clients who made a choice regarding their support and services in 2016-17. However, there are expenditure recording issues so this should be considered to be an underestimate.
 
What part can CNHC registrants play?
Direct payments allow people receiving support to have more control over their care. If complementary therapies are considered suitable to meet a support need then, in principle, funds can be used to cover costs. If you have a client who you think may qualify for a Self-Directed Support, you can recommend that they speak to their social worker or local council if they are not already receiving support from social services.
 
Useful resources
• Social Care (Self-directed Support) (Scotland) Act 2013
• Statutory guidance to accompany the Act.
 Self-Directed Support: Practitioner Guidance
• The Scottish Government funds an organisation called Self-Directed Support Scotland which champions local Independent support organisations who provide quality advice and support on Self-Directed Support.