Self-directed support (NDIS or My Way) has the potential to revolutionise support to people with disabilities. But service providers must also adapt, learn and innovate. These slides were shared at an event for over 90 service providers in Perth, WA - with the support of WADSC and NDS.

1. What Good Support Looks Like
Dr Simon Duffy ￭ The Centre for Welfare Reform
￭ 8th October 2013 ￭ for NDS and DSC, Perth, WA
reflections for service providers

2. 1. Background

3. “It’s my life, my human rights”

4. • 1990 in London:
brokerage, individual
funding, person-centred
planning and supported
living
• 1996 in Glasgow: new
models of service
provision and Individual
Service Funds
• 1999 in Scotland: self-
directed support with
local government
• 2003 in England: piloting
of self-directed support
via In Control
• 2009, established The
Centre for Welfare Reform,
global community for
social innovation
Simon Duffy, some background

6. We still have much still to learn

7. Things to remember
1. The goal is citizenship
2. Support will need to change
3. Services will need to change
4. NGOs can play a leading role, if...

8. After the big
institutions
were closed
People were
not free
People were
not included

11. Citizenship is the right goal

13. 2. SDS/NDIA/MW...

14. Professional Gift Model
• Help is received as a gift for which I must
be grateful - difficult to change or
challenge
• Help defined by someone else and
delivered as a fixed service.
• Help is inherently incompetent it takes
control away from me
• Blame moving up and down systems of
hierarchical control
• Community cut off from awareness of its
own proper role.

15. Citizenship Model of Support
Challenge: a new paradigm - but one that has to be
developed from within the old system itself.
• Individual in control
• Life led in community
• Clear entitlement to
funding
• Support agreed with
professionals

16. • it improves outcomes
• it increases demand
• it can reduce costs
• design details matter
40 years plus of
self-directed
support tells us

18. Self-directed support is a system to enable citizenship.
Ideally it has the following qualities:
1. Rights - robust rights that give people effective entitlements
2. Control - person, or someone close to them, controls budget
3. Clarity - systems, rules and budgets are clear
4. Flexibility - budgets can be used in many different ways
5. Ease of Use - it is easy to plan, manage and control assistance
6. Community - person’s contribution to society grows
7. Sustainable - system is affordable, innovative and supported

19. Self-directed support in England involved
multiple changes to the existing system.

20. Change how money works

21. Its the person’s money

22. Phase One Report
2006

23. Phase Two Report
2008

24. Place N Change
6 Sites Phase I Report 60 -18%
17 Sites Phase II Report 128 -9%
13 Sites IBSEN Report 203 -6%
Northants 17 -18.7%
City of London 10 -30%
Worcestershire 73 -17%

27. In the UK in the best places...
• Citizens and families are
trusted more.
• Citizens and families are
stronger and more in
control.
• People’s lives are much
better.
• People use services less,
community more & have
more friends.
• Money is citizen’s and can
be used flexibly.
• People drive the design
and delivery of their
support.
• No new support systems
of‘brokers’- instead better
use of community and
professionals.
• It costs much less than the
old system.

28. Mistakes and failures
• Pseudo-scientific
assessment tools (RAS
Versions 3, 4 & 5)
• Failure to build-in‘time
limits’
• Support plan treated as a
contract
• Not enough focus on peer
support
• System was not easy for
professionals and people
• System tries to‘make’people
be creative
• ‘Person-centred planning’
industry
• On-going means-testing
income & social capital
• No clear legal right to
entitlement for support

29. The UK experience is paradoxical
Commissioners invest in institutional services, despite
associated risks, regulators regulate institutional services and
observe on-going failure, but letting citizens take control is
seen as risky.
There has been rapid growth in individualised funding, but
services have changed slowly
Service providers led developments in individual funding,
but are mistrusted by commissioners.
Systems have taken steps to invest more trust in citizens, but
shown less trust in civil society.

31. 3. Innovation process

33. Government’s don’t innovate - but they can
support innovation (or not).

35. Development of
self-directed
support is a
complex and
evolving
innovation that
requires change
at 3 levels

36. 4. The challenge

37. Can we build a respectful partnership with
people and a new balance of power?

38. 5. Personalising
everything

39. What I am most proud of

41. You can use Individual Service Funds to have your
budget managed for you

42. 6. Supporting families

47. 7. Staff as people

51. 8. Peer support

52. We haven’t begun to tap the
power of peer support

53. 9. Safety

55. 10. Support with life

56. For the 3 years before 150 days in hospital -
responding to problems with breathing.
In the 3 years after leaving hospital he has spent
only 2 nights in hospital - for elective dental
treatments.
Personalised learning - on the job - 2 City & Guilds
Qualifications.
Saving NHS, LA & Education
•Over £100,000 in hospital stays
•Over £300,000 in residential care costs
•Over £100,000 of funding contributed by the LSC
Jonathan’s story

57. Schools can lead the way...

58. 11. Community
assistance

59. community brokerage

61. rethinking advocacy

62. 12. The bond of trust

63. Women’s organisations...
understand
personalisation

64. 13. Community change

67. the government money fallacy...
...money can’t always be theirs

68. 14. Commissioning...

74. 15. End thoughts

75. 1. Ask providers to lead the process of change
and deliver efficiencies
2. Build in peer support at every step.
3. Treat the money as if it already was people’s
money.
4. Innovate and seek to foster innovation.
5. Work together, learn, share and change.

76. Intework is going to remember that it is always the
client’s money
Interchange is going to build more peer supports
St Jude’s will be focusing on more individual
community-based supports.
Therapy Focus we are committed to peer supports,
individualising and innovating.
GIFSA will encourage choice and control, remembering
its the client’s money.

77. For more information:
Web: www.centreforwelfarereform.org
Twitter: @CforWR and @simonjduffy
Blog: www.simonduffy.info
Facebook: centreforwelfarereform
Campaign: www.campaignforafairsociety.org
© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org

78. For more information go to
www.centreforwelfarereform.org
These slides are © Simon Duffy 2013 ￭ Publisher is The
Centre for Welfare Reform ￭ Slides can be distributed subject
to conditions set out at www.centreforwelfarereform.org ￭