Social care - self-directed support: national framework - learning review

Background to learning review

Project to develop National Framework for self-directed support

6. In October 2019, Social Work Scotland brought together a Project Team (referred to throughout as the Team) to develop a national framework for self-directed support. The objectives were to deliver the following by March 2021:

• A shared framework model offering a detailed, coherent and systematic map for the delivery of Self-directed Support including consideration of resource allocation systems, models of assessment and delegation of decision-making;
• Engaging with local leadership and SDS leads in order to actively facilitate the sharing of knowledge and good practice across local partnerships;
• Development of effective approaches to creative commissioning at a local level along with national third sector partners; and
• Support to assist local implementers to personalise their processes and systems drawing on existing local expertise and insight from implementation best practice.

7. The SDS Project Team comprise a Project Lead, two Project Officers and one Project Coordinator.

Policy context

8. The policy and legal context in which social workers operate is increasingly complicated. The drive towards public sector reform aims to create more joined up local services based within communities and supported by regional and national initiatives and arrangements. SDS is one strand of Fairer Scotland for Disabled People, the Scottish Government's delivery plan for the UN Convention on the Rights of Persons with Disabilities (UNCRPD). Scottish Government has a commitment, vision, policy and legislation to support independent living and rights for disabled people.

9. When the Social Care (Self-directed Support) (Scotland) Act 2013 came into force in 2014, it set out five principles to guide implementation of the legislation: involvement of people in their assessments for support; clear information and real choices; professional staff and the individual working together to make a plan for the person's care and support with agreement on what is to happen; respecting the dignity of the person; and the right for individuals to take part in the life of their community.

10. Individuals were to have greater choice and control in directing their own support and four options were set out in the commissioning of services:

Option 1 Direct Payments: local authorities decides the budget available and this is paid directly to the individual to arrange support, employ care staff or buy a service from a care organisation.

Option 2 Person directs the available support: local authorities decides the budget available and the individual chooses how that support will be provided which is arranged by the local council

Option 3 Local authority arranges the support: local authorities decides the budget available and following discussion with the individual, chooses and arrange the support.

Option 4 A mix of the above: this lets individuals decide which elements of support the individual organises and what parts are arranged by the local authority.

11. In 2017, the Audit Commission published its report on the progress of implementation of SDS and concluded that there was a need for authorities to review their processes for supporting children to transition into adult services. Planning for transitions needs to be well coordinated to ensure a seamless service without overlaps or gaps in services, particularly where responsibility is split between the Integration Joint Board and the council. Later that year, Scottish Government commissioned research to contribute to the ongoing national monitoring and evaluation of self-directed support. Workshops were held involving 37 people from local authorities, providers, carer organisations, national bodies and disabled people's organisations from strategic and operational roles. The research produced the SDS Change Map outlining the overall vision for SDS in Scotland and the required changes for more effective delivery of social care within the context of self-directed support. The change map was at the heart of COSLA's and Scottish Government's Social Care Support Implementation Plan 2019-2021.

12. Other national developments included:

• Carers (Scotland) Act 2016 established rights for carers to have an adult carer support plan or young carer statement and access self-support in their own right; to be involved in planning services; and to have their views taken into account in assessing the needs of the person they care for.
• Health and Social Care Standards: My support, my life published in 2017 setting out what people should expect when using health, social care or social work services in Scotland and reinforce the values and principles of self-directed support across all settings.
• Collaborative Communities programme funded by Scottish Government until March 2020 aims to ensure that health and social care organisations use collaborative practice and tools to facilitate real choice and control for people in their communities including developments in Community Led Support.
• The Promise, which is responsible for driving the work of change demanded by the findings of the Independent Care Review to ensure that care experienced infant, child and young person grows up loved, safe and respected and able to realise their full potential.
• Independent Review of Adult Social Care in Scotland to recommend improvements to adult social care in Scotland, primarily in terms of the outcomes achieved by and with people who use services, their carers and families, and the experience of people who work in adult social care.

Learning review

Objectives of learning review

13. As part of the development of a national framework for self-directed support, Social Work Scotland commissioned a small-scale learning review to map the approach taken by the SDS Project Team and bring together the learning from throughout the project. This learning review aimed:

a. to map the approach taken by the SDS Project Team;

b. to record the process and consultation undertaken throughout; and

c. to record the development of all elements of the national framework

Approach to learning review

14. The learning review undertook a documentary analysis of the documents generated by the SDS team during the course of the review. From an initial search, 709 documents were identified for the initial stage of filtering. Documents were excluded if its topic was unrelated to the aims of the learning review or were duplicate documents. This initial stage of data filtering resulted in 391 articles eligible for further screening. The next step of data extraction considered each document in more depth. 382 documents were included in the final review through this search method.

15. The documentary analysis taken in this review considered four aspects in relation to each document: authenticity; credibility; representativeness; and meaning derived from the documents. Authenticity considered whether the origin of the document was reliable and the evidence genuine. Credibility considered whether the information was trustworthy with some level of expertise. Representativeness considered to whether the document represents the wider issues and finally, the Meaning explored whether the material was understandable and clear so that documents could be examined to understand their significance, meaning and fit with the context of the analysis.

16. The documents were effectively organised, filed and maintained in relevant folders, which allowed for a comprehensive search through all documents. The purpose of all included documents was clear and each was dated. The clarity of the context, the perspective and role of contributors and content in each allowed for confidence in the authenticity, credibility and representativeness of the material and the emerging messages and reflections.

17. The final 382 documents reviewed ranged in type:

• Research articles, dissertations and practice evaluations
• Published reports and papers
• Reports relating to SDS Team activity
• Presentations
• Surveys and responses
• Minutes of meetings and groups
• Notes of conferences and conversations
• Draft assumptions, standards, and action statements

• 18. The final documents also covered a range of topics: legislative, policy and practice context across adult and children's social care, and SDS implementation in Scotland; approaches to project management, change and implementation science; practice developments in Scotland and wider UK; developing the evidence base; proposed SDS standards, underlying assumptions and action statements; and analyses of contributor and stakeholder contributions.