Self-directed Support: Practitioners Guidance

The Four Options

Under the Self-Directed Support (Scotland) Act 2013, local authorities have new duties that require them to offer greater choice and control to people who, following assessment, have eligibility for funded support.

Social work services aspire to promote independence not dependence. One measure of success is that people are enabled to live positive lives beyond the requirement for continued support.

Whilst self-directed support undoubtedly represents an important change in social care, it is important to recognise that the offer of the four options apply to the provision of long-term support following a formal social care assessment. Practitioners need to consider the wider supports that are available to people beyond their formal social care provision and they need to consider how to integrate this into any formal support.

There are also regulations accompanying the Act. The Regulations provide additional safeguards in relation to the direct payments – safeguards for the authority and for the supported person. This is to recognise the unique nature of a direct payment and to support practitioners and individuals to choose the direct payment option.

The formal offer of the four options does not apply when :

• a person is presenting in crisis (though self-directed support may represent a sustainable approach to help prevent crisis or help a person with longer term needs manage a crisis if it occurs).
• when it is premature to make an assessment about a person’s longer term need for support, typically before every attempt has first been made to maximise their capability e.g. through reablement.
• when it is necessary to arrange support ahead of more considered planning to meet future needs e.g. to facilitate discharge from hospital.
• when a person’s chaotic lifestyle requires stabilising before their longer term support needs are identified and addressed.
• when a person’s outcomes can be best achieved through a relationship with a practitioner, access to universal services or community resources rather than through access to support that requires an individual budget.

This does not mean that the provision of greater choice and control for individuals should not be considered for people in some of the above circumstances – rather that other interventions may be more appropriate to timeously meet presenting need. That does not preclude emergency financial assistance being made available in keeping with existing legislation, practice and professional judgment.

If it is evident through assessment, or at a later stage, that longer term support or intervention is required to meet eligible need, then the duty to meet assessed needs applies and the four options should be explored.

Lack of capacity is not a reason in itself to exclude people from self-directed support. ‘Capacity’ is NOT an absolute concept. Indeed, someone deemed to lack capacity is likely to have longer term needs. They are also less likely to be able to maximise choice and control over their life if self-directed support is not used. Careful consideration is obviously required to be given as to which of the options will apply most helpfully in such circumstances.

It should be noted that people in long-term residential accommodation remain ineligible to receive a direct payment (though the Scottish Government are planning to pilot a different approach in a small number of local authority areas).

The offer of the four options applies when a person has longer term, relatively stable and predictable needs for support, for example needs associated with:

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

The four options will be offered after an outcomes focused assessment has been completed in partnership with a person (and, where appropriate, their representative/s) and where the assessment suggests there are eligible needs that cannot all be met through natural supports, personal strengths or through community resources.

Community resources could include accessing existing services and approaches – such as rehabilitation through collaboration with partner agencies such as the NHS. The law requires local authorities to provide clear information on all the four options available when a person is eligible for support. This may be in the form of access to an independent advocate, translation, an interpreter, or support that may involve a communication aid or method that supports the person to make their views known.

Local authorities will have a local mechanism for determining how much funding will be allocated as the relevant amount. The practitioner needs to be able to inform the person about how their support will be costed prior to exploring the four options, supporting the principle of informed choice.

Practitioners have a responsibility to ensure the supported person is fully informed of opportunities, responsibilities and consequences in each of the options.

• Local authorities should have a system of deciding a budget that is fair and clear to everyone.
• Practitioners should be able to advise the individual what resource is available under each of the four options.
• The amount of money allocated for support should be enough to meet the needs and agreed outcomes that are agreed in the assessment.
• Before deciding how much money to allocate, the local authority must take into account the view of the professional who has worked with the individual and agreed needs and outcomes.

Four Options and risk: considerations for practitioners

• ensure the person is eligible to access the four options (section on Eligibility).
• ensure alternative solutions have been explored.
• consider how the person will best understand the information, and how it can be made as accessible as possible.
• have the implications of personal capacity been considered?
• are there any risks or concerns about the person’s ability to manage any of the options and if so what can be done to minimise or support the risk?
• if there are significant concerns about outcomes not being met by the choice of a particular option then this needs to be explored fully with the person, the organisation and the person’s representative.
• ensure that reasons for not being able to access any or all of the four options are explained to the person and that this is put in writing.
• evidence suggests that an effective relationship with the supported person is required to promote risk enablement as part of self-directed support as well as detect and prevent harm as part of safeguarding duties.
• the skills required for risk enablement and safe guarding include the ability to support people to assess the impact of risk and explore ways to minimise and manage risks.
• supporting a more person centred and collaborative approach to managing risk is crucial in helping to move aware from inappropriate risk averse policies and procedures.
• in all our practice, but particularly around risk, we need to be confident that the decisions and actions to support risk are proportionate. Practitioners need to ensure their decisions are defensible and the reasons for decisions are evidenced appropriately.
• practitioners need to be supported by their organisations to incorporate safeguarding and risk enablement in their relationship-based, person-centred work.
• effective, consistent, trusted relationships and good communication are particularly important for self-directed support and supporting risk.
• practitioners may encounter situations where their professional assessment will recommend it not appropriate to explore a particular form of support under one of the Options. It is the practitioner’s discretion, as part of the collaborative approach, to raise this with the supported person and come to a solution that provides the appropriate flexibility to the individual and meets assessed needs.
• positive risk taking or risk enablement is central to the philosophy of self-directed support but practitioners are still required to balance empowerment for the individual whilst fulfilling their duty of care.
• research shows that risk management dilemmas are an inherent part of social work practice and existed well before the development of Self Directed Support. Therefore, there will always be a role for professional judgement when exploring risks around the choices on offer through Self Directed Support.

Option 1: direct payment

• this is an existing duty but the Act retains it as an established option. The supported person may choose option 1 to purchase appropriate support to meet their agreed outcomes.
• practitioners need to explore the implications of capacity with regards to direct payments and a part of this consideration will involve an understanding of the person’s natural supports and the level of understanding that the person has about the choices and their implications. Clearly a direct payment involves additional responsibilities.
• If a person is formally assessed as ‘lacking capacity’ under the AWI Act, then they will only be suitable for a direct payment, after being assessed and found to be eligible, if they have a formal legal guardian who is able to speak for them. Otherwise, the choice would default to Option 3.
• if a person doesn’t lack capacity in the legal sense (under the AWI Act) but needs significant assistance to make and manage decisions, then the local authority has a duty to support them in this decision making and to assist them with the management of their decision thereafter. This ‘management’ may be provided directly by a third party, depending upon the option chosen.
• Practitioners, therefore, need to be confident, knowledgeable and be able to give accurate information on the risks and responsibilities that come with a direct payment arrangement.
• If a person cannot choose the direct payment, or cannot manage their support under the direct payment even with additional support, then the authority retains its duty to provide services under Option 3.
• the supported person may use a direct payment to purchase support from a provider including those not on local authority approved frameworks – provided the authority’s assessment is that the support will meet a person’s intended outcomes safely and appropriately.
• if a person prefers to employ a Personal Assistant to meet their support needs, they must use Option 1 to do so. In this event, practitioners must signpost a person to the appropriate information and advice to ensure they are able to meet the ensuing responsibilities. There are a number of such organisations who provide this service and there is an obligation for a local authority to provide information in this respect.
• this information needs to include the need for PVG, arranging holiday cover and having clear contingency plans, since that responsibility does not then lie with the local authority.
• the test for a local authority in relation to making a direct payment for the employment of a personal assistant is no different to that set out above, i.e. that the support will meet a person’s intended outcomes safely and appropriately.

Option 2: Directing the available support

• the person, in partnership with the practitioner, can identify a third party or local authority to oversee/administer their agreed budget. Effectively, it is an individual budget that is administered on behalf of a person with eligible support needs. They can direct the local authority to make payments on their behalf for services or for the purchase of key items that will meet their outcomes, or a combination of both.
• the budget can be held by an identified provider who works in partnership with – and takes direction from – the supported person on how they wish their support to be delivered.
• the third party will oversee the administration of the budget and provide and/or arrange for the flexible support to the individual as and when agreed – to meet identified needs.
• this option should allow for the supported person to stay in control without the additional responsibility of managing a direct payment.
• practitioners need to explore the implications of capacity with regards to direct payments and a part of this consideration will involve an understanding of the person’s natural supports and the level of understanding that he person has about the choices and their implications. Clearly a direct payment involves additional responsibilities.
• if a person is formally assessed as ‘lacking capacity’ under the AWI Act, then they will only be suitable for a direct payment, after being assessed and found to be eligible, if they have a formal legal guardian who is able to speak for them. Otherwise, the choice would default to Option 3.
• if a person doesn’t lack capacity in the legal sense (under the AWI Act) but needs significant assistance to make and manage decisions, then the local authority has a duty to support them in this decision making and to assist them with the management of their decision thereafter. This’ management’ may be provided directly by a third party, depending upon the option chosen.
• Practitioners, therefore, need to be confident, knowledgeable and be able to give accurate information on the risks and responsibilities that come with a direct payment arrangement.
• if a person cannot choose Option 2 or manage their support under Option 2, even
  with additional support, then the authority retains its duty to provide services under Option 3.
• the person should be supported to take a lead but be made aware of any implications.
• consideration of intervention using Section13za of the Social Work (Scotland) Act to access option 2 should be considered – for example if the supported person has some capacity to understand the options and has a good, supportive network.

Option 3: Services arranged for the person by the authority

• the person may choose/decide for the local authority to continue to select and to make arrangements for the appropriate support that will meet their agreed outcomes.
• there are a number of reasons why a person may choose option 3 and this choice is as valid as other options in the self-directed process.
• the local authority will have responsibility for identifying and commissioning (or providing) appropriate support and making payment of the relevant amount to the identified provider/service.
• it is important to note that when an individual chooses option 3, the principles of being provided with information, offered choice and having some control still apply.

Option 4: A mix of the first three options for different aspects of support

• this may be a useful choice for someone wishing to have a taste of managing a budget e.g. a young people in transition or moving beyond care who may wish to have an opportunity to direct a small part of their budget whilst being supported to develop skills and confidence to use this more widely.

The Four options: Case Examples

James’ story

James is a 92 year old retired college lecturer who has lived his life as a socialist. This ideology impacted at times in various ways, his choice of house tenure, how money was spent, a concept of community and belief in role of state. His wife and three sons found ways of living with this, embracing and challenging in equal measures the consequences at times. His wife Sheena has been a pragmatic partner, accepting that he has strong views, is independently-minded and strongly self-motivated.

He had university potential, but as eldest son, he had to leave school at 14 and get a trade, working as an engineer following apprenticeship. He later gained a social sciences degree through Open University and an art degree at Glasgow School of Art through evening classes.

He is a well-known figure having been involved in various political campaigns and local elderly forum, and as guest speaker in schools through his local history knowledge.

James has become more forgetful, but the strong dominance of his character has made this a challenge for him and his family, particularly his wife. He is distressed at losing any kind of control, especially his independence of thought and self-determination.

His wife is adjusting to working around the new challenges, and has approached a local Alzheimer’s group for advice and options for future. There is family support but their sons do not live nearby. They are articulate and knowledgeable but sensitive to parents continuing need for independence and respectful of their lifestyle choices. James in many respects will benefit from the new approach offered through SDS, enabling him and his wife to feel they still have some control over decision making. As his condition deteriorates he will become eligible for formal support to enable him to manage, as will Sheena in her own right as carer. For James it will be to assist with his personal care, dressing and enabling involvement in activities that help him remain part of his community and support his dignity. For his wife it will be her emotional and physical strength as she adjusts to being a carer at 85 years of age. The couple will continue to use support of their sons more flexibly and for other types of activity – social activity, shopping trips etc. Power of attorney is in place.

Option 1

Given the couple’s belief that the state knows best, and due to the stress dementia has caused, this will not be a preferred option. While it gives more control, the couple have not engaged in many aspects of financial management and this would cause additional stress at a time when managing the emotional impact of change will be at it’s most intense.

The couple would not wish to manage a budget either for James or for Sheena as a carer with needs is her own right. At review Option 1 might be reconsidered. This will be guided by how effectively and flexibly the chosen option has delivered.

Option 1 might be considered if POA for any unforeseen reason has to be activated and their sons feel able to manage this on behalf of their father.

Option 2

Council manages budget but couple choose support and provider.

This option may be more openly explored at a later stage. At this time of stress and change, for a couple unfamiliar with services, it is unlikely they would feel comfortable about directing their own support. but the change for a couple previously independent with no services. It is not at this time of stress and change something they would feel comfortable about directing as a first step and good assessment will identify that. Assessment will also identify that once trust and evidence of new approach is gained, this option could be reconsidered through feeling informed through actual experience.

Good assessment skills will ensure that the couple are clear about this option and how it might work and will identify where natural support is, and where there are gaps.

At review

Option 2 may well become the ideal balance between having control and having security of council involvement as a safety net. It will take time for people to adjust to the implications of choice.

Option 3

Council decides and makes agreed arrangements to meet the agreed goals and outcomes.

The new act will ensure that the couple are well-informed about the level of support they will receive and will ensure that this is provided as flexibly as is possible.

For the couple, local authority and NHS support are what they have been used to – (they seldom see a GP, and keep well generally so see the state as a benign safety net). This will be their instinctive place of comfort based on what they know from relatives, friends and family. Of note local authority was not their first post of call when considering support, it was Alzhiemer’s Scotland they went to for advice at time of diagnosis. Given the demands of council services for James this may not be as flexible or responsive to him as at first anticipated.

Will this arrangement take account of family and community support?

For Sheena, she may find options for support to her as a carer are less creative. However to settle into a new way of life, for both this would be the preferred choice.

At review

The couple are more likely to feel comfortable at exploring again the four Options based on their new and growing experience.

James changing capacity will be an ongoing factor, but will not limit his choices, given assessment information and knowledge of what his preferences would be.

Sheena may now be more open to exploring other ways of helping her continue in her caring role.

Option 4: A mixture of all

At initial stage this may not be seen as likely to be most effective, it may feel too complicated at first, unless there are gaps in local provision. However through time experience and with information about amount of support to be offered, and a trusting relationship with assessor and through team work with others involved such as community psychiatric nurse and GP, it may be that this is ultimately the most effective option at review stage. The choice of this option will depend on good and clear information, and involvement in how the support may be shaped and what it will look like. This will require a very detailed support plan to enable the couple to make best use of this.

Rachel’s story

Rachel is 11 years old and lives with her family. She has cerebral palsy and requires to use a wheelchair. Rachel has significant personal care support needs but attends mainstream school and lives life to the full. She currently receives support from social work in the form of homecare twice per day to assist with getting showered, dressed and ready for school and bed. She also receives a sitting service one evening per week to allow her parents some time away from their caring role. Due to insurance issues with the care provider the sitter is unable to take any responsibility for Rachel’s siblings or friends who may want to visit. Rachel’s family is also assessed as being eligible for two weeks’ respite per year at a local respite unit for young people with physical disabilities. During the school holidays Rachel is able to access the local play scheme run by the local authority for children with disabilities.

Let’s consider how Rachel’s support plan could look by applying the four options.

Option 1

Rachel’s parents opt to take a direct payment for her assessed support. With this system they chose to employ a neighbour (Angela) who Rachel has known most of her life. Angela is 22 and currently undertaking her nursing degree. They employ Angela as a Personal Assistant (PA) to support Rachel with her physical care needs in the morning and in the evening. This frees up Rachel’s parents to get themselves ready for work and younger children off to school and does not leave them exhausted with the physical care needs on a daily basis enabling them to spend more quality time as a family. Rachel and her family use a specialised payroll agency to help them manage their employer responsibilities.

Angela is also employed to support Rachel one evening per week, to allow her parents a break. Angela is not restricted by employer insurance issues and therefore is able to accompany Rachel and her friend to the local bowling alley, driving Rachel’s Motability vehicle. Rachel enjoys this as she gets to spend quality time with her friends without her parents needing to be there. This works for Rachel as she looks up to Angela and is not embarrassed about her supporting her the way she is if her mum is at the bowling with her.

Instead of Rachel using the residential respite unit in her local area, she and her friend who also has a respite budget, choose to pool their budgets and employ a support person to help them access three short breaks per year. Rachel and her friend spend time finding out about places they wish to go and have been to see their favourite band, One Direction, in Manchester, staying at a hotel and going shopping with Angela’s support.

Option 2

Rachel and her family identify a support provider who are willing to be flexible and recruit two dedicated workers to support Rachel. Rachel and her family are involved in the advertising locally and interview candidates. It is important to Rachel that her supporters are ‘young and trendy and have similar interests to Rachel’. The support provider is able to recruit two college students who are undertaking an HNC in social care, they live locally to Rachel and can be flexible with their support. The local authority gives the provider the annual agreed budget the annual agreed budget for Rachel’s support and together they are able to help Rachel and her family develop a support plan that works for her. The budget can be used creatively as long as Rachel’s outcomes are being met. Rachel’s social worker meets four times yearly to review and monitor the support plan and this is done in a person-centred manner, with Rachel deciding who she wants to be there. Rachel is supported to engage in the process by developing a visual pathway of her achievements etc.

Option 3

Rachel and her family chose to continue to use the services provided by the local authority. Rachel’s social worker works in a co-productive manner and encourages the home-care service to provide Rachel with consistent workers who are young and full of energy. After discussions with the sitter service there is an agreement that the sitter is able to take Rachel out with her friend (Rachel’s friend’s parents are part of this discussion and happy for this to happen and are clear that the sitter is in no way responsible for their child).

Rachel continues to use the respite resource in her local area but works with the team there to ensure that her breaks coincide with a friend from the play scheme so they can be there at the same time and spend quality time together, Rachel and her friend are consulted prior to their stays on the outings activities they wish to be supported to do.

Option 4

Rachel uses a mixture of all the options. Her parents take a direct payment to pay for Angela to become Rachel’s PA and support with daily personal care and use the payroll agency. Rachel still uses the respite unit but only for one weekend per year when her friend is also going and has two weekend breaks with Angela and her friend to attend their favourite concerts in London and Manchester. The girls again pool their respite budgets to fund this. Rachel, with the support of her support worker, source a care provider that can provide a service that is happy to support a community outing for Rachel and her friends to the bowling. They work with Rachel, her family and friends to develop safety strategies that allow Rachel to be less reliant on the support worker when she is accessing the bowling which is hoped that, as Rachel gets older, will help her develop skills to enable her to access her community with minimal support from her support workers. Rachel still accesses the council run play scheme because she loves it and has lots of friends there with similar experiences and interests.

Vera’s story

Vera is a 46 year old woman with diagnosed personality disorder. She lives alone in a local authority house but has a history of homelessness, eviction and experience of domestic violence. She has a number of health issues and her mental health fluctuates. Vera’s lifestyle could be described as chaotic and she has been assessed as needing support to manage her tenancy including support to manage bills and correspondence, maintain relationships with neighbours and others and to keep on top of her housework. Vera also needs support with getting to health appointments and taking her medication.

Vera currently has daily support from a care provider but relationships can be difficult and she often decides not to engage with their support. This increases her vulnerability and risks as she often does not eat, wash or take her medication. Vera’s home is in a poor condition due to levels of self-neglect and a number of animals kept in the property.

Option 1

During assessment the social worker and Vera explored whether she could manage a direct payment and employ her own team of personal assistants.

Some of the risks identified included:

• Vera would struggle to manage any payroll responsibilities.
• She would struggle to remain professional when dealing with her staff if difficulties arose and would likely threaten to sack them.
• Issues of capacity arose. Vera struggled to manage her on weekly budget and was often in financial crisis and she had no-one in her life able to support her with this.

The option of a direct payment is not made available to Vera as she lacks capacity to really understand the full responsibilities and consequences of becoming an employer. This decision was fully discussed and agreed with Vera and reasons given in writing. Vera was then supported to explore and make a decision between the other options.

Option 2

Vera is supported to engage with a number of local providers and ask them to explore with her how they could assist her to live her life the way she wanted. The providers pitch their ideas to Vera based on a brief overview of what she wants from life. It is important to Vera that the people who come into her house appreciate some of the choices she makes and that they support her to help look after her pets. Vera also wants flexibility around her support times and it is important she can contact the provider in times of crisis and they can respond.

With support from social work and her community nurse, Vera is able to identify a provider she feels can support her flexibly, and she is involved in picking a core team of workers who will form a consistent team. The local authority agree to provide the care provider with the budget that has been agreed and they take responsibility for overseeing this on her behalf. Vera is clear about how much her personal budget is and how she can direct the spending of this in negotiating with the provider and her social worker. Vera has chosen people to support her that she is comfortable with and feels she can develop positive relationships. The team are supported to understand how Vera’s diagnosis impacts on her behaviour and her ability to maintain relationships and this enables Vera and her team to develop a robust support plan that helps achieve her outcomes. Regular team meetings including Vera help to ensure Vera has a forum to raise any concerns and steps can be taken to adapt and tweak her support to suit. This also enables the support team to have honest discussions with Vera about some of her behaviours that they find challenging and solutions sought to overcome any issues. Vera continues to be supported to manage her health needs and maintain relationships with neighbours. Being a responsible pet owner is critical for Vera and she is supported to do this and explore being a volunteer at the local cattery. Having independence and control is important for Vera and she appreciates being able to negotiate from week to week the support she needs, at what time and to do whatever she wants as this often changes for Vera depending on her priorities at the time. This approach and understanding from the team about what is important has reduced the number of times Vera makes complaints to the department and contacts to GP surgery and other services she would contact in times of distress and frustration.

Option 3

Vera chooses to remain with the support provider that the local authority has commissioned to provide the service. The service is allocated on an hourly basis and a designated amount of hours has been committed to support Vera. This does not provide the flexibility Vera desires and there continues to be times when Vera declines to engage with the support because she is not ready to when the workers arrive or she is less comfortable with the workers who are sent to provide support. This means there are often times when Vera does not receive support but the local authority still requires to pay for it. The social worker continues to try to negotiate a more flexible service that can respond to Vera in a more individualised way but as they are commissioned and block funded this can at times prove difficult. Due to the number of people they support, the provider cannot guarantee a consistent team and sometimes less familiar staff are sent to support Vera.

Option 4

Vera could chose to have a mixture of options 2 and 3. She could continue to access the services of her current care provider or homecare for some of the key practical tasks she needs support with; medication prompts, personal care tasks such as showering and meal preparation but chooses to access a smaller portion of her budget to purchase support from a bespoke provider that can offer her tailored support in relation to her mental health and social inclusion. Vera may also chose to use some of her budget to pay for weekly massage therapy sessions as she feels this helps to maintain her mental health and reduces her levels of anxiety. She also purchases a cat and enjoys spending time caring for it and this again has therapeutic benefits.

Adam & Sheena story – Young Carer

Adam is 14 years old and lives at home with his mother Sheena. Sheena has a diagnosis of multiple sclerosis (MS) which affects her mobility and ability to carry out some tasks like cooking, ironing, washing, shopping and dispensing her own medication. Adam has been her main carer for the last three years. The family have no other family support and Adam is determined to continue to support his mum at home and undertakes a number of the daily household chores that Sheena is unable to manage. He takes responsibility to cook their meals when Sheena’s health is poor and also helps Sheena with taking her medication etc. Sheena has been assessed for her own needs and receives daily support from the local homecare team to assist with her personal care needs as she is determined that this is not an area that she wishes Adam to support her with. She also receives a weekly shopping service and attends a local club for people with physical disabilities once a week with transport arranged by the local authority. Due to the complexities of his mum’s needs, Adam has been assessed as a young carer with needs in his own right. It is felt Adam needs time away from his caring role and the opportunity to explore his feelings around the impact his caring role has on his family life.

Option 1

Adam chooses to take a direct payment to support him to meet his outcomes. His mum helps him manage the direct payment. Mum and Adam open a separate bank account and the local authority pay his personal budget into this account regularly. Adam chooses to use his budget to meet his agreed outcomes which are to enjoy some free time away from his caring role and has opportunities to explore his feelings around being a young carer and ensure he has quality time to spend with his friends. Adam has used some of his budget to pay for his music lessons. Adam has also used his budget to pay for an computer which enables him to stay connected with friends through social media even if he is at home caring for his mum. He also uses it to link with an online forum of young carers.

The success of the direct payment and the flexibility it offers to Adam supports him to remain positive about his caring role without needing to be labelled or to link with more traditional supports. He feels in control and appreciates that people have listened to him and to what matters most to him. It has also encouraged Sheena to consider choosing to receive her own support through a direct payment and explore employing a Personal Assistant which might provide greater flexibility. Sheena would also like to access a computer to allow her to take charge of her shopping through online shop and delivery services rather than rely on the council’s shopping service. This could be purchased through her personal budget and enables her to remain n control of managing her family shopping.

Option 2

Adam wants to be able to spend some time away from his caring duties but does not really want to attend the local young carers’ support group. He does not really want to talk about being a young carer and be labelled as such by the attendance at the established group. Through discussion he also confirms that he has an older cousin who he is very close to and can talk to him about any worries about caring for his mum. During conversations with Adam, he talks about his passion for music; he has had some guitar lessons at school and is really keen to progress but cannot afford further lessons despite a local musician offering some tuition at the local community centre. After discussion with Adam and his mum it is agreed that he can use a small personal budget to support him to access the music lessons. The local authority make arrangements to pay for the lessons on a quarterly basis. This helps support Adam to maintain his caring role for his mum but also meets his agreed outcomes of having some time away from his role. Adam also advises that learning music has increased his confidence and helps him cope with any worries he has as a young carer. He finds playing music very therapeutic and Adam’s mum is pleased that he has as some time away and is able to enjoy his passion for music and just be a teenager.

Option 3

Adam is linked in with the local carers’ service who run a weekly support group for young carers. Adam accesses this on a weekly basis where he gets the opportunity to meet other young people who have a caring role for someone in their family. The group supports the young carers to access lots of activities such as ice skating, bowling and trips to the cinema as well as the opportunity to talk freely and share their experiences of what it’s like to be a young carer. Adam has made some good friends through this club and his mum is pleased that it is a fun-filled evening where Adam can enjoy being a teenager, without having to worry about her.

Option 4

Adam chooses a mixture of the other options. He receives a small budget to help him purchase a computer which helps him stay connected to friends through social media. Adam also asks the council to pay for his attendance at the music lessons twice monthly but he still likes to join the local young carers’ groups on a monthly basis as he has close friendships with other young carers and enjoys sharing their experiences and having fun. Adam also helps my mentoring some of the younger carers who attend this group and he takes this responsibility seriously and likes that he can support others in this way.