Social Care (Self-directed Support) (Scotland) Act 2013: Draft Regulations and Statutory Guidance – Analysis of Consultation Responses

7 GUIDANCE - MONITORING AND REVIEW

7.1 Section 6: Monitoring and Review details the need for the professional to review the supported person's needs and outcomes.

7.2 The review should consider the choices made and support provided are meeting the needs of the supported person and that these are meeting their personal outcomes. Any changes to the supported person's needs or outcomes should also be considered and support adjusted where required.

7.3 This section also looks at the review of the supported person's options in relation to the terms of the Act.

Question 5a: Was this section of the guidance clear and easy to understand?

7.4 Seventy-five respondents said that this section of the guidance was clear and easy to understand. Thirteen respondents said it was not and 56 did not reply.

Question 5b: How useful did you find this section of the guidance?

7.5 Most of those who replied said it was quite useful (54). Ten respondents said it was very useful and 14 said not very useful. One individual said it was not at all useful and 65 did not give an answer.

Table 7.2 Usefulness of Section 6 of the guidance

Respondent group	Very useful	Quite useful	Not very useful	Not at all useful	No response
Individuals (21)	2	4	-	1	14
Local authority (24)	2	14	6	-	2
Community Health Partnership (4)	-	2	1	-	1
Health Board (2)	1	-	-	-	1
Voluntary sector organisation (57)	1	21	5	-	30
Private Sector organisation (2)	1	-	1	-	-
Professional or regulatory body (8)	1	3	-	-	4
Support & information/Advocacy (16)	1	6	1	-	8
Other (10)	1	4	-	-	5
Total (144)	10	54	14	1	65

Question 5c: Do you have any further comments on this section of the guidance?

7.6 Eighty-three respondents replied to the question and a number of themes were noted in addition to specific comments on the paragraphs in this section.

7.7 While some respondents commented on the clarity of, and detail in, the section, others commented that this section seems brief and, given the importance of review and monitoring, needs to be developed further. One local authority said: "Although this section is headed Monitoring and Review it makes no reference at all to monitoring functions and what is anticipated or expected". Another commented "Given the importance of Monitoring and Review in the SDS journey and in achieving personal outcomes, this section lacks detail". Others commented that the brevity and the tone of the section make it appear as if review and monitoring is optional or not important. Respondents wanted to see good practice examples in this section.

7.8 There was a suggestion that a sentence could be added at the beginning of the section stressing the value and necessity of review. One voluntary organisation said that: "Rather than the last step of the process it should be viewed as a mechanism to make sure things are right for the person as they continue to learn and develop though the use of creative support options if that is what they have opted for."

7.9 In relation to timings, a small number of respondents commented on the need for a minimum timescale for reviews or a recommended period within which the review should take place; suggestions included six-monthly, annually and two-yearly. A small number of voluntary organisations wanted to see reviews undertaken more frequently and a local authority said "Clarity required to show that reviewing is not a once a year occurrence, rather this is an ongoing and crucial aspect intrinsically linked to assessment. A clear guide/timeline as to when people who are already supported in Local Authorities should be reviewed and go through the SDS pathway is required."

7.10 The importance of including this in the guidance was stressed as one voluntary organisation was "concerned that local authorities will not be able to meet the pressures on resources to facilitate reviews in a timely and appropriate manner as many people already wait considerable lengths of time for reviews." Several respondents commented on resource issues; both financial and staff time. A local authority suggested:

"There are different options available in undertaking a review which might include self review for those who have non complex stable needs. This would allow professionals to concentrate on those with the most demanding and changing needs or where significant levels of risk are involved."

7.11 There was a query as to whether a timescale would be set in relation to meeting a request for a review or reassessment. There was also a request for the guidance on timings to ensure the supported person has adequate notice and time to prepare.

7.12 One local authority asked for clarification on whether the review process would be used to offer the four SDS options to existing service users.

7.13 Some of the voluntary organisations felt that the guidance should stress the need for a collaborative approach in order to provide support to enable the service user to participate fully in the review.

7.14 Commenting that many people are worried by reviews, a voluntary organisation wanted to see good practice "reflect all the principles of people having choice and control. This needs to include where and how the reviews happen". There should also be guidance on what to expect from a review. A private sector organisation wanted to see recognition of "the uncertainty and unease which such processes and reviews can result in particular for individuals with fluctuating conditions. It would be helpful if the guidance contained some description of how these can be achieved in a manner which is enabling and positive."

7.15 Once again, respondents wanted to see the guidance include the need for signposting to independent advocacy support.

7.16 The guidance should also make clear that reviews are not used to cut the level of support. The outcome of the review should be "communicated to and agreed by the supported person before any changes to the package take place" (support & information/advocacy organisation).

7.17 Respondents felt the review should be described as a process for correcting mistakes and/or making improvements to the support package; flexibility was seen as key and the supported person should be clear that they are allowed to change their minds about the option of support planning and delivery they have chosen. A voluntary organisation suggested adding 'flexibility' to the title "to remind all involved that the selection of a support option is not a one-off event".

7.18 A voluntary organisation included an appendix "demonstrating how if SDS principles are started early for Children and Young people the initial referral in adult services consist of a review rather than a full assessment all over again."

7.19 Voluntary organisations commented on the need to consider the review of support for children and young people within this section, pointing out that the needs and outcomes of children and young people will change, perhaps frequently. One said that "this section should reference the duties in the Children and Young People (Scotland) Bill, as, at present, it is unclear how the monitoring and review proposals will work alongside the single Child's Plan and Named Person as the one key point of contact for families".

7.20 Some supported people will be being reviewed for other reasons such as Compulsory Treatment Order reviews; a voluntary organisation wanted to see these co-ordinated to ensure the supported person "is not subjected to repeated, separate reviews and to avoid unnecessary duplication of effort and use of resources amongst the different professionals".

7.21 There were also requests, from professional/regulatory bodies, to:

• include reference to the "Chief Social Work Officer role in terms of monitoring and quality assurance of service delivery."
• include reference to "the role of the Care Inspectorate in in scrutiny of local authorities."

7.22 A professional/regulatory body also commented: "local authorities should also be considering Standards or Codes of Practice in relation to self-directed support and opportunities for peer reviews across local authorities/partnerships, as already developed through the self-directed support networks".