The Transforming Social Care Circular sets out information to support the transformation of social care as signalled in the Department of Health's social care Green Paper, 'Independence, well-being and choice' (2005) and reinforced in the White Paper, 'Our health, our care, our say: a new direction for community services' in 2006. It describes the vision for the development of a personalised approach to the delivery of adult social care and context in which this policy is grounded and explains why this change is needed. The circular also includes details of the new ring-fenced Social Care Reform Grant, which is intended to help councils to redesign and reshape their systems over the next 3 years. In summary, the circular specifies a broad range of outcomes, to be delivered by 2011, for which the new grant should be used to deliver; it places personal budgets at the heart of this, and a huge onus on local authorities to shape and deliver their programmes locally.

The vision for a personalised approach to adult social care

 

The document makes the case that personalisation, including a shift towards early intervention and prevention, is the ‘cornerstone of the modernisation of public services’. This means every person across the spectrum of need having choice and control over the shape of his or her support, in the most appropriate setting. “The overall vision is that the state should empower citizens to shape their own lives and the services they receive”.

Why this change is needed

One key driver behind this change is dealing with the challenge of significant changes in the structure of our population. Between 2006 and 2036, for example, the number of people over 85 in England will rise by approximately 180%, and with it demand for support across the continuum of need will increase. Demographic changes such as this will also have a major impact on the number of people able to care and support for their family members.

Along with this, people have increasingly higher expectations of what they need and a wish for greater control over their lives. They want dignity and respect to be at the heart of any interaction so that they can access high-quality services and support closer to home at the right time, enabling them and their supporters to maintain or improve their wellbeing and independence. Because of this, the focus of care and support will need to shift away from intervention at the point of crisis to a more pro-active and preventative model centred on improved wellbeing, with greater choice and control for individuals.

What needs to be done to deliver this change?

Delivering personalisation for all within social care requires “whole system change” rather than “change at the margins”. This will mean working across the boundaries of social care - such as housing, benefits, leisure and transport and health - and across the sector with partners from independent, voluntary and community organisations. The implication is that pilots are not enough – councils need now to understand how the whole social care system will be affected by placing personal budgets at the heart of their modernisation programmes. All stakeholders will need to work in partnership to construct a comprehensive delivery model, which works across social care and touches on the wider reforms with the NHS and in local government.

Personal budgets are placed at the heart of the transformation agenda for social care; a clear, upfront allocation of funding to enable them to make informed choices about how best to meet their needs, including their broader health and wellbeing needs. To do this will require a common assessment of individual social care needs, emphasising the importance of self-assessment. There will be a move from the model of care where an individual receives the care determined by a professional, to one that has person centred planning at its heart, with the individual firmly at the centre in identifying what is personally important to deliver his or her outcomes.

There will need to be clear information points and support and brokerage services that enable individuals to navigate the system, access appropriate advice and purchase quality services or support.

The following four domains will be addressed by the government and its partners in order to reform social care:

1. Strengthening performance management to ensure all services are of a high standard and are self-sustaining.
2. Increasing capability to ensure people working in social care have the skills and support they need to deliver services.
3. People shaping services to make sure individuals can choose the services they want.
4. Shaping and building the market to create a strong, varied, flexible market in social care.

How will councils be supported in delivering change?

Individual councils will be encouraged to build on their strengths and capacity to make local decisions on priorities reflected through improvement targets in LAAs. They will need to develop their own transition strategies and to assess where they are, using a range of diagnostic tools to ensure that their plans are feasible and sustainable.

ADASS, LGA and IdeA will work together as a sector-led ‘consortium’ at a national level to support the change agenda. At a regional level the Regional Improvement and Efficiency Partnerships will work to facilitate regional implementation and local activity, and provide local leadership. DH will work with this consortium to facilitate a range of national tools to assist reform.

Very significant resources are being committed to this change programme. The vast majority of the money is being delivered directly to local authorities, with only a small residual amount being kept at the centre for further development of toolkits and technologies. The Department of Health will make over half a billion pounds available as a ring-fenced grant to local councils over the next 3 years – the new Social Care Reform Grant. A grant determination for 2008/09 is attached as an Annexe which sets out the details of the ring-fenced grant to help councils to redesign and reshape their systems.

This implies a large degree of local freedom, but at the same time, clear local responsibility for planning and delivery, and accountability for using the money in the right way.

For further information visit:

http://www.dh.gov.uk/en/publicationsandstatistics/lettersandcirculars/localauthoritycirculars/dh_081934