Personalised Support

Author: Simon Duffy

Personalised Support is a system for providing support to people with complex and challenging needs to live their own life, on their own terms, but as active citizens. Individualised service designs are developed by combining a creative organisational culture with a set of structures that enable the total individualisation of funding, staffing, policies and accountability.

Background

Personalised Support was developed in Scotland, in 1996, to provide support to people who were leaving institutions and moving into their own homes. It is a radical step forward from the standardised and inflexible support that is often provided by Community Care services. The first service to use this model was inclusion Glasgow, followed by Partners for Inclusion, C-Change for Inclusion, Support fro Ordinary Living (SOL) and other organisations who collaborate through the federation Altrum.

Concept

Personalised Support requires individualised systems, combined with key values and an organisation culture which can sustain and make sense of these features. 

There are 7 key elements:

1. Commitment to Citizenship - Above all else the organisation has to commit itself to seeing the people they support as full citizens, people with rights, people with potential, people with full lives to be led and supported. Without this vision and these values no practical systems will work.
2. Individual Service Design - Each individual is unique, and so, each support service must be unique. This means helping the person to design support that reflects their individuality, their relationships, their neighbourhood and their future plans. Each design is different, but each design supports the person to express their citizenship - their way.
3. Individualised Policies - Systems and rules need to be worked out, developed and reviewed at the level of the individual. Universal rules for the organisation are kept to a minimum and only set a framework within which individual policies are agreed. This is the only way of ensuring that people can maximise outcomes and manage risk effectively.
4. Individualised Support - High quality personalised support demands that people get support from the people who are right for them. This is much more about values, personality and interests than it is to do with formal qualifications, although Partners for Inclusion do work to the rules defined by the Scottish Social Services Council and meets their requirements. This requires a radical change in personnel policy.
5. Individual Funding - It is impossible to provide flexible support to individuals if their money is used to fund blocks of services. Personalised Support requires organisations to use Individual Service Funds to manage and protect people’s individual budgets and ensure that money is used flexibly for the best possible outcome.
6. Power with the Person - And each arrangement must ultimately be authorised by the person or those who can stand by the person and help them make the best decisions for themselves. For the organisation this means involving the individual, their family or other representatives in all the critical decisions that concern their life.
7. Creative Community - All these systems only come to life when they are used by a real community of people - both inside and outide the organisation -who can think creatively. This demands real value-based leadership and the development of trust based upon real understanding of needs and problems.

Progress

Although Personalised Support has been working successfully in Scotland for 15 years it is curious that so few organisations have really taken up the challenge to work in this new way. In fact, even when personalisation has started to become recognised as one of the most important themes in reforming public services there have been few efforts to really change how support is offered on the ground. Too often disabled people, older people or people with mental health problems are being asked to manage direct payments or take on other onerous responsibilities that are simply not necessary. Personalised Support offers a powerful and practical model for transforming the role of organisations that provide care and support, giving people the flexibility and control they value, without unnecessary complexity.

The publisher is the Centre for Welfare Reform.

Personalised Support © Simon Duffy 2010.

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