Person-centred Positives?

By Nigel Perfect

"Unless we think in a different way we won’t behave in a different way – we have to actually think about how we can get the young person going through transition at the centre and to be in control."

Jonathan Ralphs is a Person Centred Planning Manager for Buckinghamshire County Council and he works with schools to implement person centred transition planning in that area. Hillcrest school has been one of a select few across the country who have put into place the person centred transition review process. From the age of 14 the disabled teenager (his school is for children with learning disabilities) is present at the meeting and for him this makes all the difference:

"They’re present now, they’re engaged and we use ways to communicate with them that they understand, it’s wonderful to see, their very presence makes us think in a different way," he says. No longer are they left wondering where the information on their transition will come from, they won't be confronted by a cliff edge.

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In 2001 the government released the white paper Valuing People and from that they wanted to pilot a way of planning with young people which started in 2005 (Essential Lifestyle Planning, ELP). Pioneered by a consultancy it can be defined as "guided process for learning how someone wants to live and developing a plan to help make it happen." We piloted it with two young people and as he puts it, "Hillcrest caught the bug" of ELP. He says the subsequent success of it was down to senior staff at the school joining in bringing down any hierarchical barriers in the process.

 

 

The idea of involving young disabled people in the transition process is linked to the personalisation agenda that is sweeping through social care at the moment. The drive to enforce this is welcomed by most policy makers but for some one aspect of it has drawn criticism.

Individual budgets were piloted last year as part of the Putting People First announcement and essentially empower disabled people, enabling them to take control of their budget and allowing them to spend it on the care that they need. It gives them choice whereas previously social services decided how the money could be spent, in the eyes of some, denying them the choice to do what they wanted.

Aaron was 14 when he was involved in one of the pilots in Coventry and his case study states that his, "needs were put at the centre of all planning, and it focused on his outcomes. Everyone involved agreed the priorities." He now lives on his own, with the carer next door, and has an individual budget worked out that funds his support.

 

But the problem for some is that not enough people know about it and are unwilling to embrace it because of the effort involved in changing the system, as Clare Jackson explains:

"There's a lot of negativity and misunderstanding around it which means that people are unwilling to learn and that can affect dramatically on the services we provide."

And with transition there is another issue: "We are able to give them more personalisation but it's still quite hard because the services change when they become adults and the transition work is all about preparing for them for that drop in services," she says.

In other words, the drive for personalisation is all well and good but not if there isn't the resources to back it up. Jonathan Ralphs backs this view up and highlights how this affects the personalisation agenda, and by consequence, transition planning:

"I still think it’s service driven, it's still based on service provision, not young people’s lives, there's confusion about where individual budgets fit into the process between 14 and 25, the bottom line is that children’s resources cost a lot, when they go into adult care which is a third and they haven’t got the money to get that package. There isn't the money to match it."

 

The benefits of combining individual budgets and person-centred reviews are put forward by Lucia Winters, who runs the Transition Information Network for the Council of Disabled Children:

"Individual budgets certainly have the potential to have a huge impact for young people in transition. If they’ve had a person centred review they will be able to work with professionals in a way budgets are delivered so it would fit those young people particularly well to reach a positive outcome and develop personalized packages."

Jonathan Ralphs hopes that the new person- centred approach is implemented sooner rather than later:

"I know where I want to be, I’m reaching out to this personalization agenda and want other people to come along with me. Before it the reviews lasted for 20-40 minutes and we were lucky if the person attended the review. Now we can spend time with them."

 

The Transition Support Programme is an attempt by the government to make the care aspect of the transition process easier. It will be piloted across different local authorities in the UK and was first planned in ‘Aiming High for Disabled Children: Better Support for Families’ last year. Its stated objective is “to help disabled young people and their families benefit from intensive, coordinated support and person centred planning.” 19 million pounds has been allocated towards the programme and ‘Aiming High’ states that:

“It should be based on the principle of enabling disabled young people to have choice and control over the support needed in their daily lives, and should be embedded as a new model of working for the years ahead.”

The video clip of Anne McGuire on the left sums up how it will help authorities. The money will not be spent on recruitment, rather on implementing piloting programmes across the country where authorities with less experience will gain new expertise and those at a more advanced stage can finetune their services further.

Kate Jackson, Transition Development Manager for Dimensions, says: "There has been a bit of a mixture of opinions about it, there’s a little bit of vagueness about what it’s actually going to achieve. They’re going to be piloting it in the areas that need to be improved. Hoping ultimately this can be shared with other authorities."

The Transition Support Programme fits into the personalisation agenda because one of it's goals is to ensure the:

'Consolidation of the person-centred planning process from age 14, with increased information for professionals, and coordinated and timely assessments based on the young person’s aspirations, at key points to assist in the transition to adulthood, including signposting to future appropriate provision.'

But Lucia Winters also admits to being "in the dark" about how it will work:

"There is still no clear picture of what the programme is going to look like. It was supposed to start earlier this year but I think they’ve had more difficulty working how this is going to work and to work out the best way of using this money for disabled young people as a whole."

 

 

One of the goals of the programme is that after three years national minimum standards will be developed so there is more guidance for local authorities and the chances of a postcode lottery developing are less. But Roger Berry warns that this should be tightly controlled:

"Transition support cannot be left to the vagaries of local authorities, you've got to have national minimum standards and this is one area where legislation may be needed, may require more direction from the centre to bring it together."

And Rachel Christophides is concerned about how the funds will be distributed:

“Our concern would be that those people who already have an interest in transition, for whom it is already a focus have the motivation to apply for those kinds of funds so making a good system already better. Whereas for those authorities where transition isn’t a focus they may not take the time or money to put a proposal together. It favours those who are quite good with transition and not for those who haven’t had an interest in it.”

But Anne McGuire hopes that the experience of individual budgets will be repeated with the more experienced local authorities leading the way:

"In terms of tendering, what we will see are those local authorities who perhaps wish to be involved at this time and who will throw up the best practice and how we will take this forward. We did it with individual budgets we had our individual budgets piloted across 13 authorities some of whom were initially very enthusiastic and others not so and they have learned from each other through that process. "