What is Self Directed Care?

Self Directed Care is customer - focussed services. It is a philosophy and practice that assumes that carers have the right and ability to assess their own needs, determine how and by whom those needs are met, and evaluate the quality of the services they receive.

An increasing development in the long term services for older adults, carers have the ability to hire family members, friends, or even neighbors to provide some of the services they might need, support with personal care - grocery shopping, cooking, bathing, clothing and any other support.

It is a method of ensuring people are central to the design of their service, which they can then choose to manage in a variety of ways to suit their willingness and capacity. 

Self-directed support is intended to develop a culture and the tools to enable individual clients and their carers to be involved in their assessments and to allow them to make the decisions as to how this is provided, within available resources, to provide that care. The professional should be the facilitator supporting the client/carer to achieve this principle.

The overall aim would be to enable existing resources to be allocated and services delivered in ways that personalise responses to need, and give people choice over how their needs are met.

What are the advantages of self-directed services?

Sometimes carers and other clients are not happy with the quality of the services
they receive. If there have been problems with workers now showing up on time, or not
available when needed, or restrictions from an agency on what workers can do, a self
determination program might better meet your needs.
You may also be able to receive more services for the same amount of money, since you
will be hiring your own worker and therefore can negotiate the rate of pay.
If you live in a rural area, home care agencies may have a particularly difficult time
recruiting staff, since a provider might have to drive long distances to get to some homes.
A patient-directed program may be very effective since you may be able to hire
someone who lives nearby to meet some of your needs.

What role do I play ?

If you choose to hire family or friends to provide some of the services you need, there
are certain responsibilities that come with this increased choice and control. These
responsibilities include managing payroll, and any applicable employment taxes and
insurance, since you are considered the employer and persons that you hire are
considered your employees. Some self-directed care programs have an organization which
can provide an array of financial services to handle some of the employer-related
responsibilities on your behalf.

Will self-directed services replace the traditional service delivery system?

The vast majority of older people prefer a traditional service delivery system in
receiving the help they need. Though self-directed care there are a growing trend
and are therefore becoming available in more and more places, they are likely to be an
option: you as a client will still be able to choose whether the traditional service
delivery system, or self-directed care best meets your needs.

Direct Payments

"Direct Payments is a means tested cash payment made instead of social services provision to an individual who has been assessed as needing support."

Following a financial assessment, those eligible can choose to take a Direct Payment and arrange for their own care services.

The money included in a Direct Payment only applies to social services.

Individual Budget (IB)

Unlike Direct Payments an IB sets an overall budget for a range of servies not just from social care, from which the individual may choose to receive as cash or services or a mixture of both.

IBs combine resources from different funding streams to which an assessed individual is entitled. Currently these include:

IBs can be used in different ways:

You can use Direct Payments and Individual Budgets to set up or access culturally appropriate services from service providers of your choice.

Supporting & Empowering people with substantial health needs and disabilities & their carers from Black Minority Ethnic (BME) communities to access and take up:

• Direct payments
• Individualised budgets
• Information, advice & advocacy to arrange self managed care packages and support services.