SCIE Report 36: Enabling risk, ensuring safety: Self-directed support and personal budgets

Introduction

'Risk enablement is now an important self-directed support process in most local authorities' (Tyson, Brewis, Crosby et al, 2010)

Assessing risk

Safeguarding

Traditionally, continuing risk assessment and risk management has been seen as an essential part of safeguarding adults.

The assessment of risk has often raised difficult questions of balance in professional practice. The rights of adults to live independent lives and to take the risks they choose to take needs to be weighed carefully against the likelihood of significant harm arising from the situation in question.

In current guidance on assessing the seriousness of the risk of abuse, relevant issues include:

• factors in the situation which could increase vulnerability, such as environmental factors, communication and financial factors and the existence of social/cultural networks and support
• the nature and extent of the abuse
• the length of time over which the abuse has been happening
• the impact on the individual, and
• the impact on others.

Key resources to support self-directed support and planning

Click on the links below to learn more about three key resources in this area:

• Independence, choice and risk: a guide to best practice in supported decision making (Department of Health, 2007)Open

  To develop local responses to the predicted dilemmas, the Department of Health published good practice guidance and tools for supported decision-making. This helps practitioners and people using services to identify risk enablement opportunities and safeguarding issues as a core part of individual care and support planning and review.

  Link: Independence, choice and risk: a guide to best practice in supported decision making

• Personalisation and the law: Implementing Putting People First in the current legal framework (ADASS 2009)Open

  In response to some of the resistance to, and concerns about, self-directed support, personal budgets and risk, the Department of Health and ADASS have provided further clarification and guidance on legal and financial issues:

  • '…the understanding of all concerned that safeguarding is a form of risk management which should already be integral to assessment and support planning functions'
  • 'The rules that apply to direct payments will apply, as modified by any fresh guidance, or legislation, to any part of a personal budget taken as a direct payment. So there will still be monitoring, albeit proportionate to risk and amount, in accordance with CIPFA guidelines, and there will still be accountability for those who misuse money or abuse a position of trust in relation to its management'

  Link: Personalisation and the law: Implementing Putting People First in the current legal framework

• Safeguarding and personalisation – two sides of the same coin (In Control)Open

  In Control is the organisation which originally developed the practice of self-directed support for England.  They recommend that support planning should include assessment of risk enablement and safeguarding issues, highlighting the need for people to be supported to take positive risks while staying safe.

  They also emphasise the need for practitioners involved in self-directed support and personal budgets to work together with adult safeguarding colleagues to ensure that procedures match up and are person-centred.

  Link: Safeguarding and Personalisation – two sides of the same coin (428kb PDF file)

Mental Capacity Act 2005

It is recommended that all support for decision making in relation to self-directed support be in line with statutory principles of the Mental Capacity Act 2005. You can use the link on this page to read more about the core principles, but in summary we can say:

If someone has full mental capacity and is able to make their own decisions, then it is essential that they maintain control and that professionals support their decision-making at every stage (Mental Capacity Act 2005).

Further reading

• Personalisation and safeguarding (187kb PDF file) (ADASS 2008)
• Personalisation and safeguarding briefing (554kb PDF file) (In Control)
• Adult safeguarding resources (LGID)
• Independence, choice and risk: a guide to best practice in supported decision making (Department of Health, 2007)
• Personalisation and the law: Implementing Putting People First in the current legal framework (ADASS, 2009)
• In Control Safeguarding briefings
• LGID Adult safeguarding reports
• SCIE Mental Capacity Act resources