Paving the way for advancing self-direction in care and support

In this pivotal era of personalised care and support, we have an exciting opportunity to advance the agenda of self-directed support, with a particular emphasis on direct payments. 

For over 15 years, personalisation has been the cornerstone of our care policies, rooted in the belief that all forms of care and support should be person-centred. At its heart, personalisation champions the right of individuals to self-direct their own care and support, fostering a sense of choice and control that enables people to lead their best lives. 

Central to this vision is the empowerment of individuals to organize their own care and support, reflecting the ethos of choice and control—a fundamental aspect of modern societal values. Direct payments, born from the inspiring independent living movement, represent a transformative shift from traditional, systemic models to tailored, individual-centred approaches. 

Despite the strong legislative framework provided by the Care Act 2014, the full potential of direct payments has yet to be realised. This signals a compelling need for strategic communication and renewed engagement. While direct payments may not be suitable for everyone, there is ample evidence to suggest that we have not yet reached the limits of their potential uptake. 

Importantly, this is not just about increasing numbers. We understand that deciding to take a direct payment can be challenging, and those who do take them often encounter restrictions on their budget use and burdensome monitoring requirements. 

Think Local Act Personal (TLAP) has highlighted these barriers in several reports, including two produced with the Local Government Association (LGA).

Direct payments - working or not working? (opens new window)

Improving direct payments (opens new window)

Better direct payments (opens new window)

The forgotten workforce (opens new window)

These reports not only identify the issues but also offer practical solutions for improving direct payment delivery, showcasing councils and organisations making significant strides in this area. The Association of Directors of Adult Social Care (ADASS), in its "Time to Act (opens new window)" report, also outlines actionable steps councils can take to enhance their direct payments offerings. 

Additionally, we have shared and amplified the limited but promising examples of Individual Service Fund implementations, for example in Bexley (opens new window) where people can exercise choice and control over their care and support without the complexities of managing money and employment-related matters. 

We believe there is tremendous potential for significant progress in advancing self-direction. More regions introducing this option and collaborating with providers can make a profound difference for many people. 

We seek a renewed and collective commitment to self-directed support across the care and health sector. We envision this commitment leading to a revitalisation of efforts to enhance the mechanisms already available for self-direction, starting with direct payments. We've been pleased to work with a number of councils in recent years as they have set about making improvements, for example in Leicester, Essex and most recently Greenwich.  

To achieve this, we expect local systems to reset processes and practices with a focus on people’s experiences, using ‘Making it Real (opens new window)’ to guide progress and measure success. We recognise the progress already made in various regions and look forward to further advancements as more areas take action. We are working with direct payment leads in the Southwest to support them to create resources for practitioners to help them feel more confident about recommending direct payments and we hope to make these available on our website later this year so that everyone can benefit. 

We call for a rejuvenation of the system, ensuring that direct payments become not just a policy ideal but a tangible reality for individuals seeking lives of autonomy and fulfilment.  

Together, we can make this vision a reality and pave the way for a future where everyone has the opportunity to thrive.