Author: Don Derrett
Don was one of the leaders who made self-directed support successful in England. He also created a new organisation self direct to help service providers to adapt to the changing world of self-directed support. After several years of successful work self direct closed down. Don reviews the history of the organisation and the devastation being caused by the UK government's current approach to social care.
A short history of self direct 2008 – 2013; a personal view by Don Derrett, ex CEO of self direct
I was the business manager for in Control, employed by Mencap but working for Simon Duffy, from 2005-2007. During this time, in Control was doing a great job convincing national and local government of the benefits of self-directed support. Although some early work had been undertaken with providers, I came to the conclusion that there wasn’t enough being done to prepare the ‘market-place’ for the changes that we had envisioned happening once Individual Budgets became the norm. I also couldn’t see how in Control, as it was set up then, would have the capacity to do anymore work with providers than it was already doing; which clearly wasn’t enough. It became obvious to me that some extra work needed to be done and quickly. I couldn’t see anyone else doing this, so I decided to leave in Control and Mencap and set up self direct.
I started discussing my ideas with Caroline Tomlinson, one of in Control’s directors. Caroline advised me to get a few like-minded people together to explore the ideas I had and include people who could potentially be my own ‘circle of support’ if I went ahead with what I was suggesting. The first person I called was Simon Cramp, an ex-trustee of Mencap. Simon is someone I have known for a number of years and whose advice has always been invaluable to me. Simon suggested that I should invite Keith Wyatt, someone known to us both, someone with over 30 years’ experience in the social and health care sector and a leading promoter of self-advocacy. Simon brought along Jackie Lawley, a local authority commissioner and someone who had supported Simon in meetings for many years, and Caroline joined us to give advice and support if needed. We had our first meeting in December 2007 and to my delight and amazement, Simon, Keith and Jackie agreed to become co-founders of self direct.
Over the next few months we did all the practical tasks needed to set up a social enterprise, we had excellent advice from Business Link, at that time they had dedicated team members to guide new start-ups through one to one meetings and they arranged free training sessions. And to my surprise, there was also excellent help and guidance, including free training courses from HMRC. We continued to develop a business plan and created a ‘programme’ of what we intended to do to put our ideas into practice. We worked with a local design team to set up our website and we published our ideas and ‘programme’ on the website. At the time my fellow director, Keith Wyatt, wondered whether it made good business sense to share our ideas with potential ‘competitors’? I took the view that the scale of the changes needed was so huge and the speed at which they needed to happen was so fast, that it would be foolish to think that we could achieve it alone and that it could only help the change agenda if others used our ideas, even at the risk of creating our own ‘competition’!
So, with almost everything in place to promote and publicise our ‘programme’, self direct was launched in March 2008.
As anyone knows who has set up a business you start ‘trading’ as soon as you advertise that you are open for ‘business’. We opened for business after a pub lunch followed by booking our first venue in York! However, we didn’t run our first event until May 2008 having had to have a 2 month lead time for advertising the event, for delegates to book their places and all the other logistical issues with running an event. Over the first 2 years we ran events across England and worked with a large number of providers. Whilst aimed primarily at providers, our events also attracted delegates from Local Government, commissioners and other senior management officers, and some National Government civil servants. This included a delegation from the Department of Health keen to tell our other delegates about future plans to introduce Personal Health Budgets and to gain a view on potential issues etc.
The success of these events ensured self direct had a successful first year of trading that almost doubled in the second year.
As important as it was to have money coming into the social enterprise, our main measure of success was how well we were achieving our stated objectives.
Our main objective was to bring about change in the ‘market-place’ so that people who needed support were in control of their lives and their support. We defined the ‘market-place’ as anything that was needed by people who need support to live their lives in a way that made sense to them.
We started with providers because the vast majority of people were getting their support through provider organisations, but we also wanted to encourage other forms of new and innovative ways for people to get the support they needed. We wanted to encourage existing providers to change the way they delivered services in line with this approach but we also wanted to encourage the growth of new and innovative ‘providers’.
Our first events, Helping Providers to Change, were split over 2 days separated by 2 weeks of reflection and review of present ways of working. We didn’t want to tell providers what they needed to do; we wanted to work with them, in a co-productive way to identify potential issues and solutions to possible problems. We did, however, want professionals attending our events to listen to people who needed support and to listen to their relatives; people who had real life experience of how existing services affected their lives. One of our guiding principles was that we would always include in our sessions people with this expertise. Another guiding principle was that we would include people with this expertise working alongside us as equals but with a different area of expertise. We practically demonstrated this by paying them the same daily rate we paid ourselves.
The Centre for Welfare Reform published the outcome of this work in the first of self direct’s two books, Helping providers to change (2010), a guide for providers wishing to change their approach to follow the principles of Self-Directed Support.
Our second book, Self-direction: the key to a better life (2013) was published by Pavilion and includes stories of people who have taken control of their lives and their support. The stories in the book were provided by self direct members.
One of the people with real life experience that we invited to work with us was Sarah Wood. Sarah is a mother; her son Adam needs support (you can read Sarah and Adam’s story in both books).
Sarah joined self direct with a degree of apprehension telling her and Adam’s story at our events with delegates. From the very beginning testimonies, like Sarah’s, always had the greatest impact on the professionals that attended our events. Over the years, Sarah’s skills developed and her confidence grew. Sarah started co-designing our events and training courses and became an expert in delivering them. She went on to become a director of self direct.
In 2011 the National Council on Intellectual Disability of Australia found our first book on the internet and invited us to Australia to share our ideas and our learning with providers there. We worked with them in Brisbane and Sydney. We have kept contact with the people we met and worked with and more recently Sarah Wood was asked to write an article on co-production for one of their publications.
We started working for Local Authorities in the first year of self direct, being invited in to work with their providers. However, what we didn’t expect was to be approached by some Local Authorities to work with their social and health care team members. We developed a session that was based on changing social and health care team member’s practice so that they would be more imaginative in their approach when supported people to find the support they needed. Sarah became proficient in delivering these sessions.
Of course what was totally unexpected was the change of Government to the present Coalition in 2010. The economic and political uncertainty has had a profound effect on the entire social and health care sector in the UK.
I toured the UK at the end of 2010 and 2011 running ‘briefing’ sessions. These consisted of exchanging information on key developments and exploring existing problems and issues. Many people I engaged in discussion with at these sessions were fearful of the effect the political and economic uncertainty would have on the changes already well underway by then. Of course we had no idea of the severity of the measures that the Coalition would introduce over the following years. I have summarised the exchanges I had with people attending the sessions in a chapter in self direct’s second book.
We decided to invite like-minded individuals and organisations to join self direct as members; to share positive ideas of how the principles of Self-Directed Support were being put into action and how they could be applied in practice in the present economic and political environment and in the future. The self direct members supported over 110,000 people in every region of England and in Wales and Scotland. There are contributions of positive stories from some members in self direct’s second book which illustrate how self direct members have been working for a number of years to put the principles of Self-Directed Support into practice.
Self direct was not a political organisation, nor a campaigning one. However, self direct was invited by the previous administration to work with ministers and civil servants working on implementing the Personalisation agenda and earlier this year self direct was invited to join Roundtable discussions chaired by Labour’s front bench health team to discuss our thoughts on the Care Bill.
Of course not everything self direct set out to do was possible in the five years it was operating. And obviously we didn’t anticipate the devastating effect the last change of Government would have on the direction and momentum of the change agenda started under the previous administration.
There are personal reasons why I had to step down as the Chief Executive of self direct last year, 2012, and effectively withdraw all the time I had devoted to self direct. This undoubtedly has been a contributing factor.
However, I and the other directors, Keith Wyatt and Sarah Wood, came to the conclusion this year, 2013, that self direct was operating in an environment that wasn’t conducive to the work we had pioneered in 2008, largely due to the increased pressures on local authorities to spend less and deliver more. We couldn’t confidently anticipate that we would be able to attract the same interest in what we had to offer in the current environment as that we had enjoyed in the past.
Of course by 2013 self direct was not the only organisation promoting the practical implementation of Self-Directed Support in ways that will change the ‘market-place’. Therefore, I’m as confident as anyone can be under the present circumstances, that although the momentum to the change agenda may have been slowed, the change has already gone way beyond the tipping point. What the ‘market-place’ will look like in five years’ time is not predictable, however, I believe that more people than ever will by then be in control of their lives and their support.
The publisher is The Centre for Welfare Reform.
A Short History of Self Direct © Don Derrett 2013.
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