Requesting and organising care assistance at home

Understand the process involved to organise care support at home, from the initial enquiry, through the care needs assessment, care options, how to manage and pay for your care and the possible charges involved.

Contents

Choosing how you organise and pay for care

If you are eligible for social care support services you can choose how much input or responsibility you wish to have in organising your own care. 

  • Following your Care Needs Assessment and any Financial Needs Assessments, you will be informed how much money you may be allocated to spend on social care support.
  • Your social worker will then work with you to agree a Care Support Plan that meet your personal needs.
  • At this point, our social worker team will discuss how much input or responsibility you wish to have in organising your own care.  Other people, such as family and friends, or independent organisations can also help you with this.
  • This approach is known as Self-Directed Support (SDS).
     

Introducing 'Self-Directed Support'

Self-Directed Support is the name for how people organise care and support in Scotland. It is often called SDS for short. The term SDS comes from the law that came into effect in 2014, the Social Care (Self Directed Support) (Scotland) Act. It was introduced to give people who need care and support more choice, control and flexibility.  

Further information about Self Directed Support is available in this SDS Handbook prepared by Self Directed Support Scotland.
 

Your Self-Directed Support Options 

There are four main options available under Self-Directed Support: 

  • Option 1: Direct Payment
    If eligible, you will receive a direct payment to support your care needs. With this fund, you independently decide and organise how your care support is managed and paid for.
     
  • Option 2: Individual Service Fund 
    You decide and direct how you want to spend your budget, and the support is arranged on your behalf by East Lothian Council. In contrast to option 1, you direct the support, but you do not have to manage the payments.
     
  • Option 3: Organised Care 
    You request East Lothian Council to arrange and manage your care support needs for you entirely. East Lothian Council choose the care supplier, arrange the care, and manage the payments.
     
  • Option 4: Mixed Choice
    You can choose a combination of the options above to suit your care needs. You choose the parts of your support you want to have control over, and request the Council to organise the rest.

Each of these options are explored in more detail below.
 

Further information about Self-Directed Support 

The following websites provide more detailed guidance on SDS:

Self Directed Support Scotland Website

Self-Directed Support Framework of Standards (Scottish Government)
 

SDS Video
SDS Accordion

Self-Directed Support Options Explained

Option 1: Direct Payment

Option 1 gives you the most control, flexibility and responsibility when it comes to your social care support.

Direct payments can be used in a couple of ways:

  • You can either use it to purchase support directly from an agency or provider (for example for choosing your own care at home agency or respite provider)
  • Or you can choose to become an employer and recruit your own personal assistant to provide support at home.

To access a direct payment you will need to:

  • have a separate bank account, which you will access and manage, to hold the money provided to you to pay for your care services
  • complete a small amount of paperwork to show how you are spending your money
  • provide updates to our Direct Payments Team to allow us to monitor your spending under the SDS Direct Payment option
  • be willing and able to make a personal contribution to cover the full costs of the care if it exceeds the amount allocated to you.

If you choose to become an employer there are certain employment rules that you must take into account, for example arranging an employment contract. 

Our support organisation, Lothian Centre for Inclusive Living, can help you with this.  You can also download our guide to Employing Your Own Personal Assistant here.

 

Lived Example: Meet Bill

Bill decided to go for Option 1: Direct Payment. 

With his direct payment he has registered himself as an employer, and hires a Personal Assistant to visit him twice a day to assist with daily living activities. 

This includes making his meals and helping him with house work activities.

Option 2: Individual Service Fund

Option 2 is a way of choosing how your support budget is used, without managing the money yourself. 

If you want to choose how to use your support budget, but you do not want the responsibility of managing the money directly, this might be a good option for you.  

  • Under this option, the funds allocated to you are held and managed by East Lothian Council, or another organisation, such as a charity or support provider on your behalf 
  • You choose how you want to be supported, by who, and it is organised on your behalf  
  • This option means you do not have to become an employer, or submit any financial returns 
  • You may however, need to be willing to make a personal contribution to cover the full costs of the care if it exceeds the amount allocated to you.

  • However, this option does means you are unable to recruit your own personal assistant, as this requires you to sign up to being an employer.   

     

Option 2: Lived Example

Meet Sandra and Bronwyn

Sandra and Bronwyn researched local care agencies and decided they wanted to use Park’s Care* (fictional) to support Bronwyn at home. 

They choose Option 2: Individual Service Fund, and directed East Lothian Council to set up regular payments to Park’s Care on their behalf. 

As the charges for his care package were higher than his allocated fund, they agreed to pay the additional extra to cover the full cost of his care package.

Option 3: Organised Care

Option 3 is when you ask East Lothian Council to choose and arrange the support that it thinks is right for you.

  • Under this option you are not responsible for arranging your own support.  
  • Although your care will be discussed and arranged with you, you have less direct choice and control over how the support is arranged.
  • You will not have to handle any money, and you are placing the trust in the council to manage your budget.

Option 3: Lived Example

Meet Clive

Clive lives alone, and doesn’t have family near by. He didn’t want to have to manage his finances, and decided the best option for him was to go with Option 3: Organised Care. 

He directed East Lothian Council to arrange his care package on his behalf. He receives visits 3 times a day, from East Lothian Council’s internal Care at Home team in line with his needs assessment.

Option 4: Mixed Choice

Option 4 provides you with the opportunity to use a mixture of the options above.

  • You can choose the parts of your support you want to have direct control over, and what you want to leave to your council to sort out for you.
  • For example:  you use Option 2 to direct what agency you want to use to provide your care support, but also use Option 3 to ask the council to contract a respite provider on your behalf.
Option 4: Lived Example

Meet Carol

Carol likes to get out of the house and enjoys socialising. She decided to go for Option 4 Mixed Choice. 

She directed East Lothian Council to arrange her personal care package via option 3: organised care. 

With her remaining funds she directed East Lothian Council to make payments to her local day centre (option 2: individual service fund), which she visits 3 times a week.