Best practice in support planning means that if people need assistance with doing their support plan, they can choose who they want to help them with it.

However, we are increasingly finding the reality is very different. While working with colleagues at a recent event, I met people from four councils that have made great progress in support planning. Yet even they estimated that less than two per cent of support plans are done by individuals themselves. Rather, many are completed by care managers, some of whom find this a radically new approach, based on conversations and possibilities, while others see it as "business as usual" and have replaced care management paper work with  support planning paperwork.

There could be many reasons for why this is happening:

• We may have made support planning too complex for people to do it themselves.
• People may not have the right - or enough - information to think doing it themselves is possible.
• Councils may find it easier to adapt the care manager's role so they simply replace developing a care plan with developing a support plan.
• Commissioners have not sufficiently invested in alternatives and there are challenges in costing provision for support planning outside of care management.

Some areas, like the London Borough of Richmond-upon-Thames, have invested in independent support planning services, but this may lead to lengthy waiting lists. Other places, like Lancashire, try alternative approaches like 'community pathways' but this carries a similar risk. While both examples create the possibility of more choice for people in who provides assistance, it does not fundamentally change how we can encourage more people in developing their own support plan.

I believe there is a different way to think about support planning

We need to enable people to believe they can direct their own support and start the process by developing their own support plan. We cannot expect people to do this if we disempower them at the first step.

Current thinking (Architecture for Personalisation by Simon Duffy and Kate Fulton, 2010) stresses the importance of commissioning a menu of support options, and that the most efficient models will involve people planning and organizing support themselves or with minimal input from peers or community services. The proposed target is 40 - 50 per cent of people developing support plans this way.

This model is also likely to meet the needs of self-funders and people not eligible for social care funding.

The approach to support planning needs to be done differently in order to move towards this target. Here is a possible way forward:

The best information for people about what needs to be in a support plan should be provided so they have the self-help resources to make it easier to do it themselves. Some of this is happening already, but the biggest change could be made by assuming that people can and will develop their own support plan, with the resources made available to do so. We can ask them to call us regularly to see how they are getting on.

Following this, we can contact the person shortly after to see how their support plan is developing. If we discover that they want more help, we offer this in the form of a drop in or point them in the direction of someone that can offer further help (like a peer supporter of care manager).

Implications for information, advice and advocacy

If we are to move towards this model, there would need to be clear information and advice available for people on:

• What has to be in a support plan for it to be agreed
• Self help approaches to support planning (e.g. workbook, graphic template) with information in different formats (youtube, paper copies of workbooks, online support etc.)
• Advice and support through 'Direct Support' or other advice lines
• Different ways for people to manage their money (direct payments, managed budgets etc...) and what records are required.
• Information about what people can buy with their money and what it costs.

Some people will take the 'kitchen table' approach to putting the plan together by asking themselves what needs to be in the document. Others may want more guidance or step-by-step guides.

Some people may want to think about their life and how they want to spend their money by creating a person-centred plan. This is where they get together with family and friends to develop their plan with the help of a person-centred planning facilitator. The approach is similar to life coaching, except that life coaching would not typically involve family and friends.

Yet others may be happy to do some of this themselves, such as working out what they want to change, but may want help with the financial aspects (with a financial advisor). Conversely, some people may want to think about their life with a life coach then work out their options and finances themselves.

We need support planning to be (and feel more) ordinary.

Where people are not able to develop their own support plan

Where people are not able or choose not to develop their own plan, we need to know who the next best person could be.  For some, this could be family or friends using the same model of staged support.

If family or friends are not able to do this, another approach could be for people to develop their support plan in a facilitated meeting. One possibility is where people attend day centres, for example, a Shropshire day centre for older people, offered support planning sessions run by staff who had had training in support planning.

Another possibilities is where people who already use services have an annual review, which could be extended to use a support planning process to begin a support plan. For example, in Darlington, people are trying a new process for the Year 11 review as young people leave school and making this the beginning of a support plan. 

Some people will still choose to have someone else create their support plan for them, under their direction. It is still important that there are a range of people who can plan with people individually if that is what they want and need.

We are working with Lorraine Gradwell (Breakthrough UK), and colleagues in Right to Control to test out and develop this approach. We are also supporting councils to adopt this approach through Groundswell. I believe this is both the right way forward and could also result in efficiency savings. We will keep you posted on what we are learning.

What is your experience of how support planning is working locally?