Individual Service Funds: A Partnership in Care & Support Provision

Over time the Individual Service Fund (ISF) approach is starting to reshape the way that care and support services are delivered in England and Scotland (where it is called Option 2). By placing individuals at the heart of decision-making around their care, ISFs allow for a highly flexible approach using personal budgets. This model is increasingly being recognised for its potential to enhance autonomy, improve care quality, and make better use of public funds and local community resources. Here, we explore the benefits of ISFs and provide practical recommendations for providers looking to embrace this innovative approach to partnership working.

Empowerment Through Personalisation

The ISF model aligns with the Care Act guidance of 2014, which emphasises the importance of personal budgets and individualised care plans. The implementation of ISFs supports a shift towards more personalised and responsive care arrangments that are directed by citizens (or using best interest proinciples). By empowering individuals to direct their own support arrangements, ISFs facilitate the creation of unique care pathways that truly reflect personal preferences and needs.

Building Trust

The ISF model establishes a tripartite partnership between citizens, service providers, and Local Authorities, embodying the principles of autonomy, trust, and personalisation. Service providers holding ISFs operate as extensions of social services, making agile, day-to-day adjustments to support plans. This approach necessitates full transparency regarding budget decisions and a robust capacity for person-centred planning, risk assessment, and asset-based working. Overcoming potential mistrust between commissioning organisations and service providers is essential for the success of ISFs. Genuine partnerships, where providers have the flexibility and autonomy to demonstrate their capabilities, are crucial. Local success stories should ideally be documented and disseminated to promote the positive impacts of ISFs more widely.

‘Trusted Reviewing’

The adoption of ISFs presents a unique opportunity to formalise the role of trusted reviewers within the care system. By integrating the trusted reviewer role into ISF contracting frameworks, providers can enhance thier accountability, transparency, and build further trust in care delivery and funding. Here’s how this can be achieved:

  • Defined Responsibilities: Clearly defining the responsibilities of trusted reviewers ensures that they play an integral role in overseeing the implementation and management of ISFs. This includes regular reviews of care plans, budget allocations, and outcomes to ensure compliance with the Care Act principles.
  • Enhanced Training: Trusted reviewers should receive specialised training to equip them with the skills needed to assess ISFs effectively. This training should cover aspects such as person-centred planning, risk management, and ethical considerations and should link back to the Care Act guidance.
  • Structured Audits: Implementing structured audit processes allows trusted reviewers to systematically evaluate the performance of ISFs. These audits should focus on the quality of care, financial management, and develivery of personalised care outcomes.
  • Stakeholder Involvement: Involving citizens, families, and other stakeholders in the review process ensures that trusted reviewers have a comprehensive understanding of the care and support being provided. Feedback from these stakeholders is crucial for making informed decisions and improvements.
  • Transparent Reporting: Trusted reviewers should be responsible for maintaining transparent reporting practices. This includes publishing regular reports on the findings of their reviews, highlighting areas of success and identifying opportunities for improvement.

Contractual Clarity

Having clear agreements in ISFs is essential to define roles and responsibilities. This clarity helps avoid confusion and ensures that everyone involved understands their duties and expectations. Belinda Schwehr, a solicitor and expert in adult social care legal literacy, advises that it is critical to develop and implement clear, transparent contracts between care and support providers and commissioners. These contracts should outline the obligations and accountabilities of each party, specifying who has decision-making authority, especially regarding the use of the ISF budget.

The roles and responsibilities of all parties involved in ISFs, including the council or Integrated Care Boards (ICBs), support providers, individuals, and their representatives, should be clearly defined. The contracts should detail decision-making processes around the use of funds. For those lacking the capacity to manage their arrangements, the care receiver is not seen as a contractor but as the beneficiary of a commissioned agreement managed on their behalf. If they have the capacity, they should be considered to be the purchaser of the services.

Cultural Shift

Traditional social care services have long been characterised by a focus on the hours of care required by individuals. This has led service providers to view themselves primarily as deliverers of these specified hours through employed staff. The ISF model challenges this paradigm, encouraging providers to reimagine their role as deliverers of outcomes rather than mere hours of support. This cultural shift requires organisations to equip their staff with a deep understanding of self-directed support and the skills to work creatively within the framework of personal budgets. Additionally, ISFs can level the playing field for smaller or newer support providers, enabling them to compete alongside more established organisations as people and families use their personal budgets to shape the local market.

Innovation and Flexibility

ISFs enable near real-time adaptation to changing outcomes, prompting providers to think creatively in addressing barriers and meeting needs. Recognising individuals’ strengths, abilities, and the community assets they wish to access locally becomes paramount in developing personalised, outcomes-based support plans. These plans should be consistently reviewed and adjusted in alignment with the person’s wishes. Local Authorities should ideally provide service providers with the flexibility to utilise budgets and identify and meet outcomes as directed, without imposing overly restrictive processes or policies. It is vital for Local Authorities to recruit creative and values-driven organisations, granting them trusted provider status. To address concerns regarding the misuse of budgets, Local Authorities can employ third-party holding systems for remote auditing by individuals, families, social workers, and commissioners.

ISF paperwork, processes, and systems should be co-produced with those using the services to minimise process friction. Streamlining workflows through ISFs can also benefit local community-based social work teams, reducing unnecessary contacts and allowing providers to make day-to-day decisions alongside the individuals they support. Pre-agreed thresholds for risk and budget expenditure can ensure inclusion and consultation when necessary. Conditions and restrictions can be applied to the use of ISFs where appropriate, such as those set by the Ministry of Justice.

Building Community Connections

When effectively implemented, ISFs significantly enhance individuals’ connectivity within their local communities. By collaborating with a variety of service providers, including sole trader micro-providers, ISFs can create new links with local businesses, voluntary sectors, and community groups. This approach not only channels social care funding into local economies but also breaks down societal barriers, ensuring that individuals are included and able to contribute to their communities. Supporting smaller, community-led organisations in embedding ISFs within their services can often be quicker and more effective than attempting to shift the culture of larger organisations.

Workforce Benefits

ISFs create an environment that encourages shared experiences, fostering growth for both individuals and staff teams. This transformative approach has been particularly impactful, leading to staff members feeling valued and experiencing a greater degree of personal fulfilment in their roles. Surveys have shown that this contributes to higher job satisfaction, increased staff retention, and reduced recruitment costs. Ultimately, this results in the delivery of consistent and high-quality support. ISFs support the commitment to real change in how support staff are empowered to carry out their roles.

Cash Flow Benefits

One of the significant financial advantages of ISFs for providers is that they are typically paid four weeks in advance. This advanced payment model can substantially improve cash flow for organisations, providing them with the financial stability to plan and deliver high-quality care services without the constant pressure of immediate cash constraints. This prepayment system allows for better financial management and can enable providers to invest in innovative solutions and resources that further enhance care quality and efficiency.

Overcoming Challenges

Despite the numerous benefits, some Local Authorities remain somewhat hesitant to adopt ISFs, often due to concerns about the management of public funds and the potential loss of control and oversight of these. Addressing these concerns is crucial for wider adoption. Clear guidelines and robust auditing systems can alleviate fears, ensuring that ISFs are used effectively and transparently.

Some Considerations for Providers

For providers considering the adoption of ISFs, the following recommendations, based upon learning from Self Directed Futures work over the last few years can help facilitate a successful transition:

  • Develop Strong Partnerships: Foster collaborative relationships with Local Authorities and other stakeholders to build trust and transparency.
  • Invest in Training: Equip staff with the knowledge and skills necessary for person-centred planning and creative problem-solving linked back to legislative frameworks.
  • Embrace Technology: Explore and integrate technology-enabled care solutions to enhance support and independence for individuals.
  • Promote Flexibility: Advocate for flexible budget utilisation to allow for personalised and adaptive care plans.
  • Engage the Community: Collaborate with local businesses, voluntary sectors, and community groups to create inclusive support networks.
  • Document Success: Collect and share success stories to demonstrate the positive impacts of ISFs and encourage wider adoption.

Chris Watson
Chris Watson is the founder of Self Directed Futures and the Chair of SDS Network England. With extensive experience in strategic commissioning and change management, Chris advocates for innovative, community-led approaches to adult social care.

Related Posts

ISF Outcomes: Comparing Progress in Wakefield and Warwickshire

Individual Service Funds (ISFs) offer an alternative to traditional care and support models that often limit individual autonomy. This article...

The Importance of Crafting a Robust Individual Service Fund (ISF) Contract and Specification

When it comes to delivering effective social care, Individual Service Funds (ISFs) are a key tool for providing people with...

Individual Service Funds: A Step-By-Step Process

Individual Service Funds (ISFs) empower people to take greater control over their care and support, offering a tailored approach that...

The Importance of Co-Producing ‘We Statements’ with Individual Service Fund Providers

When it comes to delivering meaningful and person-centred support, co-production is not just a buzzword; it is the cornerstone of...