Councils are grappling with an ever-widening gap between rising social care demands and diminishing budgets. Faced with workforce shortages, escalating care costs, and increasing Citizen’s dissatisfaction, local authorities must rethink how they deliver adult social care. A robust Self-Directed Support (SDS) strategy, grounded in mechanisms like Direct Payments (DPs) and Individual Service Funds (ISFs), offers councils a transformative opportunity to save money, improve efficiencies, and empower individuals.
This is not a theoretical exercise. Evidence from successful models across the UK demonstrates that councils adopting self-directed support strategies can achieve better outcomes while reducing costs. Yet, many councils remain wedded to outdated approaches that are inefficient, expensive, and inflexible. The time for change is now.
The Crisis in Adult Social Care
Local authorities face escalating care demands from an ageing population, more people living with complex needs, and increasing calls for personalised, high-quality services. According to the Local Government Association (LGA), adult social care funding in England faces a £3.7 billion shortfall by 2025. Simultaneously, block contracts and traditional commissioning models are proving increasingly unsustainable. These approaches often lock councils into rigid frameworks that limit flexibility, drive up costs, and fail to deliver the personalisation mandated by the Care Act 2014.
Self-directed support offers a practical alternative. By giving individuals control over their care, SDS reduces administrative burdens, stimulates local markets, and enables preventative approaches that avoid high-cost crisis interventions. However, adoption has been inconsistent, with councils citing perceived risks, administrative complexity, and workforce challenges as barriers.
The Financial Case for Self-Directed Support
1. Reducing Administrative Costs
Traditional council-managed care involves significant overheads for procurement, contract management, and quality assurance. In contrast, SDS shifts responsibility for these functions to individuals or their representatives, reducing administrative costs for local authorities. Evidence from the Social Care Institute for Excellence (SCIE) highlights that individuals managing their own care through DPs often achieve better value for money by negotiating directly with providers and personal assistants (PAs).
2. Unlocking Market Efficiencies
DPs enable Citizen’s to employ PAs or access small-scale, community-based services that are often significantly cheaper than large agency contracts. For example, research by Think Local ActPersonal (TLAP) found that employing PAs through DPs costs 20–30% less than agency staff while offering higher Citizens satisfaction. Furthermore, fostering local micro-enterprises, as seen in Somerset and Derbyshire, has created vibrant care markets that deliver tailored, cost-effective support.
3. Promoting Preventative Care
Preventative care is critical to reducing long-term costs. DPs allow individuals to invest in activities and technologies that enhance independence and well-being, delaying or avoiding costly interventions such as hospital admissions or residential care. A study from the Department ofHealth on Individual Budgets found that Citizen’s directing their own care were more likely to access preventative services, reducing overall care costs.
Barriers to Implementation
Despite the clear benefits, SDS uptake remains limited due to the following barriers:
- Risk Aversion: Social workers and commissioners often perceive SDS as unsuitable for individuals with complex needs, despite legal obligations to promote personalisation under the Care Act.
- Administrative Complexity: Citizen’s and families are often overwhelmed by the processes involved in managing DPs.
- Workforce Challenges: The availability of PAs and small-scale providers varies significantly between regions.
- Cultural Resistance: Some councils remain committed to traditional block contracts, seeing SDS as a niche solution rather than a mainstream approach.
A Call for a Self-Directed Support Strategy
A comprehensive SDS strategy must go beyond tokenistic efforts. It requires councils to embed self-directed support as the default approach to delivering care. Key components include:
1. Simplifying Processes
- Introduce managed accounts to handle payroll and compliance for DP Citizen’s.
- Invest in digital tools for budget tracking and reporting, reducing administrative burdens for both Citizen’s and councils.
- Streamline application and review processes, ensuring they are accessible for individuals with varying levels of capability.
2. Developing Local Markets
- Provide grants and training to support the development of micro-enterprises and small-scale providers.
- Establish PA networks and hubs to connect individuals with care workers.
- Collaborate with community organisations to expand service options, particularly in underserved areas.
3. Investing in Workforce Development
- Increase PA pay rates to ensure competitiveness with agency providers.
- Offer training and professional development opportunities to attract and retain PAs.
- Promote PA roles through national and regional recruitment campaigns, addressing public misconceptions about the profession.
4. Embedding Risk Enablement
- Train social care staff in risk enablement, focusing on balancing safety with Citizen’s autonomy.
- Appoint SDS champions within councils to lead cultural change and address professional skepticism.
5. Monitoring and Accountability
- Establish robust metrics to evaluate SDS performance, including cost savings, Citizens satisfaction, and service quality.
- Publish annual reports to demonstrate progress and maintain public confidence.
Evidence
Somerset County Council
Somerset’s investment in micro-enterprises has reduced care costs by 30% for DP Users compared to traditional services. This approach has also boosted the local economy, creating jobs and fostering community resilience.
Derbyshire County Council
Derbyshire has successfully integrated ISFs alongside DPs, offering a flexible alternative for Citizen’s who prefer less hands-on management. This has increased uptake among older adults, reducing reliance on costly commissioned services.
TLAP Research Findings
Think Local Act Personal found that employing PAs through DPs saved councils 20–30% compared to agency contracts. Citizen’s reported higher satisfaction levels and better continuity of care, reducing the need for crisis interventions.
SCIE Insights
The Social Care Institute for Excellence highlights that DPs enable personalised, preventative care, which reduces hospital admissions and delays transitions into residential care—saving councils up to £30,000 per person annually.
The Risks of Inaction
Failing to adopt a self-directed support strategy has significant consequences:
- Missed Savings: Traditional models of care are often more expensive and less flexible than SDS options.
- Legal Challenges: Councils risk breaching Care Act obligations by failing to offer genuine choice and control.
- Erosion of Public Trust: As awareness of SDS grows, individuals and families expect councils to support personalisation. Inaction risks reputational damage and dissatisfaction among service Citizen’s.
A New Era for Adult Social Care?
Self-directed support is not just a policy option; it is a necessity for councils striving to meet growing care demands within constrained budgets. By adopting a clear SDS strategy, councils can achieve significant savings, improve efficiencies, and deliver better outcomes for individuals.
The evidence is clear: self-directed support works. It reduces costs, empowers Citizen’s, and aligns with the principles of the Care Act. Councils that act now to embrace SDS will not only transform their financial position but also pave the way for a more sustainable and person-centred social care system.
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.