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A NEW film which looks at ways to help people through self-directed support had its premier at Eastwood Park Theatre, recently.
Self-directed support, in practice, means that those who are entitled to social care can receive support in a variety of ways and take as much individual control as they choose.
The film focuses on the lives of people who have benefited from this work.
Attending the screening was Scotland’s minister for public health, Michael Matheson.
He said: “Self-directed support is a priority for the Scottish government and is about ensuring that people have the opportunity to take greater control over the type of support they want.
“That way they can live a full and active life and participate fully in their community.
“The Future of Care in Scotland film shows perfectly how SDS has transformed lives. Self-directed support is at its best when it is about working with people to meet their outcomes in new and different ways.
“It is about choice and empowers individuals to make the choice that is right for them.”
Those who attended the screening indicated that they had a better understanding of self-directed support and they were able to speak to those featured in the film about their experiences of taking ownership of and changing their care.
Councillor Alan Lafferty, ERC’s convener for health and social care, said: “Self-directed support is bringing about one of the biggest changes in care we have seen in decades.
“This film shows examples of how self-directed support has made a huge difference to people enabling them to personalise their own care, and explain what support is there to help them do this.”
Recently the LDAS coordinator delivered a short presentation to the service users and carers group in South Lanarkshire on issues that need to be considered in the development of Self Directed Support by local authorities.
What the Scottish Government says
It has passed the Self Directed Support Act 2013 which
- Sets out 4 options for the provision of support which the council has a duty to offer
- Duty to offer the choices and act on the person’s choice (adults, carers and children)
- Duty to explain nature and effect of options & to signpost people to information & support
- Power to offer support to carers
New regulations will be published soon
- Specifying categories of people ineligible for Direct Payments
- Allowing easier employment of close relatives
- Stopping any of all charges for carers for any services provided through SDS.
The Act sets out some general principles. It is up to each local council to decide on details
Colin Slasberg and Peter Beresford have written a new paper about how the mission to deliver Self Directed Support is actually making it harder to deliver personalised services.
Their argument is
- There is no relationship between the allocation of up front budgets and the final budgets with many budgets being significantly less. The Resource Allocation Systems are disconnected from the process of actual budget allocation and are really a waste of time and resources. This is true whether the simple check box systems are used or the complex computer systems.
- The problem with the heart of the SDS system is that service users and families think it should be based on the "enough money" model which is "enough money to enable independent living and full citizenship." However local authorities are operating a "fair share" model based on "allocation of funding affordable with current authority budgets." Given that local councils in Scotland are "cash limited" then this creates real tensions and problems.
- Self Directed Support has led to an increase in bureaucracy. This is not due to the incompetence of local councils but due to the very nature of additional check box assessments and the subsequent management of resource allocation. The National Audit in Social Care has produce figures which show a loss of productivity by field social workers of 26.9% or nearly £500 million per year.
- Further evidence from Adult Social Care Outcomes Framework shows that there is now a slight trend downwards of the more people in a local authority who have self directed support packages, the less they feel in control of their lives. This runs counter to the received wisdom but can be explained by the next finding.
- The second national survey of personal budget holders found that people who had a direct payment had better outcomes. Those who had council managed personal budgets had more negative outcomes. Given that 90% of people with personal budgets are managed by councils, any in depth survey will turn up the fact that people have less control in this situation.
- Many people with Direct Payments are confident, assertive and can articulate their needs. Many people with learning disabilities or other vulnerable people will not be able to exert the same control.
- Personalisation remains a crucial goal and policy makers must take action to make sure it becomes a reality for all and not just for a minority.
This is a detailed and thought provoking paper that will need careful consideration by policy makers in Scotland. There is little point in pushing ahead with Self Directed Support if it does not lead to better personalisation but instead creates more bureaucracy and greater inefficiencies.
The article is published in hard copy and will become available online on this site in the near future.