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The Mental Welfare Commission has published its latest report on the use of the Adults with Incapacity Act. It looks at the use of welfare guardianship.

The 2013-14 report shows a continued year-on-year rise in the number of  applications for welfare guardianship being granted, with a 58% increase over the past four years.  Dundee, Glasgow and Stirling showed the highest rates of new orders. 

There was a significant reduction in the granting of orders on an indefinite basis,  which is a positive change, but again, there were wide variations across the country.  Glasgow, Dundee and Aberdeen City all had high rates of orders approved on an  indefinite basis. The Commission also found that significant numbers of guardians were not being regularly supervised by the local authority.

There was a slight fall in welfare guardianships granted for people with dementia, and a rise in those granted for people with learning disability; a trend that has been apparent for a number of years, and which has resulted in 2013-14 being the first year when welfare guardianships were on an almost equal basis for both.

Just two areas Glasgow and North Lanarkshire had 24% of all the welfare guardianship orders taken out adults with learning disabilities.  Surely its no coincidence that both these areas claim they are the most advanced areas in the development of Self Directed Support.  This would be in line with evidence that we have found that many families are taking guardianship orders out on sons and daughters to ensure that they have a say in protecting their care.  This is a worrying trend that means people have less legal control at a time when the Parliament says they should have more.   

August 2014 saw the 2013 ESAY figures published.  ESAY is a Scottish database complied by the respected Scottish Consortium on Learning Disability on what support and services people with learning disabilities get.  

We have been concerned for a while about the decline in number of people with learning disabilities known to Glasgow City Council.  We have been given different reasons for a regular annual decline – counting systems, double counting, introduction of personalisation.  It turns out that the reason for this is that their new computer system only counts the number of people who actually get support (see Note 1 on page 3).  This computer system (Carefirst 6) was introduced in the last couple of years to help manage the personalisation process. 

As a result it is likely that Glasgow's computer system is very good tracking the number of people getting Self Directed Support over the last few years.   So the Glasgow figures can tell us how many people with learning disabilities get support  as personalisation has spread through their services.  

In 2009-10 2,724  got a service (2010 ESAY figures page 55)

By  2012-13 it had fallen to just 2,410 getting a service (2013 page 5) – a fall of 314.  

This will be made up of people who have been denied a service because they are deemed ineligible for support, those who have died and a reduced number of young people getting a service for the first time. 

We can see the evidence for some of this if we look at the ESAY figures for Glasgow.  

In 2009-10 204 people with learning disabilities in the 16-20 age group got a service (page 55)

In 2012-13 this had fallen to only 143 . (pages 6 & 7)   - a fall of 30%.

 There has been a lot of attention to what is called “transition”.   Yet this seems to suggest that many young people are not getting support as they move over to adult services.  We are not able to be sure exactly what is happening but we do think there need to some explanation of what is going on in Scotland's largest city.  

 

 

Last week LDAS published an article concerning a K, a young man with learning disabilities and cerebral palsy who had been in dispute with Glasgow City Council.

The original article contained a factual inaccuracy that we accept was wrong and apologise for any upset caused to Glasgow City Council.  The case was not heard in court but settled before this took place.  

K's budget has been restored to its original level.   The case was supported because K's Mum kept every document and every email.  She requested that everything be put in writing.  This was to prove invaluable in the battle.  (we recommend that you ask for everything in writing - it does matter!)

The lesson is simple.  Persistence can pay off.  Keep as many records as you can.  Ask for things in emails or in writing.  Ask that meetings are minuted and that you are given a copy.  If you disagree with what is in a minute, then let the person who wrote them know and keep a copy of your disagreement with the original minutes.  

 

Last year’s buzz was Self Directed Support—It was going to change everyone’s life by letting them have more control over their own lives.  Now as the results turn out to be much more mundane.  Most people end up with exactly the same service or just less of it, the buzz is now Health and Social Care integration.  Surely if we all work together then that will make things better.  

It all sounds a bit desperate to us and already stories are emerging of exactly how poor health and social work are at working together.  

Kathleen Ward from Fife, who has learning difficulties  broke her back tripping on a damaged kerb. There was a big bit missing out the kerb which she didn’t see and she fell right down on to the road. Her back is broken in three places.

While she is ready to go home,  she is stuck in Glasgow’s Southern General Hospital as Fife Council has told her family that they won’t fund care for her at home.   She previously lived in her own home with support but will now need much more support.  

 She may have to face going into a care home.  We have heard similar stories from South Lanarkshire and other areas.  Of course, many people are now worried integration will just be a short cut for taking people from community placements and steering them into inappropriate care home placements.

To add insult to injury, guess who was responsible for not fixing the broken kerb that caused Kathleen’s  accident – Fife Council!

 

In a surprising move, the UK government will not roll out a scheme to provide disabled people with integrated personal budgets after an evaluation found no evidence of improved outcomes.

Incoming minister for disabled people Mark Harper announced the decision not to roll out the Right to Control scheme in a written statement to Parliament last week.

Right to Control was designed to enable disabled people to pool resources from up to six funding streams – adult social care, Supporting People, Independent Living Fund, Disabled Facilities Grant, Work Choice and Access to Work – and exercise choice and control over how the combined budget was spent. It was tested in seven “trailblazer” areas from 2010-2013.

An evaluation published last year found outcomes for people using Right to Control, in relation to choice and control and wellbeing, were similar to people in a control group who were not using the scheme, meaning there was no evidence of positive impact.

The main suggested reasons for the lack of impact was that, in practice, Right to Control did not work as intended, and many service users received the same service they would have done before. 

“While the evaluation of this pilot may not have resulted in any measurable impact on outcomes, it was popular with those individuals who exercised their right to control and they valued the greater flexibilities it gave them. It also acted as a catalyst to developing local relationships and partnerships,” the minister said.

Read a longer article in Community Care