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|25 Oct 2016|
Dundee Stronger Together
Significant worries were raised in Perth and Kinross recently when the local council announced a plan to consider care homes for everyone who Individual Budget came to 10% more than the cost of a care home place. This arose out a plan to transform social care services. But rather than improve things this ran the risk of taking things back to the last century.
The consultation process for this measure was wholly inappropriate and inadequate. The timescales given to family carers who lead incredibly busy and stressful caring roles were totally unrealistic. A letter was written on the 8th August 2016 and by the time the families received it there was less than 3 weeks to respond. The closing date was the 31st August 2016.
This type of proposal goes against all national government policies and legislation. It fundamentally breaches the United Nations Convention on the Rights of Persons with Disabilities supported within The Scottish Government’s Draft Delivery Plan 2016-2020. It is totally discriminatory and has placed huge stress on family carers who are supporting their family member to lead a valued and included life within their community.
Fortunately in the last week, Perth and Kinross have agreed to put things on hold and make no changes until there is much wider consultation. The council said
“we accept our initial consultation process has raised concerns and therefore we are going to take much more time to discuss and consider all the options from stakeholders ... we will shortly be communicating how and when we are going to undertake the work.”
Unfortunately this does not mean the proposal has gone away for good and disabled people and their families will have to keep aware about this.
in December we said in 11 councils people were getting less Direct Payments after the Act came in than they had before. New figures including the take up of other options were published in July 2016 and show that both Falkirk and Inverclyde actually did better than that getting more people into SDS packages than the previous year. But the 8 of others were still doing worse than the year before SDS was introduced.
Glasgow has been undergoing its Personalisation process since 2009 and says that over 1700 people are now getting Option 2. We think this shows a problem with just using numbers to explore SDS. Glasgow worked out the cost of service for these people, then transferred that money to their existing social care provider in their name and declared that was their equivalent to Option 2.
After our earlier article Social Work Scotland wrote to us to complain that we were being unfair. They said that SDS must be about more than just how many people make the choice, it must be about the outcomes people get. We agree. It’s a shame that councils’ don’t publish any information on the outcomes that people get from SDS.
As a result, the Learning Disability Alliance Scotland has decided to carry out its annual survey on the experience of people with learning disabilities with SDS. We also welcome the views of family and paid carers. You can be one of the first to complete our survey here.
A High Court judge has given a disabled man permission to bring a legal challenge against a county council after it decided to reduce his care package. The case is thought to be the first of its kind since the Care Act 2014 came into force.
The claimant, Luke Davey, 39, is quadriplegic and has cerebral palsy. His disabilities were caused due to a virus he contracted as a child. Oxfordshire County Council is responsible for providing him with care and support to Mr Davey, who lives in his own adapted home and is supported by a team of carers to live independently.
According to his lawyers, Irwin Mitchell, “despite an assessment in April 2015 stating he needs 24-hours care a day and a stable care package for over 20 years the council took steps to reduce Luke’s funding over the past 12 months down to 17.5 hours which his family, and an independent report said would have a negative effect on his wellbeing”.
The law firm launched legal proceedings in the High Court on his behalf, arguing that Oxfordshire was in breach of the Care Act in not making sufficient payments to meet his care needs. An interim court order was made at the recent permission hearing, requiring the council to continue paying for the full cost of Mr Davey’s current care package until the final hearing (expected to take place later this year).
Rebecca Chapman, the claimant’s solicitor, said: “Luke is an intelligent but vulnerable man who is dependent on a wheelchair, registered blind and relies on support from the council to fund carers so that he can live his life to his full potential. Luke can make his own decisions but requires assistance with all of his personal care needs and activities of daily living and in April 2015 the council assessed him as needing 24 hours care a day. Luke has decided he does not want to be forced to spend time alone.
“An Independent report has stated that the reduced care plan will have a detrimental impact on his wellbeing and independence and Luke, through the support of his family has asked us to challenge the decision to reduce his care.”
Chapman added: “We will argue that the council has duties under the Care Act 2014 and has not taken into account the reasons why the reduced payments will have such a significant detrimental impact on Luke’s health and wellbeing.” Irwin Mitchell will also seek to argue in the case that a reduction in the rates of pay for skilled carers and assistants would be unreasonable and unlawful.
A spokesman for Oxfordshire said: “It would be inappropriate to comment at this stage pending consideration of this case by the Court. In the meantime we continue to work with Mr Davey and his family.”
An early study by the Policy Innovation Research Unit into the development of Health And Social Care Integration in England has found it struggling. Just as in Scotland, H&SCI started with ambitious visions to transform care for people with multiple long-term conditions and frail older people by shifting services out of hospitals, reducing costs and improving people’s experiences of care
There had been plans to use a wide range of initiatives to meet these objectives including multi-disciplinary teams, improved access to services, rapid response teams to reduce avoidable admissions, telecare and telehealth, increasing the use of community resilience and personal health budgets.
However such ambitions became more limited and focused on “short term, financially driven goals”, mainly around containing hospital admission and discharge costs. The range of initiatives used had narrowed to setting up multi-disciplinary teams, improving care planning, creating a single point of access for services and using care navigators to provide people with information and advice on accessing care.
Health And Social Care Integration is struggling in England. Increasing financial constraints on councils and NHS bodies are making it harder to achieve integrated health and social care, government-funded research has warned. The study also found that engaging frontline staff in initiatives to integrate care was proving challenging in a climate where they were “firefighting” to keep existing services running.
Health and social care were beset by an “integration paradox” in which the financial environment made it ever more important to integrate care but, at the same time, made it more difficult to make progress in doing so.
The findings came from an early evaluation of the integrated care and support pioneers programme, a Department of Health initiative set up in late 2013 to test new ways of integrating care for people who needed the support of multiple care services. The study, by the Policy Innovation Research Unit, assessed the initial 14 pilots from January 2014 to July 2015 and was largely based on interviews with 140 council, clinical commissioning group (CCG), NHS trust and voluntary sector staff involved in pioneers.
The pioneers started with ambitious visions to transform care in their areas for people with multiple long-conditions and frail older people by shifting services out of hospitals, reduce costs and improve people’s experiences of care. They had plans to use a wide range of initiatives to meet these objectives including multi-disciplinary teams, improved access to services, rapid response teams to reduce avoidable admissions, telecare and telehealth, increasing the use of community resilience and personal health budgets.
But the researchers found that over time their ambitions appeared to have become more limited and focused on “short-term, financially driven goals”, mainly around containing hospital admission and discharge costs. Also, the range of initiatives used had narrowed to setting up multi-disciplinary teams, improving care planning, creating a single point of access for services and using care navigators to provide people with information and advice on accessing care.
Interviewees identified a number of barriers to and enablers of integration. Most of the enablers were local factors. These included the relative simplicity of organisational structures, with the best arrangement perceived to be when a pioneer involved just one council, CCG and NHS trust with similar boundaries. The most important of the enablers was perceived to be staff involvement in integration initiatives and the extent to which they felt ownership over them.