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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

A week ago the Audit Commission published its report on "Self Directed Support".  It found that there was a mixed picture across Scotland about how well councils were preparing.   As usual in reports of this kind, there were plenty of positive stories about how Self Directed Support is helping people make a change in their lives.  

But there are plenty of other stories which paint a much bleaker picture.   Yesterday LDAS spoke to the mother of John, who has severe autism and learning disabilities.  He actually has a good service right now that helps him live a much better life.  But it does cost a lot.  The local council is now working on a reassessment programme for those who already get services.  John has been given his first indicative budget for planning his care under SDS.  It was a range budget of between 25% adn 50% of the cost of the current service.  

His mum explained that John psychiatrist, his GP and up to last week the social worker had been happy with his current service but on this new budget he would no longer be able to use the service.  Here's a snippet from the conversation. 

Mum:   How did you arrive at this budget for John?

Social Worker:  The computer told us.

Mum:   How did the computer know what was needed to meet John's needs?

Social Worker:  We feed lots of very complicated things into it and then it tell us what is a fair budget.

Mum:   speechless!!!

Only now after Mum getting external help is there a prospect of this budget being changed.  

There used to be an old saying in the early days of computers if the data put into a computer was wrong, then the answer it fed out would also be wrong.  The computer cannot make a judgement, it only produces results.   Such stories as John's rarely make it into official reports but unless they are taken seriously we are storing up problems.  

If we are serious about transforming social care in Scotland we perhaps need to be a little better about thinking about real people and a little bit less obsessed with the latest computer system or spreadsheet.  



Public Health Minister Michael Matheson has written to Glasgow City Council to tell officials a new act does not require them to charge.

Last month the council sent out letters to people who use day care centres to tell them they would have to pay up to £15 a day. The letter from Sharon Wearing, head of service development stated: "As a result of the Social Care (self directed Support) Act 2013 the council must now use the same system for financial contributions for older people over the age of 65.

"This is to make sure all people over 18 years who use social care services are treated in exactly the same way and that there is consistency and fairness across the whole social work system for adults in Glasgow."

The health minister however, has told the council this is not the case and has asked them not to make similar claims in the future.

Read the full story in the Evening Times

A NEW film which looks at ways to help people through self-directed support had its premier at Eastwood Park Theatre, recently.


Titled The Future of Care in Scotland, the film is the result of a joint venture between East Renfrewshire CHCP and the Self Directed Support Forum East Renfrewshire.

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.”