Regulations that drive out carers

Adult placement offers people an extremely flexible form of
accommodation and support provided by ordinary people and families
known as adult placement (AP) carers. They are recruited, selected,
trained and supported by AP schemes, working a bit like fostering
agencies. AP carers in England who provide overnight accommodation
and personal care are registered with the National Care Standards
Commission (NCSC).

Mabel Cooper had lived with her AP carer for more than 10 years.
She saw her carer as family and took huge pleasure in the
relationship that she had with her carer’s children and
grandchildren. But her carer has recently decided to give up
working as an AP carer because of the new regulations and
paperwork. Mabel has had to leave her home and her family.

Her story has been mirrored across England. A survey by the
National Association of Adult Placement Services (Naaps) in October
2002 showed that the regulatory approach had resulted in a
significant loss – 26 per cent – of AP carers, especially those
providing short breaks, those supporting just one person and those
providing services for people with personal care needs.

The survey, supported by statistics collected by the NCSC, also
shows that the regulatory approach is having a reverse effect to
that desired by government. Adult placement has become increasingly
unregulated as AP carers limit their services to avoid what they
see as the over-onerous burden of regulation.

The Department of Health has recognised the destructive impact of
the current regulatory approach on adult placement. Jacqui Smith,
then health minister, announced in January that she intended to
consult on changes to the regulatory approach to adult placement.
It has been a two-stage consultation with the second stage (due to
start soon) looking at a proposal to register AP schemes rather
than individual AP carers.

Naaps supports the registration of AP schemes rather than
individual AP carers. All adult placements, not just placements
providing personal care, would be regulated rigorously but
appropriately. Just as important, Mabel’s story would be different.
The scheme would have to prove to the NCSC that it was doing its
job properly and Mabel’s carers would be able to continue providing
her with the loving family home that she so much values without the
heavy burden of paperwork that has driven so many away.

Sian Lockwood is chairperson of the National Association of
Adult Placement Services