Letters to Community Care 6 August 2009

Don’t meddle with attendance allowance

I feel strongly that transferring attendance allowance to local authorities to provide care for older people would be a mistake (news, 23 July).

How would this fit with personalisation and choice? What will happen with regards to disability living allowance or are we just targeting the elderly for now?

Many older people use the AA to pay for a hot meal to be delivered at lunchtime. In the area I live this is £3.24 per day – £22.68 per week. Add to this the cost of someone to do cleaning and washing, extra heating costs through the winter, assistive technology, day care provision and domiciliary care package costs. There is very little if any left of the care allowance. Where are the figures to support the view that this would enable local authorities to deliver suitable care to individuals? How would post code lotteries be avoided?

Having AA allows the person and their family some choice over care provision. If the money is transferred to councils care will be resource-led not needs-led. How will self-funders be treated or people who do not meet the eligibility criteria to receive a service from local authorities? They will lose out financially.

The government is expecting family members to pick up the extra costs of caring despite having to work long hours. Family members who work cannot get carer’s allowance unless they work very part time. What will happen to carer’s allowance if AA is transferred?

Looking at the mess of continuing health care, that money should have gone to local authorities as they are well versed in commissioning care – health authorities are not. Now we have several layers of management in health in order to be able to assess and commission the care. There is a huge cost saving to be made here. Transfer this money to councils and the staff saving alone would be substantial. Social workers assess and commission care on a daily basis.

Continuing health care skews the market as, currently, health is able to secure nursing home fees in excess of the fees paid by local authorities. Why aren’t we looking at this?

My preference to fund long-term care would be via taxation.

Carol Baker, social worker

Resource allocation system confusion

Barry Ruffell in his letter “Flawed talk on personal budgets” (30 July) makes the mistake of confusing the level of need assessed by a resource allocation system (RAS) and the cost of meeting that need.

For example, if a person requires support in order to leave their house, they may need a PA with no particular qualification. Or if they are deafblind they may need someone with guiding and hands-on signing skills, who is likely to have taken several years to develop such skills.

There is a huge difference in the cost of meeting this need, but a RAS will allocate both individuals the same number of points on the grounds they have the same “need”. If we want a truly personalised social care system we must use a personalised resource allocation system not a one-size-fits-all questionnaire.

For more information on the various issues that must be addressed when developing personalised service, see “Putting Everyone First” (http://bit.ly/1d3fc)

One thing councils must not do is use RAS to ration money. Currently, rationing is done through following Fair Access to Care Services, which recognises that it is important to provide sufficient money to meet eligible needs.

Only once this has been done will people be able to benefit from the flexibility of controlling their budget. Responsibility for an inadequate budget does nothing to empower disabled people.

Sue Brown, head of campaigns and public policy, Sense

Bridgend deaths shrouded in myth

There is much merit in local services’ response to the Bridgend deaths in 2007 (“Suicide watch”, 23 July) but this issue is less clear cut than that portrayed. It is not certain that the unusual spate of deaths were all suicides or copycat acts.

The knee-jerk reaction of local agencies was partly driven by media hysteria rather than cool analysis of facts. A suicide management group and suicide intervention skills training are too little, too late.

Prevention is better than cure and what happened in Bridgend is a warning to the rest of the UK to invest in early intervention child and adolescent mental health services, as well as tackling the underlying causes such as – poverty, child abuse, unemployment, social exclusion, bad housing, discrimination and drug and alcohol access.

Steven Walker, senior social work lecturer, Anglia Ruskin University

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