If personalisation empowers people who use services, does that mean less power for social care workers? Or can everyone become more empowered together?
The risks to vulnerable people of hiring their own unqualified, unsupervised personal assistants (PAs) have been well-rehearsed.
But PAs experience risks too. For instance, some are pressurised to declare themselves self-employed, thus freeing the budget holder from tax and other employer responsibilities. Unless the arrangement really has the features of self-employment, such as the PA’s right to substitute someone else to do their work, the arrangement is likely to be unlawful. This has resulted in PAs losing out on employee rights, and budget holders served with vast tax bills.
So whose interests should win out: the user or the provider of support? I don’t buy the zero sum game view of empowerment: the future can be mutually empowering. The best model for that may not be lone workers and isolated employers, but the creation of small, mutually-owned services, funded by pooled personal budgets and provided by workers who share their control. This model requires budget holders as well as workers to negotiate and compromise. But that’s no bad thing: where people with support needs can make genuine contributions to a service, the lines between user and provider become blurred and both can share greater rewards and status as well as taking greater responsibility.
It’s telling that PAs remain isolated at a national level with, as yet, no representative body. Existing sector bodies mutter about the risks of representing such a disparate, shadowy group. Perhaps the point at which PAs can really begin to be part of raising the status and quality of social care will come when they come together to form their first union.
Alex Fox is chief executive of NAAPS, the UK network for Shared Lives and small community services
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