Would a network of independent brokers help service users make the most of their personal budgets? Steve Dowson says yes. Simon Duffy disagrees
Steve Dowson, associate consultant, National Development Team for Inclusion (NDTi)
Support brokerage is a term that causes widespread confusion in the UK but has long been widely accepted internationally as spanning the following, in respect of personal budget users:
1 A recognition of the person as an individual with hopes, fears, preferences and goals, all of which must shape their final support plan.
2 Discovering ways in which the person’s needs and wishes might be met, not just through standard solutions, but informal support, community resources and ordinary answers.
3 Evaluating the risks and benefits of each idea – where necessary gathering more information – to arrive at one detailed and coherent plan which in written form is submitted to the council for approval.
4 Turning the plan into reality, including by agreeing contracts or recruiting staff, and co-ordinating all the plan’s elements.
Not everyone will need help to complete the process. It is absurd and dangerous, however, to assume that everyone can do it on their own. Also, with personal budgets shrinking, it’s all the more important to help people make the best of the money.
So who should help them? It would be convenient if existing care management staff could simply be redeployed, and it appears that many councils have chosen this strategy.
But there’s good reason to doubt whether people who are part of a system that also rations public funds, answers to taxpayers and worries about risks to vulnerable people are in the right place to support creative and holistic planning.
That’s not to say council employees will never do a good job, just that it doesn’t make sense to build in a conflict of interest. The planning process starts with a person-centred, community-oriented, creative approach, but needs to deliver system-centred documents – not only the support plan but also specifications for services and staff.
There’s a risk that systems-thinking will yield unimaginative plans that confine people in specialised services. This is far more likely to happen when planning is supported by people embedded in that system.
So who else should provide the support?
Over the past eight years the NDTi has trained scores of people to be independent brokers, including disabled people, family members, former social care workers, and people with no knowledge of social care. All have brought strengths, and all have found it challenging to acquire the necessary baseline skills over a five-day course.
Many people will want and need support from someone of their choosing who comes with an assurance of trustworthiness and competence.
This is why councils need to ensure access to independent support brokers, with the necessary systems of training, funding and accreditation.
Simon Duffy, director, Centre for Welfare Reform
Independent professional brokerage is plausible for two reasons. First, there are talented people working today who call themselves brokers. Second, there is the attraction of an “independent” profession.
We may sometimes need talented people to help us solve tricky problems but building a system that relies on independent brokers is like building a system that relies on management consultants – expensive, damaging and distracting.
Independent brokers are the most expensive support option available and investing in them will draw more money away from direct support and people’s own budgets. At a time of vicious cuts to local government it is unwise to reduce the efficiency of social care.
The argument for brokers rests on the fallacy that brokers are independent. But brokers are no more independent than any other group. They are funded by the state (directly or indirectly) and they are funded only if people believe they cannot make decisions without their help.
Advocates of brokerage argue that social workers, charities, families, providers and even disabled people themselves cannot be trusted to make good decisions. But this is a damaging assumption. Creating a new profession will increase a culture of suspicion that leaves everybody worse off.
The real problem is that personalisation has been implemented with too much bureaucracy and too little trust. Progress will come from embracing community brokerage – using all the assets of a community to support people to be in control.
Even more fundamentally, we need to radically redesign the current care management system that frustrates the desire of social workers to do the very best for the people they serve. Several local areas have begun to “re-script” social work to eliminate bureaucracy and enable social workers to empower people to take control and connect to community. We need a better system for social workers – not brokerage.
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This article is published in the 20 October 2011 edition of Community Care under the headline “Does social care need brokers?”