Social workers are reluctant to refer clients to user-led organisations (ULOs) for support in using direct payments because of concerns the organisations will challenge practitioners’ decisions.
This issue appears to be holding back the development of support services of sufficient scale to meet government ambitions to significantly increase the number of people on direct payments. This was one of the messages from a guide to commissioning direct payment support services published last week by Think Local Act Personal, the sector-wide coalition responsible for supporting the implementation of personalisation.
ULOs are often commissioned by councils to provide direct payment support, such as helping service users recruit personal assistants and manage payroll systems, but also typically have an advocacy role as well in representing service users. In some cases, practitioners who referred clients to ULOs for direct payments support were having their decisions about the value of the direct payment challenged by the same organisation, council commissioners told the report’s authors.
“This has in turn led to reluctance on the part of practitioners to refer to external organisations,” said the report. “The resultant under utilisation of support services makes them appear very expensive and can render them unsustainable.” Support service providers also complained of low referral levels and poor communication with commissioners, the report said.
However, the report, by social care consultancy Groundswell, said that service users valued ULOs’ advocacy role. Author Simon Stockton told Community Care that it was particularly so currently as some councils sought to make cuts to personal budgets.
The report said that it was right for ULOs to perform both advocacy and direct payment support roles, but added that they needed to clearly separate the two functions. However, it said tying ULOs into large contracts to provide direct payments support could compromise their independence and ability to advocate for service users.
As a solution, the report suggested that councils commission direct payments support from a diverse market of providers, including ULOs and larger charities that had the infrastructure to support large groups of people, limiting the size of user-led organisations’ contracts.
It also said a “mixed economy” could tackle the lack of capacity in the support services market, which it said needed to grow substantially to meet the government’s target of extending personal budgets to all council-funded users by April 2013, and making direct payments the preferred method of delivering them.
“The market as it stands is not well placed to meet the challenge of a step change in the number of people with direct payments,” said the report
Despite a 15-year history, the market was “relatively small scale”, with mainly local providers serving “small numbers of people” and striving to “stay afloat with decreasing staffing and budgets”.
Stockton said tackling the problem would involve councils spending more on direct payment support, but he said money could be saved from other areas, for instance by reducing care managers’ role in support planning for service users, with this being led instead by users and their families, with support from ULOs or peers.
The TLAP guide is a revised version of a report published last year for the London Joint Improvement Partnership.
Community Care Live