Care packages for people with autism are being “routinely slashed” without thorough consultation, a coalition of providers has claimed.
The five autism charities said social workers were failing to undertake person-centred review meetings and were “only checking that people were safe, abandoning any concern for their quality of life”. They issued the warning in a letter to leaders of the main political parties, which called for urgent intervention from central government.
Jane Carolan, director of client services at Autism Together, said three men in the charity’s care had seen their packages cut without an assessment of their mental capacity, despite this being requested.
“The social worker came to do the review and decided that the packages would need to be cut and that’s when we raised our concerns,” she said.
“We felt the gentlemen didn’t have the capacity to understand, but the council didn’t involve their families and didn’t do a capacity assessment.”
One man’s support package was reduced from 57 to 30 hours a week, Carolan said, and funding for overnight and on-call care was also cut.
“All they [the council] are giving these men now is a crisis number to ring if anything goes wrong. We have said this will fail in future,” she added.
‘Funding pulled’
A spokesperson for another provider, who asked not to be named, said a council would not guarantee long-term funding for one-to-one support for one of its clients, even though he was assessed as needing it. The man becomes anxious and displays challenging behaviour when in a group setting, the provider said.
“The council’s own assessment, carried out in 2014, stipulates that the man requires a minimum of one-to-one support,” the spokesperson said.
The provider considered giving the local authority notice that it would end the placement, as it felt unable to properly support the man without funding for one-to-one care. “Obviously as an organisation that’s the last thing on the planet you want to do, because you’re committed to the people you support,” the spokesperson said.
“We requested a review from the social worker and she took the case to panel, but the panel only agreed to six weeks of one-to-one support. Within two weeks we were told the support was going to be pulled at the end of the six weeks.”
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The provider has since managed to get the one-to-one support reinstated for the man, but on the basis that this is reviewed every six weeks.
“We showed the social worker all the evidence of how the man had progressed with one-to-one support, the positive outcomes he’d achieved and that incidents had greatly reduced, he was a lot happier,” they said.
“We managed to get the funding back but how long for is another question – I think we will end up having this battle every six to eight weeks.
“It’s a real shame because the chap is doing fantastically with it.”
‘Specialist provision’
The charities’ letter also called for councils to pay hourly rates that reflect the cost of the living wage and new legislation on sleep-in shifts, which has “dramatically impacted” the costs to service providers.
For example, Autism Together reported a £500,000 increase in costs in 2016-17, but said it receives an hourly rate of £13.55 for supported living, one of the lowest nationally.
The letter pointed to research published by Cordis Bright consultancy in April this year that found 77% of autism providers are struggling financially.
Robin Bush, chief executive of Autism Together, said: “A lot of us stand still from year to year and consider ourselves lucky, but many of our counterparts across the sector have merged with other organisations because they can’t sustain viability or have gone out of business.
“Commissioners used to recognise that autism was a specialist condition, which required very bespoke interventions and they understood there was additional training and resources required to make successful packages.
“Now they refuse to acknowledge that point of view and lump what is effectively very specialist provision in with generic provision.”
‘Public coffers depleted’
BASW chief executive Ruth Allen said: “While I cannot comment on the specific claims made by the autism service providers about the state of funding and social work practice, their concerns fit with the overall picture of underfunded adult social care.
“The sector has suffered huge cuts in many localities and tends to be seen in national policy as being about ‘the problem of an ageing society’. Conditions such as autism can particularly lose out in the scrabble for resources. The feedback of service users, carers and partners is essential to raise awareness of the risks that can come if professionals are practising with their hands tied and public coffers depleted.”
She added that people experiencing social work as “rushed and insensitive” should provide this “vital feedback” to commissioners, but warned that social workers “cannot operate consistently well in contexts where duties and expectations demand personalised approaches but funding levels and managerial edicts and high caseloads make such personalisation impossible”.
Margaret Willcox, president of the Association of Directors of Adult Social Services, said: “All councils should have in place a strategy for adults with autism. We would encourage people with autistic spectrum disorder, or their family to approach their local council if they feel in need of help or support. An assessment of need and advice and information is an excellent place to start notwithstanding what care services might be required.
“Councils work hard to ensure their approach to individual care is person centred and flexible to meet the needs of individuals. Over the past six years councils have had to make some difficult decisions about the level of individual packages of care. As it is the public purse they are spending they will always seek to get the best value possible.
“While the additional £2 billion funding for adult social care over three years is very welcome it is not a long term solution, and will not help us deliver ongoing care, support and safeguards for people in the most vulnerable circumstances in our communities.”
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As a Care Act Advocate I have had several cases in the last few months that without my input would have seen cuts and a diminished quality of life in contravention to the wellbeing principle of the Care Act.
Recent judicial review has made the issue of anxiety a more subjective concern but actual evidence and good logging of work done provides a huge argument for people to retain their hours and even have them re-instated after review.
The old saying of ‘Use it or lose it’ applies greatly to these reviews, though it should be changed to ‘Use it effectively or lose it’
I empathise with the pressure the social workers are under but if you do the above you arm them to challenge their managers/panels in regards to cuts.
Obviously not every case is a guaranteed winner but providers and social workers should remember that advocacy services are out there and can be a great assistance with cases like this.
Families of autistic children are struggling to get the right level of support from children’s social care as it is. The bar is set too high and all too frequently, the lack of autism training leads families down the path of false allegations of abuse or neglect, because social workers don’t understand autism presentations or needs.
“Specialist autism training for social workers declined in year before Care Act reforms”
https://www.communitycare.co.uk/2016/01/14/specialist-autism-training-social-workers-declined-year-care-act-reforms/
‘The state of social work knowledge on autism must improve – the law requires it’
https://www.communitycare.co.uk/2015/10/28/the-state-of-autism-training-in-social-care/
All the while there is insufficient social worker training and awareness in autism, what little social care support is offered will not be appropriate or provide what is needed.
Autistic children are overrepresented in the care system. It’s obvious why.
Autistic children become autistic adults. If sufficient funding was put into children’s social care, there may be better outcome and less demand on adult social care services.
Nobody in authority seems to think logically. And whilst money is being poured down the drain in taking autistic children wrongly from innocent families, that is money that could be well spent in providing proper support for families, not to mention the trauma that could be avoided.
As an ‘old school’, mostly agency, social worker now retired nothing in this article surprises me but the question that always burns in my mind is whether the person who undertook the assessment and review is indeed a social worker. My experience over years is that social work as a profession has been completely undermined with unqualified staff, in every adult care/learning disability team I have worked in, undertaking the statutory tasks of a qualified social worker and getting it badly wrong. Most have no idea of how to complete a person-centered assessment and would not have a clue how to complete a Mental Capacity Act assessment. Given these are all statutory tasks I find the current use of unqualified staff to do this work as legally questionable. Rather than being public servants and acting in the best interests of the public most are simply doing what management tell them to do. The fact is that if a person is assessed by a qualified social worker as in need of 1:1 then the local authority have a duty of care to meet that need.
Our children are suffering due the drastic cuts.Especially from the bme community as we get late diagnose and not enough support.please stop this racism.
We are in a very difficult situation nationally with regard to underfunding. Trying to get any case through panel is a feat in itself as many social work assessments are picked apart by senior managers who haven’t actually worked with clients with specialist needs for many years or not at all. Indeed in my Local Authority, the head of adult social care is an ex-finance team manager and has no social work experience, so refuses high care packages without actually processing and understanding the reasons for asking it.
It must also be said that historically, in my area, many care providers have had access to 1:1 funding for decades without actually putting it in place and just taking the money. This has led to people with Autism just existing in services that are not providing the care being paid for and certainly not the hours agreed at panel. We are seeing more and more of cases like this and must do what we can to meet every client’s needs and make sure that the service is giving the best possible support where a person can live life as well as possible
Just remember- When Theresa May was asked for her thoughts on NHS nurses needing to use Foodbanks she responded: ‘there’s no magic money tree’ aka if just tough and she does not care enough to act.
A re-election of the Tories gives a green light to ‘no magic money tree’ response to all who are in desperate need.
It is true that the national debt stands at £1.7 trillion, or around 87% of GDP. But this is not particularly high by historical standards – after the Second World War the national debt stood at 243%. Imagine if Clement Attlee had listened to those who insisted that this meant Britain had ‘no magic money tree’. There would be no NHS, and no welfare state. Britain would be a very different place.
References.
http://www.independent.co.uk/news/uk/politics/theresa-may-nurse-magic-money-tree-bbcqt-question-time-pay-rise-eight-years-election-latest-a7770576.html
https://www.opendemocracy.net/neweconomics/magic-money-tree-dont-let-politicians-tell-otherwise/