As a service-user living in Buckinghamshire that uses both Direct Payments and ILF, also a family carer for my daughter who also uses direct payments
I want to defend Direct Payments and the choice and control it gives to us, the service-users, following your Serious Case Review article (Social workers failed to monitor direct payment user murdered by son) in your publication on Monday (7 November)
This tragic case could set Personalisation, and Individual Budgets back to the point where no one will trust people to dip their toe into the water and live their life.
In my role as chair for the Self Directed Support Service User & Carer Reference Group, I have along with a family carer developed and led several events to help other Service User and Carers understand self directed support and the benefits to them of taking a Direct Payment
We are currently planning an event to tell providers that we, the service-users, now have the control, choices and desire, to live our lives in the way that we want, this will be our 7th event and being held at the direct request of the providers themselves. Publicising an isolated incident, however tragic, could set us back years, taking back our freedom to choose who looks after us and importantly how we lead our lives, who comes in and when.
We have developed a really positive relationship with the Council, to the point where we are genuinely welcomed at a strategic level, – we have over the past 3 years worked alongside the council helping to develop their self directed support agenda, we have not experienced a tick box tokenism in Buckinghamshire County Council, rather to the contrary it has always been open and in a genuine desire to make Direct Payments achieve positive lives for service users
The council have, and are, putting in place better advocacy services, a brokerage service, a Support with Confidence scheme, greater access to information and advice, all to help individuals make the best use and most informed choice on how to use their Direct Payments. Our greatest fear is that this dreadful story will begin to wind the clock back again and take the plural out of the word ‘choices’ for service users and carers in Buckinghamshire.
Let's not have the future direction of direct payments be dominated by an isolated tragedy, rather let’s applaud the great success of how it empowers people with disabilities to have much greater control over their lives in a way that is taken for granted by able bodied people.
As a personal budget user since 2007 before on direct payments I totally agree with all that you say
As a social worker, DP is a complete nightmare.
Whilst it may work for the end user, which is what it is all about, we are not supported with this area of work, have to go to endless "panels" for funding, are constanly being told different things so I gave up in the end.
This was a simple request for a season ticket to the football as the service user no longer went out, no longer saw her friends who she had seen their for years and was completely isolated.
I dont waste my time anymore. If it was easy, everyone would do it.
My job is hard enough without DP aggro
Thank you for your endorsement of Direct Payments, there is no doubt that it can offer real choices for people requiring support, in order that they can remain at home rather than in residential care.
going down the route of Direct payments should remain the choice of the service user,.
I did not instantly go onto Direct payments when they were first introduced, I chose to remain with a 'provided service', I then realised that I could pick and mix which parts of my package I would like to use DP's for
I then gradually introduced DP's into the way I wanted my care package to be provided, I began by leaving my personal care with the provided service and then began by choosing my own agency to cover the remaining few hours a week.
Then after talking to other DP users, I felt confident enough to become an 'employer' in my own right - I have always used the support of our Direct Payment Advisory Service provided by a local charity, now that I have ILF - I have chosen to use a small agency which provides with with a dedicated member of staff that only works with me - this works very well for both the agency PA and myself.
The authority have altered their provided service and the new company could not cover the time of day I required, so I now take all my package as a DP and have chosen an agency of my own that can cover the time of day that I need in order to meet my outcomes!
I use a payroll company of my choice, to cover the staff that I pay directly - I even managed my daughters package, she has a LD and has a support package in order for her to live indepently.
DP's are only a part of the pick and mix choices that should be offered - they are a valuable part of living indepently, they are flexible, and should remain service user driven - bespoke - personalised by me for me!
Dear Tricky,
I felt so many emotions after reading your response to my post,
tricky: As a social worker, DP is a complete nightmare.
I was saddened for both yourself and your client, Saddended that the LA's 'in house' systems appear to have impacted so greatly and negatively on what would appear to have been a really good idea - and dare I say it 'good news story' - which at the end of the day would have been really positive for your client.
I can picture the pleasure person would have gained at being enabled to do something as inclusive and exciting as attending their favourite football team - and an activity that many do as a weekly ritual
I have no direct experience of 'panel' meetings, although I know of the process via my service user / carer involvement with our LA, I like to think that we aare able to offer an outside independent service User and Carer perspective on their policies and development ideas - the authority soon realised that our presence at meetings was not going to be that of us being 'grateful' for the invitation and opportunity and that we would not be agreeing with everything they said, far from it - we have developed a strong enough relationship for us to be able to openly 'query' what they had in mind - and if we don't have enough information on the topic we ask for it to given and explained to us in able that we can take part in a truely effective way.
In fact I was in the main building yesterday, talking with officers about the way that they manage their partnership boards from the service user/carer perspective, whilst I was in their coffee shop grabbing a coffee before going home I had an inpromptu meeting with one of their senior officers that is on the RAS meeting that I attend, he and I enjoyed a great conversation, raising queries around the fairer charging assessment, disability disregard and disability related expenditure and how from our research our LA's were tackling the same topic.
This was a very detailed conversation, that shows how far our authority has developed and opened up it's service user and carer involvement with it's work, This openess has taken a few years to develop, it has taken trust and respect on both sides - but is working well... Yes, I am sure there will still be times when the road is not totally smooth - but with strong relationships - it can work - in fact senior officers have been known to say - because of our skills in meetings, they tend to forget we are not officers like themselves.
Can I ask if you are you being offered all the support, training and assesment skills you would like in order to enable you to support your clients in the way that fits with your original social work training? I would have thought that it should have been possible for a social worker/care manager to have been able to request a low amount like this - and have agreed it without going to panel,
Do you have similar service user and carer input? we could have flagged up the irony of have the full panel machinary for a simple request such as funding for the season ticket.
We are very concerend over the future of ILF and what will happen if that does formally close it doors,
what about outcomes of the dilnott report where will that take the future of social care....
such a vast topic, take care of yourself, we need to retain social care staff that enable us to have visions such as football season ticket
best wishes
As some one who works with Service Users with PB's I am so glad this thread has been posted. I believe strongly in Personalisation as I have seen it work for all those I work with (currently 8 clients).
There has been to much Personalisation bashing recently on Care Space and often with gripes about specifics are either due to a SW not understanding or not being 'bothered anymore' as the system 'just doesn't work'!?!
I think Social Services should have some form of mandatory weeks worth of training at ground level (and possibly higher) so SWs can get the picture. It seem's like ignorance and an attitude of 'I can't be bothered to have to do something else'.
Its so refreshing to hear that PB's are and do work.
I wonder which LA's are good with PB's and which are bad. Sounds like Buckinghamshire and Cambridgeshire are the only 2 so far... Anywhere else?
JBD: As some one who works with Service Users with PB's I am so glad this thread has been posted. I believe strongly in Personalisation as I have seen it work for all those I work with (currently 8 clients). There has been to much Personalisation bashing recently on Care Space and often with gripes about specifics are either due to a SW not understanding or not being 'bothered anymore' as the system 'just doesn't work'!?! I think Social Services should have some form of mandatory weeks worth of training at ground level (and possibly higher) so SWs can get the picture. It seem's like ignorance and an attitude of 'I can't be bothered to have to do something else'. Its so refreshing to hear that PB's are and do work. I wonder which LA's are good with PB's and which are bad. Sounds like Buckinghamshire and Cambridgeshire are the only 2 so far... Anywhere else?
Shall we take it from the deafening silence that there is either total apathy or.....Bucks & Cambs are the only LA's (apparently....!) performing well?
In the same way that you extrapolate your own experiences into believing this sytem works for everyone ..you may take note that it clearly isn't working for SW's......!!
You see, this is just the types of experiences we are running up against.. a panel that sits once a month (!) and already with a considerable backlog isn't providing a service. The same panel approve underfunding when they eventually decide on the matter.......football tickets? outings? social support? NONE of those things are options for older vulnerable people who receive less on DP's and PB's than they did when directly provided for by the LA(..in our case with our LA) leaving no money to move away from Personal Care and into *personal choice* purchases. ....a vital and imperative function of care provision to the older frail population is, of course, personal care!
I understand you are working with disabled which, it seems and I have no reason to doubt, works very well under DP's.... it doesn't for the over 65's (in general)
PJ
Simple answer. Greater autonomy for social workers and more respect for their qualification.
Reason 3 – We have no bureaucracy Avaaz is a massive network of citizens, but our organization is absolutely tiny – just a few dozen full time campaigners with operational and technology support. Most large global NGOs have hundreds or even thousands of staff. Our small size means we have no time for red tape, layers of management, or being focused on anything but getting results.
The way forward from Avaaz.
And just how much are they making from 'gullible' people? - sounds like a real money-spinner to me - avoid at all costs!.
Who are their leaders / paid officials and how much to they get paid from their 10,400+ benefactors?
Rupert M: And just how much are they making from 'gullible' people? - sounds like a real money-spinner to me - avoid at all costs!. Who are their leaders / paid officials and how much to they get paid from their 10,400+ benefactors?
I'm struggling to see what this organisation has to do with Social Care in the UK in general and Personalisation in particular...
Anyone care to offer an insight as to its relevence in the context of Social Care?...... or maybe I am missing something
PJ. I quote above from Avaaz blurb in support of my contention as to how I see the problem. I am not supporting that organisation, just pointing out that less bureaucracy would mean more coalface decision making.
Shirack: PJ. I quote above from Avaaz blurb in support of my contention as to how I see the problem. I am not supporting that organisation, just pointing out that less bureaucracy would mean more coalface decision making.
Ah, ok. Thanks for that. I thought for some inexplicable reason you were advocating this organisation per se as a solution to personalisation issues!
Direct Payments do not need defending. They are under absolutely no threat. Firstly, they work very well for the 5% or so of service users who either themselves or family/friends on their behalf, have the energy and social skills to manage their own support system. But more significantly, they have the whole hearted support of the dominant neo-liberal politicians within this government and the previous one for whom consumerism is the answer to reform of public services.
It is the 95% for whom Direct Payments cannot work that need defending. Not only do DP's do nothing for them, their existence worsens their situation given that DP service users take a disproportionately large share of the cake, leaving less for the majority. They therefore have to be supported by a provenly dysfunctional system, and lowe levels of funding than those with a DP.
Colin Slasberg
And the personal Budget bashing goes on.... I'm actually starting to dispair of Social Workers.
PJ you keep pointing out I work with the disabled.. Let me reiterate I DON'T!!! Was that loud enough I'm based in Mental Health.
I'm sorry its not old people.
JBD: And the personal Budget bashing goes on.... I'm actually starting to dispair of Social Workers. PJ you keep pointing out I work with the disabled.. Let me reiterate I DON'T!!! Was that loud enough I'm based in Mental Health. I'm sorry its not old people.
Ok. Firstly, sincere apologies.. I *thought* I read in one of your posts you were working with disabled....
I've got that now...you are working with Menatl Health service users..
What you have to understand, but your experience is preventing you from (I assume...) is that there are whole swathes of people involved in the provision of care & support that know PB's are NOT the answer for older people. They just are not, I've tried to explain why that is in a small way and it's pointless writing 'War & Peace' on it here. If it gets "bashed" it is because most of us working with older vulnerable people are tired of the groups for whom it DOES appear to work just asserting it's great, what are we complaining about, it works for *me*, it works for *us*, great for our personal choices etc., etc., etc., ad infinitum. Those in power might be forgiven for thinking all is great and rosy in the la la land of PB's.....just by listening to those groups - of which, I might add, I would include largely Mental Health also...
When we roll it out to older vulnerable adults it doesn't work. Just doesn't work. They have no desire to manage their own care provision, they have no desire to swap care for some social outing and they just want safety and security with regular personal carers.... no hassle, no employment responsibility, no holiday cover, no sickness cover, no redundancy payments and so on.... In addition, we are dealing more and more with cases of dementia onset and/or short term memory loss - these service users are incapable of managing anything whatsoever ..let alone personal care provision.
And, as I keep repeating, it is ALL an illusion. All of it. We have direct experience of largish numbers of people who have moved onto DP's (they had no choice! - great, isn't it? the ultimate choice argument for pb's is not extended to people who do not wish to have them...!) and each and every one, bar NONE, have had their care & support packages reduced in financial terms. There IS NO MONEY for personal choices left... Do you understand this? There is insufficient funding to make any choice over and above buying the most basic personal care provision one can...! And, do not forget, unlike perhaps, other groups, the older vulnerable groups require personal care to allow them to remain independent for much/most of their requirements.
When social workers come here and tell you the same as front line providers (bashing PB's in your words..) you ought to sit up and ask why it is that people involved in care for the over 65's are saying these things....
We *know* they can work for disabled, learning difficulty and children.... that's no reason at all to just assume they must work for the elderly....they don't.
To reply I have never said that they work for ALL. Although in your posts you keep repeating that PB's do not work for ALL. (this is where the clarification I think may be needed).
But I do not agree that PB's do not work.
I understand your point that they do not work for Older people. This is obviously a given in terms of Dementia as well. And your experience. And statistics. etc.etc.
I will say that once a PB is up and running for not only disabled and children but also mental health they seem to be very good and have increased the quality of life of service users with in these realms.
As for Social workers there seem's to be a lack of understanding about PB's and the only SW's who do advocate them are those that use them successfully for the aforementioned groups I work with/have seen them work for.
This is why I defend PB's. I am not against old people or in the habit of generalising everyone into the ALL catagorey or to assuming that as my clients seem to get a great deal from them that everyone does.
I think we see PB's from two different sides and that I have seen them work and you have not. Obviously I may not be saying the same thing in the second half of this year once there are more funding cuts but at the moment things my end are going fine.
Finally you did read that I work with Learning Disabilities but this is a weekend job, my main full time work is with 16-65 year olds with Mental Health issues and these are the clients and examples I use. Sorry for not clarifying this in the first place.
Did I hear that right? Direct Payments CANNOT work for 95% of people? So is your calculation of how many DPs can work for based on how many are taking them up? (more than 5% now by the way)
Just checking a bit more - and DPs are basically a neo-liberal plot to take money from others? Wonder what the disabled people who fought for DPs as a way to escape from institutional provision would make of that interpretation of history?
The numbers with a DP are heading toward 10% and likely to increase further as Councils find more inventive ways of getting people onto a DP. They will do so because it is a Government target. However, there is no evidence that the addtional numbers with a DP will benefit at all. They will either be people given a relatively small sum while most of their package will continue to be Council funded, or people who have no intention to do anything other than continue to purchase mainstream services, but they will be told they are required to have a Direct Payment. This is worse than cynical as it all it will do is to add to transaction costs (financially inefficient) and increase anxiety for those service users (mostly older people) who do not want the responsiblity.
It is an over-reaction to describe what has been happening as a plot, neo liberal or any other kind. That implies a level of intention that is not likely to be the case. But the evidence is clear - people with a DP (those for whom it has been an authentic option) enjoy a much higher level of resourcing than the majority and this is the most likely explanation for the better outcomes they experience. They are people with the skills to manage the market place, which means they also have the skills to manage their way through the Councills resouce allocation processes, which are flabby at best given the hopelessness of the FACS framework.
Having said there is no plot, when an axe wielding Tory Chancellor makes mention of social care and personal budgets in his Budget statement to the Commons in announcing his austerity plans, we are entitled to wonder what it all means to him.
I agree with JBD’s comments about the needs for Social Services to provide some form of mandatory weeks worth of training at ground level for social workers.
I think a lack of clear guidance of how to operate direct payments can mean that social workers use their own discretion in determining who should receive direct payments due to communication problems or impaired cognitive ability, for example.
It’s unhelpful when practitioners group service users together and tar them with the same brush i.e. “they (older people) have no desire to manage their own care provision”.
I was placed in a care management setting last year (as a SW student), where I worked with a few older people who enjoyed the benefits DP’s, and some who didn’t like the idea but were appreciative of the fact that I took the time to explain the ins and outs in order that they, themselves, could make an informed decision. If DP’s don’t work for the individual, they are entitled to make that decision. As for requiring people to accept DP’s - I am unfamiliar with any LA having attempted this. Is this really the case?
In my experience, a lot of the expressed wishes of service users do not have huge cost implications but are about how someone wants to be supported, referred to, included in decisions. When considering the option of direct payments, social workers have a responsibility to discuss with service users the support they may to manage a personal budget as they may not have the capacity to do any of the day-to-day management (or possess the skills to manage the market place) and therefore they may need someone else to manage the administrative side on their behalf i.e. a friend or specialist broker.
With regards to the 5% or 10% percent of DP recipients - this does not mean that they do not work for the rest. In some parts of the country, rates of DP take-up amongst groups who have difficulty in accessing direct payments have transpired via a gradual increase in confidence of managers and social workers received through extensive support and training, such as cultural awareness workshops.
MK
I think I am fairly familiar with most of the evidence on direct payments. Which research based evidence are you referring to which establishes that people won't benefit from direct payments, that people are paid more via DPs and that establishes a clear link between outcomes and resources? Could you supply references?
The onus of proof surely lies with those who are proposing an action, especially when that action contains known risks (IBSEN and other research has noted the level of anxiety that many service users experience with the level of responsiblity assoicated with DP's), and not those who do not believe it will be the case. The question is therefore, what is the evidence to support the line underpinning current Government strategy that the majority of people will benefit from DP's?
The evidence for the higher allocation of resource to people witih DP's is found within the NHS Information website. That shows the amount spent on various services and the number of service users. That shows that the spend per DP recipient was about 50% more than the spend per head using all other community services. There are some adjustements to that raw data to get the most accurate positoin - some which would close the gap a little, others that would increase it - but I believe this data makes a prima facie case that should not be ignored.
M K - I completely agree with you that very effort should be made to ensure that all who genuinley want a DP have the option, and that does mean the need for skilled and aware workers. I guess we dont really know how many people that is likely to be once all service usres have been given the real choice. But evidence to date suggests it wont be more than a small minority. My concern is that public strategy for the development of social care rests enirely on PBs through DP's, and does nothing for those for whom it is not an option that will make a real difference for them.
Direct Payments across the whole of Social Services means less resources all round. Those who are happy with it now, will not be a few years doen the line, when the re assessments start, and the actual people who do Social Work have diminished to very small numbers, and accountants and non SW managers have to meet tick box targets.
oab: Sorry to disagree with the reassessment thing but all the service users I currently work with who have PB's are reviewed every 6 months? If PB's are not being reviewed at CPA meetings in your area I think someone should ask the question why.
CS: as for the onus of proof lieing with those who are proposing the action. I have been on several of the forums you have posted on saying PB's are working for my clients. And by the sounds of it Glasshalffull has to... and MK.
There has been a lot of 'well theres a lot of proof out there' stuff which seems to have been made through suposition!? I may be wrong.
If it finally gets to the stage that everyone in social care has a PB you may find that there are savings... Big statement I know but not everyone needs the same level some a lot less than others but who are given everything to start with.
JBD: oab: Sorry to disagree with the reassessment thing but all the service users I currently work with who have PB's are reviewed every 6 months? If PB's are not being reviewed at CPA meetings in your area I think someone should ask the question why. CS: as for the onus of proof lieing with those who are proposing the action. I have been on several of the forums you have posted on saying PB's are working for my clients. And by the sounds of it Glasshalffull has to... and MK. There has been a lot of 'well theres a lot of proof out there' stuff which seems to have been made through suposition!? I may be wrong. If it finally gets to the stage that everyone in social care has a PB you may find that there are savings... Big statement I know but not everyone needs the same level some a lot less than others but who are given everything to start with.
If you believe that DP's and Personal Budgets are anything other than a vehicle to cut funding and/or costs then you are living in another startosphere frankly.....
Look, the reason that disabled, learning difficulty and children have been successfully using PB's with improvements to their well being over very many years is, simply, that they are a great option for them and work because they either take control of what they want (and that, often is social care needs) or their guardian takes care of what they want. No one disputes there are clear benefits to be had by these social care sector groups.
It is no accident that we have not seen any meaningful uptake by the older vulnerable group and I am not going over and over the same old ground explaining why they havn't, hitherto, chosen PB's or why they don't work for this group. The largest social care group, by the way!
In general, older vulnerable adults do not want the responsibility of running a PB, are unable to run a PB and see no great benefits in the system. The reality is that the switch from social funded direct care - either in house provision or commissioned provision - is seeing under assessments, depreciated financial calculations (using unrealistic care provision rates) and no account of anything other than personal care needs, excluding any assessment and financial award for ANY social care outcomes. This all transpires into absolutely no choices because the funding doesn't meet the most basic personal care needs, for which there can be little personal choice... you either get up...or you don't! You either go to bed...or you don't! you either take your medication...or you don't! you either eat..or you don't ...and so on. These are not areas of any real choice and yet they are the only type of care areas being funded. It is nonsensical. No wonder the powers that be are pushing like mad for these changes - it is a giant recipe to save money.....nothing about quality of care or services...... saving money.
There is a great struggle to get the to the target for PB's in the older group and we are seeing a half way house where funding is being cut from a service user, then they are managed by a Care Manager (how long that will last, they way Care Management is being attacked in the Older vulvnerable group sector, one can never tell) under a direct payment scheme. It's not a PB and it cannot work as a PB but it works for older vulnerable adults.... Course, how the service user even begins to identify which care provider they might like (most, if not all, just stay with the existing provision ....only it gets cut down because of the under funding) is a matter for some other world, higher authority. List of names to choose from is not a real choice is it? It's not an informed choice, is it? Choices when suffering short term memory loss or worse, dementia, are not choices are they?
You keep falling into the trap of supporting the whole ethos and thrust of PB's because you work with social care groups that it *can* work for.
As I have said, repeatedly and endlessly, it just does not work for older vulnerable adults in general or, I wager, in their general majority. It is therefore my contention that if you are to continue with assertions that PB's work then you must include the ryder that it does not (necessarily) include the older vulvnerabl;e groups.
If however, you can point to overwhelming evidence that discredits my statement about PB's not being the correct system for the older vulnerable groups or that DP's are somehow not akin to PB's then let's have it....I would be VERY interested to read the evidence for the general system (not anecdotal or subjective personal accounts)
Shame to make this such a polarised debate. Practical stuff on older people and mental health and PBs from SCIE http://www.scie.org.uk/publications/reports/report40/files/report40.pdf
Findings on carers of older people and IBs from IBSEN were interesting
Service users’ receipt of an IB was significantly associated with positive impacts on carers’ reported quality of life and also, when other factors were taken into account, with carers’ social care outcomes. Carers’ involvement in and satisfaction with the service user’s support planning was an important predictor of positive outcomes for the carer. Indeed, IBs offered more opportunities than conventional social care support arrangements for carers to be involved in planning how the IB was to be used. Carers of older IB users were more likely than carers of IB users with learning disabilities to report positive experiences of IBs, particularly if they had been able to build some choices over how they used their time into the service users’ support plan.
However, local authorities varied in how the help given by carers was treated in IB assessments and how far carers’ own support needs were also considered.
The positive outcomes for carers that were achieved with no additional public expenditure costs suggest that IBs for service users are cost-effective for carers.
glasshalfull: Shame to make this such a polarised debate. Practical stuff on older people and mental health and PBs from SCIE http://www.scie.org.uk/publications/reports/report40/files/report40.pdf Findings on carers of older people and IBs from IBSEN were interesting Findings Service users’ receipt of an IB was significantly associated with positive impacts on carers’ reported quality of life and also, when other factors were taken into account, with carers’ social care outcomes. Carers’ involvement in and satisfaction with the service user’s support planning was an important predictor of positive outcomes for the carer. Indeed, IBs offered more opportunities than conventional social care support arrangements for carers to be involved in planning how the IB was to be used. Carers of older IB users were more likely than carers of IB users with learning disabilities to report positive experiences of IBs, particularly if they had been able to build some choices over how they used their time into the service users’ support plan. However, local authorities varied in how the help given by carers was treated in IB assessments and how far carers’ own support needs were also considered. The positive outcomes for carers that were achieved with no additional public expenditure costs suggest that IBs for service users are cost-effective for carers.
Interesting, I've skip read this and might make some quick comments. The first being that SCIE has a definite agenda in promoting PB's. That's a given. The report is quite a positive gloss, using mostly glowing *personal comments* whilst not publishing the negative comments.
QUOTE:
Introduction.P18:
Older people reported lower psychological wellbeing with individual budgets in
comparison with previous LA-managed care, and were generally more
cautious about such budgets compared to younger disabled people.
....lower psychological well being....see that?
QUOTE: Page 19:
P19:
In its guidance, Personal budgets for older people – making it happen, the DH
(2009) notes that, in many councils, direct payments are emerging as the option
of choice for older people.
..the irony being that there is no choice, it's PB's or nothing!
QUOTE: Personal Story Page 36:
Personal Story P36:
Personal story
Derek, an older PB holder who is physically frail, needs a lot of
support to enable him to live independently. While he was still being
supported by the homecare reablement team, his social worker
came to his home and went though the assessment with him and
his wife Gillian. However, because his needs were quite complex,
other practitioners and agencies were involved in assessing
Derek’s overall needs. An occupational therapist sorted out all his
equipment needs, and the Fire Service ensured that smoke alarms
were fitted. He and Gillian also had a visit from a financial assessor
to discuss their personal contribution, and Age Concern (Age UK)
made a home visit to give them information about care agencies.
Although there were a lot of people involved in the process, the
couple felt that it was all well co-ordinated and Derek said that ‘the
[PB] process had been explained quite clearly by the social worker’.
Interestingly, he added that he had found it difficult to explain what
his needs were because he had never previously had to consider or
articulate them. His social worker helped him to think them through.
Read it carefully.... the only older person account of PB's.
Nothing positive about the PB. I suspect he had no choice, doesn't sound like it. I do not see one word about the positive aspects of his PB whatsoever in his comments. Not one. (there is no negativity either, I accept, but that's not the point. - clearly he had no choice in the matter)
That is the way this report is presented, in my view. A report of 69 participants (only...) and of which 29 were from the older vulnerable group....and that is the best comments they could find from 1 of the 29...? Not entirely inspiring is it?
Speaking from the Martian Startosphere.
Seem's we've got to the same place. Let me see if I've got this right.
PB's don't work for older people.... Therefore no one benefits from PB's this also seem's to include in your dialouge that Children/ Disabled obviously can't get any benefits either.... Hows Venus's stratosphere at themoment?
Ok so probably not much point carrying on the conversation. I had hoped that we could agree on some things - older people are in the main not currently getting personalised suupport, that there are various ways this might/needs to change - in difficult times we need to think about what can be done. PBs are a reality and will not go away and are clearly benefiting some older people. As well as other things what can we do to improve older people's experience of PBs. i don't think you are up for a shades of grey conversation but perhaps are focused on winning an argument that I don't want to have. I wish you well in your work and good luck to the people you support
glasshalfull: Ok so probably not much point carrying on the conversation. I had hoped that we could agree on some things - older people are in the main not currently getting personalised suupport, that there are various ways this might/needs to change - in difficult times we need to think about what can be done. PBs are a reality and will not go away and are clearly benefiting some older people. As well as other things what can we do to improve older people's experience of PBs. i don't think you are up for a shades of grey conversation but perhaps are focused on winning an argument that I don't want to have. I wish you well in your work and good luck to the people you support
Thanks. Just to say, I'm not entering into a personal argument either......debating the issue is not the same thing. ;0)
I'm also prepared to consider "shades of grey" ...why not? It's not a mindless black or wight issue.
What I'm getting however is PB's work (..they don't in general for older people) if they don't work for older people what can we do to make them work!!!
That's no way to implement a system frankly... What we all might like to consider is that this wonderful nirvana of PB la la land is the most inappropriate system we could devise for older vulnerable people. And not enough people are listening to that or want to hear it.
This report of 29 older people.... I've personally surveyed over 600 service users about having a PB... making sure they are aware of the Employment resonsibilities and obligations of course. Not one, ONE person... said they wanted to have the responsibility of a PB. Let alone the numbers we now support with a PB that, in EVERY case, receive less funding under the PB than they did under Social Care direct provision.
It's an illusion, it's a scheme driven by financial incentive and has little to do with quality of care for the majority of older vulnerable adults who are worse off under the scheme. They have no choices to make, that's an illusion - Hobsons Choice - also as awarded budget barely covers the most basic of personal care needs. There IS no money left over to make a choice. And LA's happen to like it also as it moves towards a no responsibility environment where everyone is just buying whatever they can privately. It's privitisation as it will be with the NHS...
I love the irony of this PB mantra of personal choice...... if you choose to NOT have a PB...then what. ? Where's the personal choice gone..?
I'm not even going to get into the wholesale opportunities for abuse for those so inclined as they realise the deregulated provision of, say, PA's...
Meanwhile, care providers will start to drop like flies leaving enormous gaps of non fulfillable care need...
JBD: Speaking from the Martian Startosphere. Seem's we've got to the same place. Let me see if I've got this right. PB's don't work for older people.... Therefore no one benefits from PB's this also seem's to include in your dialouge that Children/ Disabled obviously can't get any benefits either.... Hows Venus's stratosphere at themoment?
Nope.
PB's don't work, generally, for the older vulnerable group. Period.
I'm prepared to accept there are benefits to the disabled, to children and to Learning difficulty groups.
It is not an appropriate delivery vehicle for care to older people, in general terms. It is, however, a clear cost saving exercise...
dede: For goodness sake PJ you really need a language etiquette course "THE DISABLED" to you we are one glbulous group are not indviduals. We are people who are disabled "Disabled People.
It's just this sort of politically correct, nitpicking that gets in the way of exchanging views and ideas.
This is a professional forum and it would be remarkable if people posting here didn't have a modicum of understanding of current social care terms issues.
Clearly, I was mentioning the group - like any group made of of individual members - and you understood what was meant..... I certainly do not need to be lectured on language in this, or any other, forum...
So, let's be clear, the "The Disabled" to me in the context of my posting is brevity for..... Disabled Groups, Disabled People, More than one Disabled Person, Disabled People collectively, People with Disabilities ...... all juxtaposed to the 'older vulnerable groups or sector (over 65's) of social care.....
Clear now...?
PJ: dede: For goodness sake PJ you really need a language etiquette course "THE DISABLED" to you we are one glbulous group are not indviduals. We are people who are disabled "Disabled People. It's just this sort of politically correct, nitpicking that gets in the way of exchanging views and ideas. This is a professional forum and it would be remarkable if people posting here didn't have a modicum of understanding of current social care terms issues. Clearly, I was mentioning the group - like any group made of of individual members - and you understood what was meant..... I certainly do not need to be lectured on language in this, or any other, forum... So, let's be clear, the "The Disabled" to me in the context of my posting is brevity for..... Disabled Groups, Disabled People, More than one Disabled Person, Disabled People collectively, People with Disabilities ...... all juxtaposed to the 'older vulnerable groups or sector (over 65's) of social care..... Clear now...? PJ
Suggest a little care here. This being a professional forum, understanding of and respect for the social model of disability is a reasonable thing to expect
glasshalfull: Suggest a little care here. This being a professional forum, understanding of and respect for the social model of disability is a reasonable thing to expect
Of course, which is why I wrote disabled, .......................................................groups.
Just to further add to this nonsense...
Here is what was aid (written by me....):
..........there are benefits to the disabled, to children and to Learning difficulty groups.
Now, if someone wishes to nitpick about whether or not the word *groups* on the end of the sentences applies to just "Learning difficulty" ...or to the words "the disabled, to children and to Learning difficulty" then I have no control over that. Only to re-iterate it IS just this type of political correctness, this nitpicking and over sensitivy to language which makes certain discussions well nigh impossible. (on the basis they are derailed by received interpretations and personal insults...)
I do not need to be lectured about these words, or these groups of people and as a professional in this field I am fully aware of the issues to hand. In this case, the intention of the grammer was to include *groups* within the sentence that encompassed the word *disabled*.... those who want to see it differently I have no control over. And, as always, the message gets lost...
Which hole is that? Which previous hole are you also referring to.
Maybe you should read not only the sentence that the poster found to be offensive (wrongly, in my view) but my subsequent posts....
There is no hole, there is no "ignorance" and there is no need to persist with this nonsense....
3 PJs in a row, who's persisting?