The High Court's decision to rule Isle of Wight's decision to further redstrict its eligibility criteria may appear a victory for servce users, but in reality it will be little of the kind. The FACS bands are virtually meaningless, and so all that will happen is that the interpretation of the existing bands within IoW's eligibility threshold will narrow to fit the new, reduced budget. There is clear evidence that, with most Councils now operating at 'critical' and 'substantial', the interpretation of what that means is huge - both between Councils and within Councils in terms of differences betweeen user groups - with the size of budget determining whether the interpretation is broader or narrower.
What is required is a completely new eligibility framework to replace FACS that ensures Councils are transparent in their use of resources and the impact the level of their budgets have on service users.
Colin Slasberg
But budgets are budgets so the 'bottom line' surely has to be in legally binding and absolutely clearly defined criteria.
Spending has to be within budget, absolutely, but it has to be possible to construct an eligibility framework that supports sensible, flexible decision making within budget. We all know that there is no relationship between the priority of need and the cost of meeting it, or even the preventive impact of meeting a need. Rigid criteria are wholly unift for purpose given the complexity of social care - all they do is create a spurious but quite meaningless appearance of equity. There is little dount that even within Councils, what is critial and substantial for an older person is quite different to what it is for a working age persom. Having an eligbility framework that supports flexible decision making within budget will require skilled practice to identify needs and outcomes that are accurate, and the most cost effective ways of meeting them. It will also require intelligent budget holders able to make best use of the budget. And it will require political honesty about the extent to which the budget has made available does and does not enable their vision for social care to be realised.
Well, the *budget* is a fluid thing that is made up by guesswork, not knowing waht the central government allocation is to be and a sprinkling of Polictical dogma...... amongst other things.
Who is to say, that the budget for social care in a LA area is anything like fair, is unbreakable, unmovable and without alternative?
The IOW council have been monkeying around with care for some time now...indeed, it is disgracefulo how they moved from social care for all (subejct ONLY to financial threshold criteria) pre February 2011, changing it to substantial immediately following the Council resolution in February and then again to Critical & Substantial during the summer of 2011.
The Council claim only 38 (!) people were affected by the Court ruling yet I have evidence of hundreds of older vulnerable people being denied social care since February 2011. The Council claim they will not appeal and will put back the threshold criteria to the February levels ...but they havn't and older vulnerable people are still being denied social care because they do not have critical or substantial needs. Usually this is being done at the first phone call (carried out by untrained staff as it happens) and very few are getting through to assessment stage - also carried out at first by untrained staff on the telephone.
Clients are being refused more than 4 incontinence pads per day, the LA is cancelling Medication overseeing visits (..dangerous) and have imposed a domcare provision rate that is unrealistic and unsustainable (a quarter hour - of which they have increased enormously over the past two years at the expense of one hour calls - is paid at £3.50) Some of the mani care providers on the Island refuse to undertake quarter hour visits as a result but..... worse... this rate is used to calculate both DP's and PB's when assessing the finanacial award! This means that the client goes out into the community to buy care at the LA enforced rate but cannot find a provider to do so at *that* rate (they charge higher privately - thus including PB's and DP's)
It wasn't a surprise that the IOW council were found out, so to speak, but they continue with alarming methodology and practicesa that are not seen anywhere else in the UK. They must be the only LA who do not commission ANY care services anymore...?
Let's all understand that however we want to talk around this issues, the LA's are interested in saving money...and any scheme they can adopt without associated repercussions they will....whatever the outcome for clients. There really is no *care first* approach to provision and I'm waiting for the first of many vulnerable people to pass away as a direct result of care cuts that hits at the older vulnerable people in our communities...we need much, much more TV and Press accounting that shows up both central and local governemnt decisions for what they are... a shameful disgrace.
PJ