I've been following some of the threads on personalisation in England and thought it would be useful to try and get a discussion going on the push for personalisation in Scotland. We now have a draft Bill out for consulation on self directed support and the authority I work in has is just coming to the end of a pilot on individual budgets. So far there seems to be a real issue for some practitioners about the validity of the claim that personalisation is about citizenship and the rights of the individual to be instrumental in deciding what they require in order to meet outcomes which are important to them. The 'cynics' see it as a the next 'big fix' to try and make ever decreasing resources stretch across ever increasing demand. I for my part see it as being incredibly liberating for those who wish to have a greater say in how their support and care is delivered but I also recognise that it isn't necessarily the panacea which some advocates such as In Control would have everyone believe. I also have concerns about it's sustainability in the face of the current austerity measures. One of my greatest concerns though is the constant battering which the sociall work profession seems to be coming under by those who would have others believe that we have got it wrong for so many years. Not everything about community care and care management is bad. For some individuals it has been their passport to a better quality of life and they have no wish to be anymore in control their support than they are at present. Personalisation, if it is to have a positive passage in Scotland needs to build upon what is sound and solid in the existing structures and not 'throw the baby out with the bath water'.
TJ - just so you know someone else is interested just in case nobody else replies! I'm in Scotland - and not so much an advocate for personalisation as an advocate always for better ways to help people have as good a life as possible. My specific reason for being on here today is to read about what's happening in practice (to compare this to the aspirations for personalisation).
You've raised a huge number of issues. I guess my starting point on all of this is that the current work on personalisation is the latest of many efforts to improve the stuff which needs (desperately) to be improved (note an assumption here that not everything needs to be improved). As with all policy/system changes things will be difficult. People who are enthusiastic may be able to use this opportunity to support radical improvements in people's lives - changes which mean the difference between life and death. People who think this will be The Answer will find themselves disappointed after a few years. People who are challenged by this - perhaps by the changes in power - will find reasons why the sky is falling down (and reasons to make it not work).
Lots more to say - but if you look at my other posts you'll see I tend to go on a bit if I'm not careful so I'll stop there (at least for now).
Always happy to talk about this in person.
Hi TJ
My team has been implementing Self Directed Support for 18 months now so we have a wide experience of the benefits and constraints that it brings. Many of our service users have complex needs and we have found that the RAS is not a tool that can really give any meaningful individual budget for many in this service user group and we are still trying to find a fair and consistent way of applying SDS principles to high cost packages of care.
There is a huge shortage of brokers around so care managers are still undertaking support planning with families, although in fact many families like the input of care managers. This is far from the vision of In Control where care managers would have little input into support planning.
Supported self assessments are also undertaken with care managers most of the time and where they are not we would normally have to verify them with the family and it is absolutely key that these are accurate as this is what generates the budget.
One thing that I believe is often forgotten is that prior to SDS many good care managers were implementing really imaginitive and personalised support packages for service users although they were sometimes limited by the imagination of local authority funding panels.
Anyway back to SDS and the issues that we face:
I am all for carers being recompensed for what they do and SDS means that some things that parents did for nothing now cost us money. However this is inconsistent as not all parents chatrge for their services if the service user is living away from home. If all carers charged for their time then there would be no money left and morally this is a difficult question.
Personal Assistants - their rate is different so we have some people paying £8 per hour and others pay £12 or more. Those who use agencies pay a lot more. So some people pay a lot more for their support than others and so some people use a lot less of their IB than others.
Some people want to use their money to pay for holidays (fair enough perhaps in certain cases) whilst others use it to meet basic personal care needs. There are older people who have very small budgets and struggle to meet basic needs within their IB and so their sometimes appears to be an inequality between service users groups. It can be very difficult to work out if some support plans are meeting needs or wants.
Some councils allowed people to meet the very basic need for sex by allowing personal budgets to be used to go to Amsterdam. This has now been stopped because of the public outcry whereas I am convinced that some of the challenging behaviour for service users with a learning difficulty comes from their inability to express their sexuality. I recognise that this is a very complex area with all sorts of moral questions about the exploitation of women but I would say that a trip out to the shops or a college course in independent living skills is a poor substitute for sex. But this need cannot be met and I don't know what the answer is - it looks like personalisation will not be the answer.
We have loads of experience and it is impossible to ignore the current funding crisis in the implemenmtation of SDS because there is less money available ans budgets will be squeazed further. This is not necessarily the fault of the local authority but the Government appears to be cutting costs and increasing targets with very few LA's publicly objecting to this.
This is a quick response and I don't mean to be negative at all but there are many issues that practitioners need to understand with SDS. It's not a panacea but it has potential if well implemented.
Julian.