Letters published in the 2 October 2008 issue of Community Care magazine
Letter of the week: Countering accusations about Devon Council support brokerage arrangements
From David Johnstone (pictured right), director, adult and community services, Devon Council
It is disappointing to read the false and damaging assertions about brokerage in Devon in J Marks’ letter (Community Care 18 September).
Contrary to the writer’s claims, our personal brokers come from a wide range of backgrounds and expertise and are not from “elderly care”.
In addition, they undertake eight weeks of intensive specialist training and assessment. People are not “going through the system several times”. The personal broker service is currently focused on those with the most complex needs who often require the most expensive care packages. Some 90% have their care plans met first time, based on the service users’ own defined outcomes.
We look for services which will meet outcomes creatively. Potential providers are evaluated on the basis of 60% quality and 40% cost. We do not seek “the cheapest deal going, whatever the cost to the service user”.
Depression and deafblind people
As Mark Hunter writes (“This is a job for social care”, 18 September), social care services can play a vital role in preventing depression among older people.
Deafblindness, or dual sensory loss, is a trigger for depression among older people. Sense estimates that one in 20 older people over 75 are deafblind and that deafblind older people are nearly three times more likely to develop depression.
Providing a specialist social care assessment and appropriate support services can allow deafblind older people to stay in touch with friends and continue taking part in activities they enjoy. Sense’s Fill in the Gaps campaign provides information for professionals, care home workers and relatives to enable them to support deafblind older people and to prevent depression.
Simon Shaw, policy officer (older people), Sense
Carers are more than a “resource”
The Princess Royal Trust for Carers agrees with Peter Beresford that the independent living movement and the feminist ethic of care have much to offer in challenging the disempowerment of people receiving support (Big Picture, 18 September). In the full JRF report, he further suggests that relationships involving caring “may diminish personal relationships, rather than being a positive expression of them”.
Being a carer does not always mean taking control of another’s life. Carers are often entirely focused on promoting the independence and dignity of the people they care for.
Independent living is a powerful concept that can bring huge benefits in many situations. However, it is not a catch-all solution. Consider an elderly person in the late stages of dementia: is their goal independence or living with dignity within a family unit?
Peter Beresford’s report rightly tackles the government’s perception of carers as a resource. They should be recognised as people in their own right. Perhaps only then will we see fewer trade-offs between the independence of those who require care and those who provide it.
Alex Fox, director of policy, The Princess Royal Trust for Carers
Why councils must learn to let go
Effective support brokerage is one component of interventions that assist people to define their own notion of a good life and weave a tailored robe from natural and specifically commissioned paid-for supports (“Going for broke,” 11 September).
I suggest it is difficult for a public authority – that is part of a risk averse and managerialist welfare state – to deliver a counter-cultural approach in-house. The Commission for Social Care Inspection’s early advice in respect of support brokerage was pretty clear. Brokers should be independent of local authorities and work under the direction of their clients.
The support broker’s challenge is to help individuals be clear about how they want to live their lives and then to help them and their allies to find ways of sustainably delivering these outcomes through natural and paid for support. It isn’t about placements. It is about finding resources and problem-solving. Relationships are at the fulcrum of the approach.
Restoring autonomy to the populace demands deregulation, risk engagement, trial and error, faith and trust. So, if we want a large-scale paradigm shift, we need to divert serious resources to agencies that meet the person specification.
Bob Rhodes, LivesthroughFriends (support brokerage organisation)
An open letter to Gordon Brown
We at mental health charity Rethink welcome your commitment to end prescription charges for people living with cancer. However, people with long-term conditions such as severe mental illness also need an end to prescription charges.
Your conference speech committed the government to “plough savings back into abolishing charges for all patients with long-term conditions” over the next few years. We would welcome a clear timetable for abolition and an explanation of when and how the contingent savings are to be made.
People with long-term conditions such as severe mental illness are paying the cost now and in these difficult economic times will increasingly have to make stark choices between paying for their health and paying for food and heating.
Paul Corry, director of public affairs, Rethink
Team N5 reunion
I am trying to organise a reunion of members of team N5, North Area, Kensington and Chelsea social services department, 1975-86, which was based in Westway. They were very stirring times. Who can forget the day the office was fire-bombed, for example? Could anybody who has not yet been contacted by me call me on 020 7431 1548.
Kevin McCarthy, London