Letters to Community Care 13 November 2008

Valuing People Now delay hardly a shock

Your report on care minister Phil Hope’s delay of the Valuing People Now programme for people with learning disabilities does not come as a surprise (“Valuing People Now delay as Hope works on delivery”, 29 October).

When Valuing People Now appeared it was no better than a copy-and-paste of concerns. It should have grabbed hold of the central tenet that people with learning disabilities require groundbreaking support from the government to help them become equal citizens. With that comes status, employment, healthcare, housing and equality.

Phil Hope needs to not just connect to the voices of people with learning disabilities but comprehend the implications of what they are saying. Earlier this year parliament’s joint committee on human rights published, A Life Like Any Other? It was a call to action which, if acted on, would significantly change the way learning disabilities issues are integrated into citizenship.

The results of Community Care’s survey on personalisation, (“Professionals split over future of adult care”, 23 October) said almost half of council practitioners stating it was not the right way forward demonstrates the depth of the problem. We have waited this long, I guess we can wait until the Spring. But the wait is only worth it if Phil Hope’s green paper brings with it a fresh impetus for change.

Steve Day, director of communications, Brandon Trust

What happened to independent reviewing officers?

If moves in care have not been in the interests of individual children, as suggested by John Kemmis, Roy Williamson and Jonathan Stanley, (and I do not doubt them,) the child’s independent reviewing officers should have taken this up with senior management, up to and including the local authority chief executive, and if decisions had not then been changed in accordance with the child’s human rights, the IRO should have taken this to Cafcass for advice and possible litigation (“Moving stories”).

What should we read into the failure to mention IROs in this article? Sadly, in many local authorities the IROs seem to have little idea of what the ‘I’ stands for that the IRO is now there in an independent role for the child, not the authority. The IRO should provide the bulwark against the events described in the article. Why did they not do so?

Michael Griffith-Jones, trainer and social work consultant, London

Don’t jump the gun on approved mental health professionals

It is far too soon to be asserting that “Other professions shun successor to ASW role”. In my county, other professions are not being offered the necessary training, for fairly obvious reasons. The training priority has been to provide the conversion training for existing approved social workers to become approved mental health professionals, which is around four days per person. That has only just been delivered on time. So it is hardly surprising that priority has not been given to the massively more expensive and onerous task of providing around four months full-time training that would be needed to train an occupational therapist or community psychiatric nurse who has not previously done the ASW course.

Whether any extra budget has been provided to facilitate this level of training I don’t know, but even if it has been or is available, still social services departments have a whole range of other new measures to implement, like the rest of the Mental Health Act changes, Mental Capacity Act, the personalisation agenda, and ever more performance monitoring. So again, it is hardly surprising if they are not rushing in to facilitate the training of CPNs and OTs to become AMHPs.

John Harvey, service manager, Glossop Mental Health Project

Personalisation: let’s get real

Once again, a Community Care article (“Basics of personalisation”, 30 October) sets out an account of the worthy themes of self-directed support. But what of the nuts and bolts?

Let us assume for a moment the theoretical possibility that all councils can, and will, adopt a fair, transparent resource allocation system based purely on an assessment of needs, focused on the customer’s desired outcomes, and avoiding all reference to service-led responses. Yes, I know but let’s just assume it.

The core question is: “Who spends the money allocated to the budget?”

Certainly the customer can opt to spend it through a direct payments scheme – a right that’s existed for some years. But will authorities adhere to the spirit of DPs and refrain from dictating or policing people’s decisions? Evidence suggests that authorities insist on vetting people’s proposed support plans in order to give or withhold both “permission” and money, and then inspecting the actual spend. How is this justified, if the resource allocation system is really the rationing tool for relating “investment” to “level of need”?

If the customer opts not to take the money as DPs, the next question is: “How good is the local authority at using the allocated budget flexibly on the customer’s behalf and in line with their choices?” The short answer, I suspect, is “not very good at all,” since their experience is largely in buying standard-issue care services in bulk.

How can an authority set up a system to manage individual accounts and purchase goods, services, and amenities flexibly for individual customers, when they are furiously cutting back on admin and back-office costs?

It becomes obvious that authentic self-direction can only be achieved if people who opt to take personal control of their allocated budget have the freedom to do exactly that, without interference of any sort. Those who opt to have the money managed by their council (or have no choice) must have access to a responsive purchasing service to spend it for them.

In the absence of these possibilities the new system offers nothing that is not already available, and the rhetoric surrounding personalisation will attract scepticism and hostility. Which is a shame, because it’s a good idea.

Barry Ruffell, former local authority direct payments officer, West Sussex

More from Community Care

Comments are closed.