Readers views on personalisation, service brokers, and the plight of carers


Letters published in the 5 March issue of Community Care magazine

Personalisation is not consumerist

As someone who uses direct payments, and as a board member of the Social Care Institute for Excellence (Scie), I do not accept Steve Rogowski’s proposition that personalisation was born out of consumerism (Frontline Focus, 19 February).

Direct payments have transformed my life from being a recipient of traditional services that did not meet my needs, to a life that included returning to paid employment as well as opening many new horizons.

Personalisation includes the co-ordination of several funding streams other than health and social care. This offers countless ways for people to take control and enjoy the same freedom that I have experienced.

Rogowski fails to recognise that Scie’s guide to personalisation does in fact cover the influences that he implies have been left out, for example, Demos, the community care reforms of the 1990s and care management.

He also misses the point that Demos used many of the principles developed by the disability movement in its personalisation manifesto, and that In Control continues to have a strategic relationship with Demos.

Furthermore, the market isn’t just made up of “nasty” corporate private providers. The point of personalisation is to diversify at a local level in response to local need. This means strategic commissioning from all sorts of providers – voluntary, private and service user-led – with the local authority remaining responsible for ensuring equity.

Of course, personalisation doesn’t equal individual budgets, or cash payments, which is at the root of Rogowki’s “consumer” argument. Personalisation is about universal access to information, advice and advocacy so that everyone can make informed decisions about their support no matter where their money comes from.

Personalisation represents a real opportunity for individuals to focus on the outcomes they want, rather than traditional services.

Whether or not professionals can turn the power they hold into liberating opportunities for those who have been oppressed, remains to be seen.

Ann Macfarlane, direct payments user and Scie board member

Brokers and sensory impairment

As Rob Grieg and Steve Dobson write (“Going for brokers,” 19 February) service users may need support from brokers to ensure that they make the most informed choice when directing their own support.

This applies to individuals with sensory impairments and those with complex needs. Brokers must be aware of specialist support and services for these groups.

The recommended key skills for brokers also highlight the need to understand communication methods and how to support people to overcome the challenge of communication.

All brokers must be enabled to develop such understanding through access to training that encompasses the communication needs of all groups.

Another practical way to ensure specialist needs are met would be to take proactive action to foster, resource and publicise a network of specialist brokers.

Simon Shaw, Direct payments project co-ordinator, Sense

Don’t leave carers in the lurch

The article on brokers made for worrying reading from a carer’s perspective. Most social care, however well brokered, is not delivered by social care professionals, but by the country’s six million unpaid family carers  – 1.3 million of whom care for 50 or more hours per week.

Greig and Dowson write that friends and family brokering a support package is “a private matter'” It is not that simple. Carers often find themselves the only broker available to their friend or relative.

Although the state should not add to the bureaucracy they experience, it is in the public interest that carers are given easy access to advice and support.

For many people – especially older people – moving to a brokered care package does not diminish the amount of care needed, it simply changes the caring role required of families. Therefore, it was depressing to see that the list of 19 competencies for brokers did not include “Understands the rights and needs of carers”.

Brokerage fails in this competency: carers tell us that the gains made for relatives’ independence can be at the expense of their own, as they find themselves obliged to give up their social lives or even their jobs to fit around a new care package.

Alex Fox, Director of policy and communications, The Princess Royal Trust for Carers

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