Care packages for people with autism are being “routinely slashed” without thorough consultation, a coalition of providers has claimed.
The five autism charities said social workers were failing to undertake person-centred review meetings and were “only checking that people were safe, abandoning any concern for their quality of life”. They issued the warning in a letter to leaders of the main political parties, which called for urgent intervention from central government.
Jane Carolan, director of client services at Autism Together, said three men in the charity’s care had seen their packages cut without an assessment of their mental capacity, despite this being requested.
“The social worker came to do the review and decided that the packages would need to be cut and that’s when we raised our concerns,” she said.
“We felt the gentlemen didn’t have the capacity to understand, but the council didn’t involve their families and didn’t do a capacity assessment.”
One man’s support package was reduced from 57 to 30 hours a week, Carolan said, and funding for overnight and on-call care was also cut.
“All they [the council] are giving these men now is a crisis number to ring if anything goes wrong. We have said this will fail in future,” she added.
A spokesperson for another provider, who asked not to be named, said a council would not guarantee long-term funding for one-to-one support for one of its clients, even though he was assessed as needing it. The man becomes anxious and displays challenging behaviour when in a group setting, the provider said.
“The council’s own assessment, carried out in 2014, stipulates that the man requires a minimum of one-to-one support,” the spokesperson said.
The provider considered giving the local authority notice that it would end the placement, as it felt unable to properly support the man without funding for one-to-one care. “Obviously as an organisation that’s the last thing on the planet you want to do, because you’re committed to the people you support,” the spokesperson said.
“We requested a review from the social worker and she took the case to panel, but the panel only agreed to six weeks of one-to-one support. Within two weeks we were told the support was going to be pulled at the end of the six weeks.”
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The provider has since managed to get the one-to-one support reinstated for the man, but on the basis that this is reviewed every six weeks.
“We showed the social worker all the evidence of how the man had progressed with one-to-one support, the positive outcomes he’d achieved and that incidents had greatly reduced, he was a lot happier,” they said.
“We managed to get the funding back but how long for is another question – I think we will end up having this battle every six to eight weeks.
“It’s a real shame because the chap is doing fantastically with it.”
The charities’ letter also called for councils to pay hourly rates that reflect the cost of the living wage and new legislation on sleep-in shifts, which has “dramatically impacted” the costs to service providers.
For example, Autism Together reported a £500,000 increase in costs in 2016-17, but said it receives an hourly rate of £13.55 for supported living, one of the lowest nationally.
The letter pointed to research published by Cordis Bright consultancy in April this year that found 77% of autism providers are struggling financially.
Robin Bush, chief executive of Autism Together, said: “A lot of us stand still from year to year and consider ourselves lucky, but many of our counterparts across the sector have merged with other organisations because they can’t sustain viability or have gone out of business.
“Commissioners used to recognise that autism was a specialist condition, which required very bespoke interventions and they understood there was additional training and resources required to make successful packages.
“Now they refuse to acknowledge that point of view and lump what is effectively very specialist provision in with generic provision.”
‘Public coffers depleted’
BASW chief executive Ruth Allen said: “While I cannot comment on the specific claims made by the autism service providers about the state of funding and social work practice, their concerns fit with the overall picture of underfunded adult social care.
“The sector has suffered huge cuts in many localities and tends to be seen in national policy as being about ‘the problem of an ageing society’. Conditions such as autism can particularly lose out in the scrabble for resources. The feedback of service users, carers and partners is essential to raise awareness of the risks that can come if professionals are practising with their hands tied and public coffers depleted.”
She added that people experiencing social work as “rushed and insensitive” should provide this “vital feedback” to commissioners, but warned that social workers “cannot operate consistently well in contexts where duties and expectations demand personalised approaches but funding levels and managerial edicts and high caseloads make such personalisation impossible”.
Margaret Willcox, president of the Association of Directors of Adult Social Services, said: “All councils should have in place a strategy for adults with autism. We would encourage people with autistic spectrum disorder, or their family to approach their local council if they feel in need of help or support. An assessment of need and advice and information is an excellent place to start notwithstanding what care services might be required.
“Councils work hard to ensure their approach to individual care is person centred and flexible to meet the needs of individuals. Over the past six years councils have had to make some difficult decisions about the level of individual packages of care. As it is the public purse they are spending they will always seek to get the best value possible.
“While the additional £2 billion funding for adult social care over three years is very welcome it is not a long term solution, and will not help us deliver ongoing care, support and safeguards for people in the most vulnerable circumstances in our communities.”