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Learning Disability Alliance Scotland Highlight text with your mouse and click the speaker to hear it said aloud

What is happening on Guardianship.

Numbers of guardianship orders in the Glasgow City Council area registered by Office of the Public Guardian up to end of December 2011 (by type):

That makes in 2011 an increase of 67% in the last year alone.  The all Scotland increase has been of the order of 7% for the last 5 years. 

Read more: What is happening on Guardianship.

Social Care (Self Directed Support) Scotland Bill

The long awaited bill was published this week and these are a few quick notes on what is in the Bill and associated paperwork. 

 The Bill…..

 ·         Sets general principles for carrying out Self Directed Support of

o   Involvement

o   Informed Choice

o   Collaboration

·         Introduces a statutory power to provide unpaid carers with support if this will help them maintain their caring role.  A carer’s assessment will have to be carried out first

·         Sets out 4 options for the provision of support which the council has a duty to offer

1.      Use of a direct payment

2.      Directing the council to provide support of their own choosing

3.      The council should selects appropriate support to meet needs

4.      A combination of the above

·       

Read more: Social Care (Self Directed Support) Scotland Bill

RAS under legal challenge

A case in front of the Supreme Court raises "important and profound" issues for disabled people.  Seven judges are  being asked to clarify whether local authorities should base funding decisions on patient need or budget limitation.

The 26-year-old man, KM, who has visual impairment and learning disabilities. He has been blind from birth, had learning difficulties and a "constellation" of other problems that meant that he needed constant care, the court heard.

The case centres around the use of resource allocation systems to award budgets to purchase care.  Resource Allocation Systems link individuals to standard budgets.  The law says that local authorities can still be mindful/take into account resources when deciding how to meet need.   They have to meet assessed and eligible need but not necessarily in the way you want it – eg provide you with incontinence pads at night rather than staff to help you use the commode.  

What KM is about is if a local authority uses a RAS, then they must provide you with a rational and understandable explanation about what they are providing for a final budget.  It cannot simply be because we said so.  It must be rational and transparent but not necessarily fair.  Cambridgeshire did not give KM such an explanation therefore he had no way of challenging it.  

Lawyers representing KM are challenging Cambridgeshire council's decision to award £84,678 a year as a direct payment to meet assessed care needs. An independent social worker had estimated that the total annual cost of support was £157,060, judges heard.

KM’s lawyers are arguing that there is a real danger that in the use of RAS’s when there is no clear connection between the sums provided and the needs of the disabled person is that the decision as to how much a person is provided with to meet their needs becomes arbitrary and crucially the needs of the most vulnerable members of society may be left unmet.

Lawyers went on to describe local authority’s use of personalisation.  "They are ostensibly driven by a desire to personalise social care in order to give disabled people more choice over the way in which their needs are met.

"That of course is unobjectionable, indeed laudable. It is, however, objectionable if the sum of money generated by the resource allocation system is insufficient to meet the needs of the disabled person."

A decision will be given at  a later date.

Highland Council SDS test site report

Self Directed Support remains the big driver of social care reform for people with learning disabilities but if an internal report for Highland Council is to be believed then the strategy may have to face major challenges before it becomes widespread. The report is a detailed reflection on the local authorty's experience with the Scottish Government's test site project.  

Major issues that have been understated in the official test site reports include:

A local authority swamped with modernisation programmes and unable to find a way of prioritising them all.   Self Directed Support "was only one of the 15 workstreams in the Highland Community Care Change Programme."  Such pressures made it hard for those responsible for driving change in the local authority to put SDS at the top of the agenda.  Many opportunities were missed in development because of conflicting priorities. 

Failure to get the NHS to sign up to working jointly with the local authority on SDS - The report quotes stakeholders saying “NHS staff on the ground were resistant. Nurses didn’t want to buy in. (Saw this) as a Social Work job”.   A view developed that some of the problems were due to the culture of the NHS being predisposed against personalisation and the new ways of working and thinking it implied.

A failure to properly cost what existing budgets were as it would show a high level of costs and inefficiencies within in house services.  This meant that the development of Individual Service Funds was limited because the council would not put a price on the services it delivered.  Stakeholders were quoted saying "We have a number of areas were it would be difficult to say we couldn’t get cheaper” and again "Internal service costs are vastly higher. There is a concern about exposing The Council to market forces”. 

There was heavy internal disagreement between local authority staff over the development of Self Directed Support.   Some of this was linked to the professional questions of assessment of need while other disagreements were linked to the protection of in house services.  This meant that “... meetings were dogged by the internal politics (of the Social Work Department) and initially were quite belligerent…It was difficult…”

Highland Council is a good local authority where many staff try and deliver good services to thousands of vulnerable people but this report shows that it (and other councils) are not monoliths.  The process of change is full of difficulty and unforeseen problems.  It is likely that such problems will be repeated in many other areas as Self Directed Support becomes more of a national strategy.