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A new research paper has been published by Peter Beresford and two other researchers that looks at how Resource Allocation Systems (RAS) are working to deliver personal budgets.
A RAS is a points based system for giving initial budgets and is popular with councils as an easy way of helping people quickly find out what level of support they might get. It is often linked to a simple Self Evaluation Questionnaire that given points for different levels of needs.
What Beresford and his friends found was that in the councils looked at there was no link between the initial budget people were offered and the final budget that was actually approved. It was if there were two separate budget setting processes going on. First was the RAS and then secondly was an old style social work decision making body. Given the large amount of money and time put into developing a RAS this was highly wasteful.
The following chart shows the deviation between the initial budgets and the final budgets. In some cases the final budget differs by a factor of 5 from the original budget.
The research also found that while the number of social workers carrying out assessments had risen, their productivity had gone down. It is suggested that the reason for this is that they now have to spend longer doing assessments, planning and finalising budgets. Instead of Self Directed Support putting service users in control, social worker are spending more time “controlling” the process. The costs of this extra bureaucracy had risen by 65%,
One of the three researchers, Colin Slasberg had previously found that outcomes were only better for people who had a Direct Payment. Often those with Direct Payments got more money than those without. There was no evidence that personal budgets necessarily improve outcomes. That doesn’t mean that outcomes don’t improve for some people who get personal budgets but we can also say that outcomes improve for some people who just get a standard social work service.
They conclude by arguing that personalisation can be saved by introducing better rights for people needing support
· There should be a full assessment allowing people to know exactly what needs councils will meet
· There should be better Eligibitliy Criteria so it is fairer for people and councils know what they have to meet.
· There needs to be more person centred planning at the core of social work
Stressed parents are finding their relationships breaking down as a result of councils' cuts to care for disabled children, according to a new report. Services provided by local authorities and health boards have declined significantly in the last two years putting increased pressure on families with disabled children The report, commissioned by Scotland's Commissioner for Children and Young People, warns that families are affected by direct cuts in public funding and a reduction in help provided by charities which themselves are seeing budgets slashed.
The result is that increasing numbers of parents are stressed and isolated, according to the report, written by Strathclyde University's professor of disability studies, Kirsten Stalker.
Prof Stalker surveyed parents, disabled young people, councils, and charities providing services to families. The report says: "Service providers fear that cuts in public funding ... coupled with recent changes to welfare benefits will increase the stress and isolation experienced by families and disabled children and the consequent risk of marital and family breakdown.
The report also reveals widespread mistrust of policies such as direct payments and self·directed support which give families a budget to commission care. Charities working with disabled children and many of the families of those children told researchers they saw these policies mainly as a money-saving exercise.
In its Self Directed Support Bill Policy Memorandum the Scottish Government is clear that local authorities should not be entering the Self Directed Support process expecting to save money.
They say "In the long term (that is once change has been effected) a shift towards self-directed support (in practice greater uptake of options 1 and 2 in the Bill) is expected to be broadly cost-neutral so the recurring costs and savings will be expected to cancel each other out." This is borne out in the Scottish context by research commissioned by the Government from the University of Stirling which found that self-directed support packages are roughly similar to standard arrangements in terms of hours. The study found no significant difference between direct payment users and those receiving traditional community care services in terms of hours of care
The IBSEN study in 2008, a study of the personalisation pilot sites in England found that the difference in the mean weekly cost of support funded by an individual budget and for standard mainstream services was not statistically significant.
Taken together with the Stirling findings the Government views this as an indication that in the long term self-directed support is broadly cost-neutral with increases in social care costs more likely to arise from wider changes in demographics and other associated factors.
Hidden behind the modernization of social care in Scotland are a network of companies who, for a fee, will provide advice, computer systems and benchmarking for local authorities to cut care packages for vulnerable citizens.
OLM group advises Glasgow and many other councils on personalisation. OLM also provides advice to councils on how to reduce the cost of individual care packages.
OLM also part owns Valuing Care FM who advised Fife Council on its recent learning disability retendering. In this controversial exercise, hourly rates of support were restricted to a maximum of £14.85 on the advice of VCFM.
Many councils keep the range of their involvement with these companies secret. However recently Edinburgh published a list of all its payments to private consultants showing annual payments to OLM group of £43,000 for MyCareCosts. This is a system aimed at reducing the costs of “high care” clients. Freedom of Information requests show that OLM can charge up to £850 for every “high cost” client and a further £850 for negotiating a budget reduction.
OLM makes much money by selling computer software to manage personalisation such as CareFirst, and MyCareFirst the leading management systems for adult and children's services.
However something doesn’t seem to be working as after deducting salaries and office costs, OLM managed to turn this into a pre tax loss of £1.5 million, consequently reducing their corporation tax payments to less than a £1/4 million over the same 4 year period.
The OLM group is owned by Peter C O’Hara (96%) and Saltire Trustees (Overseas) Ltd (4%), a Guernsey based firm specializing in tax and wealth management.
The problem with companies like OLM is not so much that they suggest that people with learning disabilities have services that cost too much but that their focus on the money and technical aspects of personalisation undermine the creativity and individual choice that should be at the heart of SDS.