IT’S hard to object to a policy that aims to give elderly and disabled people more control of their lives.
As a result, the 10-year self-directed support strategy launched by the Scottish Government in 2010 has widespread support.
Many people getting social care services were already able to use direct payments to achieve a measure of control over the way money was spent to help them. But the SDS concept is more far-reaching. Rather than spending budgets on a limited range of services, often provided by councils, SDS allows people to choose to pay whoever they like to provide whatever support they felt they needed.
It is an antidote to situations such as one-size-fits-all day centres for people with learning disabilities, or older people who could get help with the shopping but not money for garden equipment or a computer to keep in touch with relatives.
It isn’t just about changing the way services are planned, the Audit Scotland report says: “Authorities must... transform the way they provide social care so individuals have as much choice and control as possible.”
However, concerns have been growing that elements of the policy have stalled. As The Herald reported in July, fewer than one-third of eligible social care clients are being given an informed choice about services, with the numbers plummeting for those aged over 65.
There are four options for the policy: these allow people to take complete control of their care budget; to choose their care but allow the authority to manage the budget; to opt to leave the authority to choose and arrange their support; or a mixture of the three. The latest figures show 86 per cent of over-65s “choosing” to leave councils in charge, but some question how much choice they have really been given.
Progress has been delayed by the integration of health and social care, with new joint boards responsible for coordinating services provided by councils and health boards. The policy has also suffered from being introduced at a time of public sector cut backs.
The new Audit Scotland report points out that since the introduction of SDS in 2010, there has been a 10 per cent fall in the numbers receiving home care. That may not be connected with the policy, but there is no doubt some of those receiving social care feel direct payments and SDS have gone hand in hand with reductions in the resources on offer.
One issue is the extent to which people needing social care should be allowed to put themselves at risk. Social workers and others need more training and support to be bold and innovative, but many do not feel supported.
The report says those most likely to be denied real choice are those without family, friends or carers to support them, and people aged over 85, as well as people with mental health problems.
It is careful to say the policy is working for many people and says more data is needed. But it concludes the Government doesn’t know how many people are missing out on choice and control, and whether those who get it are seeing an improvement in their quality of life.
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