This means that every person who receives support, whether provided by statutory services or funded by themselves, will have choice and control over the shape of that support in all care settings.
The work on direct payments and individual budgets, alongside that of In Control, are crucial to delivering greater personalisation, choice and improved quality. They are not separate initiatives or fleeting experiments, but fundamental components of a future social care system.
My knowledge of the more practical agenda of implementation is shaped mostly by Community Care articles, a brief session I attended at Community Care Live (are we seeing a theme here) and a chat I had during my annual appraisal with my team’s manager about my goals for next year, when he told me about a conference he had been on to discuss personalisation and I was desperately trying to find something vaguely interesting to talk about during the appraisal.
Personalisation seems to be the buzz-word of the moment. It is, of course, good to be person-centred. ‘Old style social work’ has to be A Good Thing in comparison to that horrible, evil care management that turns social workers into pen pushers and administration officers – shuffling pens in the offices while the ‘real’ people suffer.
Personalisation – individualised budgets – how can anyone possibly find anything that promotes independent living and choice be criticised in any way?
Look, we’ve done pilot studies – see, lots of happy people presenting wonderful examples of how individualised budgets have helped them to have the funding for personal assistants to accompany them to football matches, go out for dinner with friends to help rather than carers, have a more ‘normal’ life. And see how the helpful social worker has been able to work around my own personal needs to create a care plan that truly is mine – none of this pre-ordained times and imposed care agency providing services that they think I want – when they think I need it.
It sounds perfect. Seriously. It does.
Just like direct payments sounded perfect. And I suppose that’s the reason for most of my cynicism.
Daniel Lombard wrote, a while back, about Personalisation in The Social Work Blog and brings up some of these points (although I have no doubt he speaks from a position of far more knowledge than me!) but I was struck that he wrote of a conference that he attended that
‘conspicuous by their absence are detailed examples of the innovative, user-focused practice that sector leaders hope will become an everyday occurrence.’
This is what I’d really like to see. I know the examples of how personalisation can help physically disabled adults who are able to advocate for themselves or have friends and family who can do so. I can see very clearly how it can work in the field of learning disabilities where there is a very strong culture of personalised care and often there are ‘care managers’ with much smaller caseloads who are able already to focus much more on individual needs already – and who may often link in with families who are able to advocate.
I mentioned, going back to my appraisal last week, to my manager, that I’d love to see my service in the forefront of pilot studies. Please, give a pilot to the our service where we work with many older people with mental health problems who sometimes live on their own, sometimes with no family, friends or support structures around them. Where the access is limited on the 12th floor of high rise blocks of flats with lifts that seem to be almost perpetually broken (or is it just when I visit… ).
Let me see how personalised budgets work in the field of dementia and how they can be managed by people who lack capacity. Please. I really honestly would like to see more flexible care – but who makes the decisions when someone is not in a position to do so themselves and when there is no caring family living locally at hand. Will it be the job of the social worker, and if so are caseloads going to be adjusted in older people’s services (where they are traditionally much higher than in other adult services) to take this into account.
Does that mean there will be more social workers? Or more social work assistants?
I want personalisation to work, I really do. But I want it to work better for those people that direct payments didn’t address.