Cuts – a personal tale


A couple of weeks ago, I had one of those deeply depressing moments that will generally punctuate a career in social care.

I had to go and tell a woman, who cares for her mother with enormous patience and dignity, that we could not increase their personal budget although her mother’s care needs had grown.

I suppose I went to my manager in a relaxed almost casual way and explained how the needs of the older woman had changed and to ensure her well-being, she needed additional time.

I was told, with a degree of equal sadness and regret that there would be no increase. If we were to provide what I felt was a necessary increase in care, the time had to be taken from the the hours already allocated.

She did, to her credit, try to have a discussion about this with her own manager but there was no budging on budgets. Despite the change in various situations, there would be no extra money. In fact, she added, the plan really needed to be cut.

It had been my first personal budget implemented. The council, in an attempt to encourage and prod us to implement these personal budgets had promised us and by extension, the service users and carers we work with, that no-one would be disadvantaged by moving to a personal budget so even if the RAS (resource allocation system – the way that figures are attached to needs through the personal budgets  system) did not ‘deliver’ enough money to provide an equivalent package of care that had been delivered under the ‘old’ system – it would not be reduced (and here’s the key) at least, not initially.

Now this particular service user and her daughter had what was a high package of care. It had costed much  more than the ‘RAS’ had spat out.

After making the promises, after the move to personal budgets is no longer an optional roll out of volunteers – the cuts are coming.  There is no longer the carrot to offer of ‘equivalent packages of care’ because we now offer everyone as a matter of course a personal budget and those who were not receiving them are being transferred over to the new system regardless – they don’t have to be self-managed, of course, but they have to exist.

So I visited the family and we looked at ways of shifting around hours.

The hours that were cut were the respite hours.

I suppose it was inevitable.

Family carers are invisible. The work they do is not costed. Of course the daughter was sacrificing her own needs for a few hours respite to her mother’s needs for additional personal care.

This is what the cuts mean to one family.

I had to tell them and negotiate with them about what to cut from their own package of care.

Not the Prime Minister. Not the Millionaires in the cabinet. Not any elected politician or Council Chief Executive. No councillor had to sit in that room with me and look the service user and carer in the face and ask them what they would prefer to give up from their package of care.

I’ve known this family for many years. I have a good understanding what is at stake for them and how much these cuts are hurting. I also know they won’t complain or grumble or shout from the rooftops.

They are not going to be going on any rallies or demonstrations against the cuts – not least because the respite hours have been cut.

We who can, have to demonstrate and shout and scream on their behalf.

And you know, as I know and I say this with a heavy heart – they’ll be much more of this to come.

13 thoughts on “Cuts – a personal tale

  1. Pingback: Cuts – a personal tale - Fighting Monsters - Member blogs - Social Work Blog - Carespace from Community Care

  2. Yes and the sad thing is (and you might pick up that I’m bitter about this) – the choices that we were promised we could deliver about wonderfully creative care-planning and making positive choices and helping people have much more enriched lives of things they choose for themselves – at the end of the day come down a choice between personal care to maintain dignity and basic hygiene standards or a sitting service to allow a family carer to have a little bit of respite.
    Not much creativity there, Mr Burstow. Yes, I’m bitter.

  3. The RAS system has endemic design faults – especially about calculating the value of family carers.

    There are major issues about fettering discretion. This is happening nationally and as I understand it clearly unlawful and discriminatory.

    Britain believe it or not does have the Chronically Sick and Disabled Persons Act, – this has not been repealed, has signed up to the UN Charter on Disabilities, has passed a brilliant Equality Act.

    We are talking statutory responsibilities. I recommend coordinated legal action about this. And actually social workers implementing this stuff are guilty of professional malpractice.

  4. RAS system is borked.
    It doesn’t sit comfortably with me but if it is malpractice, the GSCC is going to be very busy.

    I can’t afford to lose my job 😦

    Maybe if BASW wasn’t so busy having it’s little argument with the College of Social Work, they could help us challenge some of these issues.

  5. And then the powers that be will be stunned and surprised when hospitalization and time off work due to stress and overwork of the caregivers goes up and up and up and, in retrospect, cost WAY MORE than keeping the respite in budgets would cost. Depressing, depressing, depressing. You must take very good care of yourself during these times so that you do not fall prey to the same issues!!!!!

    • Yes, Carolyn, I agree. The government doesn’t seem to be interested in preventing these. I am already worrying that my own care package will be cut at the end of this year, because, with the high care package and the help of meds, I managed to stop having behavior problems. But, wait, if meds help you, then you don’t need behavioral care, the indication center reasons. Sorry, I’m rambling off-topic, but just had to get that off my chest.

  6. The thing that gets me about all this is that it was clear that personalisation was only seen by both governments as a way of saving money, that carers would expected to shoulder the additional burden, and the people responsible could leave it to the ground floor grunts to deliver the bad news, keeping their hands relatively clean.

  7. And what our governments don’t realize is that in addition to being so hurtful to a family, ultimately this type of a cut will result in more costs. The lack of respite services on a family results in increased stress, which translates into more health/mental health problems and more sick time and lost productivity from work. A destructive cycle.

  8. Thanks all for the comments – Carolyn, Astrid, Charles and njsmyth – I think they are all along the same theme that, yes, it is glaringly obvious that not supporting carers and taking away services is going to lead to much much higher costs in the longer term.
    The problem is there is no forward planning – no preventative work.
    The government is cracking down and is on an ideological march to take away vital services.

  9. In my authority the RAS scorer is not printed on the assessments. We are not encouraged to tell the family/ service user what the score is in fact on a verbal level we have been told not to although I havn’t seen it written down anywhere. I cannot see that it has made any difference at all to the way services are provisioned although it does obscure more effectivelybudget cuts as the RAS can be manipulated behind the scenes and it gives panels some spurious justification for their decisions rather than actually reading and properly understanding assessments.

  10. Hi! Please believe BASW is not going to take its eye off the ball re the cuts and the effects they have on service users and carers. Please contact us with examples and issues and we will help you challenge and clearly explain the risks to managers.

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