Third sector bodies said the failure of Self Directed Support is infringing people's human rights

Disabled and elderly Scots are having their human rights infringed by the failure to provide them with choice and control over the social care services they receive.

Third sector bodies providing evidence to a Scottish Parliament committee today (Thursday, 30 November) said the numbers of people receiving Self Directed Support (SDS) was “woefully low”.

They highlighted a catalogue of failings in the system to the Scottish Parliament's public audit and post-legisltaive scrutiny committee.

One organisation said a review of SDS legislation, which was only introduced in 2013, was “urgently required” and the overall mood suggested organisations are losing faith in the current system to deliver SDS.

An Audit Scotland report earlier this year revealed that just over a quarter of Scots who receive social care support are accessing SDS.

Third sector bodies today said social workers are simply not having conversations with people about SDS and service users are not getting the information they need to make a decision about how they receive their care.

SDS’s four options range from direct payments that enable the service user to purchase their own support to a package of support being provided directly by their local authority.

However, research suggests just 27% of people who are receiving social care services are having conversation about SDS. The rest are continuing to receive the services their social worker believes they need.

Iain Smith, policy and parliamentary officer at Inclusion Scotland, told the committee: “The implementation rate for SDS is woefully low.”

Later he added: “The balance of power between the professionals making the assessment and the individuals receiving the service has not yet shifted in the way that SDS was meant to do.”

In a written submission to the committee, The Health and Social Care Alliance Scotland highlighted research it had carried out with 100 people across Scotland.

Given the findings of the Alliance’s research, and that of other third sector organisations, the Alliance believes a review of the Social Care (Self Directed Support) Act 2013 is urgently required.

It found half had to wait a year or more to have their SDS package put in place after assessment and over half said the amount of hours they were given were not enough to meet their needs. Those who had chosen local authority led options were likely to have felt social workers or carers had made the choice on their behalf, and over half of the those who were getting a local authority designed package knew little to nothing about SDS.

Its evidence stated: “Given the findings of the Alliance’s research, and that of other third sector organisations, the Alliance believes a review of the Social Care (Self Directed Support) Act 2013 is urgently required.”

Other organisations that submitted evidence, were equally scathing of the process.

Mecopp, a body representing ethnic minority carers, described the system as “patchy and inconsistent”.

The organisation said: “Our casework to date has highlighted consistent failures to ensure that practitioners with a responsibility for assessing individuals under self-directed support provide full and unbiased information about the options available under SDS”.

It also highlighted concerns that SDS was being driving by budgetary concerns.

“We cite one example of a young man who purchased exercise classes with his budget to be informed by the social worker that they had sourced a cheaper alternative and that this would be what they would pay for despite the relationship he had built up with his previous and preferred provider.”

Jess Wade of Self Directed Support Scotland also said “it’s a really patchy provision”.

SDS Scotland’s written evidence said: “SDSS Members report that SDS is often seen by local authorities as an add-on rather than as the mainstream way of delivering social care in Scotland.”

Although, a range of bodies have raised concerns that SDS has been side-lined as a result of the integration of health and social care in Scotland, Wade argued it is central to transforming Scotland’s care system in the face of ongoing financial and demographic changes.

She said: “Members recognise that SDS cannot be properly delivered in the current financial climate, as with smaller packages it is very difficult to facilitate the kind of choice and control that is crucial to SDS.

“They also see SDS, if delivered well, as being at the heart of health and social care successful transformation. Therefore, if/ when SDS fails, so too will this wider agenda. Particularly in relation to prevention”.

In its evidence to the committee, Scottish Care said failure to deliver SDS was a human rights issues.

"To treat one group of citizens in a manner less favourable than others is essentially a description of discrimination," it stated,

“Further the limiting of choice whether by design or default, the restriction of information, and the failure to properly resource to enable choice to become available are all in essence human rights issues.”

The acting convener of the Public Audit and Post-Legislative Scrutiny committee, Jackie Baillie MSP, said: “We heard today that some people are “overwhelmed and intimidated” by the process around Self Directed Support and that there are inconsistencies in how the system works across Scotland.

“It’s understandably frustrating for people if they are deprived of having a say on the social care they receive.

“Our committee will soon hear from the Scottish Government and Cosla to ask about these concerns and how the barriers to accessing potentially life-changing support can be removed."