Keith Robson on why more needs to happen so older Scots can have more choice and control over their own social care
It sounds a great idea in theory. Instead of a “one-size-fits-all” social care package, people can choose to manage their own support.
One service user might hire an assistant to take her shopping, while another takes a computer course to keep in touch with family and friends online. Others might choose to pay for transport to their place of worship, a day centre, or even a football match.
The Scottish Government’s self-directed support policy is designed to give people who receive care greater control over their everyday lives. It has invested £70 million in the 10-year strategy with the aim of transforming the lives of more than 200,000 adults and 17,000 children throughout Scotland, who use £3.4 billion worth of care.
But seven years into the scheme, Audit Scotland has found no sign of the radical transformation that was promised. It's recent report highlights disappointing take-up, a lack of information, and problems with delays and excess bureaucracy.
Only one in four is taking advantage of the options available. This rate is even lower among people aged over 85, those with mental health needs, and people lacking support from carers or relatives.
Users complain that the process is “long, unwieldy and bound in secrecy”. Many of the oldest and most vulnerable users feel that it’s more for younger people and not worth the hassle of putting in place.
In too many cases there are unacceptable delays in arranging a care package. If an older person has been in hospital and needs assistance to move back into their home, then they need help right away. Waiting six months and wading through a quagmire of bureaucracy isn’t an option.
This is extremely disappointing. Care shouldn’t be something that is done to people – it should be about letting them choose the assistance they need to live as independently as possible.
Care users are experts in their own experience and personalisation makes care more effective. It can mean fewer trips to hospital or the doctor, a better quality of life, and allowing people to stay in their own homes.
Of course there are success stories. Users comment that they are finally “the boss” and the services make them feel valued and improve their quality of life.
One case study highlighted Margaret, a woman living on the Western Isles, who has built up a very good relationship with care assistants who take her shopping and out to lunch once a week. Another adult with mental health issues is able to use his budget to go to sports matches and pursue voluntary work.
But much more needs to be done to inform people of all ages on their options. While managing their own budget doesn’t suit everyone, users can also direct the council to spend the money on their behalf. Social workers should have the time and resources they need to fully assist people in taking advantage of these choices.
While the traditional model of care might be easier to administer, personalised support delivers a better, more cost-effective service in the longer term. Most importantly, it puts users back in control and empowers them to live more independent, fulfilling lives.
Keith Robson is chief executive of Age Scotland
