Personalisation of Social Care

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2009 Local Government Service Group Conference
18 February 2009
Carried as Amended

Conference notes growing evidence of serious shortcomings in the implementation of ‘personalisation’ in social care. The primary focus of central governments and local authorities is the roll out of ‘cash for care’ schemes such as direct payments, personal budgets or individual budgets. Other aspects of personalisation such as early intervention and prevention of dependency have received little attention.

This Conference notes with concern that many local authorities are rushing to put all social care service users on to personal budget arrangements. The independent evaluation of the 13 Individual Budget (IB) pilots in England found that these arrangements provided some positive outcomes for certain groups, but not for older people whose psychological well-being was found to have been damaged. Conference is also concerned that while the personalisation of services can meet the specific needs of some LGBT people, the needs of some vulnerable LGBT people could be neglected – for example where homophobic family may be involved in arranging care.

The rush to roll-out personal budgets appears to be motivated by the need to deliver cost-savings, rather than meeting the needs and wishes of services users. Conference notes that the IB evaluation report also provides further evidence that these cost savings claims do not add up.

Individual or personal budgets were designed to give people other alternatives to the potential burdens associated with direct payments. But in practice little work appears to have been done to develop models for local authority managed ‘virtual’ budgets, and people are still being channelled down the direct payments route where they have to take on administrative and employment responsibilities themselves. Conference believes that this lack of progress is also down to the cost-cutting agenda.

Conference believes that the consequences of ‘personalisation on the cheap’ are serious for the quality of services provided and for the jobs and livelihoods of UNISON members employed in social care.

Conference notes that in the context of a cost-cutting agenda, the shift to social care delivered by personal assistants (PAs) employed by service users will mean the replacement of thousands of jobs in homecare and daycare services with casualised and more insecure jobs on inferior terms and conditions. Where service users end up becoming employers, the issues of employment law, contracts, vetting, training, pay and conditions are a major area of concern. Service users are not always equipped and supported to take on the range of legal and other responsibilities and often do not receive enough money in their budget to offer a decent employment package. High staff turnover, cover arrangements and difficulties in accessing funds for training are headaches which now have to be borne by service users and their families.

Conference is also concerned that equality issues will be overlooked both on the part of the service user and on the part of the service provider. It is aware that there have been cases, where a service user has refused to employ a carer because of their sexual orientation and / or gender identity.

Conference notes that the Commission for Social Care Inspection’s report on the State of Social Care in England 2007-8 states that a human rights approach should be “at the core of personalising support to people, however complex their support needs”. It further notes that the Equality and Human Rights Commission report ‘From safety net to springboard’, on the future of social care, argues that one of the most critical priorities is “action to instil an equality and human rights culture across care and support, including a national rights-focussed framework of outcomes laid down in statute and actioned by the Commission in partnership with the Care Quality Commission to ensure compliance with the law”.

Conference calls on the SGE to:

1)Lobby the 4 UK administrations and local authorities to halt the current dash to roll out direct payments and personal budgets

2)Campaign for adequate funding for social care and against ‘personalisation on the cheap’ and develop alliances with organisations representing service user interests

3)Reflect in UNISON campaigns and public awareness raising activities that ‘cash for care’ arrangements work well for some service users but ‘one size does not fit all’

4)Develop an agenda for improving in-house services building in a quality, equality, security and flexibility guarantee – this could include innovations such as an in-house pool of PAs employed by the local authority who can meet individual support plans and establish good practice. Fight against any cuts in services on the back of hte personalisation agenda.

5) Ensure that equality and human rights issues are integral to all its work in this area

6)Campaign against attempts to de-skill and cut social work and occupational therapy roles. Monitor implementation on a local and national level, with a strong focus on caseload and workload levels for affected staff, ensuring these are not increased.

7)Develop an organising strategy to encompass all affected UNISON membership groups

8)Build on the partnership work undertaken by UNISON Scotland to establish standards and good practice in the employment of PA’s

9)Undertake further work on the needs of PA’s and the services UNISON could offer in order to recruit and retain them