Personalisation strategy ‘is undermining care and support’

The government’s strategy for delivering its personalisation agenda is “undermining” the quality of care and support provided to disabled and older people, leading academics, consultants and campaigners have warned.

They have written this week to social services directors and other leaders in the social care sector, including the director general of social care in the Department of Health, to call for a change in direction in how personalised social care is delivered.

The group, headed by Professor Peter Beresford, an influential disabled activist and academic, say that delivering personalised* social care through what is called self-directed support is “failing” and “undermining the quality of the care and support provided”.

Under the self-directed support system, each individual’s personal budget to pay for their own care and support is supposedly allocated “up front” through a resource allocation system (RAS).

But the letter points to a paper published by the Social Services Research Group – co-authored by Beresford – which concludes that self-directed support is “causing significant damage”.

The paper adds: “There is an increasing urgency for sector and political leaders to recognise what is happening and bring about a change in direction. This is required if personalisation is to be a reality for all, not just a minority.”

The paper says that self-directed support has led to two parallel systems of allocating resources to disabled and older people, and that the RAS plays little or no part in the eventual funding an individual receives.

It also says that the Department of Health’s own evidence shows councils with the smallest proportions of people on self-directed support have more people saying they feel in control of their lives than councils with the highest proportions on self-directed support.

The paper concludes that the extra bureaucracy necessary to deliver this parallel system costs about £0.5 billion a year while “further depersonalising the assessment process and demoralising the social care workforce”.

The letter says the evidence shows that the model of self-directed support is “fundamentally flawed and not capable of delivering personalisation”.

But they say that the government’s care bill, which is approaching its final parliamentary stages, provides an opportunity to “re-envision” what a personal budget is.

And they call for “open, honest and informed debate” from social care sector leaders on the need to learn the right lessons from the “various attempts to deliver transformational change over the past 20 years”.

Those who have signed Beresford’s letter include the disabled academics Professor Colin Barnes and Professor Nick Watson, and the disabled consultant and campaigner Jane Young.

*The paper defines personalisation as support that is responsive to the individual and gives them greater control over their life, and a personal budget as a sum of money that enables someone to pay for the support that is most appropriate for them.

10 April 2014