“OBSCENE and illegal” was the description Donald MacAskill of Scottish Care gave in July, when discussing the amount of choice offered to older people who need social care. He was helping launch a report on self-directed support (SDS) which conveyed the same message – albeit in less colourful language – and which was co-authored by the charities InControl Scotland and Alzheimers Scotland.
The illegal part arises because under the 2013 self-directed support act, anyone with a social care need is supposed to be given a full range of options to take control of their own care.
But the report suggested few people over 65, are being given a genuine choice about the care they received, still fewer of those aged 75 or 85.
And it is not just elderly people this affects. Expert witnesses told the most recent meeting of the Scottish Parliament’s public audit and post legislative scrutiny committee that despite the law coming into effect in April 2014, most users of social care still do not get a say in the help they receive – despite the best intentions of ministers and despite the fact that it is the law.
The act places the onus on councils to ensure people needing help to live independently – because of age, disability or sickness, for example – get options so they can choose the service that works best for them. This could include choosing and managing your own support, choosing support but having someone else manage it for you, or letting the council choose what it believes suits your needs. A fourth option is a combination of the above.
But such options are not routinely discussed, Jess Wade of Self Directed Support Scotland told MSPs. In fact only 27 per cent of people receiving social care had had a conversation about SDS, she claimed. Some who raised it were told “that is nothing to do with you”, in breach of the law and their rights.
Other witnesses told a similar story. Iain Smith, of Inclusion Scotland told the committee access to SDS is “woefully low”, and that it is unacceptable that three out of four people eligible for social care are not having their rights, or the law, upheld.
David Williams, Glasgow’s social work chief told the committee it was wrong to suggest social workers were not trying their best to give members of the public the choice they should expect.
But MSPs heard a catalogue of problems. These included a disabled person being told by a social worker that whatever needs-based budget they agreed would cut by 70 per cent anyway when it reached an allocation panel. Others are steered towards in house services, or a restricted list of care providers. Sometimes workers sit down with a calculator and work out what someone “needs” on the basis of what is left in the pot.
Jackie Baillie MSP, the committee’s convener, says the public are overwhelmed, intimidated and frustrated with SDS. The committee will now hear from the Scottish Government and Cosla, as well as NHS Scotland chief executive Paul Gray in a bid to understand just what has gone so badly wrong with this flagship policy.
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