1 Do you agree with the proposal to consolidate and update existing legislation on direct payments? If not,why not? Ambivalent on this. Although there are some marginal benefits to the proposals, other proposals (such as making this opt out rather than opt in ) concern me hugely. 2. Should a new Act be based on a set of guiding principles? If so, what are your views on the most important principles? The guiding principles referenced (included better outcomes and choice ) sound great in theory, however, in practice I think that neither better outcomes or choice will be achieved through these proposals. Research on direct payments has shown that cash-strapped local authorities often use this as a means to scale back provision, resulting in less, not more, choice for individuals 3. What are your views on the proposal to place legislation on direct payments in a Bill that defines the term self-directed support? If you do not agree with this proposal, why not? See answer to Q 1. Social workers and clients are very confused about the difference between direct payments/sds and in control. I think that more emphasis should be placed on getting Direct Payments right before trying to extend scope of them. There are lots of barriers to DPs at the moment that need to be addressed. No reference in consultation about the barriers of lack of support for personal assistants, and division of legal/employment responsibilities between client (employer) and local authority (payer) of services. 4. Do you agree that the proposed bill should set a framework that would allow the Government to consider in future extending direct payments and other forms of selfdirected support? If not,why not? No. See answer to Q 3. We are a long way away from getting it right. We need to focus on the problems rather than seeking to extend DPs. Also we need to listen to clients. Vast majority of people I work with have not wanted a direct payment. I am pro direct payments and pro choice for clients there I am offering them in a positive way, and yet the response time and again is I don t want the hassle, can the council just organise it directly please. It is an obligation when carrying out a community care assessment to offer a direct payment. Although this practice may not be carried out in all local authority areas, I am confident in our local authority area that we are very aware of this obligation and our local assessment tool carenap obliges us to check a box stating that a DP has been offered, so the low uptake is not about the fact that DPs are not being offered. The Scottish Gvt has done little to recognise and address existing barriers to DPs but I think Scottish Gvt is driving forward.
5. What are your views on the broad areas where Ministers should be permitted to bring forward further legislation? If you think it should cover other areas what should these be? See answer to question 4. Get existing system right first. Could bring forward legislation to make it a duty rather than power to provide services to carers QUESTION 6 Do you agree with our proposal to amend the legislation so that self-directed support is the default position for the provision of social care, requiring individuals to opt out of this method as opposed to the current situation whereby they can choose to opt in? Absolutely not! Concerns: In my experience vast majority of clients do not want this I have concerns that many, many carers/individuals I work with would mismanage this, putting the client at risk. Presents an excuse to local authorities to scale back local authority provision our local authority currently encourages people requiring learning disability respite to take direct payments because there is a scarcity of local provision. This gives the problem over to the client, who may end up purchasing a service hundreds of mile away 1 Unclear on LA/social worker responsibility ie if client contacts us at last minute because their inadequate/poorly structured care package has gone wrong and social worker left trying to unravel a mess (has happened to me before) If clients situation changes/or there is a crisis what is responsibility of local authority? Again I can see a cash-strapped local authority leaving a client in crisis stating it is their responsibility to resolve 2. It makes it very difficult for the social worker who is caught in the middle, with the danger that any harm that comes to the client as a result of a poorly planned care package could ultimately be blamed on the social worker QUESTION 7 1 Spandler, H. (2004) Friend or foe? Towards a critical assessment of direct payments, Critical Social Policy, 24(2), pp. 187 209 documents the dangers of this from a Canadian perspective 2 McDonald, C. (2006) Challenging Social Work: The Context of Practice, Basingstoke, Palgrave Macmillan documents that direct payments are often for local authorities about doing more for less
If a default position is introduced, should it be for the broader range of options for self-directed support, or for direct payments? If you do not agree, why not? No QUESTION 8 Do you agree that the categories of persons who can receive direct payments on behalf of adults with incapacity should be expanded? Yes. Currently very difficult for individuals who lack capacity to receive DPs. QUESTION 9 Do you agree with the proposal to remove the current requirement for Guardianship or Power of Attorney to be in place before a direct payment can be offered? Yes QUESTION 10 Do you agree that where a guardian or an attorney is not already in place, the Access to Funds scheme should be capable of being used as an alternative way of receiving Direct Payments? Yes but not all clients have an individual who can use Access to Funds. Not all authorities operate an Access to Funds scheme (ours does not) QUESTION 11 Do you consider that arrangements other than the Access to Funds scheme should be put in place to expand the categories of persons who can receive direct payments on behalf of adults with incapacity? If so, what arrangements? Yes, but not clear what. This is part of huge problem of how you help people who have no family member who can act on their behalf. If LA does not operate
corporate appointee or Access to Funds scheme there is often nothing open to these individuals other than a costly financial guardianship operated by a third party. QUESTION 12 Do you have any other views that you would like us to consider if we proceed to bring forward legislative changes on this matter? new Bill on SDS may remove the restriction to direct payments and other forms of self-directed support for people with mental health problems who are subject to compulsory treatment orders. QUESTION 13 Do you agree with our proposal to amend the legislation in order to remove the restriction on providing direct payments and other forms of self-directed support to those with mental health problems I have reservations about this QUESTION 14 Do you agree with our proposal to provide local authorities with a power to provide self-directed support to these people, as opposed to a duty to use this method of support? Yes this is an important safeguard QUESTION 15 What are your views on the proposal to remove the current restriction on the use of direct payments/self-directed support for residential care? If you think the restriction should remain, please explain why. Not clear what benefit this provides to the individual. I think local authorities should always retain the right to refuse a DP/SDS to an individual who we deem inappropriate to manage their own care QUESTION 20
Do you agree with the principle that carers should be made eligible to receive self-directed support and direct payments in certain circumstances? Yes, but I think the issue is more about placing a duty rather than power on local authorities to provide services to carers in response to carers assessments. Currently we can provide services for carers in the DP to the individual ie holidays (not just respite), or housework services.