Care Choices

I was confused by this article on the BBC web site about The Self-Directed Care (Scotland) Act which is intended to provide people who need home support more flexibility in deciding how it should be delivered.

Because while everyone involved says they support the principle of greater choice and freedom, for those who want to go down this path, the trade union comments come across to me as very negative, almost as if they're trying to pour cold water on the initiative.

The case study referred to seems more complex than most with a package of 24-hour care, but Suselle Boffey seems to have managed perfectly well for the past 20 years.

And service users are not acting as employers in a traditional sense with all the associated red tape, because all they are doing is buying in a service that suits them personally - in the same way as other people come into your home to carry out a particular job of work.     

New legislation introduces 'DIY' personal care option



By Eleanor Bradford
BBC Scotland
The new Act aims to give people who require care greater flexibility in when they are treated

New legislation means people who need care from a local authority now have the option of being given cash to organise it themselves.

The Self-Directed Care (Scotland) Act requires local authorities to offer personal payments if requested.

It means people who require care can hire assistants and arrange for them to come at a time that suits them.

Unison said it supported the Act but is concerned that it will be used to cut funding for social care.

Around 10,000 people are currently assessed by local authorities as needing social care support.

Suselle Boffey has been organising her own 24-hour care for more than 20 years, under a pilot scheme in Edinburgh. She employs four personal assistants, working in shifts, to look after her.

"I was apprehensive at first," she said, "I didn't know how it was going to work, but it made a huge difference. I could meet friends for lunch or dinner. It meant I could wash my hair at midnight if I chose."

She added: "I had much more choice in life about who worked for me, and what I could do when."

Suselle, who has a muscle wasting condition and needs a wheelchair and ventilator, has since enjoyed holidays all over Europe with one of her assistants. However, it also means she has become an employer.

"It can become difficult and challenging, particularly when you are arguing with each other," she said.

"That does happen. I suppose the most difficult aspect of that is when you are getting up or going to bed and there is something that you need to sort out while you are having your personal care delivered, but for the most part it is near enough perfect."

Calculating wages

Suselle uses the services of Lothian's Centre for Inclusive Living to help her manage her employees.

They calculate wages and accompany Suselle when she is conducting interviews.

Under the Act, local authorities will continue to provide care packages for people who don't want to organise their own care.

Trade union Unison supports the principle of self-direct care but is concerned that it will be used to cut funding for social care.

"The rhetoric of choice and control is often used as cover for a deteriorating service," said Scottish organiser Dave Watson.

He added: "Cuts in budget provision means that the individual has a smaller budget to buy equivalent services. This has contributed to the 'race to the bottom' in home care."

Unison also points out that many people don't understand or want the responsibility of being an employer. Meanwhile fewer users of council services, such as day centres, means these could face cuts.

"This leads to greater social isolation that we know has a damaging impact on health," said Mr Watson.

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