The Direct Payments scheme in Northern Ireland was introduced by
civil service decision without any involvement from disabled people.
As a result, take-up has been very poor, largely because the local
social services authoritiers - here amalgamated with Health Trusts -
have produced schemes of byzantium complexity which have been
distinctly undersold by staff. All the things Barry refers to of
course apply. People are fearful of losing what littler support they
are getting at the moment and, in the complete absense of proper
support mechanisms, don't relish taking responsibility for their
organising their own support. But, the Department of Healkth and
Social Services here have produced a users' guide to the scheme which
disabled people were involved in wording. To get a copy, write to:
DHSS,
Disabilty and Mental Health Branch,
Castle Buildings,
Stormont,
Belfast.
BT4
Hope this info is helpful.
Nick Acheson
Centre for Voluntary Action REsearch,
University of Ulster
> Date: Thu, 28 Jan 1999 12:04:55 +0000
> Subject: "Assessment of Needs for Community Care services"
> From: "Barry Ruffell" <[log in to unmask]>
> To: [log in to unmask]
> Reply-to: [log in to unmask]
>
>
>
> Under the UK personal social services system, assistance is provided to
> people with disabilities following an "Assessment of Needs", usually
> conducted by a Social Worker.
>
> Owing to financial constraints and other factors, these assessments tend to
> be very limited in scope, and focus pretty exclusively on requirements for
> physical interventions (transfers, dressing, personal hygeine routines,
> etc.). Consequently, they are "service-led" rather than "needs-led" -
> that is, they seek to answer the question, "How much of our customary
> survival-at-home service are you entitled to?", rather than the question,
> "What can be done to overcome the barriers keeping you from a more
> satisfactory quality of life?"
>
> I am involved in developing and implementing a Direct Payments Scheme, the
> aim of which is to place more choice and control about service delivery in
> the hands of the user, by transferring the management of the funds to
> him/her. This raises the inevitable question, "What can the money be spent
> on?" - or, put another way, "What is to be described as a 'need' with
> the terms of this arangement?"
>
> There is a logical tension between a broad view of 'needs' derived from a
> notion of 'reasonable quality of independent life', and a very
> circumscribed view based on the concept of risk-management and the
> avoidance of (more expensive) residential care. This tension has to be
> resolved in the negotiation which tkes place between the Client and Social
> Worker: the trouble is that Clients are generally disempowered and at a
> disadvantaged in representing their own interests as robustly as they might
> in this negotiation. For example, people are only likely to ask for
> services they know to be available rather than seek innovative solutions.
> Furthermore, people often don't like to get stroppy in dealing with
> service-providing agencies because they are frightened of losing what
> they've already been allocated.
>
> The point, then of this enquiry is to ask whether anyone on the list can
> help me to identify or draw up a guide to which disabled people can refer
> in the Assessment process. The aim would be to support disabled
> service-users in thinking broadly about the assistance they require, not
> only for maintaining physical 'care' but also for accessing valued roles in
> family, community, work, education, and so forth.
>
> Barry Ruffell
> West Sussex Direct Payments Scheme
> 35 Worthing Road, East Preston
> West Sussex, UK. BN16 1BQ
> Tel: 01903 782345 Fax:01903 776377
>
>
>
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