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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