Hi,
Barry Ruffell wrote:
> 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?"
So, is West Sussex going to 'buck the trend' and provide genuine 'needs-led'
assessments? - I don't think so!
> 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?"
If the aim of the Scheme is to 'place more choice and control in the 'hands'
of the user' - then why are'nt you asking THEM? - Try involving them in
developing and implementing the Scheme, it sounds like YOU are doing it all.
Apart from any 'local' aspirations, you will find that the national Direct
Payments legislation and Practice Guidelines along with Independent Living
Fund (ILF) criteria have already determined a 'narrow' definition of 'need'
and have clearly 'prescribed' precisely what the money can and cannot be
spent on (albeit somewhat implicitly).
> 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.
This says much about the local service-providing agencies and social
workers, surely the onus is on them to provide more 'empowering' solutions -
especially if they actually 'know' how disempowering they are.
A widely adopted solution to this is to establish a 'User-led' Scheme which
includes a good advocacy service.
> 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.
There are such guides around, try contacting the National Centre for
Independent Living, or some of the already established 'User-led'
Independent Living Centres (CIL's) and Direct Payments Schemes in the UK.
Or better still, start empowering the disabled people in West Sussex and
involve them in developing a guide they would be happy with. You don't have
to accept the 'Status Quo' and assume that your 'clients' have to remain
'generally disempowered'.
Regards
Steve Comerford
Coventry Independent Living Group (CILG).
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