Report from Audit Scotland finds new joint integration boards are a long way from providing self-directed support to all
SPENDING WATCHDOG Audit Scotland has warned that not every patient is getting the right to choose and control their social care across Scotland.
Audit Scotland warned that while many people have benefited from what is known as self-directed support (SDS) – an approach to healthcare that gives service users far more control over care plans – the country’s new joint integration authorities still have a lot to do to provide those services to everyone.
As a result, providers are facing a challenge in offering flexible services, particularly in recruiting and retaining social care workers.
Ronnie Hinds, acting chair of the Accounts Commission, said: “There is a growing body of evidence that SDS is helping many people with support needs to live more fulfilling lives. However, there is no evidence of the transformation required to fully implement the policy.
“There is a growing body of evidence that Self-directed Support is helping many people with support needs to live more fulfilling lives. However, there is no evidence of the transformation required to fully implement the policy.” Ronnie Hinds
“Radical change of this kind is never easy but we are in the seventh year of the 10-year SDS Strategy, and it’s been three years since the legislation was introduced. Authorities must respond more fully to provide services that make choice and control a reality for everyone who needs social care.”
Auditor General Caroline Gardner said: “SDS is clearly working well for some people but many more people can and should benefit from it. The Scottish Government has invested £70m in SDS and needs to work with its partners to boost progress and develop its full potential.”
SDS was introduced in 2014 by the Scottish Government to give councils authority to offer people more choices of what kind of care they would receive from social work and how that service is managed.
SDS was then passed from local authority control to the new health and social care integration boards, which are made up of employees from both council and the NHS. Health and social care integration is a significant reform of the way a number of healthcare and support services are managed, and the transition from the previous model to the new structure is ongoing throughout Scotland.
“However, the report’s recommendations give clear direction on what must be done to ensure that self-directed support becomes embedded as Scotland’s mainstream approach to social care.” Aileen Campbell
Local councils spend £3.4bn a year on social care supporting more than 200,000 vulnerable adults and 18,000 children and their families.
The range of support that social workers provide is from everyday tasks such as changing dressings and preparing meals, to making sure individuals are supported to live a fulfilling life at home and in their local communities.
Research from Alliance found that that people’s experience of SDS is mixed across the country. Alliance is concerned that SDS is not being implemented according to the “underlying rights-based values and principles”. As such, Alliance believes that it will not achieve the transformational change in “social care culture and services or help improve people’s lives”.
Ian Welsh, chief executive at Alliance, said: “Recent Alliance research highlighted long delays in accessing self-directed support, a crucial component in supporting people to live independently.
“We intend to further monitor the implementation of SDS and its impact on our members, and we call on the Scottish Government to improve data collection in order to ascertain whether SDS does lead to improved outcomes for everyone who requires support and act on the findings.”
“Recent ALLIANCE research highlighted long delays in accessing self-directed support, a crucial component in supporting people to live independently.” Ian Welsh
Scottish Government Minister for Public Health and Sport Aileen Campbell said: “I welcome this Audit Scotland report, which demonstrates that many people are already benefitting from being able to make decisions about their own care and support. However, the report’s recommendations give clear direction on what must be done to ensure that self-directed support becomes embedded as Scotland’s mainstream approach to social care.
“We expect local authorities, who are responsible for implementing self-directed support, to make progress on implementing these recommendations. People must be able to make decisions about what is important to them within their social care support. They must be actively assisted to understand the choices open to them and supported to recognise the assets they already have in their lives – friends, family and community interests.”
The Scottish Government has asked the Care Inspectorate to lead a review into SDS as part of its future inspection programme.
Picture courtesy of WorldSkills UK
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