Coventry's direct payments policy consultation closed on Monday
9th January. We hope very much they will listen to local people and
organisation's concerns about introducing a standard rate for
anyone on direct payment.
We know the financial situation facing all of us is very tough
but for people with high support needs there could be unintended
and costly consequences.
Local authorities do not have to fund preferences in choice of
support, only an appropriate level of support. But in our
experience the two standard rates described will not fund an
appropriate level of support for this group.
National and local policy is for those who need the support of
social care funding to be enabled to manage their lives
independently in the community as much as possible.
People who have become disabled after an accident or illness
have a life of activities, friends and family to get back to. For
them basic support provided at the rates described may be enough to
bridge the gap. People with high support needs have no life to get
back to. It's a much bigger gap and the support task is very
different - it is to build a life with them.
People with a learning disability and high support needs have been
and still are segregated from mainstream services and mainstream
life at every stage from earliest childhood to old age. This
pattern of lifelong segregation results in a dislocation and
disenfranchisement from mainstream society which is unique to this
group of people. There is a need for appropriately skilled staff
with knowledge and understanding of that disenfranchisement and the
ways in which it can be overcome. There is a need too for
appropriately skilled and experienced staff who understand their
communication and behavioural difficulties and who are able to
establish trusting relationships with them.
The services/family dynamic is unique to this group also. The level
of family anxiety over change and need for reassurance in regard to
adult children with high support needs is exceptional. Such
families are more likely to take a developmental step with their
loved one where there is good relationship with services they know
and trust, services that have credibility and track record.
Families are the decision-makers in the lives of people with a
learning disability. They can be partners in change with a service
(or a policy) they trust or they can be lobbyists for the status
quo.
For this group of people and their families the process of change,
of acquiring strength, relationships, skills, acceptance and roles
in communities is the accumulation of years of skilled work. The
two standard rates described will, in our experience, be too low to
properly and sustainably meet their support needs. Where support is
not properly trained and skilled, care arrangements break down -
sooner rather than later - with the family and person plunged into
crisis. Crisis is costly not just to the health of a disabled
person and their family but to public services too. In the past it
has meant out of city placements having to be found and input from
consultant psychologists, occupational therapists, and community
nurses all of whose time is already stretched
Let's pause and try to get this right
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