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It’s Not What It Says On The Tin

April 23, 2012

Language. Language used to create a false reality. Language used to unsettle and wrong foot. That is the subject of today’s sermon.

The world of social care has got this art of to a fine T. It uses the language of transparency to slam down the cast iron shutters. In proporting to shed light, it plunges us into darkness.

Many, many times I have been on the receiving end of this cynical manpiulation of language to divert attention from the actual truth (usually, with money at the core of the truth). One has to grudgingly admire the aplomb with which the authorities perform this brainwashing. They do it with mirrors. They are empowering me. Their approach to social care is person centred. And when I wake up in the morning feeling thoroughly disempowered do I realise that I’ve been on the receving end of the biggest social care centred con trick.

The current fad, the latest illusion is that care plans have at their heart, the person’s independence. So, why is that this newly gained independence suddenly feels like I’m trapped; I’ve lost out big time; my choices evaporate. The greatest independence con trick of recent times occured in the infamous case of McDOnald vs Kensington & Chelsea. Miss McDonald had managed to live, for some time, reasonably independently in her own home. Due to an unfortunate medical condition, she needed night time assistance to access her comode. Along comes the Royal borough and they decided that to facilitate Miss McDonald’s independence, they should stop the night time support and provide the lady with incontinence pads and sheets instead. Not a single acknowledgement of cost savings, K&C acted solely to promote Miss McDonald’s independence. I’m sure she is extremely grateful for this new found independence as she lays in her piss night after night. Last December, I was invited to speak at the Legal Action Group Conference, and the over-riding memory of the day was of the many hardened legal professionals still reeling from the cynical manipulation of a needs assessment by Kensington and Chelsea.

I’m embroiled in something similar at the moment, although thankfully it doesn’t involve faeces. For the most part of 2010, my 22 year old autistic son was illegally detained by social services in a positive behaviour unit, having gone for three days respite at a local respite facility, familiar to him. Both the respite centre and the positive behaviour unit cause him considerable anxiety and I have to still reassure him daily that the trauma of that experience is in the past. Since he’s been back home, respite has come to us and the council pay a support agency top provide a support worker once a fortnight to stay overnight in our home. Now, all of a sudden, Hillingdon council have decided that Steven’s independence is at risk with this arrangement. And how will they encourage his independence? By sending him back to the council’s respite centre for once a fortnight respite. You see how insidious this is: lets gloss over the fact that he hasn’t slept through the night since he got wind of Hillingdon’s plan and instead lets applaud that we are developing an independent, albeit traumatised young autistic man.

Lets turn our attention to personalisation and personal budgets; the “where its at” ideology of social care in 2012. Lauded as being the pinnacle of choice and flexibility, many people are bewildered that their reality of personalisation reveals that the limited choice they once had, has now contracted admidst the inflexibility of the RAS system. Under personalisation, each person has a care assessment at which their specific needs are identified. Those care needs are then fed into the RAS (resource allocation system) and converted to a personal budget: a cash figure designed to pay to have those needs met. Proving that transparency is alive and kicking, you try and find out the figures used by yoour local authority to calculate the personal budget and you’d probably have more  luck trying to relaunch a new series of Love Thy Neighbour. The truth is that most local authorities are feeding the RAS with their old direct payment rate, usually about £10 per hour. Now, picture this Debbie Harry. Prior to the flexibility of personalisation, your care plan consisted of 30 support hours a week, which the local authority commissioned a care agency to provide at, say, £15 per hour. A weekly bill of £450. Under personalisation, your needs havent changed and you still need 30 hours of support per week. The RAS whirls into action and produces a weekly budget of……£300. But hang on a minute mister, prior to personalisation, I was £150 per week better off. The support agency aren’t interested in providing the same level of support for £150 a week less. “Ah, but wait, dear service user. Personalisation is all abouot flexibility. You can commission your own support, tailored exactly to your needs. Thats the beauty of choice”. The end result of all this choice is that although I have been assessed for needing 30 hours per week support, I can only afford to pay for 20. I’ve had to reduce my working week by 10 hours and my wages have dropped by £200 per week. The person I care for cannot access some of her weekly activities as she doesnt have the support to go with her. But hey, never mind, I’m feeling excitedly independent.

I know this reads as a cynical, probably bitter piece, but that is where the continual presentation of a false reality leaves you. It’s not what it says on the tin. But all is not lost. To retain a stable footing, we have to learn how to decode the language. If I am told repeatedly that they are only acting in my son’s best interests, I have to be alert to the possibility that it is someone else’s best interests that are in play. If I am presented with the idea that my choices are being widened by the latest flavour of the month, I mustn’t be too surprised if it feels like my choices  have actually narrowed. If my independence is being trumpeted, be aware that my personal dignity, sense of safety and possibly quality of life, may be compromised. If you’re about to have a person centred plan, dont bother reading up on your Carl Rogers but prepare yourself for someone deciding what is best for you.

Someone pointed out to me that people working in the field have it very tough and are under constant pressure. I agree. Perhaps my expectations are too high. But I believe when dealing with the most vulnerable people, the onus to be honest and straight forward is more important than ever. My son is very literal but also, very intuitive and if he is given a message that his instinct tells him is fishy, then the anxiety cranks up to almost unmanageable levels.

Just imagine how liberated, how independent we will feel if we can decypher the language and be able to stand our ground and retain a sense of our own reality. Now that would be personalisation.

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From → Social Care

One Comment
  1. Clem Feeney permalink

    Your experience of the RAS is not unique. My last job as an LD social worker, I wasn’t allowed to know how the RAS operated. This suprised me because when I did a “personalisation” pilot up north 6 years ago, the Social Workers did the RAS and explained the system to the client and/or carer – but that was a Labour Council, whereas my more recent employers were Tories. Also, I don’t know if the openness continued after I left.
    Any “innovation” in social care is going to be seen as a cost cutting exercise by a bean counter somewhere and in many councils the bean counters hold sway over the service managers.
    Nice blog by the way.

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