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Service Without A Smile

December 31, 2013

I’ve spent the last two days ploughing through the draft copy of Steven’s FACS assessment. It is dispiriting reading. To see this lively young man’s life reduced to a series of scores from 0 to 5 rots the soul. In fact, I don’t recognise his life from the document at all. If it’s meant to be a potted summary of who he is, it fails miserably. But then the whole process of care assessments exist as an entity that has precious little to do with the person being assessed. And waiting in the wings is the knowledge that these 0 to 5 scores will be totalled up and fed into a computer and Steven will change from being a score to a monetary value. From a human being to a score of 276 to a cash sum in two simple steps. It seems to me that these assessments are a con – first and foremost they are an instrument for cutting costs, disguised as a service to the person needing care. Secondly, they are food for the large care industry to justify its existence. Somewhere, way down the pecking order, comes the service user and what the exercise is promoted to be about.

Talking of service users, the next phase of the FACS assessment is to have a “one to one meeting with a support planner to review appropriate services for the service user to access”. Support planner? Que? I’d like to see that job mimed on What’s My Line. Even if we leave the mystery of what a support planner is all about to one side for the time being, we’ve still got the second half of the sentence to wade through and decode. Appropriate services? Are there any? What is a service in the adult social care world of 2013?

At the last meeting of my local parent/carer group, some of the following professionals turned up – “Team manager for adult services”, “Team manager for disability services”, “Category manager for outreach services”, “Service Participation manager”, “Carers services champion”. So many people. So many services? When you get down to the nitty gritty of these meetings, you find alarmingly that there aren’t any real services being offered. The Category manager for outreach services talks proudly of its “partnership working” with organisations with snazzy names like Dimensions and Aspirations but try and pin her down to what these “services” actually consist of and you could cut the awkward atmosphere with a spoon. The minute a services engagement manager is appointed, you just know that services have become disengaged. Is this equation a truism – the more service managers employed = the less services available? If you’re going to have 20 senior services managers, you’re not going to have much money left for actual services.

So what happens is the machine starts to feed on itself even more – more services managers are engaged to reinforce the illusion that services actually exist. At school, I had a rather paranoid football coach – when a free kick was awarded against us, he would have all 10 outfield players lined up in the wall – “Most important thing lads – we’ll block the goal from the buggar’s view”. Social care line up all their services managers in the wall in the hope we can’t see through, above or around it. Trouble is, one toe punt, in the form of an innocent question like “So, what services are you actually offering” and the wall collapses.

The truth is, services packed their bag and left the building a long time ago. I’m a bit old fashioned but I don’t see something that is a statutory duty, like assessing someone’s care needs as a service. It’s a duty. We have to wise up to this. I keep hearing people forlornly hanging about for a service that isn’t going to arrive. Trapped in the illusion. Lets forget the idea of services being provided – the only way is to provide our own services. I’m not talking big jobs here – not necessarily collective action. All the things that Steven does during the week have been found by him, me or his support workers. When he goes to the Arts Centre for his music session, we don’t think about it in terms of availing himself of a service – he’s sorted something he wants to do out for himself. He pays his money and gets on with his business of the day. It’s very liberating because we don’t have to engage with the “services” lie – he can realise his own aspirations without the input of Aspirations.

Wouldn’t it be fabulous if that was something we could all aspire to?


From → Social Care

  1. lisa permalink

    We were ‘allocated’ a support planner., LOL..As lovely as she was, her role was to find unsuitable things for my son to do and then her manager would look at cutting the things that actually worked and my son enjoyed! It is a cost cutting thing, veiled as being helpfull!!

    • Pauline Thomas permalink

      Mark you have uncovered the appalling abuse of power that reigns in most of the LA;s social service departments.

      My husband and I have stopped going to our local carers forums with the council because we are sick of the way council personnel talk at you instead of to you. They do not listen to anyone’s point of view and the only reason they exist is to make it look like they are actually engaging with us. They are not and it is only for cosmetic reasons that they exist at all.

      In the last decade since ‘Valuing People’ was introduced (what a lie that was), we have seen many social service executives/managers/commissioners come and go. Most of them blotting their copy books with our LA and lo and behold they turn up in other councils ready to start again in another social service department. It seems that they ‘hit and run’ for ever. Is there a no stopping them?

      My son will be 42 in 2014. I like think up until 2010 he had a happy and anxious free life. School was great, college too, and even the day centre was fun most of the time. It was only when they wanted to value him did it all go pear shaped. The only people getting any value were the commissioned care services. The learning curve that everyone was on at the time turned into a nightmare for alot of service users Although our councillors were warned that many people could not take change, they went ahead anyway, silencing anybody who objected with the phrase ‘dinosaurs’. Nothing that was promised in those far off days were ever implemented and many people who did not deserve to be hurt in this way have suffered terribly.

      I would like to hope that 2014 will be the year that we (carers and cared for) have our voices heard and acted upon by the powerful ones.

      Happy New Year to you and Steven.

  2. lisa permalink

    It really is madness because if id believed them regarding ‘trying new things’ and ‘viewing services in a different way’ my son would have been back to self injuring, on a full wack of risperidone and anything else being dolled out and his life would be Grim at the very least! Thankfully eventually I was listened to, ‘Don’t change what works’!! URghhhhhh

  3. Meg permalink

    I know exactly what you mean Mark. As a support woker I have found over the last year, increasingly in the past 6 months that the services I depend on to support my service users (learning disabled adults) have become less accessible.
    My service users are being discharged from medical, psychological and psychiatric LD services unless their need is assessed as acute. Which of course, it never is.
    A while ago, I had a service user in emergency respite, alcohol dependent and suffering some form of emotional overwhelm. I was informed by mental health assessors (who spent a whole 10 minutes ‘assessing’) that she was not a mental health case and they would not help because her issues were “environmental and emotional”.
    The result was a very harrowing time for service user and support workers. Don’t know about you Mark but I thought all our mental processes, good and bad, fair or ill were as a result of environmental input (whether within our own bodies or without) and our own emotional response. I don’t reckon any politician could beat these ‘assessors’ at fobbing off and flannel

    • Weary Mother permalink

      I tried to explain what you are saying Mark, again so spot on, to some people who live in the ‘real’ world. I said ”think of a frozen pea factory, where all their smart word advertising language/ ‘Brand’ image stuff, talks up their being the best ever frozen peas factory, but where all the money goes on hiring people who make less and less peas; success coming when the last pea clunks off the conveyer belt. In the real world they would go out of business, fast. But LA’s have your money coming in the other end, and they believe that they are (only) in business to the machinery shiny……………. ”
      It is the stuff of madness?

      • Weary Mother permalink

        …………..I missed out ‘keep’… between ‘business to (keep) the machinery shiny

  4. Sally permalink

    I am put in mind of the episode of “Yes, Minister” in which the staff of a hospital were happily and fully occupied holding meetings/stock taking, evaluating etc etc. There were no patients, but this was seen as a plus. The second memory is of Sir Humphrey offering “Every support short of actual help”
    Mark, I think a grim party game could be played at the meetings you describe :”Pin down what is actually on offer”. In this game, parents each have, say, 20 questions and must use them to wade through the management speak to discern what , if anything is actually there.
    Services have rewritten their remits to change offering concrete services to helping/enabling/supporting (delete where applicable users to access services…from…well, not them. And if the services are not there, or are inadequate, not their remit so not their problem. In the game parents would have to find out:
    Do they have any staff who work directly with the disabled?
    What do they offer the disabled themselves?? Work? Activities? Place to be?
    Do they wrok from anywhere the disabled can go to?
    How long will they work with them? And what happens afterwards?
    Who (extra points here) is responsible?
    What is suggested always assumes: heaps of other services around which we need only encouragement to link up with.
    LD children who are able to say what they want, plan, budget, weigh up short and long term gains,and get better.
    DP’s of hundreds of thousands, well able to provide, everything a LD operson would ever need. (The number of times a puzzled bod from the copuncil has said to me: But he could pay for that with his DP” Their shock when I explain how much a DP is and what the money goes on.

    The silly repackaging is only to give managers somehting to do and to try to please their bosses-see, we CAN run a service on nothing, you’ll save so much money, and the parents will love it! None of this lifelong help nonsense!
    I am in a different position to you Mark because my son isn’t able to say much of what he wants. there are a lot of things I think he might like-a day centre with friends and activities, sheltered employment maybe, however token, to help him feel part of things…..I never ever want to sit in a meeting again and have some person from the council describe some idiotic rebranding of nothing to me ever again.

    • Sally permalink

      (Sorry for un-spellchecked email-my son’s video ran out at the critical moment!)

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