Monday, 16 July 2012

Worcestershire County Council, Past Caring?

Austerity is hitting social care hard. More and more councils are changing their eligibility rules, directly affecting who qualifies for care. In turn, the closure of the Independent Living Fund (ILF) and the reduction of the care budget by local authorities, are antithetical to what the modern disability movement has been striving for in the last 40 years. As a result of this, the archaic model of residential care is threatening to make a comeback. Bringing with it a wholly paternalistic way of thinking: social services and those in positions of authority are restricting the freedom and responsibilities of people subordinate to them. 

Harsh wording perhaps, but this may be the reality for service users within Worcestershire County, as highlighted by the WeAreSpartacus report titled ‘’Past Caring’, released on the 12th of July, which served as a response to Worcestershire County Council’s Maximum Expenditure Policy. ‘Past Caring’, criticizes any impending policies that would impose a cap on care costs, meaning that anyone needing significant amounts of support may have to go into residential care. The initiation of such policies by WCC would only affect new service users, or those experiencing increased care needs. I suggest that this will result in a two tier system: service users with fixed care needs, already established within the system, will be temporarily safeguarded by such changes, however those with fluctuating or increased needs would be assessed under the strict eligibility requirements, and therefore be forced to make a fresh case for their right to live independently. The reality is that independent living in post-austerity Britain is under threat.

The 'Past caring' clearly state, there are three options: 1) Pay for the shortfall privately 2) Change the type or volume of care provided, or 3) Access community voluntary organisations and faith groups for additional care support. The proposed alternatives are unrealistic for those in long-term care. The first option is only available to a wealthy minority, or at best could be utilized as a stopgap measure for anyone until their savings run out. This contingency measure may well become a reality for some who are backed into a fiscal corner. However, WCC clearly states:

You (or a family member) could decide to make an additional financial contribution towards the care package (this would be in addition to any financial contribution you are required to make under the Council's Fairer Charging Policy) 

This suggests then, that a disabled person would not only have to continue paying for the council’s ‘Fairer Charges’, but also any additional care that isn’t covered by social services’ new policy. This begs the question, what has happened to the familiar phrasing found on most DWP letters, namely the fixed amount that you are legally entitled to live on - has this fallen by the wayside? Its absence under the new policy is palpable.

The second option, the reduction of hourly care, directly conflicts with the ethical and legal obligation of required social services. The ‘Past Caring’ report identifies that the number of care hours an assessment recommends would be fundamentally unmet after a reduction in “volume.” It’s important to note however, that once a person’s needs have been identified, then the state has a legal obligation to acknowledge their entitlement.

In turn, WCC have also suggested that the usage of adaptive technologies should be considered, which seems laughably absurdist. Cheaper alternatives, such as Direct Payment. have been identified by ‘Past Caring’ as not suitable for all, because many people cannot meet the demanding regime of paperwork, which is required from the service users themselves.

To my mind, the third option is equally as inadequate as the first two. The mere suggestion that disabled people can automatically access community voluntary organisations and faith groups, fails on many levels, not least because it places disabled people’s autonomy under pressure by forcing service users to seek charity, locating funding from sources whose social, political or religious leanings might not be in line with their own. Are we suggesting then, that people with disabilities are supposed to be grateful for help with the cost of personal assistance, wherever the source of this support comes from? This negates peoples rights to a personal social or political opinion, moving dangerously close to Cameron’s Big Society, which has shown to be unsuccessful and hardly sustainable as a long term solution.

Residential Care, a flawed alternative?

The report identifies the two groups at most risk, namely those with significant disabilities and care needs that will exceed the capped cost under the new guidelines of such policy. Thus the Maximum Expenditure Policy will undoubtedly lead to the routine institutionalisation of entire user groups, who will be shunted off to care homes for the rest of their lives. In the event that such suitable accommodation can be found, it is furthermore highly unlikely to be local due to its scarcity. This would lead to uprooting the service user, severing local ties to family and community, resulting in the loss of a broad social network. Depending on the location of the residential home, it may be extremely difficult for friends and family to visit regularly, leading in turn to extreme isolation and the deterioration of existing relationships.

The second group are those who are approaching the financial ceiling of the cap. Such service users, in order to avoid residential care, are likely to make detrimental life decisions in order to keep costs low. For example, skipping certain meals or utility costs to curb spending in their own care package. As a result, and as ‘Past Caring’ puts it, ‘the quality of life and safety of this user group is highly likely to be compromised by the Maximum Expenditure Policy’.

To sum up the main points made by ‘Past Caring’, firstly and most importantly, WCC service users are faced with the possibility of being forced to choose between home and the daunting possibility of residential care. The policy’s three suggested alternatives highlight the extent of WCC’s capabilities. WCC’s failure to provide an accessible consultation with service users opens the council up for legal scrutiny. Therefore, this report provides evidence that the only other valid option they are offering is that of being placed in a residential care home.

It has been suggested that the White Paper will put an end to the postcode lottery, delivering equality of care wherever one might live. Yet, the adoption of WCC's policy directly contravenes this. The action taken by WCC reveals certainly that, within the near future, there will be a clear disparity between provision for those who live in different counties. The bureaucratic mess gives counties a window of opportunity to exploit the weaknesses of Welfare Reform, meaning that unfortunate individuals will fall between the cracks of the system; becoming increasingly unheard and unaccountable. The impending changes greatly undermine lifestyle choices and the ability for people with disabilities to imagine a long-term future within Worcestershire County. ‘Past Caring’ states: 

...Moving into residential care for purely economic reasons will lead to curtailing of independence, curtailing of freedom, loss of income, loss of social ties, loss of community ties, loss of daily social activities, potential job losses and perhaps most shockingly family break up. 

The loss of community is a loss of social network, which I would define as a supportive component of independent living. Yet, questions have to be asked, does the introduction of such policy reflect a fair ratio of cuts, or are these burdens falling squarely on disabled people? Will there be additional financial burden from living within residential care, such as curtailed employment prospects due to prohibitively high costs? Let it be stated that freedom is under threat here and social isolation is the likely result. Therefore, it’s important for all local disabled people, their families and allies alike, to speak up before consultation finishes at the end of July. For more information, visit We Are Spartacus.

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