As an Area Manager with The Richmond Fellowship Scotland, Karen Robertson can see a lot of practical challenges with Self Directed Support as well as potential benefits.
Karen, whose services support people with mental health related issues, said: “As an organisation we are trying to get our heads round exactly what Self Directed Support means for us as professionals, and more importantly how it will impact on the individuals we support.
“As a national organisation, we work across various local authority areas and a priority is to ensure that any learning from one particular area is available to the whole organisation.
“Self Directed Support is undoubtedly the biggest culture change since Community Care came in with the closure of long stay psychiatric hospitals over 20 years ago.
“For it to work, we need to look at the people we are supporting as individuals who lead on the support that they receive and not as passive recipients of services that already exist, and that is going to be a big change.
“Everyone who provides services is trying very hard to ensure people are involved in directing their own support, but the reality is that many service users are not integral to their own assessments at the moment, so there is still a lot of work to be done.
“I think it is going to be very interesting, and I think it potentially will be a really good way forward for an awful lot of people who could take to it like a duck to water.
“But as a social care worker, I do have concerns about those individuals who require support who will struggle to come to terms with it all and I’m concerned that we build in safeguards to sure the vulnerable are not exploited in any way.”
Karen sees major logistical and structural changes ahead as, for example, the present system is geared to providing contracts for and services to numbers of people, not to catering for individual budget holders.
Potential hurdles include adapting systems to bill hundreds if not thousands of individuals rather than billing local authorities for bigger contracted services . She also makes the point that the all the statutory legislation covering service providers is still in place.
Karen added: “Things like how we are registered with the Care Commission doesn’t necessarily sit comfortably with the freedoms that come with Self Directed Support.
“We have to report quite a lot on what we do in terms of inputs into support, whereas the new system would be much more about looking at what the outcomes are for the individual and what the provider’s contribution has been to these.
“That’s simply not how the current reporting systems are set up and all that has to be worked through. A lot of it requires quite a fundamental head shift about how people are supported and what that means.”
Despite the organisational challenges, Karen is looking forward to the introduction of Self Directed Support.
“There is a lot of work to be done getting people to understand that support is something that is there to help them with their lives, not something they receive and are grateful for.
“With mental health, people tend to be told that there are a whole lot of things they can’t do due to their mental health issues, but not necessarily that there are lots of things they can do.
“Self Directed Support could help address that imbalance.”
Karen believes a priority will be building the self-confidence of potential personal budget holders to take more control of their lives.
She added: “It might appear easier to have other people decide on what support is needed, but that would not enrich the life of the person concerned.
“Self Directed Support means embracing a different world view, and that applies at least as much to service users as the providers.”
