One of the biggest challenges in social care is realising the goal of independent living and self-directed support for everyone who needs it in Scotland.

Leading experts in the sector shared their thoughts on what’s next for this approach in an online seminar held by healthandcare.scot.

In the first of two reports on the event, here we look at the discussion around the issues currently facing self-directed support (SDS) in Scotland.

 

“People are being charged for exercising their human rights. I think that’s completely unacceptable.”

Sally Witcher, Chief Executive of disabled people’s charity Inclusion Scotland, said this is just one of many problems when it comes to how SDS is being implemented.

The existence of a “postcode lottery” across the country and a tightening of eligibility criteria have also been highlighted in recent research findings. 

Now the covid pandemic has served to “massively exacerbate” these existing faults, while also creating new problems, Ms Witcher warned.

“Inclusion Scotland has carried out various surveys which have shown people experienced their care packages being withdrawn overnight or cut sometimes,” she said. “In our early survey, 30% said they had their care stopped or reduced.

“People felt abandoned, no access to food, medication and there was very clear evidence of the devastating impact on people’s mental health.

“We also more recently founded evidence some people are still being charged for services that have been withdrawn.”

The Scottish government announced £100m of emergency funding for health and social care to help cope with the covid crisis, but Ms Witcher echoed concerns over whether this was reaching frontline services.

“Where on earth has it gone?” she said. “If you know the answer please do tell as I would really like to know.

“As far as I am aware, third sector providers haven’t seen it, people using social care support very often haven’t seen it – so where is it?”

The issue of whether people are able to exercise choice over their support was also highlighted by Lucy Mulvagh, Director of Policy and Communications at the Health and Social Care Alliance.

She said it was important for people to have access to information about all four SDS options to have fully informed control over their support, and research had indicated the majority of people were on their preferred choice.

However she added: “There are variations when we look at different population groups – so for example, people living in areas of high deprivation reported being less likely to be on their preferred choice.

“Targeted work is required to ensure people with learning disabilities and black and minority ethnic people in particular are offered the four SDS options, and that the support provided subsequently is person-centred and rights based.”

She said more work was also required to ensure people living in rural areas of Scotland can access all four SDS options without having to “incur disproportionate expenditure or move house”.

“That has actually happened to some of our participants,” she said. “They either incurred additional expenditure or were told that in order to have the range of all four SDS options, they would have to move to a more populated area.”

Florence Garabedian, a board member with Self-Directed Support Scotland and Chief Executive of the Lothian Centre for Inclusive Living, raised concerns over differences between the national drive for SDS and what was happening locally.

There was a “disjoint” between the two with no accountability process, she warned.

She said: “Here we are with a postcode lottery situation, different eligibility criteria between one local authority to the other and local interpretations of budgets.

“As an example, if you are a disabled person with a social care package in one local authority, and you must move for whatever reason to another local authority, at the moment it is a huge gamble.

“The other local authority may not have the same eligibility criteria, what you have been supported for may not be seen as a priority for the local authority you are going to.

“That is a major setback in terms of the freedom to move in the country, as many of us can do.”

Ms Gararbedian said that changes had to be made to how SDS was operating.

But she said: “We have something which could give us the opportunity to do great things in social care.”

 

Supporters – If you can help support our reporting for Scotland's health and social care community, please head to our donations page.

Bulletin – Sign up for all the latest news and events.