Self-directed support makes little headway

Self directed support in Scotland hasn’t exactly shaken the rafters – a report in 2014  called the system “nebulous” – but an Audit Scotland report suggests it “shows many examples of positive progress”.  The vague welcome is hardly justified; this is a system that’s hardly stirred into life at all.  The Social Care (Self Directed Support) (Scotland) Act offers four  “options” for self-directed support:

  • Option 1  Direct payments
  • Option 2  The individual chooses the support and the authority manages it
  • Option 3  The authority chooses the support and arranges it
  • Option 4  A mixture of options 1, 2, and 3.

It’s highly debatable whether option 3 can be thought of as self-directed support at all, and it’s far from clear what qualifies as option 4.

An Audit Scotland report claims that  “at least” 53300 people, out of 208,000 adults receiving non-residential support, are getting SDS.    Of that figure,

  • 11% chose option 1
  • 9 per cent chose option 2
  • 75% chose option 3, and
  • 5% chose option 4.  (para 24)

So out of that 53,300, something between 10600 and 13330 people chose an option.  Direct payments have increased, from 3680 to 7530 people 2010-16,  but as a proportion of more than 200,000 people it’s a very long way from the ‘total control’ supposedly offered by SDS.

It’s also troubling that at this stage the evaluation has not been able to show any clear advantage in personal budgets, even for the selected few who receive them.  A few qualitative comments show that some people support the idea in principle; other comments point to difficulties in knowledge, implementation, resources, restrictions from the local authority and a lack of choice.  My own experience as a carer has been that assessment came cursory and late, with no effective choices at all.  I’ve previously expressed some scepticism about personalisation; developments to date have done nothing to change that view.