Increased choice over personal care risks Scottish voluntary sector ‘instability’
Measures designed to give people who use social care more choice about the support they receive, could destabilise Scotland’s voluntary sector, impacting the workforce and service quality, according to a new report published by Strathclyde Business School’s department of Human Resource Management this week.
The report, produced in conjunction with the Coalition of Care and Support Providers in Scotland, found questions regarding the future sustainability of some voluntary organisations as large-scale employers.
This is as the provision of social care, following the introduction of self-directed support, moves from block contracts – whereby local authorities allocate the support of a group or population to one provider – to increased financial controls for individual service-users – either through direct payments (DP) or Individual Budgets (IB). These mechanisms, extended as part of the Social Care (Self-directed Support) (Scotland) act, give service-users more choice and control over which services they use from providers.
Combined with austerity in public service funding, the report warns that personalisation casts doubt on voluntary organisations ability to sustain current services. There are also concerns regarding a future of unregulated personal assistants (PAs) providing services with voluntary organisations acting in a brokerage role to ensure their training and accreditation.
Voluntary organisations and those who receive support also raised concerns about local authorities’ introduction of charging and stricter eligibility criteria leading to the isolation of some vulnerable people who cannot afford additional costs or are ineligible for services.
Among the report’s key recommendations, priorities include:
• Greater sharing of information between local authorities and voluntary organisations to ensure agreement on service levels and policies.
• Increased dialogue between voluntary organisations, local authorities and service-users themselves, to ensure service provision meets their expectations.
• Further emphasis on skills development for both local authority and voluntary organisation employees to ensure they are equipped to meet the demands of personalisation.
Strathclyde Business School Professor Ian Cunningham, who led the research project, said: “While our findings demonstrate a clear support, both among local authorities and voluntary organisations, for giving those who access care greater choice, there a clearly a number of difficult issues which need to be addressed to ensure the policy is delivered effectively, for service-users and providers.
“We’ve made a number of recommendations to improve delivery, including the need for local authorities to be proactive in sharing market insights with voluntary organisations to allow them to properly adapt to the new service expectations.
“Adequate resources must also be devoted to ensure both local authority and voluntary organisation staff have the skills required to meet the demands of the new legislation.”
Against the backdrop of wider austerity measures, the report also points to evidence of concerns among Scotland’s voluntary sector workforce resulting from reduced working hours and rates of pay, as local authorities change their requirement for care provision to meet service-user demand.
While the report found a rise in the number of voluntary workers considering learning new skills to make themselves more adaptable, it also suggested training and resources are being squeezed in financially vulnerable voluntary organisations. There are also a number of emerging tensions between voluntary sector workers and service-users arising from differing expectations of care delivery, especially around working hours.
Dee Fraser, Providers and Personalisation Programme Manager, Coalition of Care and Support Providers in Scotland, said: “We welcome this report as it clearly articulates the challenges faced by providers in making self- directed support a reality in a time of budget cuts and downward pressure on hourly rates.
“The clear link between the context in which support is purchased and the experience of provider and frontline staff gives weight to our observation that effective commissioning is key to the successful delivery of self- directed support.”
Annie Gunner Logan, Director, Coalition of Care and Support Providers in Scotland, said: “The report is valuable in its confirmation of the extremely positive approach that the voluntary sector is taking to the implementation of SDS. It also provides a clear focus on the biggest challenge for the sector, which relates neither to the principles nor the practice of personalised support – it’s the way in which the economic and financial storm threatens to blow them off-course.
“In particular, the report highlights the difficulties experienced by voluntary organisations in their efforts to strike the right balance between increasing flexibility, choice and control for individuals, and maintaining staff terms and conditions at a level where care and support remains a positive employment choice. In that context, there are as many lessons in the report for funding authorities as there are for voluntary organisations.”