Culture change puts people first

There’s a shift in care provision, away from what professionals think people need towards the needs of the individual, says Andy Rickell

Putting People First is the government programme that will change the delivery of social “care” from one mainly decided by professional providers to one decided by the people who need support. This is called “personalisation”. It is a key plank of the government’s Independent Living Strategy and offers disabled and older people choice and control over the funding that pays for their support. People who were involved in the pilots of these so-called “individual budgets” said that it
really gave them much better life choices, and I expect the rest of England will agree when it happens for them too.

Some local authorities are keen to lead in making these changes. I suspect though that many are wary, and certainly many of the people they employ are wary, thinking this change may either cost them their jobs, or at least take away important parts of their roles. I am keen to put their minds at rest.

The bottom line is that after these changes, disabled and older people will continue to need paid workers to provide their support and professionals to ensure effective meeting of their needs. Some workers’ employers may change and so might their roles, but these changes will make the work more interesting and rewarding.

The fundamental change will actually be about “culture” – the way things are done and the reasons why they are done that
way. There are two key ideas underpinning the current social “care” culture that personalisation will challenge. Firstly,
that disabled and older people who need support are somehow not competent to decide on that support. Secondly, that the best way to manage “care” is for as much of the decisions about assessment, funding and delivery as possible to remain within the hands of the local authority, or its tightly-monitored suppliers.

Instead the new culture needs to be one where each disabled or older person becomes the decision-making customer, and gets every help to make what choices they can, irrespective of impairment. Such customers will need to know what they might have, and here the professional can act as advisor (possibly now employed by a user-led organisation (ULO)), both about their potential choices and sources of state funding via supported self-assessment.

The local authority must still gate-keep the funding via other professionals, but now they must ensure that the “market” delivers the solutions people want, rather than necessarily delivering it themselves. Provision is likely to be increasingly community-based than institutionally-based, and self-funders and people who get state funding will “shop” together. But they will still want paid support, though now called personal assistants/support workers and provided by competing providers.

Some changes in employment will be more apparent than real. However, I can understand employees’ concerns about changes to terms and conditions that might result as people move from local authority employment to ULOs, and these need to be addressed fairly. This new independent living system will require greater skills from staff than the social “care” system we currently have. I want to see the status of people in this profession improved, not worsened.

• Andy Rickell is a disability rights campaigner