In this essay I am going to critic, evaluate and analyse direct payments and the implications they have had on social work practice. The Direct Payments Act 1996 enabled local authorities to offer cash in lieu of social services. They were introduced for adults of working age in April 2007 and extended to include older disabled people in 2000. Since April 2001 direct payments have also been available to parents of disabled children, 16 and 17 years and carers.
Direct Payments have also been extended to people with short term needs for example someone who needs help at home while recovering from an operation and for Children Act services to help disabled parents. Since April 2003 regulations came into force requiring councils to offer direct payments to all people using community care services. Direct payments may also be used to pay for education, leisure, assistance or services to help service users to be fully involved in family and community life, and to engage in work.
As we are aware the government is committed to revitalising modern public services offering range quality and choice to service users. This has been done and should continue being done by taking as a starting point at all times service users’ opinions (voice) including carers and families. By doing so social workers are able to listen to their experiences and get to know what they want from their services. In this way service users contribute to the improvement of quality of services provided and they may also feel empowered as their voice counts and is taken into consideration when it comes to making decisions.
Dame Denise Plat DBE 2004:2 states that “we have been listening from the start. And no matter what their age or background, people tell us they want social care services which offer choice, control, independence and flexibility. ” Direct Payments facilitate for this as they enable people to choose and pay for their social care. However access to and using direct payments is not always easy as they are restrictive or patronising attitudes about the capabilities of people who might use a direct payment and a reluctance to devolve power away from professionals to service users.
With professionals failing to embrace direct payments as a realistic option for more service users. Social workers do however need to acknowledge the fact that direct payments do not meet the needs of all service users and therefore this should be kept in mind and not ignored as professionals try to meet management targets at work. This in itself is worrying as social workers we are supposed to work without being judgemental and empower the service users we work with. Social workers and other professionals should get training and ensure that they do not stereotype service users and always place service users first.
With such perceptions of service users it would be difficult to place welfare of service users first. Social workers and other professionals need to have an understanding of what direct payments are, how they may benefit a service user and when they are best applied. This will improve on their ability to promote direct payments to service users that would benefit from them. Getting access to Direct payments is not always easy as service users face barriers such as lack of information and loads of paperwork.
Service users have to become employers as they take on the responsibility of hiring their staff. Social workers are faced with the task of ensuring that service users using direct payments receive a good quality of care. Direct payments transfers considerable responsibility to the service user and it is therefore important that policies and procedures are in place to help people access and manage their direct payments effectively. Partnerships should also be formed between agencies and local authorities enabling them to recommend services that they are confident in.
For the local authority direct payments have enabled more service user involvement, reduced contact with service users once care packages are established and few complaints however there are complex administrative arrangements and cost constraints faced in the early phases. Wilson et al (2008) suggest that using the exchange model rather than the procedural or questioning model empowers would enable social workers to assist service users and their family members to make informed choices about how to best manage their direct payments or any other benefits given. The exchange model llows practitioners to arrive at a mutual understanding of service users problems and concerns, in turn giving them more control over they care, for example by informing them when they are entitled to Direct Payments. As a general principle local councils should leave the choice with direct payment recipients as to how they meet their needs, whilst satisfying themselves that agreed outcomes are being achieved. Although there are some variations from one local authority to another, one of the social work values that should be kept in mind while working with services users is the promotion of choice and control.
However the implementation of direct payments has resulted in some criticism and concerns about the schemes, the recent 2003 direct payments regulations can be described as being loose and imprecise this has therefore resulted in variable and inconsistent interpretation of the guidance that has influenced local implementation. Pearson 2000: 467 argues that “the choice and flexibility of the direct payments packages can maximise user control but it is also the factor that varies greatly between each local authority. This suggests a postcode lottery, Which would disadvantage people wanting to take greater control over their own support arrangements but who live in what can be deemed as less progressive local authorities Direct payments can be used to deliver a more individualised and improved service. Service users value flexibility which direct payments offer, however local authority systems are sometimes too controlling and limit potential creativity in the use of funds. Social workers need to make sure that they do no set people up to fail by making inadequate payments.
They should be aware that calculating the appropriate level of direct payments is crucial. “Social work has an important role in supporting people facing life-changing circumstances and working with people whose rights may be undermined through abuse and neglect. Social workers in multi-disciplinary teams contribute a holistic view with a perspective of the whole person, rather than a focus only on their symptoms or circumstances, and are therefore in a good position to support better person-centred outcomes. SCIE 2010 “The campaign for direct payments in the UK was inspired by the ideals of the independent living movement and it is interesting that to date the main beneficiaries of direct payments have been people with physical difficulties aged between 18 and 65, who still make up by far the largest group of direct payment users. There are currently moves to equalize access to direct payments for other groups, including people with learning difficulties and mental health difficulties, older people and disabled children.
This raises questions about what it means to be ‘willing and able’ to manage a direct payment and how much support can be made available to those with permanent cognitive impairments or fluctuating conditions. One could also question the ability of centres for independent living to represent effectively the interests of newer user groups such as frail older people. As in the future with an increase in the ageing population older people will make up the fastest growing group of direct payment users, raising major questions about the type and quality of support and advocacy which will be needed and provided.
Resistance to direct payments appears to be driven in part by a desire to defend collective approaches to welfare provision and to protect public sector jobs against ‘creeping privatisation’. ” Health Committee Report (online) In order to ensure that direct payments are successful and efficiently work for service users local authorities need to ensure that they are support systems in place to assist with the smooth running of direct payments.
According to SCIE publications on personalisation in order for social workers to achieve better outcomes for services uses they need to play a key role in developing and delivering personalised services. I would like to conclude by saying that in addition to changes to the training and attitudes of front line workers and number of policy measures will also be required to promote direct payments. The history of community care is full of new developments that have promised much during their pilot schemes only to fail to deliver on implementation.
Therefore the challenge is left to social work students, service users, practitioners, policy makers and governments’ to ensure that history does not repeat itself. Bibliography Carlin, J. and Lenehan, C. (2004) Direct experience: A guide for councils on the implementations of direct payments in children’s services, London: Council for Disabled Children Dame Denise Plat DBE ,Commission for Social Care Inspection 2004,Direct Payments. What are the barriers? Davies, M. ed. (2008) The Blackwell Companion to Social Work 3rd ed.
Oxford: Blackwell Dalrymple, J. and Burke, B. (1999) Anti Oppressive Practice Social Work and the Law Buckingham: Open University Press Department of Health (1996) Community Care (Direct Payments) Act, London: Department of Health. Hasler Frances and Stewart Angela 2004, Making Direct Payments Work. Identifying and overcoming barriers to implementation. Joseph Rowntree Foundation Health Committee Report. http://www. scottish. parliament. uk/business/committees/health/reports-06/her06-10-vol01-03. tm accessed on the 19 /02/201 1 Leece, J. (2003): Direct Payment: Veture Pulication Littlechild R and Glasby J 2009, Direct Payments and personal budgets. Putting personalisation into practice. The Policy Press SCIE 2010,At a glance 29: Personalisation briefing – Implications for social workers in adults’ services Pearson 2000 The Implementation of Direct Payments for People who use care service. Wilson K, Gillian R, Lymbery M, Coop A, Social Work 2008: An Introduction to Contemporary Practice. Pearson Education Limited