The Human Cost of Cuts in Social Care

Yesterday I was sent a link to this blogpost by Lucy at The Small Places. I highly recommend everyone involved in social care read this post. It is written by someone who uses and needs support that is provided by the local authority, however their services have been, are being cut significantly.

The narrowing of the eligibility criteria isn’t a ‘paper cut’ made in an office within accounting departments of local authorities, it has a harsh and detrimental effect on the day to day quality of life of another human being who is dependent on the way that provisions are allocated. These are the choices that have been and are being made in the context of cuts and these are the people, actually, we are all the people that Burstow has to justify himself to when he talks about no money being taken out of social care budgets.

The author of the blogpost explains

Yesterday, my care plan was reviewed, and despite the social worker agreeing that I have substantial ‘needs’, to every question that I answered regarding what my carers do for me, the reply was: ‘we don’t fund that any more’. So from now on, no one is allowed to do: laundry, from putting into the washer, putting on a ceiling clothes rail, ironing and putting away…

no shopping allowed or putting it away; paying bills or doing any post office visits; carers aren’t allowed to accompany you out any more either socially, or to hospital/doctors/dentist/opticians or other practical appointments where you need someone to propel your wheelchair; they can’t put the bins out; can’t stack or empty the dishwasher or do any kind of clearing up whatsoever: the list goes on and on. All of the things that I cannot do for myself.Just about anything you can think of that a healthy person would do in the home or outside the home on a day-to-day/week-to-week basis is no longer allowed.

I recognise this. From the ‘other side’ so to speak. I have been, I am, that social worker (well, not in literal terms) but I have to explain that we no longer provide hot meals delivery, we can’t count time for someone to be taken to medical appointments, we deprive people of assistance for some of the tasks we, ourselves, take for granted.

There has always been an issue of resourcing with some user groups benefiting more than others. In older adults services, for example, it was always rare to allow carers time to accompany service users to go to the shops – however, wasn’t the new and wonderful era of personalisation and choice supposed to change this?

We are now able to offer the choice between the hours (and money) spent on someone helping with a bath and use it instead to go out for an hour to the shops. Not necessarily a palatable choice we would expect for ourselves, is it?

The author of the post goes on

I am supposed to have everything delivered now, but they don’t understand the costs of that. Fresh food (and I say that in the loosest sense since they mostly send you stuff that’s about to go out of date), in terms of fruit for example does not last a whole week; you’re lucky if it’s a few days. I can’t eat processed food because I also have IBS. So I’ll have to do an internet shop twice a week which will cost £8 delivery and I will also have to spend a minimum of £25 per shop, that means my four weekly food bill would be £240: I cannot possibly afford that. And since no one is allowed to put it away, what do I do with it when it arrives?

Cost transfers from local authority to user and is the ‘personal budget’ supposed to allow for this? You’d think so.  This was one of the more baffling parts of the post

Ah, now the very helpful social worker had a suggestion for all of this: I can use my D.L.A. to employ someone to do all of the other things now and pay for any transport needs! That’s what D.L.A. is for isn’t it? As I replied however, I pay ALL of the care element and part of my severe disability element back to the local authority for my care, so how can I use that?

Well, exactly. Disability Living Allowance (or Attendance Allowance for over 65s) is non-means tested however it is counted in terms of assessments for charges so there is an expectation in the finance departments within Local Authorities.  This allowance is seen by the local authority as a legitimate  target for charges to be recouped back to the Local Authority for the costs of care – and to be honest, I can see the point. These benefits (at least, the care component) are paid because there are care needs specifically. However for the social worker to lack this information is no doubt rubbing salt into the wound of cuts.  The social worker sounds to have been put in a difficult position and I know the feeling. We are tasked to pass the news of cuts to those who can least afford it and who rely most heavily on the provision of services – but it’s a duty to give fair and honest advice at this point.

It does make it clear though that ‘better information’ and shiny web sites providing directories of services or new ‘Trip Advisor’ type sites rating services are all very well and good but the real thing that social care needs is funds to meet basic needs. The focus needs to be on quality of life not ‘how much can we slice off budgets’. There no easy answer but being disingenuous about the nature of ‘choice’ available and being honest about the realities of decisions being made is significant.

This post speaks the truth of many others who cannot speak up – and this is someone who has been able to use a direct payment positively. There are many many more who haven’t.

As a social worker this post spoke the realities I see every day and highlights the benefits of social media to improve my personal practice – it shows me how social workers are perceived with an honesty I rarely get in terms of feedback on a day to day basis due to the power differentials which exist.  I hope I don’t respond to people in the way that social worker did but I will be more aware of my responses and how they are interpreted when I am in people’s homes.

And I will continue to fight against the cuts agenda all the harder. We have a powerful collective voice as social workers and we have to use it to tell the stories that we say, to not passively accept some of the hardships and injustices we see on a daily basis.

We can and must do so much better.

10 thoughts on “The Human Cost of Cuts in Social Care

  1. Thank you for reposting this. It really is shocking and sad to read about someone in such a situation. I feel like something must have gone wrong in assessment somewhere for her standards of care to have fallen so short of what she requires. I find it hard to believe that the LA would find it acceptable for her to be in the situation as she describes it, it seems to be negligent in my opinion.

    The OP alludes to expecting a formal diagnosis of MS/ME in the future. I am not a SW myself but perhaps you might know if she’d get more of the care she needs if she were to obtain such a diagnosis?

    I can recognise the desire for the LA to want to cut back on carers doing cleaning, but when it comes to fundamental health issues such as taking out rubbish or washing clothes I fail to see how the removal of such a service can be justified?

    • I agree but I didn’t want to comment too much on the detail as it’s really hard to know the context and guidelines the LA are working towards so wanted to concentrate on more general than specific issues.
      Formal diagnosis as such shouldn’t make a difference to an assessment as they are quite task-led, similar to DLA type assessments.

      However, it might help with the arguments that are held by those who hold the purse-strings. Doctor’s letters are given a particular credence.
      Of course I agree about cutting back on cleaning/laundry. We have certain concessions made for extra time/money allowed with some specific health conditions which might necessitate more laundry/housework – like issues of incontinence or asthma (in terms of dusting in the home etc) – but it’s the kind of thing that may well vary massively from LA to LA – hence difficult to comment except responding how it is where I work (and honestly, my LA is quite generous compared to many so not necessarily a good baseline)

    • I think cleaning and domestic tasks are some of the most vital! Traditionally these services were widely provided to the elderly and frail – and indeed home helps (a wonderful term, perhaps we should return to this) provided all these services to new mothers as well.

      This is a disgrace – cleaning, laundry, basic domestic tasks – this is what is needed.

      • I guess the problem ultimately becomes that someone needs to pay for it. I think it’s extremely difficult to draw lines under what “needs” to be done and what “can” be done, but LA’s have to draw it somewhere as there just isn’t the money available to pay for everything.

      • Very concerning, though, when what needs to be done can’t be done.

  2. This is absolutely inhumane. I foresee a scandal brewing at some stage in the future where somebody is found dead and living in squalor.

    I also foresee that it’ll be the professionals who are blamed rather than those who cut the funding.

    • Thank you for posting this, it helps my understanding somewhat. Each time I read a blog of a SU affected by the cuts I wonder how many more cannot access the Internet and are living in neglect, I wonder how many are living near me and I wonder what I can do. I still feel that SW is not using it’s collective voice sufficiently enough to challenge.

  3. Yes, sadly this is the tip of a very large iceberg I fear! That’s why it is important blogs like this are here, your voices not only need to listened to they have to be truly ‘heard’ (this article needs to be in the Daily Mail or Express really to get the message out further). We have to change the tone of the debates around provision as well, everything keeps coming back to ‘who pays’ like some mantra! We as a society need to decide what we want to spend our money on, for me a decent welfare system is the mark of progressive society – i say this because throughout all of my childhood my family was dependent on benefits because my Dad was disabled in his 30’s and could not work – Is it really a case that we can’t afford or don’t want to afford? For example £9 billion on the Olympics or maybe some extra care for those most vulnerable…..I don’t know what the answer is but i do really feel we as a society have to be honest with ourselves, what do we want and are we willing to pay for it?

  4. Surely this is depersonalisation?

  5. I’m the person this article is referring to.

    I hadn’t written another post since the last one due to doing a little experiment. Over the period of a week, I did some of the things my carers do for me (nothing heavy as I’m completely incapable of that). As a result, by the weekend of that week I was basically bed-bound, very sick indeed; it took about 10 days to recover from it. That’s what I have to look forward to, and I only did a small fraction of the things that need doing. Eventually, like before, I will just have to stay in bed, and of course, whilst I’m bed bound I am able to do nothing else.

    The social worker said that she would contact me 3 days after our appointment to confirm what was happening, but I didn’t get that call until 4 weeks later (last Friday), on a phone I told her that I rarely used. I had a message saying she was on holiday now for 2 weeks. It’s disgraceful. It has made me ill worrying about my main carer who will lose her job. This carer needs to know where she stands in order to work her notice and search for another job.

    It has all been handled very badly, with not a thought for the consequences. I’ve been pro-active however. I’m sharing the shopping costs with a friend, and the only member of the family who is well will come and do cleaning and take me out occasionally, but she works alternate weeks in London and she lives some distance from me, so she is unable to do the vital daily jobs that need doing like laundry and tending to my multi fuel burners (my only source of heating and hot water).

    I appreciate that social workers are put in a very difficult position; it can’t be easy. But I think the most startling thing is that this assessor did not make me aware of my rights at all. I suppose the Local Authorities bank on that.

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