SUBMISSION FROM SOCIAL WORK SCOTLAND TO THE SCOTTISH PARLIAMENT’S HEALTH, SOCIAL CARE AND SPORT PARLIAMENTARY COMMITTEE
12 January 2024
INTRODUCTION
Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We very much welcome the Committee’s scrutiny of the Social Care (Self-directed Support)(Scotland) Act 2013 (the Act), at this critical juncture in the development of social work and social care policy in Scotland.
The reflections within this response are drawn from consultation with our membership, which covers senior leaders, including Chief Social Work Officers, service and team managers from across Scotland’s local authorities, and from consultation with our Self-directed Support project partners which include a wider representation of frontline social work views than our core membership.
In the following paper, we address the question:
‘Please tell us what you, or the person you represent, think about the implementation of self-directed support to date.’
and a three further subsidiary questions asked in the stakeholder engagement sessions:
‘The current picture of Self-directed Support – What does Self-directed Support looks like to individuals in receipt of care in 2023, considering the pandemic and cost of living?
Improvement plan 2023 to 2027 – How does the Government’s new improvement plan deliver the original aims of the Act where earlier plans have not?
Monitoring and evaluation – How is Self-directed Support currently monitored and evaluated?’
We work closely with colleagues from all local authorities / HSCP who are implementing Self-directed Support locally within a Community of Practice, and equally closely with national stakeholders who have come together voluntarily to form the National Self-directed Support Collaboration. Amongst colleagues there is a strong sense of purpose and a shared understanding of the implementation gap between the legislation and policy as it was originally envisioned and intended, and the practice as it happens today.
Social Work Scotland has contributed to several consultations – notably the Social Care Inquiry (20 February 2020), and the Independent Review of Adult Social Care (6 November 2020)1 – in which we expressed our continued commitment to Self-directed Support, and laid out our concerns arising from the experience of social work leadership and practitioners about system constraints and failures.
Collectively, we have mapped the implementation gap. We broadly know what is and is not in place, what is working well and where, what parts of the system need to change and what improvement work needs to be supported. But the environment in which we are trying to realise Self-direct Support is very complex, and over the years attempts to simplify the issues have often further compounded the complexity. The Act is a progressive policy that seeks to give more choice and control to those receiving services by transferring control over decisions about support and personal budgets to supported people / carers. We should not underestimate the significance, and scale of challenge, or what such a change represents for local government and integration bodies, with cultures based on decades of different ways of working. A Self-directed Support approach to people’s healthcare, by means of comparison, seems many years away.
The different roles of social work and social care in Self-directed Support should be made clear at the outset. The transfer of choice and control is mediated through professional social work practice undertaken by registered social workers or social work paraprofessionals (collectively referred to as social work practitioners) working within social work teams or multi-disciplinary teams within local authorities or integration authorities. Social work practitioners undertake assessments of need and the development of support plans which may include paid-for social care provision. Social care encompasses a range of services to meet needs, including personal care and other support to uphold the human right to independent living2, is provided by a mix of providers, including some in-house local authority social care but is usually commissioned by the local authority from third sector or private sector providers. Social care can be provided under all the options in the Act. Personal assistance is the term used to refer to the direct employment of workers by supported people under option 1 of the Act.
