Making tough decisions easier

Published on 5 Aug 2014

While everyone wants to believe providing social care is giving service users what they need and ideally want, sometimes limited resources and other factors will mean that social workers may have to look at needing to cut people’s level of support in the name of fairness. Many disabled people fear, but not including myself, that the Independent Living Fund’s transfer to local authority control will result in a major cut of the support they will receive, including the possibility of being put into residential care.

I am not convinced this is going to be the case although I do believe one area that is going to be a bone of contention for some time is the provision of overnight care, and this can be seen with the recent court case under the Human Rights Act. I believe there are many reasons for overnight care such as from major medical needs to simply companionship and security. While ILF may have been happy to provide the later, I believe many local authorities will be less keen to do what they may regard as a non-essential call.

I think that when a council in put into the position of having to withdraw funding for a specific need, it is very important they consider how to present the situation to the service user. For example, it should never be simply a case of announcing the fact the council is unwilling to provide overnight care for this reason and here are some pads/nappies. It should rather be about fully establishing the existing reasons for the overnight care, and going through all the obstacles to withdrawing it one by one to see what alternatives may be found with some lateral thinking. This may include acknowledging and talking through the emotional issues of wearing pads/nappies as a precaution, or seeing what other equipment could be provided

I believe in trying to work with service users to reach the best solution for the money available in a manner that is open to creative ideas, it may make it easier for them to accept difficult decisions, because they had a real say in how the decision was made. The decision can also be made easier if service users are explained how their situation is compared to others ‘competing’ for the same resources, so that they are able to see the bigger picture and see the issue from the assessor’s point of view.

Engaging more with service users does not mean they will always be happy with the decisions being made about their support, especially when it involves cuts, but I feel it should make the tougher decisions easier to swallow.