Personalisation…..Inevitable Abuse?

The government’s Personalisation Agenda is currently under way, and at a swift pace I must add! But what exactly does this mean for us all? And perhaps more importantly, how does this affect the safety of Service Users in the community and the standards of care being delivered?

Notwithstanding the above, do I see a potential safeguarding issue on the horizon? Yes – and I don’t think I am the only one.

The personalisation agenda offers an opportunity to make home care (and other services) more responsive and flexible so that it is actually doing what people who use services want and need, rather than being constrained in rigid tasks and time specifications. There are, however, some unintended consequences for service providers, especially home care providers, which could spell large-scale destruction of the sector.

Let me be clear, I believe in the overall approach, but in my opinion, the speed of implementation and lack of control on spending are simply out of tune with the needs of the service users.  Personalisation is a way of promoting choice within the provision of care services, but when choice allows service users to employ friends, family members, strangers, or to even spend the funds on non-care related items or activities, suddenly the overall picture of homecare changes.  Targets mean rapid changes, and capacity issues within Regulated Services due to this pace, will no doubt force more unregulated care provision in the community.

Opinions vary. Mine are without prejudice and quite simply I have huge concerns over the speed of uptake of personalisation, the huge targets set for the individual Councils regarding the implementation of the personalisation agenda, and of course, what this spells out in the short, medium and long term.

Community care for the elderly is without question cheaper to deliver than residential care.  The average costs for the delivery of homecare vary dramatically dependant of individual needs, however the abundance of “pop in calls“ provides a cheap way of meeting the “ Basic “ care needs of the Service User, but shouldn’t a care service offer more than this?  In my experience, cheaper does not necessarily mean better.

I believe the fundamental ideas behind personalisation are correct: personal choice is without doubt an important improvement to the delivery of care in the community. But this must not come at a price where quality and safety is concerned.

There are a significant number of carers working as personal assistants through the personalisation agenda, without relevant training, supervision or CRB disclosure checks to validate suitability!  Are risk assessments, ELP’s and care needs assessments becoming a thing of the past?  With no CQC regulations to adhere to, this is likely to be the case.  Standards are achieved because consequences exist for non compliance, poor performance and lack of value for money.  It goes without saying; if rules and regulations do not apply…..they simply will not be adhered too.

So does personalisation really mean choice?  If choice promotes the deterioration of Quality, is it really a positive outcome?  Indeed does it highlight some real issues surrounding potential abuse through unsupervised care provision by non-regulated services and personal assistants?

Domiciliary care agencies with sufficient management structures, supervisory support and clinical experience still have difficulties surrounding capacity and safeguarding in the community. Are we simply passing on the inevitable issues of Financial Abuse, Safeguarding Incidents and poor practice to the service users themselves by pushing the agenda at such a pace?  I’m inclined to believe that rapidly introducing a system, where quality benchmarks, supervision procedures, adequate training and suitability checks are no longer required, indeed spells out trouble, not choice.

If choice and responsibility is shifted away from the Council services, and placed in the hands of the individuals at such a pace, where will the advocacy service’s that are needed to assist with these decisions come from, and who will pay for it?

Charities such as Action On Elder Abuse that provide such services are having funding withdrawn, not increased!

Food for thought in my opinion, but what do you think? Have I missed something?

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