Examination of Witnesses (Question Numbers
380-399)
MS LIN
HINNIGAN, MR
ALLAN BOWMAN
AND MS
ANDREA ROWE
12 NOVEMBER 2009
Q380 Chairman: In turn, do you think
that has improved the quality of care?
Ms Rowe: It is very difficult.
Qualifications are a proxy for skills really. There is a lot of
research that says the more employers invest in their workforce
development then the likelihood is their services are better.
You have only to look at high achieving businesses in other sectors,
private business, they invest in the qualifications of their workforce
and deliver very good services if you think of Marks & Spencer,
John Lewis, big companies like that. There is a lot of research
that that is so. In terms of the contribution, David Behan once
described social care as the data desert. We knew very little
about both the employers and workforce in social care, so we set
out to improve that data. Because we are a Sector Skills Council
we have responsibility for providing world-class information on
the sector. We set up this database called the National Minimum
Data Set for Social Care and we now have about 80% of the registered
providers who are registered on our database and they have begun
to register their individual staff on this database. Into the
data warehouse we are also pulling all the other research that
goes on that is funded by LSC and the Government so there is one
place where you can look for the data on social care. That is
still a work in progress, but I pride myself that it has not cost
anywhere near the databases that there have been in health. It
has not crashed. We are working with a very good provider in that
and it is progressing very steadily. Where we have maybe not done
as much as we could and that may lead to poor quality care is
we have not been as strong, if you like, about a career framework.
If you look across at health and their skills framework, it is
very clear. It has always been difficult because of the opportunities
to progress in social care and we know this has an impact on retention.
Retention is a problem. The turnover in the sector is running
at about 18.3% across the whole and that is very poor. We do know
that not having a good career path is a problem. I think with
personalisation that is going to become an even bigger problem
because if the personal assistants do not have training then they
are not going to be on any kind of framework and progress. That
is going to be an issue in the future.
Mr Bowman: SCIE as an organisation,
unlike many others, covers the whole of the UK and, uniquely,
we are also a charity. I will not go into the technicalities of
why we are a charity. We cover children and families as well as
adults and in that sense we are quite uniquely placed to draw
on sources of information from across the United Kingdom. Our
main function is to identify what works, why it works and to translate
that into the kind of successful guidance that people can put
into practice and use across England, in particular, for what
we are concerned with here. The issue for us is that we need to
put that in a format that is readily accessible. In fact, last
month we launched—we did not dare call it Sky TV for obvious
reasons—Social Care TV, which is an online television channel,
a different way of trying to get to a sector. We have got 35,000
employers of varying sizes and a workforce of about 1.5 million.
We may have a more limited number of commissioners in local authorities
than health but we need to get to all of these people in different
formats that enable them to use what works. One of our big focuses
is to ensure that when we say what works, it is what works for
the people who use the services. We road test everything we recommend
very carefully before we produce guidance. That focus on the views
of users and carers in terms of the outcomes that they want very
much guides the advice we give. When it comes to the issue of
do we have any responsibility for poor social care, I think the
challenge for us is to get out to that very diverse workforce.
Our main focus is how can we get to those parts that we do not
reach currently: do we need to change the way we provide the information;
do we need to make it much more accessible. We go out and take
a great deal of stock of what people say they need in terms of
accessible information and are guided very much in that by a whole
range of stakeholders, providers, users, carers and local authorities,
and we work very closely with that range of people to try and
produce for them something that is useful.
Q381 Chairman: And improve the quality
of care?
Mr Bowman: And improve the quality
of care. As you would know, in social care there is very often
no one way of doing things, there are several ways. We want to
encourage innovation. We help people assess the new ideas and
approaches in terms of "Does this actually work?" As
the Care Quality Commission is trying to do, we encourage people
to take responsibility for what they are providing and help them
assess and evaluate whether it is genuinely producing better outcomes.
Ms Hinnigan: The General Social
Care Council was established in 2001 specifically to raise the
quality of care through regulating the workforce. Currently we
only register social workers, so it is only one part of the social
care workforce, and we regulate their training. I think it is
important to say that we are a young regulator and in the development
of the profession as a regulated profession it is quite early
years. In setting up the register it became an offence for you
to hold yourself up as a social worker unless you were appropriately
qualified and on our register. That meant we had to define the
population and their requirements to get onto the register. Then
we created the codes of practice for all social care workers which
set out the standards of conduct expected from them, and we hold
social workers to account on that. That is an important part of
public confidence and raising quality. We regulate the training
of social workers. Social work became an all-graduate entry qualification
with the beginning of the new social work degree in 2003. Again,
that has raised the bar for the quality of entrants and quality
of training and has put it on a par with nursing and teaching,
for instance. Social workers do an immensely difficult job in
very demanding circumstances and many of them work to very high
standards and help to keep individuals and their families safe.
There is more to do and we have set out to the Social Work Taskforce
ambitions where we can do more as a regulator and we intend to,
both in terms of quality, the robustness of our regulation and
inspection of initial training, and in terms of what we demand
of social workers in their continuing professional development.
I would describe as fairly embryonic the requirements at the moment
that every three years social workers have to re-register and
demonstrate that they have done a minimum of 15 days'—90
hours—continuing professional development. The requirements
of that need to be more robust, we need to focus people much more
on particular requirements and levels and standards. There is
more that we can do and we propose that we should do in that respect.
That is our major contribution to pushing up the skill level and
quality of social workers. It is really important to recognise
that when they complete their first degree that is really only
the beginning and as a professional you need to carry on learning
and increasing your competence and adapting as new challenges
come along, as indeed through the personalisation agenda social
workers need to adapt to that and we need to keep them up-to-date
and progress that.
Q382 Chairman: Last September the
Government commissioned a "delivery chain review" of
all three organisations that allegedly was going to be published
in December of last year. We are now into November and it has
not happened. What is your understanding of the situation and
the reason for the delay? Lin, you mentioned the Social Work Task
Force. Does that review fit in with the Social Work Task Force
at all?
Ms Hinnigan: It is important to
say that the social care landscape has changed considerably since
we were established and, therefore, as GSCC we welcomed the opportunity
to review the role of the different bodies and to see whether
together we had the right sort of architecture to deliver Putting
People First and, indeed, Building Brighter Futures
on the children's services side. Also I should say that we cover
social workers in children's services as well. We welcomed it.
Our understanding is that the review was completed in terms of
the review team having made their findings but, given the Social
Work Task Force being established, it was right for Government
to wait until the outcomes of the Social Work Task Force because
that will define what is the task. I think that is going to lead
to a radical reform of the social work profession and will define
much more clearly what are the tasks of social workers, how should
they be trained, supported, particularly what sort of role employers
play in supporting social workers in order that they can deliver
the agenda in Putting People First. It is right that we
should wait for that outcome and look at the totality of the task
and then say what bodies are needed in order to deliver that and
support social workers in that role.
Mr Bowman: Certainly the arguments
around the Social Work Task Force have been a good reason to delay
and look at things that are important. There is one other factor.
Within the Green Paper there is a recommendation that there be
an independent source of advice, hopefully it might well be from
SCIE, in terms of adult social care. Things like that will impact
on what the landscape will look like in the future, so it seemed
sensible to look at all the likely directions and then to bring
forward recommendations. On the Social Work Task Force we are
looking at over 80,000 or 90,000 social workers and we have provided
a great deal of information and advice about how social workers
should do their jobs more effectively. Again, we would want to
look at how we would play into that in terms of whatever recommendations
may be made, perhaps in a National College for Social Work.
Ms Rowe: The Social Work Task
Force is a very important body that we have contributed to. We
have provided quite a lot of the regional planning around the
post-qualifying social workers, so regional planning of numbers
and working with the supply side. Also, we provide the National
Occupational Standards that underpin social work. Within the Sector
Skills Council we have got our partners in the three countries
and the Children's Workforce Development Council, so that is where
we do the work that crosses all the different bodies. I suppose
for us the review was more about us not being a Sector Skills
Council, if you see what I mean. We have a whole life, which is
the Sector Skills Council, which somehow seems to escape the Department
of Health's mind occasionally. We often have to tell the Department
of Health what DBIS and DCSF are up to and link it into their
strategy. The review has been difficult for us. We had work to
do in promoting what we did at the beginning of this because we
had been busy doing what we had been doing and not being outward
facing so much, we had been getting on with the regions and doing
the work, but suddenly the Department, I think, found out what
we do and liked what they saw and that has caused them to think
again. For us, one of the difficult things is the Skills Academy
because having made a proposal to set up the Skills Academy within
the SSC—twice—the stumbling block was that we could
not get employer buy-in and could not use our DH funding as proxy.
That changed and that was what got the funding for the Skills
Academy. We have accepted that it was set up as it was and the
DH, after pressure from us, have made the boundaries clear between
what they do and what we do. They are focusing on leadership,
management and commissioning. We have handed that work over as
far as we have done it. Ideally, within Skills for Care we think
that the Skills Academy does fit within our structure, and that
is what it does with other Sector Skills Councils.
Q383 Chairman: It is a little bit
of a confusing picture. Do you think we have too many quangos?
Let me just qualify that because this is not numerical. This is
about whether or not the roles that there are that each of these
institutions have get confused and if there is the potential for
confusion about who is responsible for what it does not seem to
me that is good for the workforce or anybody else for that matter.
Do you think this is an issue?
Mr Bowman: When our organisations
were established, and CSCI was one of the organisations established
at the time, there was a real problem with the alphabet because
a lot of them sounded too similar and that did not help anybody.
Of course, no sooner was CSCI about to come into existence than
its transformation to CQC was announced. What we have is a relatively
new set of developments in social care that are long overdue.
When our organisations were established that was a very welcome
and very comprehensive strategy to shift social care into the
forefront of provision and consideration. As with everything else,
things evolve over time and the National Skills Academy is now
part of the landscape but was not there when the review began.
We are seeing things evolving and developing, but I do need to
put it in something of a numerical context. I do not think we
are over-provided with organisations in social care compared to
health or education.
Q384 Chairman: Is there any overlap?
That is what users are going to look at.
Mr Bowman: That is one of the
things that this review, when it is eventually published, will
help us clarify. It is quite a favourable review, having seen
the draft, but inevitably with organisations there are functions
that one may be doing that might be better done by another. We
have to see that as a normal part of evolving. The issue is, however,
are we able to work together effectively whatever we do. I would
argue that we have worked effectively and we work now with CQC.
We try to manage that landscape and the overlaps rather than get
caught up in structural and boundary issues, and you can see the
products of that in some of the things that have come forward.
The Centre for Excellence now comes in children, for instance.
I could have argued that should have come straight to me as SCIE
but then we would not have had onboard a whole range of other
organisations which made that a better set of structures. It is
that capacity as a relatively large number of organisations to
work together that overcomes the potential for confusion that
could arise.
Q385 Chairman: I saw some nodding
heads when you were saying that. Has anybody got anything to add
to that specifically?
Ms Rowe: It is really important
for employers to hide the wiring. They do get confused if you
describe it all, particularly the SSC with six organisations.
Effectively, for the employers in adult social care we are the
SSC in England. That is what they know and that is all they need
to know. Similarly, with our set-up we have got better at describing
all the work that we are all doing and how it fits together in
a whole, all the pieces of the jigsaw. We get onto platforms and
we are always amazed at how much it does fit. I am with Alan in
saying I really do not think with a workforce of over a million
that we have got too many bodies.
Ms Hinnigan: I would absolutely
endorse the fact that the partnership working across us is very
strong and, therefore, while there may be some potential for duplication
and overlap, we make it work. I think there is an issue about
needing to clarify that particularly for the sector so they understand
who they need to come to for what and where things come, but the
quality of the work that we get out because we are engaged with
numbers of stakeholders, not only our own bodies but other bodies,
benefits from that. The Social Work Task Force is saying there
is a gap in the bodies in terms of a gap for a body to be a strong
voice for the profession and a champion of the workforce. We,
as a regulator, are very clear that we are not a champion for
the workforce. There is a really clear role for a regulator which
is strongly focused on standards in practice and in training,
and that must be separate from the voice for the workforce.
Q386 Dr Stoate: Lin, you did say
that one of your tasks is to hold to account social workers and
what they do, yet a report last week by the Council for Healthcare
Regulatory Excellence found serious failings in management and
in particular found that you had been deliberately stalling investigations
into social workers in order to save money. What are you doing
to try and address that?
Ms Hinnigan: That is a report
that we obviously take very, very seriously and take very seriously
our role in respect of public protection. We began to identify
the difficulties in our conduct operations when we brought in
a new interim director of regulation last April. As we began to
uncover those we drew them to the attention of the Department
of Health and put in place a recovery plan that was there in its
first form in July before CHRE even started. We very much welcomed
that and, indeed, our Chair had invited the CHRE to come in and
do that report. The things which they have recommended of us in
terms of operational conduct matters are things that we already
had in train and have made significant progress on. For instance,
we have over 100 interim suspension orders where we believe that
social workers may represent a risk to public protection and,
therefore, they have been stopped from working. We have no cases
unallocated as of the end of last week, although there may have
been one or two that have come in since. We have revised our risk
assessment framework. We have raised our threshold for risk assessment.
All cases are risk assessed within 24 hours. If we believe there
is a public protection issue those are referred to a committee
for consideration of an interim suspension order within 48 hours.
We have brought in external casework specialists, expertise, and
brought onboard nearly 50 external investigators with investigatory
skills, people like police officers, et cetera, who have experience
investigation so that we can use them to help get rid of some
of the older cases. All of the older cases pre-2008 will be dealt
with by the end of March. We have that flexible resource now to
enable us to do that. We are very confident that we are on top
of the issue. There is a lot more work still to be done to make
sure that the conduct operations are on a sustainable basis going
forward and we need to revise the way in which we work. There
are some recommendations that we welcome from the CHRE around
changes to our powers, et cetera, but in terms of the immediate
casework issues we are very much on top of those.
Q387 Dr Stoate: Obviously that is
very reassuring indeed, but it does rather beg the question of
how you could have let literally a backlog of, at one time, 700
unallocated cases build up that had not been dealt with, including
a number of public protection cases. It does make me wonder how
that situation could have arisen. I am very pleased with what
you said about what is happening to put it right, but how did
you get into that mess?
Ms Hinnigan: There were probably
a number of factors, and I have to say neither the Chair nor the
executive team have knowledge because we were not there at that
time, so we are not able to explain exactly what happened. It
was clear as we began to uncover the problem and it was clear
from the CHRE report that a very significant factor was lack of
appropriate, robust management information so we knew what was
happening. We were getting certain indicators around certain aspects
of the process reported but it was inadequately robust to enable
us to properly manage the caseload.
Q388 Dr Stoate: We just have to hope
that it has now been put right.
Ms Hinnigan: That has been put
in place.
Q389 Dr Stoate: One of the recommendations
in the report was that you should move to a system that effectively
considered fitness to practise rather than conduct. How do you
feel about that?
Ms Hinnigan: It is certainly something
that we are keen to work with the Department of Health to explore.
It will be a significant change in role because at the moment
we look at conduct. To look at fitness to practise and competence
implies quite a significant shift. We need to be very clear about
what professional standards are at particular stages for particular
roles. We need a lot more work, which we hope the Social Work
Task Force will move us towards, around defining exactly what
you should expect of a social worker in particular roles at particular
stages of their career. The other thing we would need, and again
this comes out from the CHRE report, is a wider range of sanctions.
At the moment we are only able to remove somebody from the register
or suspend them or give them an admonishment. In order to have
an effect on competence we really need the ability to set conditions.
In other words, "You may only work in a certain case. You
must undertake certain additional training or whatever before
you can be allowed to work in certain cases." That enables
us to lever up quality. We do not have those powers at the moment.
There are a number of factors to be addressed and it is not a
simple matter but something that we are positive about exploring
with the Department.
Q390 Dr Stoate: It only brings you
up to where the General Medical Council is, for example. They
have been doing exactly that in terms of fitness to practise and
conduct and making recommendations and sanctions, particularly
around extra training and so on. There are plenty of examples
of models out there.
Ms Hinnigan: There are models,
particularly models for medical professions. A slight caveat is
that many experts in the social care field would say that one
has to be a little bit careful about translating medical models
directly into social care, they may not be so easily transferable,
and that is what we need to look at. In terms of setting standards
for competence, that is something which we think would help to
raise standards.
Ms Rowe: We should recognise that
the domiciliary care sector and employers had got really fired
up to register homecare staff. Although there was lots of debate
about it, there was this energy there. I am anxious that we do
not lose that and we work with the employers to see whether we
could come up with some kind of recognition. I have held a long-term
belief that, like the Health Service, we do not have the nursing
profession that is like the mean running through the whole workforce
and you identify the NHS in other nurses. Social workers have
never been like that in the social care workforce, they have always
been the elite doing something different from the social care
workforce. Our mean is around Level 3 and Level 3 is mainly in
the domiciliary sector. There is worth in exploring some kind
of employer recognition because I think it would be a real shame
if that workforce got the message they are not worth registering
because of the difficulties that have happened. This would be
a way of not pre-empting what the GSCC might do in the future
around regulating it, but it would be a stepping stone and would
not lose that energy.
Q391 Charlotte Atkins: Mr Bowman,
what evidence do you have on how much personal budgets are now
being used?
Mr Bowman: I have got some figures
that were produced relatively recently. In March 2009 some 93,000
people in England were using services and 41% were older people.
What that translated to across England was that was 8% across
all local authorities with a wide variation from 1% through to
31%. There are some interesting developments. A recent survey
carried out by ADASS said that they should achieve the Government's
target, which they agreed with ADASS, of 10% of people receiving
personal budgets by March next year. They believe that puts them
on target to meet the 30% April 2011 target. That is because by
October all people are going to be offered a personal budget at
the point of assessment. There is a fairly strong direction of
travel established and with all the necessary pieces in place
it does look as though the targets will be achieved. The issue
with personalisation is do you have the infrastructure to support
it, because we do not want simply to say, "Yes, we have met
30%" but 30% of what. You need to have the necessary support
available in each community to enable people to access personal
budgets and to use them well. Local authorities need to ensure
the range of provision is there. There is no point having a budget
if you cannot buy what you need. There is a whole range of activities
that local authorities are engaged in. It is not just about meeting
the target but changing the way services are provided. As we heard
earlier, that is against a background of threats and reductions
to budgets.
Q392 Charlotte Atkins: Are there
big variations between areas?
Mr Bowman: There are big variations
between areas. These are being addressed particularly at regional
level by the Department of Health, who have their own regional
directorates, but also through ADASS where I think the directors
have seconded one of their number to work in the Department with
a view to achieving this transformation in a uniform way across
the country. Drawing on the best practice where some people are
doing it, you have to ask the question why their next-door neighbour
cannot do it. When you come to our role in terms of dissemination,
if we identify good practice in one authority then whether working
at regional or national level we are endeavouring to help people
do what is done elsewhere and to get the benefits that those authorities
have been able to identify.
Q393 Charlotte Atkins: Is it possible
to further break down those figures that you gave us and tell
us what proportion of personal budgets are taken as cash direct
payments?
Mr Bowman: I do not have that
information in front of me. I imagine it would be possible. The
point was made earlier that we need to be very careful about personal
budgets. The fact that somebody gives you a pot of money and leaves
you to get on with it is not the case. Some people want that and
will be perfectly capable of getting on with it, but a lot of
personal budgets are made up of a range of services that are administered
by the local authority to meet an individual's aspirations. It
will be interesting to compare the elements because some of these
will be part cash, part kind and others will be wholly cash and
others wholly a range of different provision from different sources.
Q394 Dr Naysmith: Lin, if I could
quote from your memorandum. You say that social workers' skills
and knowledge will fit them to "take on the new roles aimed
at supporting people to design their own care packages" and
supporting service users' families. However, the Director of Community
Services at Lancashire County Council has suggested that personalisation
could mean service users being left to their own devices, sounding,
as he says, "the death knell for social work". How can
you be confident that he is wrong and you are right?
Ms Hinnigan: Our submission that
social workers have an important role to play is based upon the
training and skills they have and develop and the values that
underpin their training, which is around helping individuals to
get the best value out of their lives to achieve the things they
want to, which absolutely fits with the choice and control and
personalisation agenda. Listening to the first set of witnesses
this morning, Dr Stoate asked the question about how do we ensure
that there is more personalisation and I was thinking absolutely,
that is where the role of the social worker is. The social worker
can support the individual to help them think about what their
needs are, to help facilitate the assessment, to help them make
decisions about what is the right sort of package for them. The
brokering skills, the advocacy skills are absolutely the skill
set of social workers. I know that amongst the directors of adult
social services there are indeed varying opinions about how personalisation
will affect the mix of staff and what the role of social workers
will be in that and in remodelling the workforce we need to make
sure that we use the skills of different parts of the workforce
to the right effect and in the best way possible. That is exactly
where I see social workers, they are part of that mix. That mix
will change and the roles are changing as the personalisation
agenda develops, but I am confident there is a critical role because
of the skills that social workers can bring to that and the ability,
therefore, to make the personalisation agenda deliver the vision
that is Government's intention.
Q395 Dr Naysmith: Do you think there
are currently enough social workers with these skills who have
been exercising them enough recently to be good at using them,
or have we got too many of them? I suppose we could look at it
the other way round as well.
Ms Hinnigan: Whatever changes
may be going on locally, the vacancy rates do show overall there
is 10.9% of all posts vacant, 13% in children's and 12% in adults.
The LGA released research this week around children's services
saying that 60% of councils are experiencing retention difficulties.
The idea that there are too many social workers around does not
seem to be borne out by the evidence. In terms of the skill sets,
because of changes to the way in which social workers have worked
some of them do feel they may have lost some skills in terms of
they have been more in a rationing role. Again, I revert to my
earlier theme around continuing professional development. We need
to ensure that social workers are skilled up through their continuing
professional development to develop the particular skills they
need for personalisation. I think they are there in their basic
core skill set but may well need refreshing because they have
been using them in different roles recently.
Q396 Dr Naysmith: I think we heard
from a witness either last week or the week before that she felt
this would enable her to return to what she had been trained for
as a social worker.
Ms Hinnigan: Absolutely.
Q397 Dr Naysmith: You would agree
with that?
Ms Hinnigan: That is a very common
message you get from social workers, that they see real opportunities
to return to what brought them to social work around helping and
empowering people to take control of their lives.
Ms Rowe: We are doing a piece
of work with the Department of Health and the Association of Directors
of Adult Social Services to define the roles and tasks which is
due to report very shortly. In a sense, this will take a leadership
role through the project to bring those directors who are perhaps
out of synch with that into the fold.
Q398 Sandra Gidley: This is to Alan
Bowman. Your memorandum refers to "concerns about the wider
consequences of expanding numbers and roles of personal assistants",
including "the emergence of unregulated `grey' markets, the
effects of migrant labour, quality assurance and employment and
training conditions". It would be helpful if you could elaborate
on some of that.
Mr Bowman: I think some of the
ground was covered in the earlier discussion with UNISON in particular.
There is a real issue about the tension between people's aspirations
in terms of employing staff directly and the regulation they are
safeguarding. As quoted, my predecessor, Baroness Campbell, is
very strong on wanting to retain independence and choice. The
issue is about informed choice. It is all very well employing
someone with a criminal record but you need to know that they
have it, you need to know what they have done, and you then need
to make that decision yourself. We do have to respect the very
strong wishes particularly of working age adults to be very firmly
in control. They have often felt badly let down by publicly provided
services before and feel if they relinquish that control and their
own authority over it that somehow they will be at risk again.
The local authority, as we have heard, has a responsibility, a
duty of care, so it cannot simply run a free-for-all. My experience,
and this applies in some ways to personal budgets, has been that
if you simply hand people money the chances of that working are
very, very limited. If you try and provide services on the basis
of you know best then the chances of them being happy with these
services are almost nil. There is something about bringing the
skills and expertise of the professionals who assess the role
of the social worker, the people who provide services, commission
services, in partnership with those receiving them. If you begin
to get that kind of co-production or co-working right then the
issue about the risks of a potentially unregulated market will
diminish. It is right to flag up there is that potential. As personalisation
develops and goes on, we do not know what other forms of provision
people might choose to access and how that might be provided.
There is likely to be considerable interest in self-provision
or self-help from a whole range of groups working as co-operatives,
or whatever, and we need to be alive to the fact that these are
good innovations and we need to help them manage the risks in
these innovations because usually they are about people taking
control of their own lives and getting a better deal than they
had before.
Q399 Sandra Gidley: I do not quite
understand where migrant labour comes into it though.
Mr Bowman: That has been an issue
in certain parts of the country about the costs of employment.
We do not know what skills or backgrounds people have. My own
view would be that was a temporary phenomenon as particularly
immigration from Eastern Europe reached quite a high level and
people were coming forward to do jobs when others were not offering
to do these jobs. My view would be that as we move through and
mature, in a sense, in our relationships with migrant workers
we can begin to look at opening that up, and there are particular
opportunities being opened up to migrant workers to train in residential
care, in supporting people as personal carers and domiciliary
care, but we probably did not react collectively quickly enough
to the issues and implications of that.
Ms Rowe: Can I just add that one
tends to see personal budgets and direct payments as being a personal
assistant and a service user, whereas the reality is it is a service
user and quite a body of personal assistants through the night
and working shifts. Employment issues are really key. The service
user does need to be confident that they are acting as a good
employer and even if they do not want to be seen as an employer
they need to be able to manage that risk as well. Also, I do think
that if service users invests in development, and I do think they
intend to do this because many of them want their personal assistants
to have development opportunities, it is how that happens that
they find difficult and where they are going to get the funding
from for doing that. At the moment they can get personal assistants
quite easily, but I think that will change and it will be more
difficult. A lot of the personal assistants now are trained and
inducted into the social care sector by the local authorities
but it will cease to be like that and that is going to store up
problems for the future.
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