It's a matter of choice: Making direct payments work in Staffordshire

Abstract

This article examines the responses and experiences of service users to evaluate one social services direct payments project. It brings together research findings from other schemes t o raise important considerations for practice in the operation of direct payment schemes around the country, whilst revealing some features unique to the Staffordshire scheme. It also has some relevance for policy making.The study highlights the many challenges to direct payment schemes: increasing the take up rate, ensuring all groups are included, making all disabled people aware of the direct payment option, the difficulties in recruitment of personal assistants, enthusing and training social workers and so on. The article makes suggestions for improvements in practice t o ensure greater numbers and diversity of disabled people can enjoy the many benefits of direct payments.

Keeping the cash under control: what's the problem with direct payments in Scotland?

“…However, suspicion from social work practitioners, fearful of job losses, has meant that the option of a direct payment has not been adequately communicated to potential users. These type of concerns from frontline social work staff have been highlighted across a number of studies both in Scotland (see Witcher et al, 2000) and England (Dawson, 2000;Leece, 2000;Carmichael & Brown, 2002). Although many authorities, CILs and support organizations like DPS have performed a vital role in offering training and information sessions for social workers, over the longer term, a fundamental change is required in the culture and understanding of independent living and disability for all social work staff.…”

Support workers’ mental health knowledge and confidence in relation to exposure, experience, work setting and training

“…Once almost exclusively supplied by the UK National Health Service, services are now provided via a competitive market based in part on cost, with implications for staff recruitment and training (Raghavan and Patel, 2005). Some contracts are with social services, others rely on service users' direct payments, and some utilise both (Department of Health, 2009;Leece, 2000;Lucas et al, 2009). Inevitably, there will be competition between care providers to price services as keenly as possible to improve their chances of being chosen by social services and individual service users, which may impact on salaries offered and the calibre and experience of staff recruited (Woodward and Halls, 2009).…”

Re/moving care : making care accessible through the Ontario Direct Funding program

“…The IL movement creates an employer/employee relationship through promoting direct funding. There is a surge of studies on direct funding programs, with the results overwhelmingly reporting that the programs are empowering and satisfying for service-users (Beatty, Richmond, Tepper, & DeJong, 1998;Blyth & Gardner, 2007;Caldwell & Heller, 2003;Centre for Independent Living in Toronto, 2010;Leece, 2000;Stainton & Boyce, 2004;Williams et al, 2003;Zarb & Nadash, 1994). Some studies, however, note that user-empowerment can vary substantially based on location or policy framework (Askheim, 2005;Barnes, 2007;Pearson, 2000;Ungerson, 2004;Ungerson & Yeandle, 2007 (Aronson & Neysmith, 1996;Watson, McKie, Hughes, Hopkins, & Gregory, 2004).…”

“…In the UK, there is a push from governments as well as the disability community to get more people on Direct Payments 1 (Barnes, 2007) with whatever supports are needed to make this feasible. The emphasis for the UK model is not on reporting, accountability and selfdirection, but rather on solutions to make Direct Payments suitable for different individuals (Leece, 2000;Maglajlic et al, 2000;Ridley & Jones, 2003). As I explore in the concluding chapter, the Direct Funding program is central to Independent Living in Ontario, almost shorthand for Independent Living, leading to substantial anxiety around the possibility of losing the program funding.…”

“…Do the programs target and encourage new and temporary Canadians to fill these jobs? When the selfmanagers have more control over who is hired they often hire by word of mouth or choose post-secondary students who benefit from an "ideal student job" but do newly Secondly, amidst the sea of studies documenting user satisfaction with direct funding programs in a variety of contexts (e.g., Caldwell, 2007;Leece, 2000;Stainton & Boyce, 2004) and a few studies that have begun to complicate those messages (Askheim, 2005;Pearson, 2000;Ungerson, 2004) there is a substantive need for studies that explore the "satisfaction" and strategies of people who remain on waiting lists for years, or who are ineligible to apply, or are rejected from a program. Further, there is a dearth of studies in Ontario exploring how people with intellectual disabilities and their families piece together pockets of individualized funding and how these experiences resonate with or differ from the Direct Funding experience, particularly the highly unregulated and undocumented individuals employed through these programs.…”