What should care packages cover?
The Care Act 2014 makes it clear that the aim of care is to promote disabled person’s wellbeing; it is no longer sufficient for care to be restricted to covering a person’s basic needs of personal physical care. Now, Care Act Assessments covers a whole range of eligibility needs that includes the maintaining of social relationships, accessing and participating in the local community and so on. It’s through purposeful activities with shared interests that friendships and relationships are formed between humans. The legislation allows Local Authorities to not only fund social care provision but also activities that will meet Care Act assessed need within a disabled person’s care package. In a legal briefing, examples covered gym membership and attending a place of worship; activities that are just ordinary, ones that many people partake in without LA financial assistance. This led me thinking about to what extent local authorities’ should be expected to pay for activities and what should disabled peoples benefits cover. Does this promote choice and control, or paternalism – after all it is LAs that will make the decision what activities will meet the disabled person’s assessed needs? Further, does it infantilise the disabled person, where they see no need to take responsibility for paying for activities, even though they are on benefits at a higher level than their non-disabled peers in similar circumstances?
However, I have heard the argument that LAs once provided day services, day centres or other subsided services, which were all funded out of their social services budgets.
Since the introduction of personal budgets and direct payments, many disabled people have opted to create their own plans of structured activities such as taking up paid employment, being a student or engaging in a wide range of community activities. For many disabled people they would use wages and benefits to pay for their own activities. But, what happens when there are few activities that are inclusive of all, what should the LA’s role be? Many disabled people still continue finding it hard to feel welcomed by mainstream activity providers, whether that is the local leisure centre, adult education class or cinema and alike. Many mainstream activities are structured around the needs of the non-disabled population, for example dance and general fitness classes are designed and set at a pace of non-disabled people with few mobility or coordination difficulties.
It was expected that the market will pick up the services and facilities that once were provided by local authorities. Both private and voluntary organisations will arrange opportunities for disabled people. In the early days of community care revolution, post NHS and Community Care Act 1992, Local Authorities and grant giving organisations would fund both national and local organisations to arrange opportunities for the local community. Stars in the Sky, Heart and Soul, Action Space and Gateway are amongst various organisations that would organise a network of dating and friendship, night club nights, arts events and social groups for people with learning difficulties. However, since the beginning of the decade, things have changed with fewer stable funding streams and short-term project funding, the number and range of opportunities available for disabled people has declined. Many organisations are operating market principles in their financial modelling recognising that chargeable fees can be much higher than similar activities for the general population. Activity providers are covering all costs including private accessible venue hire, additional support staff, specialist equipment, transport and parking fares and so on, which often means that the fees will be higher than similar activities provided for the general population. Such costs would have been bared by the state when community activities were financially subsidence and arranged by publically funded institutions in their venues such as the local adult education institutes and community centres. Given that there are very few mainstream activities that some groups of disabled people such as those with learning difficulties are accessing and where many of the specialist leisure activities are unaffordable for those on limited financial means, the question is what should the LA’s role be in ensuring that they promote the wellbeing of disabled people?