UNISON's
approach
We are in favour of flexible and responsive services which
are adequate to service user needs.
Government must develop a coherent
strategy for care services that reverses the cuts in funding,
staffing levels and increasing service charges.
The privatisation of services must
be halted and full cost recovery introduced for the voluntary
sector. The use of direct payments are appropriate
for some service users but this must not be used to cover
for shortages in other services – nor should the funding
of direct payments be seen as a choice between direct services
and direct payments.
BACKGROUND AND OUTLOOK
UNISON members working in social care believe in working
alongside service users to achieve the best possible quality
of life for each individual. In recent years their efforts
have been stifled by bureaucracy, mass privatisation and
ever tighter rationing of care.
UNISON supports the principle that everyone should have
as much independence and control over their own care and
support arrangements as is right for them. However the current
funding gap in social care means that the personalisation
policy is likely to over-promise and under-deliver, just
as care in the community did before it.
Free Personal Care
UNISON welcomed the decision to deliver free personal care
to Scotland's elderly population. However it
is clear that this initiative is under-resourced and is
heavily reliant on the traditionally poorly funded care
sector.
Free personal care for the elderly was one of the landmark
decisions of the first Parliament and there is broad public
support for it. In recent years the balance of care has
changed with a shift to more care at home. This brings out
a need for more clarity in calculating the cost of free
personal care. And more needs to be done to establish
how well it is working in practice, and whether it is delivering
what was promised. The work of the Care Commission
in registering and inspecting care homes also needs to be
examined.
We must back up public statements of support for community-based
health care with the financial resources. Terms and conditions
for voluntary-sector staff are lagging behind their role
and responsibilities and resources are often project based,
time limited and insecure. The Scottish Government must
ensure that proper funding is available both to resource
community-based services and to ensure good employment practice.
This should also apply to community-based mental health
projects in order both to improve accessibility to these
services and to increase local educational work combating
the myths and stereotypes affecting people suffering from
mental illness.
Direct Payments/Personalisation
Within the above context, direct payments to enable disabled
people either to purchase services directly, or to employ
staff directly, have a legitimate role. Disabled people
are entitled to make a positive choice to access direct
payments where this is the most appropriate method of service
delivery.
However, it should be recognised that direct payments are
not a substitute for other flexible and responsive public
services, and are not appropriate for all care service users
needs. Direct payments must complement a range of public
services and must not be used to cover for inadequacies
in public provision. It is inappropriate for direct payments
to be used to cover for shortages in other services where
the disabled person’s preference is not for a direct
payment. Nor should the way provision is funded be seen
as a choice between direct services or direct payments.
Where direct payments are the most appropriate method of
providing services, and are the choice of the service user,
the payment must be set sufficiently high to cover the cost
of a decent level of pay, training, and holidays, and to
enable that person to fulfil their other responsibilities
as an employer. In our view, this is not the case at the
present time.
As more people receive direct payments, the number of people
employed directly by disabled people as personal assistants
has also increased. These workers are entitled to expect
good conditions of employment, including the right to join
a trade union such as UNISON. Membership of a trade union
brings many benefits to the worker (such as access to advice,
support, and representation). But it is also beneficial
to the good employer in fostering good industrial relations
and enabling access to training in order to develop the
union member’s skills.
Registration
We believe that all staff who are involved in carrying
out tasks which can substantially impact on patient health
or welfare should also be regulated to ensure protection
of the public and the continued maintenance of high standards
of care.
UNISON Scotland recognises that there needs to be a system
supporting the development of flexible, multi-skilled staff
working across traditional professional boundaries and across
specific care settings.
UNISON believes shared standards of competency, fitness
and conduct and would support the development of a collaborative
framework between regulators in both health and social care
in order to extend the protection of regulation without
setting unnecessary barriers to staff movement.
The Establishment of Social Care and Social Work Improvement
Scotland (SCSWIS), could- assuming issues regarding the
restructuring of existing bodies can be resolved - be a
positive development. We believe that rigorous regulation
of services, such as child protection must be undertaken
by professionals who are able to ensure that such services
meet the standards outlined by the Scottish Government.
UNISON would urge that it should incorporate a duty for
all employers, in the public, private and voluntary sectors
to be bound by the SSSC Code of Practice
KEY QUESTIONS
How do we ensure that personalisation is about improved
services rather than cheaper services?
How do we prevent personalisation being used as an excuse
to drive direct payments?
How do we make the case that direct payments should complement
and not replace direct services?
Draft published: 5 December 2009
Current version updated: 20 January 2010
Members and branches can help to develop these
policy ideas further.
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