Councils are operating tighter eligibility thresholds for adult care than they claim publicly in order to manage cuts, an adult care director has claimed.
Some authorities have in practice raised their threshold without formally deciding to do so, claimed Ian Anderson, director of community services for Isle of Wight Council.
Anderson was defending the Isle of Wight's decision to raise its threshold from substantial to critical from 1 April.
"I think what we are doing on the Isle of Wight is being more honest with the community than probably other councils are," he said.
"I think a good number of other councils have effectively shifted their eligibility threshold informally but might formally still operate at a lower level."
Anderson's claim was backed up by other sector leaders.
David Congdon, head of campaigns and policy at Mencap, said he had heard of councils doing this.
Ruth Cartwright, joint manager for England at the BASW - The College of Social Work, said: "I think this has always been there. When things get a bit tricky there's always a bit of smoke and mirrors.
"Local authorities should be honest about what they can and can't do because they've got to be accountable."
Anderson said the problem related to the government's Fair Access to Care Services (FACS) guidance on eligibility for care, which states that councils must set a threshold at one of four levels: low, moderate, substantial and critical.
"As a tool it doesn't allow you to fine tune," he added.
However, Local Government Association strategic lead for adult care Andrew Cozens said he had not heard of councils covertly tightening thresholds.
"The guidance requires them to set a threshold in accordance with FACS criteria," he said. "Each must take their own advice on implications."
Isle of Wight's decision, which is designed to save £1.6m a year, puts it among a small but rising number of councils with a critical threshold. This means formal support is limited to those with life-threatening conditions, people unable to carry out vital personal care tasks or family roles or those at risk of serious abuse.
Anderson said that 1,100 care users would be reassessed on the island over a three-month period, starting shortly.
He said that most people would continue to be supported at a similar or increased level and those no longer considered eligible would still receive some support based on the risks they faced, along with information and advice.
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PDF version Social care professionals working with disabled children and those with special educational needs are anxious about their future role after publication of the government's strategy document sparked confusion.
The SEN and Disability Green Paper proposes wide-ranging changes, including a move to a single multi-agency assessment process and a combined health and social care plan for children lasting from birth to 25 years of age.
But there is a lack of detail about how this process would work on the ground and no reference to social workers' roles. The details will instead be determined by pilots due to launch in September.
"It's the unknowns about all this that are threatening to social workers," said Nushra Mansuri, professional officer for BASW - The College of Social Work. "Children's services are quite a scary place to be right now; there's always this anxiety."
What does come through clearly is that ministers want to increase the role of the voluntary sector in carrying out assessments for disabled children. The government believes this would reduce the current conflict of interest within local authorities, which currently both assess the needs of disabled children and commission services for them. This shift presents the question of where social workers, who currently carry out the assessments, fit into the process.
Mansuri fears some might try to use the move as a way of replacing social workers with a less expensive substitute.
"This cannot become an excuse for local authorities not to use social workers and go for a cheaper option," she said. "That would compromise the level of services these children need. It really does take a qualified social worker to take on the kind of complex work behind an assessment."
Certainly, some in the voluntary sector see the government's hands-off approach as an opportunity.
"It's better that the government isn't prescribing something and is letting the pathfinders take the lead - I would be concerned if it was the other way around," said Graham Jowett, education consultant for the Treloar Trust, which runs a school for disabled young people in Hampshire. "It's a good approach so long as the government shows it is receptive to new ways of working."
Jowett said the government's lack of prescription would enable the voluntary sector to take a more dominant role, moving away from the current emphasis on local authorities.
However, Christine Lenehan, director of the Council for Disabled Children (CDC), thinks it unlikely the voluntary sector will take full control of assessments: "The government's been told there's a conflict within local authorities around assessment and commissioning and this is about how we can use a voluntary agency to mediate the process rather than carry out the assessment themselves."
But nor does she want to see the workload of social workers increase as a result of the changes. "We need to make sure the single assessment is properly joined up and distributed among the different agencies," said Lenehan.
"We need to make sure all the assessments carried out by social workers are incorporated into the single assessment and it isn't just put on top of everything else. We don't want a situation where the new system simply means social workers are doing yet another assessment."
Key changes
● A single, multi-agency assessment to replace the current statementing system, with greater inclusion of the voluntary sector. The single assessments are expected to be piloted in 25 local authorities from September this year and will see children given a single care plan including health, social care and education support.
● A legal right for parents of disabled children to a personal budget from 2014
● Children's health and social care plans lasting from birth to 25
● A reduction of the assessment process from 26 to 20 weeks (actual assessment to take no more than nine weeks).
Pilots will decide social workers' role, says children's minister Sarah Teather
Children and families minister Sarah Teather admitted she does not yet know where social workers will fit into the vision set out in the Green Paper proposals.
She told Community Care she was relying on local authority pilots to be launched in September to decide both the social worker role and how best to involve the voluntary sector in assessment and co-ordinating services.
"The thing I want to stress is that this is a Green Paper, so it's a consultation," she said. "One of the things we want to test in the pilots is the role of the voluntary sector within the assessment process. The voluntary sector might sit on the assessment panel, it may co-ordinate the assessments - we don't know yet what will work best on the ground."
http://www.communitycare.co.uk/Articles/2011/03/14/116461/social-work-ro...
Council duties to support disabled people and carers could be scrapped on the back of the government's review of all social care duties launched last week.
Of the 37 adult social care duties under review by the Department for Communities and Local Government, legal experts have identified some that may be at particular risk.
These include the duty under section 2 of the Chronically Sick and Disabled Persons Act 1970 to provide services to disabled people in order to meet their needs.
"The courts have made it very difficult for anyone to create for themselves a right to receive services," said Ed Mitchell, editor of Social Care Law Today and Community Care legal columnist. Specifically, the courts have interpreted this duty as meaning that councils can define what is necessary to meet someone's needs according to local resources. Mitchell said this made it easier to wipe the duty off the statute book, adding: "They would be finishing the job the courts have started."
Also at risk could be carers' rights to assessment and to be considered when the local authority is providing care, under the Carers and Disabled Children Act 2000 and Carers (recognition and services) Act 1995.
Luke Clements, professor of law at Cardiff University and social care law expert, said there were indications of a shifting of responsibility for caring to families.
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More than half of councils have raised charges or eligibility thresholds for care in the past year or consulted on doing so, research has revealed.
One in five (21%) had raised eligibility thresholds or carried out a consultation, while a further 36% had done the same in relation to care charges, a Learning Disability Coalition survey of 60 authorities found.
Most councils who have consulted on raising charges have acted on their plans, Community Care has found.
The coalition, which represents charities, providers and user groups, said the impact of the cuts was potentially "catastrophic", particularly for people with moderate or mild learning disabilities.
"The cuts in funding mean that services [have] become more targeted on those with the most complex needs," said one respondent. "This has meant that there is little provision and support for people with mild to moderate needs meaning that these people only come in to the service in a crisis."
A separate survey of 300 people with learning disabilities, carers or family members found a third had been contacted by their council about an increase in eligibility criteria, and 27% had been contacted about increased charges.
"My sister, who has a diagnosis of severe learning disabilities, has had all her care removed, with funding cuts being cited as the reason," said one family member. "It is not possible for the family to replace this care, as well as the support the family were already providing. We are also not trained to give the specialist services needed. My sister is now suffering from serious neglect certainly due to funding cuts."
In terms of specific services at risk, 36% of councils said residential care was likely to be affected, 44% cited supported living and 48% day care.
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Fears grow over non-social workers carrying out reassessments
Concern is growing over use of non-social workers to reassess service users amid new evidence of the number of councils tightening eligibility criteria.
Social workers and service users warned that staff without social work qualifications may lack the advocacy skills to argue for clients and may miss key sources of need, including abuse.
Over recent years, responsibility for assessments has increasingly been passed from social workers to community care officers and other non-qualified staff.
Ruth Cartwright, joint manager for England at BASW - The College of Social Work, said: "Many non-social work qualified people are very good and very caring but they have not had the benefit of two or three years' professional training."
She warned that assessors needed to be aware of the impact of complex needs and family dynamics, and of the possibility of adult abuse.
"It is also possible that non-social work qualified staff will be less confident and less assertive in arguing the case for service users when there is an agenda of reducing numbers eligible for services and making cuts."
One social worker said her council had a new advice, information and assessment team that takes all new referrals and only assesses them if they look likely to be eligible.
"Most who took these posts had worked on reception, so they did know a bit about the area and local resources, but they see the job as information work," she said.
"I worry that many difficult issues such as domestic violence or abuse will be missed, and that there is no sense of advocacy being a core function. They certainly don't have a view of themselves championing the rights of the service users, or of ever having to challenge authority."
Sue Bott, chief executive of the National Council for Independent Living, said disabled people had little faith in some of those carrying out reassessments.
During a regional network meeting in the East Midlands disabled people were telling her how "the people conducting reviews don't seem to have much of a clue about what they are supposed to be doing".
"People said that the process was completely unimaginative with other options for meeting support needs that might be cheaper not being explored," she added.
"There's no scope for getting [reassessments] wrong, otherwise the outcomes could be disastrous," said Stephen Lowe, policy adviser at Age UK
However, the process was defended by Ian Anderson, community services director at the Isle of Wight, which is due to reasses 1,100 service users over the next three months as it raises its threshold from substantial to critical.
Anderson insisted non-social workers were fully trained to carry out assessments and their work is overseen by a social worker.
"We've given them extra training on how to look for the risks people face in their lives," he said.
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