Interim National Care Service Advisory Board: Advice to Scottish Ministers and Council Leaders - Self-Directed Support

Risks/challenges associated with advice

While this advice aims to deliver significant benefits, it is important to acknowledge potential risks that may impact its successful implementation. These include operational challenges, resource constraints, and unintended consequences that could affect service delivery and outcomes for supported people.

Risk/challenge: Resource constraints: Insufficient staffing, training, or infrastructure could hinder delivery

Response/mitigation: The Board recognises the resource constraints in which local areas are operating, but as stated in the advice note background, this cannot supersede the need to meet people’s fundamental human rights. The advice notes the need for further training and information resources and suggests this could be provided through Year 4 funding of the SDS Improvement Plan; as well as through using existing forums for sharing good practice.

Risk/challenge: Budgetary: No costings have been completed on this advice, limited funding could impact scope and sustainability

Response/mitigation: The majority of the Board’s advice does not require additional budget but relates to the more flexible use of funding which has already been allocated. It is designed to ensure that statutory duties are fulfilled and is in line with the widespread recognition of the benefits of a preventative/early intervention approach wherein, by enabling independent living and access to the types of support which will make the greatest difference to people, more acute/intensive care – with associated additional cost – can often be avoided. This is a key theme of the Population Health Framework and the Health and Social Care Service Renewal Framework and must be acted upon if improvements are to be made and scarce resource best invested.

Risk/challenge: Option 1: This advice focuses on option 1, consideration should be given to whether this advice could mean that people accessing social care and support through other options could be subject to different process and criteria

Response/mitigation: The Board recognises the need to consider all elements of self-directed support implementation and will advise on further means of improvement in due course. We cannot delay making the improvements which most readily present themselves. None of the Board’s advice requires a change in statutory provisions. It goes without saying that where local areas identify wider applicability of our advice to other support options or wider practice they should implement it as they see fit.

Risk/challenge: Engagement: Though the advice relates to social work practice, engagement with the social work and professional organisations on this advice has been limited

Response/mitigation: It is the responsibility of the Board to consider how to improve the outcomes of support for people; and to embed the voice of lived experience in its decision making. While the Board has consciously chosen to frame its advice around the lived experiences of those impacted by cuts and inflexible practice, it is aware of work recently published and underway by professional related organisations in this area – with Social Work Scotland publishing their findings on 26^th January and a report from the Scottish Association of Social Work pending. The Board’s advice also recognises the considerable pressures faced by social work practitioners in working in ways which undermine a values based approach. It will, of course, be for statutory partners to work with their wider workforce to consider the implementation of this advice.

Risk/challenge: Additional pressure: The intention of the recently published SDS standards was to minimise bureaucracy for workers and individuals, consideration should be given to whether advice could create additional asks.

Response/mitigation: The Board’s advice is not intended to increase bureaucracy, but rather to enable workers to work in line with their professional standards and values. Empowering staff to adopt a values based approach which is based on value and respect for individuals has a powerful and positive impact on the ground. The SDS Improvement Plan has already been agreed by Scottish Government and COSLA and the advice to build on existing activity to support flexibility within SDS is consistent with the aims of that Plan.

Risk/challenge: Lack of robust data: Creates a significant risk for decision makers because of limits in understanding of actual needs, service gaps, and outcomes.

Response/mitigation: The Board has gathered substantial evidence of the harms currently being caused to individuals. The advice offered is consistent with the existing statutory landscape and the SDS Standards. The need to adopt an outcomes based, people led, flexible approach to implementing SDS remains irrefutable irrespective of quantitative data trends. While recognising that additional, quantitative data would be valuable to understand and support wider issues impacting the successful implementation of SDS, there is no justification for delaying in the face of wholly evident harms which are being caused to individuals daily.

Risk/challenge: Pre-empting data: Delivering advice in advance of the collection of reliable data risks being required to change or reissue advice in future if emerging data identifies different needs to those that advice is based on.

Response/mitigation: As noted, the Board recognises that further advice on the successful implementation of SDS will certainly be necessary. That does not remove the need for critical action to be taken in response to the issues on which Board members have already gathered compelling evidence.

Risk/challenge: Reporting burden: the requirement for the implementation of recommendations to be monitored and for data on the number of assessments/re-assessments each month place new and unreasonable administrative demands on local areas.

Response/mitigation: The Board has recommended that this work is progressed through the Social Care Data and Intelligence Programme Board, as part of wider efforts to rationalise and maximise the value of social care data collections through all partners, in line with the ambitions of the Verity House Agreement.

Risk/challenge: If direct payments – option one – are awarded on too flexible a basis, there is a risk that DWP could treat these funds as income for benefits purposes – with potentially significant consequences for individuals.

Response/mitigation: The Board recognises the importance of protecting the DWP disregard of funds allocated through direct payments – option one – and/or the Independent Living Fund, when assessing eligibility for benefits. When considering steps to support the adoption of a flexible approach to spend for direct payments – option one, ministers and local authorities should take appropriate advice to ensure that additional flexibility does not detrimentally impact recipients' positions with respect to benefits.