Self-Directed Support: A Review of the Barriers and Facilitators

This is a report on the published literature on the barriers and facilitators of self- directed support. It was undertaken to inform a research study funded by the Scottish Government 2009-2011 that is evaluating initiatives in three local authorities. These initiatives aim to improve take up of self-directed support for people eligible for social care and other public funds.


6.1 In this summary we reflect on some of the main points that have emerged in this review that may be relevant to the development of SDS in Scotland and the key aims of such changes.

6.2 There is significant agreement about the perceived barriers to the development of SDS. There are also numerous comments about ways in which SDS may be facilitated. Many of these relate to DPs and there is very little evidence about other forms of deployment. Some barriers and facilitators are linked - for example, lack of information is a barrier and good or accessible information appears to be a facilitator. Similarly, lack of legal clarity is a barrier, while clarity about legal responsibilities appears to assist users, carers and staff alike.

6.3 Other areas are not so simple. This is exemplified by concerns about risk and cost-effectiveness, and what is regarded as the proper or legitimate use of public money. In the longer term, barriers or limits to an individual user's choice may be affected by the choices of other users (such as the viability of day centres). These are not simple trade-offs. None of the research scrutinised for this review took place in the context of the current recession. This is an important point that may affect the art of the possible. We have very little evidence about the best ways to monitor SDS but there are suggestions that what is across the board 'light touch' monitoring may enhance risks at a number of levels. These are matters for wider public debate in Scotland and beyond.

6.4 The theme of the desirability of reduced bureaucracy and less red-tape occurs in several commentaries and is touched upon in a small number of studies. The matter relates to perceptions and the balance between over- and under-protection. It also relates to the intentions to blend funding streams because these may have different accounting models and systems of scrutiny.

6.5 Leadership is less frequently disputed as a necessity for such a change process, however, most of the commentary and experiences reported around leadership are in the context of SDS as an innovation rather than mainstream activity. Moreover, while leadership might be called for, it is sometimes lacking in specificity about where this responsibility lies. When talking of 'local authority leadership', for example, ( 178) who is being seen as responsible? Councillors? The director or his/her delegates? The precise parameters of leadership are unclear. Uncertainties about legal and risk management responsibilities need to be addressed at national levels; other leadership responsibilities at local level may relate more to communications and workforce development.

6.6 Finally, the availability of transitional funding is regarded, not surprisingly, as a helpful spur for innovation by those who are likely to be the beneficiaries, but there is little evidence about the long term effectiveness of this and its impact on other areas, parts of the system, or other groups of users that might have similarly welcomed any or extra resources. All these comments support the importance of a system wide approach to the roll out of SDS.

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