A new report by the Health, Social Care and Sport Committee has found that implementation of the Social Care (Self-directed Support) (Scotland) Act 2013 has been hampered by a range of factors.
The legislation was introduced to ensure that care and support is arranged, managed, and delivered in a way that supports choice and control for individuals. Although the Committee has heard that Self-Directed Support (SDS) has been implemented well and is transformational for individuals in some areas, the report highlights a number of challenges that have meant the legislation is not always implemented in a fair and equitable way across the country.
The Committee say that restrictions on available providers, how services are commissioned and procured, and the financial systems and models of care currently in place mean that, in many parts of the country, SDS has not been delivered in the way intended by the legislation.
The post-legislative scrutiny report concludes that a lack of knowledge and understanding of the principles of the Act among key staff is also limiting effective implementation of SDS. The Committee says social workers face a number of constraints which prevent them from taking a relationship-based approach to their work in a way that would enable them to fully implement the principles of SDS.
Other issues highlighted by the Committee include inconsistent application of eligibility criteria by Health and Social Care Partnerships. The Committee concludes that, in many instances, the way current eligibility criteria are applied contradicts the aims and principles of SDS.
While the Committee heard examples of good practice from certain local authority areas, which are offering those in receipt of care more choice using a range of different collaborative initiatives, they say there have been challenges in applying this good practice across the country.
The Committee also concludes that there is an urgent need to establish a process of national oversight and clear lines of accountability across all levels of decision-making to ensure a significantly improved approach to monitoring and evaluation of SDS.
On the report’s publication, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said: “While it’s clear from our evidence that stakeholders strongly support this legislation, its implementation has not been consistent across the country.
“During our scrutiny, the Committee has heard that there is a lack of national consistency in relation to information, advice and support to ensure fair and equitable access to social care through SDS.
“We also have concerns over recruitment and retention of the social care and social work workforce, the continued impact of Covid-19 and wider funding constraints across the social care system that are affecting proper implementation of the Act.
“Our conclusion is that the current underlying system of social care delivery based on individual assessment, eligibility and transactional care contracts is incompatible with the principles of SDS.
“The Social Care (Self-directed Support) Act was introduced ten years ago with the intention of empowering individuals to have greater choice and control over the care they receive. However, in too many cases, the principles of SDS are not being observed, meaning individuals are not receiving the care they want or deserve.
“We are calling on the Scottish Government, Local Authorities and Health and Social Care Partnerships to ensure proper implementation of the legislation through greater national consistency, by improving local authority practice and processes, addressing issues around commissioning and tendering, and significantly improving processes for ongoing monitoring and evaluation of the policy.
“We would like to thank all of those who contributed to our post-legislative scrutiny of SDS.”
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