Personalisation as the Preffered Social Care Method

Due to growing population and longer life expectancy, in December 2007 the policy of personalisation has been actively pursued across all four British countries (Dunning, 2008). Drawing on the work of the disability movement, personalisation aims to increase the levels of choice and control for adult users of social care services. This assignment will focus on how personalisation can help or hinder Gladys who suffers from dementia.

Personalisation is a social care approach, meaning that, every person who receives support will have choice and control over the shape of that support in all care settings (Department of Health, 2007). It enables the individual alone, or in groups, to find the right solution for them and to participate in the delivery of a service (Gardner, 2014). From being a recipient of services citizens can become actively involved in selecting and shaping the services they receive (Carr, 2008). While it is often associated with direct payments and personal budgets, under which service users can choose the services that they receive, personalisation also entails that services are tailored to the needs of every individual, rather than delivered in a one-size-fits-all fashion (Community Care, 2017). It also encompasses the provision of improved information and advice on care and support for families, investment in preventive services to reduce or delay people’s need for care and the promotion of independence and self-reliance among individuals and communities (Age UK, 2013). The key test of personalisation’s success is the extent to which it improves the lives of service users and their carers (Gardner, 2014). The 2011 National Personal Budget Survey of 2,000 users and carers in England found that personal budgets were generally likely to have positive effects, with most users saying they had seen improvements in 10 out of 14 outcome areas from using personal budgets (Department of Health, 2007). A 2010 report by charity in Control found that 68% of service users said that their lives had improved since they started using a personal budget (Housing LIN, 2017). However, according to Community Care (2017) personalisation can present challenges, the most important of which is achieving the right and the balance between care and control when helping individuals to make decisions about their life. As individuals are supported to make their own choices, some decisions, from the professional’s perspective, might not be in the client’s best interests. Some areas have robust statements that personal budgets must not be used for the purchase of illegal items, alcohol or gambling, however, this may prove difficult to regulate and enforce (Age UK, 2013).

According to Community Care (2017) there is evidence that this is taking place as a result of personal budgets but also concerns that a number of groups such as people with dementia, those with other mental health problems and those who lack mental capacity, are not yet benefiting from this approach. Alzheimer's Society (2011) argue there are clear benefits to people with dementia and carers using direct payments. However, the number of older people with dementia with a direct payment is unacceptably low. Local authority data shows that ten or fewer older people with dementia have a direct payment in 70 councils (Alzheimer’s Society, 2011). To raise this level, barriers to uptake must be removed, more people must be offered the option and good information must be available (Lymbery, 2010). According to Department of Health (2007) whilst direct payments may not be appropriate for the many who are growing old with dementia, the political consensus is that a personalised approach should be followed, using all available resources, to allow people with dementia to grow old well with their condition. Alzheimer’s Society (2011) state, knowledge of what is available and advice on choices both as to housing, and in particular extra care housing, must be accessible to people with dementia; they have a right to receive a publicly accountable quality of, and a risk enabled, service chosen by them (or their proxy), in so far as they are able to choose, and, to the extent that they are not, one that is in their best interests (Lymbery, 2010).

For Gladys, who is suffering with some dementia but has mental competency, personalisation will give her independence, choice and control over her care needs (Alzheimer’s Society, 2011). The use of direct payments or an individual budget will allow Gladys to access social networks and promote independence in a setting that is normal and enjoyable to her, as well as allowing her to employ carers she feels comfortable with and who can meet her needs and lifestyle choices (Carr, 2008). Housing LIN (2017) state the fact that dementia is a degenerative condition, people with dementia may experience difficulties of comprehension and inability to articulate their own needs. They may be able to come up with a solution that feels good for them, and if unable to express themselves in straightforward language then they are likely to express themselves in verbal and non-verbal behaviour, which an assessor or the carer in charge, this could be a family member, should have the skills to interpret. According to Lymbery (2010) one of the central tenets of self-directed support is that the person directing their own support, with help from their family and friends if they want, is often the best person to work out what the choices are and how to make them happen. To achieve stimulating and meaningful engagement, it is essential that the family and community networks of care and support of Gladys is built upon rather than removed by any individual package of care arranged for that person (Alzheimer’s Society, 2011).

Personalised care means you have to spend some time and effort thinking about your care and support needs and the outcomes you want (Age UK, 2013). Although personalisation can help Gladys by giving her the choice, independence and control over her care needs, it also can hinder Gladys, as her condition is progressive, and becomes progressively worse, she will be very vulnerable and will need full time care. Gladys will lack capacity to consent to particular types of treatment or care that others have assessed as being in their best interests (Housing LIN, 2017). Sometimes a decision made about Gladys’s accommodation can mean that they are at risk of being deprived of their liberty and it is important that the council recognise where this is happening or has the potential to occur and take action if needed (Assessing and Supporting Your Needs Policy, 2015). This must be authorised under the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005. Sometimes a vulnerable person like Gladys can be at risk of abuse or neglect, if this is detected during an assessment, then the council should carry out a safeguarding enquiry and decide which action is necessary and by whom (Assessing and Supporting Your Needs Policy, 2015).

Gladys cannot pay her neighbour who provides her with meals through direct payments as she is not registered as her carer, she can, however, pay from her personal budget but this will only reduce her savings. If Gladys’s grand daughter who is made the power of attorney of her finances when she cannot make decisions herself, can provide Gladys with support in making decisions in providing the type of care that Gladys needs, then Gladys does not need to move out of her home into a care home. Gladys can stay in the comfort of her own home near her family and friends and still be part of the community.

Overall, personalisation can help Gladys in many ways, it enables Gladys to find the right solution for her the delivery of service that is tailored to her needs. It is a person-centred care that focuses on how Gladys can have more choice and control over decisions affecting her, and be supported by her family, enabling Gladys to be part of the community.