What is a Personal Assistant?

For many years disabled people, like myself, who have needed care and support have employed personal assistants (PA), using monies from the government, instead of using care agencies. While disabled people once had to fight hard to employ a PA, in recent years the government has recognised the benefits they bring as they have encouraged them as the norm for many people. But as the number of personal assistants supposedly rises, it is important to properly define what a PA is, something so far the government has refused to do.

Before going any further I wish to make it clear that I am not judging the individual relationship any service user has with someone who supports them that is working for them, merely whether we have accurately call the person providing the support a PA. It is also helpful to understand what the term carer means which is a confusing term with many meanings. A carer could be an informal carer, a family member or friend who is unpaid. The term also refers to a paid care worker who works from someone other than the user(s). And finally, simply to confuse matters, it could refer to a personal assistant and many people prefer or insist on using this term to describe their personal assistants. I admit that to simplify matters in some situations, I just say carer to ensure people know what I mean.

So getting to the heart of the matter, I would define a personal assistant as someone independent directly employed by a person who is capable of directing them and requires care and/or support tasks to be performed. Let us break this down to ensure we understand this definition. The person has to be employed rather than self-employed, which has been a bone of contention between myself and the government who believes it does not matter how people are employed. But HMRC guidelines clearly state you can not direct someone who is self-employed, only specify what you want doing not how you want it to be done. Many people think the difference between being employed and self-employed is simply who pays the tax but the reality is its significantly affects the control and responsibilities each party has and therefore the relationship, making the difference between a PA and a care worker.

I would also argue that for a person to employ a personal assistant, they must be able to direct them on a day to day basis themselves. A true personal assistant simply follows the instructions of the user and is only responsible for the quality of their work, not specifically the welfare of their employer. Rather, a employer is responsible for the welfare of the staff they employ and direct. If someone is unable to direct than they may employ someone with assistance or have someone employ a person on their behalf, but the person employed is likely to be directed by someone else, or required to follow a specific support plan, aligning themselves to being care/support workers rather than PAs.

I also believe a true personal assistant has to be independent from the employer to avoid any conflicts of interest. It has become increasingly fashionable for people to employ family members as personal assistants. While it is not my business so long as it is working for them, when we are talking in terms of accuracy, I have to question whether they can be defined as a personal assistant. The government is now putting money into developing the PA workforce and the question to be asked is whether that family member would continue to work as a personal assistant after the user no longer requires them? The answer is probably not! I am really unsure how well you can truly direct a family member, especially immediate family, as there must be a whole range of potential conflicts of interest occurring. I would certainly not like my family involved in my care and support.

In terms of what a personal assistant does on a day to day basis, this is a very individual thing depending on the needs and wants of each user and the outcomes agreed by the funding bodies paying. I do not feel you can specify this in any way nor create standards and mandatory training as the government has been trying unsuccessfully to do. The relationship between personal assistants and those they support is so individual and is more like a marriage (and a divorce!) rather than an employer/employee relationship.

So these are my thoughts of what a personal assistants is and I hope this article can maybe begin a proper debate on the subject so everyone can properly understand the issues involved.

Needs vs entitlements

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I believe there is a big difference between needs and entitlements in terms of both welfare benefits and social care. I see entitlement has someone people get between of specific labels given to them from various tick box assessments. The entitlements are often fixed amounts opt benefits or services which go somewhere to compensate people for the difficulties they are having and its an estimate and does not really fit neatly to the real needs people have.

 

Needs have to be considered to be individual and I believe are formed by understanding someone’s goals and therefore outcomes, along with their abilities and difficulties. If we had a combined welfare and social care system that really met individual’s specific needs, where they were no winners or losers, then I think it would change the conversation and remove people from the dependency culture that currently exists.

 

I think the meeting of needs as a matter of course rather than fixed entitlements has to be the way forward and it will happen.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  


The 15 minute support call

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A few weeks ago I attended a major disability conference where the Chief executive of Leonard Cheshire Disability was talking about her concerns about 15 minute care calls asking the audience if they all agreed that it was wrong to have these ‘limiting’ calls. While it was asked as a reciprocal question, I could not resist answering it but saying actually there is nothing wrong with them if that is what people need.

 

I think the whole issue had turned into an emotional one where the feels of users and carers and they natural desire for more support has replaced the reality of a social care system. Social care is about meeting people’s need and not everyone is a totally dependent user charities wish to portray. I feel if users has 15 minute calls, they should be empowered to make the most of the time so if someone needs help with showering but can dress themselves, they could be undressed and in a dressing gown ready for the call so they can make the most of the resource provided to them.

 

It is time to see social care as an empowering resource and not seemly looking after people.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  


I always knew RAS was wrong

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Resource Allocation System or RAS is something devised by a social worker called Simon Duffy who managed with very little evidence to convinced an Labour government over 7 years ago to implement it nationally as personal budgets. It is a way of assessing what people need by providing them with a cash entitlement first which they to plan their support or that was the idea. It was sold as something amazing where people can be creative and money would flow.

 

I can only saw RAS working in the closure of day services where it is cheaper and more creative to give the users the money to spend as they wish. But in terms of personal care and support, I am afraid there is often little room for creativity and what people need is what people need. RAS uses a tick box form, insultingly called a self assessment, to create what has become an increasingly become a computerised mystery. Many authorities realised quickly that RAS was not working, calling what was an entitlement into an indicative budget which could be customised to reflect what people actually need, making the process pointless.

 

RAS has become disliked and even hated by service users and professionals alike as a mysterious cost cutting measure that has disempowered a generation of service users and I knew what the start it was a bad idea.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  

 

Need makes no sense

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As a social care service user, I have had the concept of need used by others to try to control my life for 20 years, and I have realised is it something that is meaningless on its own. It is easy to come up with a whole range of reasons why someone needs or does not need something. I used to say and believe need is what someone’s else’s want and this is often quite true. I now realise that need stems from people’s outcomes and in the past, these outcomes were simply dictated by funders as something unspoken. Now service users are having a say in their outcomes, when their needs are clearer and makes sense.

 

But when people say disability living allowance meets people needs when the amount awarded is not assessed on an individual basis, it makes no sense and the money is simply free for people to spend as their wish. Until everyone has individualised payments based on their outcomes and therefore needs, it is an illusion to say its making any kind of needs.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  

 

My understand of the social model

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I feel that many people are using the social model of disability to either support to condemn the welfare reforms based on this understanding of the model. I feel many people see the barriers disabled people face in terms of a political group and all disabled people can be seen as equality oppressed regardless of the degree of their impairments. I however believe in the same way as the medical model, the social model as about the social, environmental and attitudinal barriers individuals face.

 

By this I mean if you reduce the barriers someone with an impairment faces as a result of their impairment or no barriers exist than they are no longer considered disabled. Everyone has impairments but it makes sense that as society continues to improve, less people with impairments can be considered disabled. People with impairments will still require specific services to manage their impairment and they will have to some degree an impairment identity which is different to an disability identify.

 

We have reached a stage where the social model is reaching its conclusion and people need to catch up to a new way of thinking about themselves as people are impairments.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  

 

All quiet on the disability front?

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I do not know if it is just me but it seems very quiet on the disability front. We are still getting the endless ‘victimhood’ articles in the liberal media portraying disabled people are unemployable objects of pity for the benefit of middle class charities but it is just now boring and I believe other than alarmist lies, they are running out of stream. Any than exploiting the occasional suicide, the facts that for most disabled people, 80% even if we take Scope’s worst imaginary estimate, are not being affected by the so-called cuts means they are have nothing serious to moan about.

 

I can now see the one minute disability activists born out of the anti-cuts movements simply fading away, allowing us serious activists get on with really making a different for all disabled people and not just the minority trying to avoid their responsibilities.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  

Health and social care together

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I believe the labour party may have it correct when they are considering merging health and social care together especially now social care have moved beyond warehousing people either in care homes or indeed their own homes. Enablement and empowerment should be key components to secondary care solutions after acute medical solutions. It is indeed about saving money but it is also using common sense to keep people back their lives by correct working out the balance between health and other services require.

 

My only concern as always is to ensure that the needs of working aged adults with support needs are not overshadowed by the focus on older people. Working aged adults needs support to work and make other contributions and so a much wider range of services are needs and this is still possible within the Labour plan. So lets watch this space and see what happens.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  


Residential care in 2013

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Those who are attacking the government for closing the Independent Living Fund are using the idea of residential care as a metaphor for something worth than death as they portray a level of institutionalisation from the 1970s, but it is fair to portray residential care in this way. While it is not my personal choice or the choice of many people, residential care is very different and better than the image the activists are portraying. It is indeed an insult to the large social care workers are deliver the best quality care they can and I would argue that people who employ personal assistants are as likely, if not more likely, to be abused in one way or than then in residential care.

 

So long as I had my computers, the internet and had my basic needs met, I could comfortably survive in any environment offered to me. But I am sure with tele care and the whole assessment process, it is indeed unlikely many ILF users will be put a residential care as it is not the best value solution people are wrongly implicating.

 

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com  

 

How would my ideas on social care work for me?

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I am aware I have some quite radical ideas about social care that would change the way a lot of person receive support, potentially reducing the amount their receive while still dramatically improving the quality of their life, and I accept that would include myself. Unlike many people who talk up ideas until its affects them, I am indeed prepared to face the music of my own creations and lead by example.

 

I feel if we move away from label based compensation and towards meeting outcome based needs to benefit everyone and once people got over the change, including myself, we will all be better off in the long term, but change is difficult but often very so worthwhile.

 

If you like what I say, have a look at my site at www.simonstevens.com or follow me on twitter, @simonstevens74, or even leave me feedback on +44 (0)121 364 1974 or email simon@simonstevens.com