Bridging the self-directed support rhetoric-reality gap

January 10, 2018

There seems to be universal agreement that we are facing an urgent crisis in long-term health and social care. In Control and our allies have positively influenced national policy and legislation, but there is much work to be done to close the "rhetoric-reality gap" in the context of the severe financial pressures being faced by statutory bodies. Failure to deliver the authentic self-direction promised by policy in social care, health and education is severely impacting on too many people and families.

In Control run a support-line to advise people. Thankfully we are often able to help people to get better outcomes and help local professionals improve how they deliver. However we are increasingly finding that even when individuals, families and professionals know the law and have the correct information, people are saying they are being ignored and their rights denied. Simply having good information is not enough; people are needing strong, independent, authoritative support behind them as well.


Many are now seeking legal advocacy. Solicitors are currently overwhelmed with cases regarding breaches of the new Care Act and Children & Families Act. We are working with them to support individuals and families with a range of issues. This might mean supporting drawing up correspondence, liaising with the local commissioner, mediation, support planning, emotional support, resolving complex issues or conducting independent analysis and reviews. We also make links to local advocacy and local user-led organisations and are finding there are challenges for them too. Some user-led organisations and advocacy organisations are losing funding, or are very dependent on local authority funding. Some report to us they are finding it more difficult to act independently as either they fear their funding will cease if they are seen as adversarial, or they have limits to the range of work they can do within their contracts. In our experience, the developing effect is seriously hindering the support available locally to help people achieve self-direction.


For this reason, local groups often refer through to us to give the extra support we can offer. We can mentor local people and can use the authority linked to our national position and independence to add persuasive strength to their local efforts. Our national links and networks also allow us to connect people with strong images of what is possible to achieve and link them with those in other areas that have found effective solutions to similar challenges.


As well as helping individuals to realise the potential of self-directed support, we support local leaders on how to work through complex conflicts constructively so they feel more confident in supporting people on the ground to keep them included and in their own community, accessing the support they need. This work has often emerged via demand from statutory members wanting conflict resolution support or from families and local groups directly accessing our support. Whilst this can be tough going, we are already seeing benefits where local statutory bodies have changed their local policy or pathway based from the live experience. The relationships built during this kind of intervention can help build a positive loop to help make positive progress on other issues.


Where next?


We are faced with the problem that we are only able to directly help and advise a small proportion of the people who could benefit and the local systems that can improve. For this reason we need to find a way to massively amplify advice and assistance. We don't believe the best way to do this is to expand our direct advice provision, but rather to support and enable local support to people.


We therefore propose to develop a national support network, operated by local individuals and groups, with In Control inputting and facilitating support while helping the growth of local expertise and capacity. We believe this to be the right approach because local groups and organisations already exist to support local people. These groups do not need to be replaced but instead enhanced by the added value that In Control expertise, local collaboration around choice and control and links to advice and help from other local networks can provide.


We are currently working on this idea and hope to launch the first phase in the next few months. If you are interested or want to offer idea or support, please do get in touch.


Julie Stansfield