A tale of personalisation in Adult Social Care, Personal Budgets, and how I still can’t access them.

I have been so very foolish. And arrogant. And ridiculously, ridiculously foolish.

I have been hoping to navigate my way through this complex beauracracy with the benefit of my knowledge of healthcare. I’m one of the insiders, you see, I know of the C.P.A., the E.C.G, the P.F.T and how to measure your oxygen sats. If you were on my ward, I could phone up the benefits agency and they would listen to me advocate on your behalf. I can minute meetings and manage complex cases. So you’d think I would be able to manage one little case, with a whole year to focus on just this one ‘little’ case? To make sure my client (in this case, me) got the services they needed and was facilitated to begin the process called recovery, to adapt to their changed circumstances; to adapt their environment to best enable them to perform their chosen activities?

Sometimes, it’s not easy being an OT and loving it. I had begun to think I could OT myself. And something that they teach you in all the healthcare professions is that you can’t treat yourself (or your family).

During my descent into disability, I have encountered various professionals. Some helpful, some less so. I recently hit some kind of wall of frustration, that has been building through one particular therapeutic relationship, and burst through it into pure sweet fury.

I worked with a woman from Children’s Services for 6 months. She was originally supposed to help with the kids, but she somehow managed to end up working with me. This is partly because she has been unable to offer any solutions to any of the problems I face with my parenting role, so we ended up talking about my personal care problems. And despite her offering to help me find out (for example) about Direct Payments, she couldn’t quite find time to do it. In 6 months. I’m using my usual defense mechanism of humour, because I literally feel like I could cheerfully throttle someone. Lets not forget that this may, or may not, have even been her role- having identified the need, she chould have referred this matter to her team in order to make a referral to Adult Social Care. At any point over a 6 month period!!!

I didn’t have an holistic assessment of my needs. Let me repeat that, because it is a bit mind boggling. As a pregnant Mum of a 3 year old, I became a wheechair user. I came into contact with Children’s and Adult’s social care when I gave birth to my second child, and the hospital was alarmed at how we we’re living. In fact, I couldn’t be discharged until they got involved.

Now a Mum of 2, I have been housebound since April 2010. I’ve been in contact with Children’s Social Care and Adult Social Care since August 2010. That means,

  • I have had no social activity out of my house.
  • I have not been to church.
  • I have been trapped by the unsuitability of my housing.
  • I’ve been unable to take the kids to school, the doctors, even to A&E.
  • I’ve not been to a single baby group.
  • I’ve given up all my previous activities.
  • I’ve been unable to work out how I’m going to get to work at the end of my maternity leave.

And I have had no assessment of my needs.

But the thing that bothers me most, is that I’m a health professional and I have allowed this to happen! Because people involved in my care have constantly reassured me that their role was to sort it out, and my role was to make them aware of the issues, I have relied on them.

I have made the fatal error of presuming that they would ensure that my care needs are taken care of in a timely manner, and that if there are services that they think I would benefit from, then they would make me aware of them. How wrong I was. I was working under the misapprehension that all our public servants would be working as I would be working- really trying to put the client first and see life through their eyes.

In February, I decided to attack this situation as any member of the public would, from scratch. I went to the City Council website and followed the steps outlined there, under “Adult Social Care“. I think this was an angle I should have tried from the outset, and I may blog about it another time. There is clear information on the website showing the statutory duty of the Adult Social Care Department, which makes clear how no services are going to be accessed until an assessment of needs is made. Currently, services will be provided to adults with ‘substantial’ or ‘critical’ needs.

After a single phone-call, albeit a long one, last February, I received an apology from my local Council Adult Social Care department. Now aware of the extent of the difficulties I have, they gave me an assurance that there would be an holistic assessment of my needs “soon”.

But that doesn’t take care of my personal feelings of disappointment,

I had seen this woman for the past 6 months, at least once a fortnight. She has recently emailed me twice, both emails she called my children by the wrong names. But different names. So for  6months, at least 12 visits, she has singularly failed to learn the names of the children she is charged with helping. That makes me feel a kind of hollow terror about the state of Children’s Services, because I don’t understand how that is even possible. But if it is true for me, you can bet there are so many other children with workers who don’t even know their names.

And these are the people who are charged with keeping our children safe.

And she did precisely nothing in that entire time to help my children or our family unit.

Update: It is now two and a half months since that initial phone call to Adult Social Care. I have been visited by my Case Manager three times, and she has “helped” me complete my self-directed assessment. Surprisingly enough, this included telling me I had filled it out ‘wrong’, but that’s another story.

I still have no completed Holistic Assessment of Need, the first step in Adult Social Care Planning. Once a Care Plan is developed, it will give me access to a Personal Budget, in order to fund a personalised service. Indeed, a brief examination of the Council website shows their own information , which states that

If you are a new customer, from July 2010 you will have a personal budget. This will mean different things to different people – SDS allows people to choose how much control they have.

So much for the theory, then…….

Leave a comment


  1. Sounds like a really terrible experience.

    From a former insider manager my advice is simple though.

    Write to your MP, put the above in a letter and ask them to contact social services on your behalf.

    You will then find you receive an assessment very quickly.

    Failing that complain to the LA and be prepared to go all the way to the Ombudsman

  2. Sorry I meant insider/ Care manager.

    I never attained the lofty rank of manager!

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