Every sector has its buzz words. The two I hear most in the learning disability sector right now are ‘care’ and ‘control’. Care providers make decisions in light of whether they provide people with enough ‘care’ to live fulfilling lives, and enough ‘control’ to remain independent and autonomous. These principles tie in with the progress we’ve made as a sector over the last thirty years in ensuring services provide people with more dignity, security, choice, and a stronger voice.
Worryingly, this progress is currently at risk. As austerity increasingly drives decision-making at local authority level we are seeing the care and control so central to the lives of people with learning disability being stripped away.
With increasing pressures on local authorities to find further savings we are witnessing more examples of procurement processes being driven solely by a need to reduce costs. We are seeing less consultation with the people whose services are out to tender, and their families. Why? Because meaningful consultation might make it harder to cut the costs and award the service to the cheapest provider.
This can be disastrous for the people in receipt of the services. It can mean that people who have had a care provider working with them for over thirty years, sometimes since they were children, who have a strong and bonded relationship with an organisation, are not consulted. They are simply notified that a new care provider could be taking over their care. It leaves many feeling powerless and confused, including the families who have built up a strong sense of trust and security with a care provider.
Staff members who have a loyalty to their employer and who are now facing an uncertain future with a new employer are often torn between staying to support the individuals with whom they have built a strong relationship, or ‘jumping ship’ to stay with a trusted employer. These are people’s lives and without due diligence to consultation their needs are being lost in the process.
Yes care providers must be kept on their toes, yes local authorities must ensure the best care provision through tender processes, and yes, they have a duty to ensure that scarce resources are used efficiently, effectively and economically. But we must not let this be an excuse to ignore the needs, wishes, preferences and rights of the people we exist to serve, and we must not strip the humanity out of our social care provision.
The good news is that this isn’t happening across the board; some local authorities are managing to keep the voice of the service user at the heart of their decision making. We must all look to these examples of best practice as inspiration and a reminder that we can and must emphasise the needs of the people who receive the care, and their staff, when embarking on a process of procurement. Even – or perhaps especially – when austerity is biting hard we must not stop listening to voice of the people we are here to support, or we risk losing the gains we’ve made as a sector over the last thirty years.