Future of Social Care – Getting it right for PAs

Donald Macleod of Self Directed Support Scotland reflects on getting it right for Personal Assistants

When Derek Feeley listened to people with lived experience of SDS as part of his engagement process, the outcome of his work in relation to Personal Assistants was to recommend their explicit recognition as members of the workforce, achieved with the full partnership of the independent living movement. In the consultation for the National Care Service, this has been interpreted as a registration process.

In collaborating on the process of administering the £500 thank you payment for Personal Assistants through a short life working group, a portal and a helpline, what has emerged is a picture of a neglected,  unacknowledged workforce; lack of credibility driven by fear and perceptions of risk. A successful outcome of this process was reaching 4628 of an estimated 6000 strong workforce. A supplementary outcome of this process was the instigation of another process: a Programme Board focused on Personal Assistants, which I co-chair with Scottish Government. The emerging visibility of this workforce as a result of the pandemic is a positive outcome to be approached with a note of caution.

In elevating the profile of PAs as part of the workforce there is a potential danger in assimilation within the wider social care workforce. If recognition has been translated into registration, will PAs be regarded from the same perspective as the rest of the social care workforce, in terms of scrutiny. Will they be seen as a means of plugging gaps in the system? The ultimate fear expressed by people employing or contracting personal assistants from within the programme board is that registration will be of a standardised nature, resulting in regulation, transforming their homes into care settings. A criticism expressed within the group is that the value of lived experience is absent from the consultation document.

The relationship between the employer/contractor and the Personal Assistant must be at the heart of any improved support. Any developments must be administered from within. The impact of imposing a framework of mandatory training in line with the social care workforce has to be considered. If the key success lies in a supportive relationship, any training administered externally to one party will naturally change the nature of that relationship. There has been a plea for any development or training to involve both parties, nurturing and developing the relationship itself. Where then does this leave the PA in terms of the right to career development and support? A natural fear is that if PAs are trained and professionalised in line with other staff, then the relationship will be under threat. It has traditionally been difficult to recruit PAs, although estimated attrition rates are significantly lower than in the social care workforce. Recruitment is often of an organic nature, based on local relationships. Should there be a national campaign to recruit PAs on a centralised basis? Attempts to recruit at a local level have been successful in part, the maintenance of lists being a challenge as part of overwhelming caseloads facing social work employees. Centralised approaches may lose sight of local intelligence and relationships. Certainly a collaborative cross-border approach might address some of the complexities and inequities involved in paying for travel, when there is availability of support within neighbouring localities. This, however, is challenged by at least 32 differing Direct Payment compositions and a vast range of Personal Assistant pay rates. Social Work staff grappling with these challenges and trying to support individual choice and control across all SDS options would surely welcome a national centralised framework of guidance, retaining local autonomy and flexibility.

What else is needed? If the success of support hinges on a successful relationship, what then when things go wrong? Surely there is a need for support for the PA outwith the relationship, in terms of employment and legal support, grievance procedures and mediation, as well as peer and union support. The right to career development and registration must be an available option for those who wish it, but not imposed routinely, excluding those who do not.

An emerging view from the discussions within the Programme Board has been that until we change our language from service user to employer; from Social Care to Independent Living, we will continue to consider the PA Workforce from the wrong perspective. Surely we can be flexible in considering voluntary recognition and support as an option to ensure that PAs have equity in terms of recognition as well as terms and conditions, valuing lived experience and ensuring that any changes have the full support of the independent living movement, if PAs are to have a legitimate place within a National Care Service.

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