People in receipt of self-directed support face an ‘inconsistent and unpredictable’ complaint process when challenging decisions about their care, a report has found.

Self-Directed Support has been a ‘passport to independence’ for many people since its introduction in 2013, but implementation has been held back by a lack of transparency in decision-making and budget cuts.

Under the policy, people using care can choose from four options giving them increasing scope to organise their support, ranging from the council arranging care for them to them employing staff themselves.

Analysis by healthandcare.scot found there had been little change in the numbers of people opting to take personal control over their support.

Pauline Lunn, Director of charity In-Control Scotland, a charity working to improve the SDS system said: “The Independent Review of Adult Social Care highlighted the need for greater accountability for people using social care, and laid bare the experiences of those who felt powerless in the system.

“Our research found that these experiences are not isolated incidents and that barriers to redress are high and plentiful, with people and advocates alike struggling to navigate an opaque system to challenge when rights are not upheld.”

In-Control partnered with the Centre for the Study of Human Rights Law and Strathclyde Law School to deliver the report. Researchers found recipients of social care support face barriers at every stage of the complaints process when problems arise.

Though complaints processes were generally clear, surveyed advocacy organisations and law centre workers across the central belt said experiences were inconsistent and unpredictable, dependent on both the local authority and reporting individual.

While the 2013 Act aimed to place human rights at its core, advocacy and advice organisations and law centre workers across the central belt voiced concerns that this is often not the case in practice due to a lack of awareness.

The report said: ‘When complaints processes are pursued this can take place within a culture that is neither proactive in improving service delivery in response to individual complaints, nor in framing complaints around human rights.’

The research indicated better outcomes were often achieved when complaints were framed around human rights, suggesting a greater focus on this could be valuable in SDS implementation.

An absence of specialist solicitors with knowledge of the 2013 legislation was also a barrier to judicial review despite this being an essential part of rights protections, according to legal researchers.

Meanwhile, those in receipt of SDS were found to be fearful of seeking legal action in case support was withheld or their relationship with social workers was damaged.

In-Control’s Pauline Lunn added: “As we approach the dawn of the new National Care Service, it is more important than ever that we address this accountability gap to ensure that systems and processes are in place to allow complaints to be heard and actioned, and for people to achieve redress when they are failed.

“The only way to do this is for decision makers to work in partnership with rights-holders to co-design a new way of working which prioritises human rights and dignity."

Donald Macleod, Chief Executive of Self-Directed Support Scotland, told healthandcare.scot last year that social work and advocacy are “critically underfunded” and a ‘significant system change’ is necessary for the ambitious aims of the 2013 Act to be realised.

Though he criticised a lack of lived experience in Scottish government plans for a national care service, Mr Macleod said he was “tentatively hopeful” it would improve accessibility and knowledge of SDS.

 

Read more: SDS: still in the foothills, but tentatively hopeful; Where is lived experience in NCS consultation?; Sector reforms "must put social back in social care"

 

 

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