More people are supported at home on any day of the week than in hospitals and care homes combined, but in the community, care at home recipients had services withdrawn with alacrity and without much in the way of alternative support. The immediate cessation of visits and meal services put many vulnerable individuals in potential peril. Families often had to step into the breach, and, when shown to be managing, often did not get services reinstated as quickly as they should have. Day Centres and locations all had to close doors, thus denying individuals important social contacts and stimuli.
Care packages that truly are about an individual’s needs, that can be responsive to changing circumstances, making good on the right to home and family life, the right to self-determination, autonomy and participation, and utilised in whatever way derives the greatest support are exactly what the Self-Directed Support Act was designed to create. With informed choice, control, and involvement in their care and support, SDS can enhance lives. A more committed approach to the most flexible iteration of these would have seen individuals able to pivot away from care visits from providers that could not fulfil those needs. The Scottish Government issued guidance encouraging councils to react to these exceptional circumstances in creative ways, but a survey of carers undertaken by Health & Care Scotland (reference) found that more than half had not been made aware that their support could have been utilised in a different way to maintain levels of support. Packages could have been redirected towards paying for technology that would allow for connections to be maintained, transport costs for food shopping, home gym equipment or payments to family members who stepped into the breach when regular support services were halted.
We would echo the Health and Social Care Alliance in their recognition that, although UK and Scottish COVID-19 emergency legislation allows for an easing of health and social care assessment duties, there is a lack of transparency and independent scrutiny of decisions to reduce and cut social care through a narrower application of the social care eligibility criteria, and the grounds upon which these decisions have been made. The British Institute of Human Rights also express similar concerns, but additionally recognise that social care staff need to be equipped to be able to recognise when an individual’s human rights are at risk on account of emergency legislation measures.