We are entering into an important phase with regard the setting of standards and regulation of home care. Several months ago, first drafts were published of standards and also a draft bill.
Since then, there have been updates to the standards and also we have also been advised that an Authorisation Scheme for the provision of home care services within the disability sector is to be published along the lines of the scheme we have seen under Older Persons. This authorisation scheme will draw up a list of approved corporate providers for home care provision within the disability sector.
The first published standards and draft bill on home care provision clearly highlighted the fact that personal budgets and personal assistance services were different and would not come under these initiatives in the same way as normal top-down home care provision.
However, since then, there has been a lot of lobbying on the part of large corporate providers to ensure that personal budgets and personal assistance services are regulated in the same way as mainstream top-down services.
With this in mind it is interesting to see that in the latest draft standards circulated on the 6th March, the definition of home support is broader that in the draft regulations and the specification of “in the home” has been removed and as such could be interpreted to include PA services.
It is imperative that the new Home Support Adults Disability Authorisation Scheme doesn’t unintentionally diminish the independent living model of personal assistant service currently been delivered. The work being carried out, at present, to clearly define the difference between a personal assistant service and a home support service is crucial with regards to protecting current and future personal assistant services.
The overall concern is that individuals who should be offered a personal assistant service will be provided with a Home Support Adults Disability service because there is no clear guidance for those who are commissioning the service, particularly if they don’t have a clear understanding of personal assistant services. There is a significant risk of this happening if the new Home Support Adults Disability Authorisation Scheme commences before there is a clear definition and assessing criteria distinguishing the difference between home support and personal assistant services.
A potential unintended consequence of the new Home Support Adults Disability Authorisation Scheme, is that if providers don’t sign up to the authorisation scheme, they will not be offered any new work so therefore it will be providers who primarily deliver home support services that will be offered all new services. It may also prevent people from contracting with or employing PA’s directly.
The WRC pay alignment ruling could further complicate this issue as well.
It is vital that in any move to bring in regulation and standards for home care services especially in the disability sector, that people retain the right to go down the independent living road with personal budgets and personal assistance services and can have control over what their support looks like and who provides that support.
It is imperative to retain real choice within our home care arrangements.