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Mitigate risks with more information

At the same meeting with charities and the Department of Health that I talked about in my last blog, we also discussed the regulation of care providers and personal assistants. Currently in England, if a person hires an individual who is not employed by any agency, charity, council or company to provide care, then that person – a personal assistant – does not have to be registered with the Care Quality Commission (CQC). This can be if the person is using their own money or a council funded personal budget or direct payment.

Some people were in favour of this as individuals should be able to employ whoever – friends, non co-resident relatives, neighbours etc – they want without that person having to go through the lengthy and expensive registration process. It may be that this is the right choice for the family and provides the most appropriate care.

However, there were other people horrified at the risks involved in this. What if the budget holder doesn’t employ a friend or relative but sees an ad in the local paper and hires a perfect stranger who doesn’t have to be registered or go through regulatory checks? You could be increasing the opportunity for vulnerable people to be taken advantage of.

And what if this stranger was actually being hired by numerous people and it was like a full-time job for them? There could be multiple opportunities for abuse.

The key phrase here is “vulnerable people” meaning people who may not have the capability to make safe choices for themselves. In response, some will ask what gives us the right to decide who has the ability to make safe choices or not? We should not assume that people with disabilities cannot make informed, sensible decisions in their own best interests.

My view is this. Individuals should be able to hire whoever they want – friends, relatives, neighbours, strangers even if they are not registered with the CQC. However, there is a risk that people may make unwise choices (even those who we don’t consider ‘vulnerable’ may do so). What mitigates this risk is information.

If we think there is a danger that they might make unsafe choices, then let’s help them understand the choices they have and decrease the chance of them making poor decisions that could lead to abuse. People should have access to brokerage and support services that know the local area, people and providers and can help individuals find the people and services they want. And part of this may be advising them who is and who is not registered with the CQC.

This won’t mean that nobody will ever make a bad or unsafe choice that will lead to them suffering harm. Unfortunately, no matter the system, abuse will always happen. It happens now even with people who work for registered care providers.

Take care

Gordon

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March 29, 2011 - Posted by | Health, Mental Health, Relationships, Social Care | , , ,

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