By Rob Greig
I‘m old enough to remember the ‘right to work’ campaign. Whilst I always had some reservations about elements of its rhetoric, it felt important that all people should have the opportunity to work and, as a result, obtain income, a reasonable standard of living, contribute to society and build and develop relationships with co-workers.
NDTi’s recent research into the use of personal budgets[i] to support people into paid work drew some worrying conclusions about attitudes from parts of the social care system towards disabled people working. Put simply, a common if not prevailing attitude found amongst social workers was that work/employment was not an important social care outcome.
There were a number of reasons for this, most notable were:
- A continuing belief that people with more complex disabilities could not gain and sustain paid employment
- Considering supporting people into work as only the responsibility of Job Centres,
- A belief that in difficult financial times, social care funding should be targeted on providing basic personal care and safeguarding and that supporting people into paid work was an unjustifiable luxury.
The research described how these things led to gaining and retaining paid employment not being identified as an outcome in assessments. Consequently, no funding was allocated through RAS systems and support planning failed to draw in the necessary service and system supports.
The new Care Act[ii] contains an important change that should help to address this problem. The new Act states that a core responsibility of local authority social care functions is the promotion of wellbeing. The definition of wellbeing explicitly includes work. This change should not be under-estimated. Gone is the outdated mentality of the 1948 National Assistance Act that saw the public duty as being to (essentially) provide residential and day care for disabled and older people, and in its place is a concept of citizenship and inclusion. The role of social care is now to support people to ‘get a life’ and, as part of that, get a job.
There are inherent challenges and tensions in this as it requires a cultural shift by services. So, let’s take the above three points from social workers as our starting place:
To deal with the simple one first – there is a wealth of evidence that even people with complex disabilities can, with the right support, gain and retain jobs. For example, NDTi’s recent research for the School for Social Care[iii] clearly showed this for people with learning disabilities. The challenge is about people’s belief systems and an understanding of the evidence about how to do it – not whether it is possible.
As for the respective roles of Job Centres and the social care/healthcare system, in an ideal world the employment sector would be fully inclusive of disabled people. However, principles and aspiration have to be grounded in reality and recognise the journey that society in taking towards full inclusion. Most Job Centres and disability employment advisors do not have the experience and skills to work with people with complex disabilities. Add to that, local authorities have resources that previously (and indeed currently) were spent on day centres and the like. In the new wellbeing world, these should clearly be diverted to functions like supporting people into paid work. A partnership between the social care and Job Centres is sensible in terms of both expertise and resource usage – with social care supporting (i) disabled people into work and on a journey towards long term support from DWP programmes, and (ii) DWP programmes on a journey to developing the competence for full inclusion of all disabled people.
So what about the money argument? The most ridiculous thing about the current trend of social care and NHS funding for employment supports being cut, is that commissioning evidence based employment supports for disabled people saves money. This holds true whether from the perspective of social care on its own[iv] or the taxpayer as a whole[v]. If wider social return on investment is considered, the benefits are event greater[vi]. A view that social care should be focusing on basic care and safeguarding in these difficult financial times not only limits people’s lives, but also increases the cost to services and the taxpayer in the medium term.
Employment is not a luxury. The opportunity to work is something we should aspire to for everyone. It creates additional life chances for people and, when done properly, saves money. Across the country, individual social workers and some Council’s understand this and do good work – but they are the exceptions. As local authorities gear up to implement the Care Act, with new guidance being written on support planning, national training packages being developed, amended regulatory regimes put in place and so on – will access to paid work assume a central place in all of these and the social care system adopt a new mindset towards people being in paid work?
About the author
Rob Greig is Chief Executive of the National Development Team for Inclusion. He was previously National Director of Learning Disabilities at the Department for Health and Vice-Chair of the ODI Independent Living External Advisory Group.
[iv] Beyer S (2008) An Evaluation of the Outcomes of Supported Employment in North
Lanarkshire (2007) Welsh Centre for Learning Disabilities, Cardiff University
[v] Department of Health (2011a) Financial Case for Supported Employment; Commissioning
High Quality Supported Employment Makes Financial Sense, Department of Health,
[vi] Coutts P, Durie S (2011) An Evaluation of Social Added Value for Real Jobs, the Action
Group, Edinburgh. Social Return on Investment (SROI) Analysis, the Scottish Government,
Employability and Tackling Poverty Division (August 2010, revised May 2011 for SROI