Harnessing the opportunities for independent living

It feels almost impossible to think about opportunities to advance independent living in England, such is the parlous state of the public finances and recent direction of public policy.   But in the spirit of the motto of this blogsite to ‘make hope possible, rather than despair convincing’ I’m going to have a go.  After all, the early pioneers of independent living did so against often unimaginable odds and some of the chief victories of the disability movement happened not under a centre left, but under a conservative government.

From social welfare to social investment

The first thing I want to highlight is how so called ‘austerity’ is not always cover for public spending reductions, but for public spend re-allocation. That is, recent government policy has often been about re-engineering the State to serve a different purpose, not necessarily shrinking the State (though that is clearly a goal as well). Such re-engineering in places appears to signal a trend from a social welfare state to what one might call a ‘social investment state.’ A prime example is the policy of 30 hours a week free childcare for households earning less than £100,000 a year. Here, a significant investment of public resources is designed, it is hoped, to increase labour market participation, increase tax revenues, decrease benefits expenditure and improve children’s life chances. Contrast this with social care, which continues to be viewed not as an investment but as the spiraling cost of an ageing society and is suffering eye watering cuts, or disability benefits, which suffer misrecognition and stigma permitting recipients only to be cast as ‘on the take’ or ‘vulnerable’.   Can we learn from the repositioning of childcare, not as a personal private matter, but as part of the public infrastructure and demonstrate the public interest case for investment in independent living?   This demands both credible, compelling evidence, new ideas for policy and clever strategic communications – something the DRILL programme might usefully support.

Halving the disability employment gap

Some regard this government goal with suspicion and the fact that policy makers and think tanks consistently start by identifying the primary ‘problem’ as the design of benefits and their effect on individual ‘incentives’ to work does little to assuage concern that the real goal is to extend sanctions (including in relation to failure to pursue courses of health treatment and rehabilitation) in order to cut benefits.

However, the commitment is also throwing new light onto the problem of barriers to employment for disabled people. The government has already decided to replace the Work Programme and to increase spending on Access to Work, and a White Paper is on its way.

DWP has pilots underway involving the use of personal budgets to pay for bespoke employment support.   The creation of the joint Department for Work and Pensions/Health ‘Disability and Health Employment Unit potentially offers opportunities to pick up where the Right to Control left off in looking beyond narrow ‘employment support’ at the wider supports a person might require to engage in the labour market. Moreover I feel there is a chance to reposition employment as a building block, rather than mere outcome or expression, of ‘independent living’ – in particular as a route to social connections, challenging the isolation that often predicts wider exclusion.   In this sense, employment and employers become part of the means to the end of independent living.

Health and social care integration

Again, people have many legitimate concerns about what this will mean in practice: that the cultures and approach of the health service will dominate, undermining the social model of disability both at a theoretical level but also in everyday practice as clinical decision making and health outcomes trump everything else; that what money is available among the NHS and local councils narrows down to focus only on ‘healthcare in the community.’ Conversely there are concerns about the implications of integrating two systems based on very different traditions of funding and entitlement.

Yet at the same time there are many areas where the doctrines of early action and prevention coincide with independent living and where the steps required to promote health and well-being are essentially the same as those long pursued by independent living advocates. For example I recently did some work in Scotland where disabled people in one city had been asked about their priorities for health and well-being. Top of their list was having somewhere to go and something to do. Here we can see the goals of choice, control and participation coincide the aim of overcoming isolation.   If resources could be levered out of acute healthcare towards supporting participation under the rubric of prevention of isolation, this strikes me as an opportunity to grab hold of.

Law Commission review of the Mental Capacity Act

With a draft Bill expected this year, the Law Commission consultation on replacing Deprivation of Liberty safeguards proposed that they be replaced with a new system, to be called ‘Protective Care’. The Law Commission suggest that

‘This system is not focused on authorising deprivations of liberty, but instead upon providing appropriate care and better outcomes for people who lack mental capacity and helping their family and carers.’

Patient safety

Bit of a tangential one this perhaps, but patient safety is a major priority for the current health secretary, mostly because of the Mid Staffs scandal but also in light of the death of Connor Sparrowhawk. While his focus may be on what happens to people in hospitals, it nevertheless also raises the question of why some people are in hospitals as opposed to being supported (and treated) in the community. Certainly the recent meeting of Connor Sparrowhawks parents with the Health Secretary indicated that this was the way he identified the problem.

Care Act implementation

We should make the very most of the opportunity presented by the Care Act.  Yes, it seems absurd to talk about social care as offering any opportunities in the face of the scale of cuts being implemented, but at the same time we have a number of key things enshrined in law and the opportunity is to positively shape the manner in which they are implemented – whether information and advice, care plans, personal budgets or independent advocacy. This is partly about monitoring, such as the report produced by the Independent Living Strategy group last year. But it is also about promoting ideas and showcasing best practices – about influencing by demonstrating the art of the possible.   In particular, it is about showing that independent living, far from being a problem, offers much needed solutions.

Beyond the State

Finally, I have concentrated here on the role of the State in advancing independent living, but in practice what makes the greatest difference in the years to come is likely to lie beyond the State – new technologies, the changing nature of the workplace, social action, new civil society institutions, social attitudes.   I will explore these in a separate post soon.

I am sure there are other opportunities, just as I am sure people will regard what I say above as hopelessly naïve, but I look forward to the debate.

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Integration of health, social care and beyond – mergers, acquisitions or hostile takeovers?

All our lives rely upon functioning infrastructure and on mutually understood and commonly practiced rules and rituals. From the moment we wake up to when we go to bed and on through the night we depend on stuff to just… work. From switching on the light in the morning, checking our Twitter feed, making a cup of tea and getting a shower to catching the bus or train, or driving our usual route to work, to arriving at work, switching on our computer, accessing our emails, using the photocopier, making ourselves a cup of tea, going to the toilet, a post work drink, making our way home, making our dinner in the oven, phoning friends and settling down to watch the TV.   Only if these things function seamlessly can we function seamlessly. All the while, multitudes of different actors are each independently ensuring that this infrastructure is working properly.

When the chain ceases to function seamlessly, we can no longer function seamlessly.   There’s no hot water to take a shower. The train is cancelled. We do not have an internet connection and so on.   Sometimes we wrongly assume that things are going to be there for us when we need them, only to find out too late that they are not – like flood defences, or social care.

To these ends it seems intuitive to welcome coordination and closer integration of different elements of public infrastructure, including health and social care, as a vehicle for creating more seamless support.   Yet with such integration come risks of both ‘domination’ and ‘infection’.

There is clearly a trend towards the integration of health and social care. On the one hand this makes sense in removing some of the nonsensical and artificial divisions that exist between the two systems, and in making better use of public resources, in particular through early action and prevention. It also offers the prospect of leveraging resources from the still popular and comparatively protected and well-funded NHS into the still largely unknown, already under-funded and increasingly decimated social care system. Yet there seems a genuine risk that social care simply becomes ‘healthcare in the community’, with health outcomes dominating strategic decision-making and the outcomes attached to individual packages of support. In this scenario social care is increasingly positioned as an answer to the pressures of the NHS and little more – an acquisition or hostile takeover, not a merger – and there is certainly evidence of this in the recent rhetoric of politicians from all sides and from the head of NHS England, Simon Stevens. Despite the Care Act, the role of social care in supporting wider dimensions of ‘well-being’ as ends in themselves, such as participation in family and community life or employment could be overwhelmed.

Regarding infection, the risk cuts both ways: healthcare largely remains a system in which professionals knows best, whereas social care has at least strived to embrace notions of self-directed support. On the other hand, healthcare remains overwhelmingly focused on improving people’s lives, irrespective of means, whereas social work is increasingly focused on gatekeeping ever-scarce resources and on managing risk.

It seems probable that we will soon be talking about how wider public infrastructure might be more closely aligned or integrated, including for example employment support, support with education and social security.   The government has recently announced its plans to devolve Attendance Allowance to local councils.   In Scotland, to which much of the disability benefits system is to be devolved, the Convention of Scottish Local Authorities (Cosla) is already making a bid to administer the benefits alongside its roles in relation to integrated health and social care. A new ‘Disability and Health Employment Unit’ has been established under the auspices of the Department for Work and Pensions and Department for Health.

Which imperatives will dominate as these areas of policy and delivery become more closely aligned and integrated?   What culture and ethos will infect the whole? Can DWP’s culture of behavioural management, conditions and sanctions successfully combine with social care’s goal of restoring self-determination to those requiring support (certainly the experience of the Right to Control pilots suggests not)?   Will getting well become an obligation, with people forced into courses of health treatment as a condition of benefits entitlement, especially in relation to mental health for example?   Will health treatment increasingly be subject to the same gatekeeping as social care? How can the idea rooted in modern ‘welfare to work’ policy that receiving benefits amounts to dependence be combined with the idea of people receiving money in the form of direct payments from the State to support their independence?   And what of public attitudes – which differ markedly in relation to support for the NHS when contrasted with social security or social housing for example? Will greater integration help soften attitudes where they are presently harsh, or harden them where they are currently more benign?

There is a grave risk that we are on a slippery slope towards integration without first asking what the various items that are being integrated were originally for, how they function in different ways and hence what might be lost as well as what is to be gained.   How can we harness the ‘added shareholder value’ of integrating public spending and services without the risk that hostile takeovers rob us of those things we hold dear while increasing the influence of those we object to most?

 

A future for social care in a Scottish ‘investment state’?

By Neil Crowther*

I’m really excited to be travelling up to Edinburgh this weekend to support an event hosted by the Independent Living in Scotland project on Monday.  The event is part of ILiS’s ongoing dialogue on the future of social care in Scotland, bringing together diverse social care stakeholders to develop a ‘statement of ambition’, which I am helping to draft.

The reading I have done in preparation is depressing and terrifying in equal measure.  Scotland has already endured massive spending cuts, but with respect to everyday services such as social care the biggest cuts are yet to come.   The Commission on the Future of Public Services in Scotland estimated that the Scottish public sector would face a £39 Billion shortfall between 2010/11 and 2024/5 – the year public spending is forecast to return to 2010 levels. To put that figure into perspective, it is equivalent to funding adult social care in Scotland for 13 years.

In the immediate term there seems little that the Scottish Government is able or prepared to do about Westminster-imposed austerity.  Scotland’s Finance Minister John Swinney recently ruled out using powers to set higher income tax rates in Scotland and froze council tax for a further year.  The grant to Scotland from the UK government will continue to go down in real terms for the next decade as George Osborne pursues a budget surplus.  Since Scotland introduce free personal care for older people in 2003, local council charging for social care has risen sharply, albeit unevenly with councils charging between £18 per hour and zero for home care depending on where people live.  As with the rest of the UK, eligibility for social care focuses on those with ‘critical or substantial’ needs and people who are eligible are receiving less generous packages of support or having their packages cut.

But amidst the gloom, some potential light.  Scotland may have decided to remain part of the UK at its recent independence referendum, but be in no doubt that the political economy of Scotland is developing along very different lines to that in England.

Of particular interest to readers of this blog will be central role that the UN Convention on the Rights of Persons with Disabilities, and human rights more generally, is playing in shaping policy and programmes.  The Scottish Government is presently consulting on its draft delivery plan on the UNCRPD, while the Convention of Scottish Local Authorities (Cosla) is ahead of the game having already published its own CRPD implementation plan.       In December, First Minister Nicola Sturgeon indicated the Scottish Government’s preparedness to consider incorporating the Convention and other international human rights treaties to which the UK is party into Scots law.

Arguably the biggest influence on social care reform in Scotland right now is integration of health and social care.  Following the Public Bodies (Joint Working Act) 2014 National Health and Wellbeing Outcomes have been established for health and social care and there is a requirement for NHS Boards and local councils to integrate health and social care budgets.  Each area will have an integration board by April of this year.   While there are many reasons to celebrate these developments, there is also concern that social care may become narrowly focused on ‘healthcare in the community’, undermining its broader role in supporting disabled people’s social and economic participation.  This is a particular risk if the only new funding to go into social care comes from the NHS.

To those ends, another big change on the horizon is contained in the Scotland Bill: devolution of social security powers related to disabled people.  This will see DLA/PIP, Carers Allowance, ESA and other benefits devolved to Scotland.  On the positive side, this presents an opportunity for Scotland to cultivate an entirely different approach to that which has evolved in England, and in particular to carve out a social security system that genuinely supports independent living.  Yet there is a grave risk that this money could end up plugging gaps in underfunded social services, and indeed Cosla has already proposed that such benefits should be administered by local councils.

More broadly, what I find exciting is the potential for Scotland in time to emulate a Scandinavian model, shifting from a ‘social welfare’ approach to a ‘social investment’ one. Nicola Sturgeon seemed to exemplify such thinking in her articulation of a future SNP government’s policy on childcare when she said this week:

‘Our most transformational infrastructure investment in the next Parliament will be in early years and childcare.  We will provide parents with 30 hours a week of government funded childcare enabling them to return to work, to pursue their careers and to know that their children are being well cared for, well educated and given the best start in life’ 

Social care has not benefited from such framing to date, nor has it enjoyed a research agenda to underpin a narrative that positions it persuasively not as a growing cost, but as crucial part of the national infrastructure ripe for investment.  As I have argued elsewhere, I believe that for independent living to have a future, it also has to be situated within the frame of social investment, not social welfare.

The public spending environment in Scotland is bleak.  Yet choices will continue to be made about how to spend the many billions of pounds that will still be invested in public services over the coming decade. Spending that can be shown to save money down the line, to strengthen communities and which can contribute to economic growth and prosperity is most likely to win out.  Without a narrative and underpinning evidence to sustain the case that social care (and independent living more widely) meet these investment tests, it will I believe continue its journey to the margins.

 

*Neil is writing in an independent capacity

 

 

 

 

 

Promoting people’s right to choice and control under the Care Act 2014 – how are local authorities performing?

13 October 2015

The Independent Living Strategy Group has today published a report concerning the performance of local authorities in respect of people’s right to choice and control under the Care Act 2014.  The report draws on the findings of a survey of social care recipients regarding their perceptions of choice, control and well-being over the past year and of a survey of local authority guidance regarding the Care Act 2014.

The key findings are:

  • Despite the emphasis on wellbeing and choice and control in the Care Act 2014, almost half (45%) of respondents to our survey said that their quality of life had reduced and almost a third (30%) said that they had experienced a reduction of choice and control over the past year
  • Half said their need for support had increased and yet only 22% had experienced a corresponding increase in paid support over the past year. Most additional support came from family and friends. Where people did receive additional support it was most likely to come from family and friends if available.
  • Of the 57% of respondents who had their care package reassessed in the previous 12 months, 17% said that they had been told that there was a financial cap placed on certain types of expenditure
  • 29% of respondents reported restrictions being placed on their use of direct payments or personal budgets. 33% didn’t know whether they were subject to any restrictions. 
  • Of those reporting that their use of direct payments or personal budgets had been subject to restrictions, stipulations regarding the tasks of personal assistants/carers were most commonly reported (48%). 18% said that they had had their personal support plan declined. 14% reported they had been limited to choosing from a shortlist of providers. 11% said they had been limited to using a pre-payment card.
  • Of those survey respondents who are transitioning from Independent Living Fund to local authority support, 14% reported they had been told that they should expect less support in future, while the majority (56%) said they had not been told whether their support would increase, decrease or stay the same.

Our analysis of local authority guidance on the Care Act found that:

  • Local authorities are generally not yet meeting their duties to ensure the provision of clear, accessible, accurate and locally tailored information regarding care and support.   This means that those seeking or receiving care and support lack access to information regarding their rights and entitlements, sufficient to exercise choice and control.
  • Some local authorities have produced ‘quick guides’ explaining the key features of the Care Act. These rarely emphasize choice and control and the universal entitlement to a personal budget.
  • Local authorities are not defining personal budgets in a way that corresponds with their definition in the Care Act statutory guidance. Whereas the guidance describes personal budgets as a mechanism for choice and control, the guidance we reviewed typically describes personal budgets only as the sum of money allocated to meet care and support needs.
  • Some local authorities infer that if a person opts for their personal budget to be managed by the local authority that they should anticipate having less control over how it is spent than if they choose a direct payment. Some say, in effect, that the person will need to accept that the council chooses to provide. This does not meet the requirements of the Care Act statutory guidance which says that the option chosen should have no bearing on the ability of individuals to direct their support.

Looking beyond local authority care and support:

  • In relation to NHS Continuing Care, some Clinical Commissioning Groups have adopted explicit policies which place financial limits on the amount that will be spent to support an individual to live in their own home as opposed to residential or nursing care. This is likely to have a particularly impact on people who would previously have accessed support from the Independent Living Fund

Alongside the report the Group has published a ‘key messages checklist’ to assist individuals in understanding their rights and local authorities to meet their duties to produce clear, accurate and accessible information about the Care Act 2014.

The state of independent living – survey

There’s still time to complete this important survey on the state of independent living.

This short survey is being carried out by a group of organisations and activists that have been meeting for past two years to think about how to move the independent living agenda forwards. You can read more about us here http://www.in-control.org.uk/blog/losing-control.aspx

We want to know about the experiences of people who access support from their local councils and find out whether choice and control over that support is changing. To help us understand these issues we would be extremely grateful if you could spare a few moments to complete this short survey to share your own experiences.

No right ignored… just based on duff advice from the Law Commission

This afternoon I finally sat down to read the Green Paper ‘No right ignored, no voice ignored’, in part prompted by Lucy Series’ tweet regarding its (mis) interpretation of independent living. And how right Lucy (as ever) is.  This isn’t a minor issue – this whole paper is premised on the idea that people with learning disabilities and/or autism must enjoy the same rights as everyone else to live independently and to be included in the community.  To get such a fundamental underlying principle so wrong does not bode well for the rest of the proposals.

Para 1.5 says:

‘During the passage of the Care Act through Parliament, the issues of independent living and inclusion in the community were carefully considered. However, the Care Act does not include an explicit duty to promote independent living. The term “independent living” is usually associated with Article 19 of the UN Convention on the Rights of Persons with Disability but the term is not defined in article 19.’

Actually I don’t think that in the UK the term is usually associated with Article 19. It has a much longer history in the UK and a definition was agreed by the previous government and included in the Prime Ministers Strategy Unit report on the life chances of disabled people – a definition which formed the basis the subsequent Independent Living Strategy in 2008.  It also underpinned the Valuing People Programme.  The definition was originally drafted by Gerry Zarb when at the Disability Rights Commission:

‘Independent living refers to all disabled people having the same choice, control and freedom as any other citizen – at home, at work, and as members of the community. This does not necessarily mean disabled people ‘doing everything for themselves’, but it does mean that any practical assistance people need should be based on their own choices and aspirations.’

Nevertheless, if the UN Disability Convention is a touchstone here (and I welcome the fact that it is) then the Paper’s claim that ‘independent living is not defined in Article 19’ is somewhat challenged by Article 19 itself:

Article 19 – Living independently and being included in the community

States Parties to the present Convention recognize the equal right of all persons with disabilities to live in the community, with choices equal to others, and shall take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community, including by ensuring that:

a) Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement;

b) Persons with disabilities have access to a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community;

c) Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs.’

The Green Paper goes onto note however how:

The Law Commission explicitly looked at whether “independent living” should be included in the Care Act and they concluded that what was important was that people’s wishes and feelings about where they lived were respected. It is also important to note that, as many self-advocates tell us, this is not just about where you live but about exercising choice and control over who comes into your home and who supports you.’*

Paragraph 1.6 of the Green Paper says:

‘As the Care Act is implemented from April 2015, we will monitor its impact and explore whether guidance needs to be made clearer, for example, to underline the specific intent of the legislation for local authorities to promote independent living where this is the person’s choice. Some people will want to choose other arrangements which are appropriate to meet their needs. For some people, this might include residential care. There is no policy to prevent or deny people choosing these arrangements, including for people with a learning disability and for those with mental health needs.’

Perhaps the authors of the Green Paper might like to blame the Law Commission at this point because here’s the thing: they got it colossally wrong.  In fact it seems clear that when they read the bit of Article 19 that says very clearly that people ‘should not be obliged to live in a particular living arrangement’ they read it as ‘people should be obliged to live in a particular living arrangement.’  How else could the Law Commission have read Article 19 and concluded that: ‘We agree that a principle based on an assumption of home-based living would not be suitable to be included as a principle in the statute. The key issue should be the person’s wishes and feelings, and in effect this principle could skew choice in one particular direction’ ? 

Not only is Article 19 (a) crystal clear on the point about respecting a person’s right to choose where and with who to live, Article 19 (b) then talks about the need for States to ensure the provision of ‘in-home, residential and community support’ (my emphasis).   Advice to these ends was provided to government by an expert source: the Joint Parliamentary Committee on Human Rights.  In its 2012 report on independent living it noted how:  ‘This (the Law Commission’s) conclusion appears to be based on the assumption that independent living equates to “home-based living”. Article 19 makes clear that disabled people should “have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement”, and that the option that should be made available to people should include “in-home, residential and other community support services”.’  Yet JCHR’s advice was and still is being ignored by the government.

What the Law Commission was perhaps distracted by and which may explain why it is reiterated again in the Green Paper is the emphasis in Article 19 on rights to full inclusion and participation in the community and to the need to ensure that whatever supports are available for people to choose – whether in-home, residential or community supports – ‘prevent isolation or segregation from the community.’   The Law Commission read this – entirely incorrectly – as limiting people’s choices only to receiving support in their own home.  The Green Paper shares this misunderstanding when it says with respect to the possibility of issuing further guidance to local authorities ‘to promote independent living where this is the person’s choice. Some people will want to choose other arrangements which are appropriate to meet their needs. For some people, this might include residential care.’ (my emphasis)

In the avoidance of doubt and to make this as simple as possible: if a person is living in a place or with a person that they did not choose to live with then they are not enjoying independent living.  If a person is isolated or segregated from the wider community by  living arrangements that they did not choose, or which they were obliged to live in, then they are not living independently.

People do not ‘choose’ independent living, because independent living is choice.

Both the Law Commission and the authors of this Green Paper either fail to understand this or are providing wilfully misleading accounts of the meaning of independent living and of the UK’s obligations arising out of it having become party to the UNCRPD.  If the former, then they should both correct their mistakes.  If the latter then I would venture that it is an attempt not to respect ‘the equal right of all persons with disabilities to live in the community, with choices equal to others’ but rather to justify the very restricted choices faced by far too many people and which in practice will continue to isolate and segregate them from their families and the wider community.   If this is the case, then all those who have been campaigning for a change in the law should recognise that this Green Paper is trying to hoodwink us into believing that it is genuinely committed to equal rights when it very clearly is not.

Postscript

*While we’re on the Law Commission’s inability to understand the law, in making its case against including independent living as a statutory principle in the Care Act the Law Commission said: ‘this concept is covered adequately by Articles 8 and 19 of the United Nations Convention on the Rights of Persons with Disabilities.’  

Firstly, it is difficult to see why the Commission saw fit to place emphasis on Article 8 – which concerns awareness raising and has little to say in particular about independent living.  But more crucially, the Law Commission should know that the obligations undertaken by the UK – as a ‘dualist’ State when it comes to international treaty Conventions – is to implement the Convention through domestic policies and laws. The Convention does not enjoy statutory force in its own right.  Article 4 of the Convention requires the UK government(s):

‘a) To adopt all appropriate legislative, administrative and other measures for the implementation of the rights recognized in the present Convention;

b) To take all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices that constitute discrimination against persons with disabilities;

c) To take into account the protection and promotion of the human rights of persons with disabilities in all policies and programmes;

The fact that independent living is included in the Convention should therefore have led the Law Commission to conclude that it must be reflected adequately in the Care Act.  In deciding against this they not only failed to understand its standing in UK law and the obligations of the government, they chose simply – and without I would argue any mandate to do so – to contest the very principles underlying an international law that both government and Parliament had agreed to be bound by.

It is sad that the scrutiny Committee on the Care Act, chaired by Paul Berstow MP (previously Care Minister) also chose to reject representations calling for a statutory principles on independent living, instead also heeding misleading advice of the Law Commission.  Mr Berstow went on to chair the Commission on the Future of Residential Care. One of its members Clare Pelham, Chief Executive of Leonard Cheshire Foundation, major provider of residential care services to disabled adults of working age, recently wrote  a piece in the Huffington Post arguing that ‘Instead of talking about someone ‘going into a care home’, we should talk about them moving to a new home because it’s the best choice for them…..wherever you choose to live, that’s your home. And that’s why you need your own front door. And for many, that’s also why they are happy to see it as a choice. A choice to sell their current house and buy a lease or take a tenancy in housing with care. A positive choice.’   

As Lucy Series has deftly noted tonight, the interpretation of ‘independent living’ in the Green Paper is that defined by service providers as a service model, not by disabled people as freedom to lead the lives they choose.  And it seems clear that the resistance to the idea of a statutory principle on independent living has come principally from those with a stake in the future prosperity of residential care, however one attempts to reframe it. Given the facts about the precise obligations arising out of of the UNCRPD, the only thing they should fear is people’s choices and aspirations.