1 Understanding personalisation and its history
The Social Care (Self-directed Support) (Scotland) Act was given Royal Assent in January 2013. Its purpose is to ensure that people have more choice and control about the care that they receive.
The law about self-directed support has changed because of a steady shift in policy in Scotland and the rest of the UK towards greater ‘ personalisation ’ of health and social care services. Understanding the principles of personalisation – and how and why these principles are increasingly recognised as crucial to supporting people – is an essential first step to understanding what self-directed support is all about.
The term ‘personalisation’ has been around for a while: it has been an implicit theme in the development of social care policy since the start of the twenty-first century. The definition of personalisation provided by the Scottish government in its report Personalisation: A Shared Understanding is that it:
Enables the individual alone, or in groups, to find the right solution for them and to participate in the delivery of a service. From being a recipient of services citizens can become actively involved in selecting and shaping the services they receive.
Personalisation may seem like the obvious way to organise health and social care services; after all, who could argue with the idea that people should determine how their care needs should be met? But in practice the achievement of personalisation has had a rocky road to climb. It involves a major shift in culture: a move from viewing individuals who use health and social care services ‘... as passive recipients of care to genuine partners in making decisions about the services they need’ (Scottish Parliament Information Centre, 2012, p. 4). It is not just about individuals: we need to think about families and communities and about how people are connected with each other across the whole life course:
A 'whole life approach' to personalisation is one that supports individuals to self-direct all aspects of their lives and over the whole course of their lives within the context of community – acknowledging the full extent to which services should support people to live lives that are connected and purposeful.
This section sets personalisation in a historical context. This will allow you to see where the ideas of personalisation first came from and why we have struggled – and continue to struggle – to put them into practice.