Making decisions about risk
You may remember Sara and her family, who have appeared at several points in this course. In the Introduction to this course we explored the question of who makes decisions in Sara's family - and concluded that the answer was complicated. Sara makes decisions, but she also has decisions made for her by her mother, Lela, and her grandparents, Gita and Samuel.
Activity 4.4 Sara and her family: making decisions
Lela, Sara's mother, is exploring the possibility of self-directing Sara's support with her care needs through an individual budget with Sara's social worker, Heather. As Sara gets older, and her grandparents become less physically fit, it is getting harder for the family to continue to meet Sara's need for support to enable her to keep as , for example, as active, healthy and involved as she wants to be. Lela is discussing with Heather the possibility of employing a personal assistant (PA) to support Sara, particularly with enabling her to keep active and involved with her friends and leisure activities. A PA could also to support Sara with her personal care (including continence care), after school before Lela gets back from work.
Make notes in your learning log to answer the following questions:
- Who do you think should make decisions about accessing and using an individual budget?
- What might be the benefits for Sara of self-directed support using an individual budget?
- Are there risks to Sara - or anyone else in the family - that might arise from self-directing her care?
You may well have thought that all members of this family should have an input into any decision making about Sara's budget. After all, her welfare and interests are closely tied to those of her mother and grandparents (and possibly her father too, if he is actively involved in her life). Any comprehensive assessment of Sarah's need for support should look at all relevant aspects of her world - her needs, those of people who are close to her, and the environment that she lives in. You can find out more about assessing children's needs in Scotland by clicking on this link to the.
You will remember that the Social Care (Self-directed Support) (Scotland) Act 2013 says that parents ultimately have responsibility for making decisions about self-directed support for children who are under 16. So, in this family, Lela (described as the 'supported person') has the legal right to decide if and how Sara's individual budget is used. However, the budget is there for Sara - to enable her to meet the eight wellbeing indicators or SHANNARI outcomes of being S afe, H ealthy, A ctive, N urtured, A chieving, R espected and R esponsible, and I ncluded. Importantly, the Act, as well as other laws in Scotland (such as the Children (Scotland) Act 1995) says that Lela must have regard to Sara's views.
A list of possible benefits and risks for Sara has been started below, but you may well have included other ideas in your own list.
Benefits and Risks
|Choice and control - Lela can choose one or more PAs that she and Sara will get on well with, and who have a child-centred approach to providing support.||Extra responsibility and stress - there are already not enough hours in the day for Lela - will there be support available to help her take on new responsibilities including supervising staff and managing money?|
|Flexibility - Support can be arranged at times of day that it is needed so that, e.g. Sara is able to continue, and maybe broaden, her social activity and leisure opportunities at times that suit her and the family.||Family tensions - There may be tensions if family members disagree, e.g. some family members may be unhappy about having a PA in the family home. Will anyone be able to help the family to resolve these?|
|New opportunities - the whole family may benefit from new opportunities for less pressurised time together, e.g. it may be more possible to take a family holiday with support from a PA, Sara may be able to take up new activities, forge new friendships more easily...||Harm to Sara - If a PA is inexperienced, and, e.g. lacks sensitivity in supporting Sara with personal care, this may threaten Sara's welfare...|