5.9 Different roles: personal assistants
One of the major changes brought about by the introduction of individual budgets has been the growth of a new workforce of personal assistant s (PAs) to support children and adults with a range of needs. The role is no longer a very new one. It does, however, mark an important shift away from formal carers being almost entirely agency-based.
Citizens can use an individual budget to employ a PA (or several PAs) to meet their agreed support outcomes. PAs can be involved in a very wide range of support activities, including personal care, such as showering and helping people to eat, and enabling people to take part in social, leisure and sporting activities The Social Care (Self-directed support) (Scotland) Act 2013 describes over 16 year olds as 'the supported person' because they are responsible for managing their budget or individual service fund (unless they lack legal capacity to make these decisions - see Section 4 ).
The PA may be drawn from existing paid staff or directly from the wider labour market. Sometimes PAs can be family members or someone in the individual's existing social network, although there are restrictions on these circumstances (e.g. when undue pressure has been exerted on the citizen or potential paid carer).
There are some important differences between the role and accountability of a privately employed PA and someone employed by an agency, such as local authority or voluntary agency. These are explored in the next activity.
Activity 5.6 The role of the personal assistant
The video below is about Simon Stevens and Flora, his PA. Flora describes her role and contrasts it with her experience as a carer working in an agency. Towards the end of the video she reflects on issues such as job security for PAs.
Based on Flora’s comments in the video, note in your learning log :
- those aspects of Flora’s role that are important for personalisation
- those aspects that might make the role of personal assistant challenging.
Flora notes many positive aspects of caring for Simon Stevens as a directly employed PA:
- huge flexibility
- limited and simple accountability to Simon
- the emphasis on relationship rather than on procedure.
Nevertheless, it is a working relationship, not a friendship. As Simon says, ‘I’m the boss.’ Towards the end of the video, Flora explains that being a PA can be challenging as well as rewarding:
What I find as the challenges as a PA is you’re not recognised within the care profession if you’re a PA, there’s no mandatory training. You have a lot more responsibility; you don’t have anybody else saying what you can and can’t do. What your boss asks you to do is, is what you have to do, so there’s so much more responsibility with so much less protection. Working purely for Simon, if anything happens to Simon my job’s gone, so there’s no security either. So it’s an extremely intense relationship that we have, you know and I’m sure it’s challenging for him, I’m sure it’s not just for me, I’m sure at times that, you know, it’s challenging for him, and I think it’s all about attitude, all about allowing Simon to be himself, express himself and be what he wants to be.
In workforce terms, then, there are downsides to being a PA. Flora has received no direct training to be a PA. It is possible that Flora’s role as an agency carer provided a range of experience and ‘on the job’ training that equipped her well for her role with Simon. This may have provided her with the confidence she needed to cope with the increased responsibility that being Simon’s PA required. Lastly, although Simon and Flora’s working relationship seemed very good, Flora’s livelihood depended on Simon. If Simon’s health deteriorated, then Flora’s employment position might become more precarious. Indeed, if there was any loss of trust, then as Simon said:
My PAs are employed to be friendly with me, but they are not my friends. We can have a wonderful relationship, but at the end of the day I’m their boss. And if they don’t do what I want, I will – well it won’t work and I’ll eventually ask them to leave.
In 2010 the Scottish Government published a study of the workforce and employment issues surrounding self -directed support (Reid Howie Associates, 2010). The research suggested that PAs needed a wide range of skills and attributes (see Figure 5.10). One PA summed up the necessary personal capabilities by saying:
You need patience in abundance, tolerance, flexibility. You need to be completely confidential and know when to bite your tongue.
The report found that both PAs and their employers were positive about the benefits of self-directed support, and that most support arrangements were working well. However, there were concerns expressed by participants about issues relating to employment rights, pay and conditions, retention, and insurance, for example, that needed to be addressed. Similar issues have also been raised by UNISON, one of the UK's largest unions, in its response to the consultation on the self-directed support legislation:
User-appointed personal assistants hired directly by individuals raise questions over opportunities to scrutinise their working conditions and regulate practice standards; of awareness of employment rights; of their accountability; of opportunities to benefit from best practice developments; and for collective bargaining.(UNISON, 2012, p. 10)