The growth in number of personal assistants is good news, but some careful thinking is needed to address the regulation issues that arise
Figures released over the weekend show the number of personal assistants – people hired by disabled and older people to help them with their daily lives – has grown by an enormous 35% in the past year.
Unlike home carers, personal assistants are hired by an individual to carry out all sorts of tasks. PAs will often accompany disabled people to the shops or on holidays. They don’t need any particular skill set or training. For those with care and support needs, they are the ultimate in personalised support – their boom is linked to the increase in personal budgets being rolled out across the country.
Someone with a personal budget is free to choose how to spend their funds to meet their support needs, rather than receive services from their council. They can buy the things they have always been given – a few hours of care a week, a trip to the day centre. Or, they can depart from the set menu and go to the gym instead. And, they can become an employer of a personal assistant to carry out tasks which might fall out of the remit of a nurse or formal carer.
People looking for a PA can write the job spec (eg ‘must like football and have good sense of humour’), and tasks required. This makes the PA system the gold standard for giving people control over their own lives and treating them as grown adults, in a system that all too often wants to ‘look after’ people.
But I can’t help worrying that this progress will come undone in the face of the first abuse scandal. Because the fact is, PAs are unregulated. You can hire pretty much anyone to be a PA. You don’t need a criminal records check, you don’t have to require any training or references. This is a knotty issue. On the one hand, why should people have to carry out a CRB check to hire their daughter as their PA? On the other – many disabled people are vulnerable to financial, physical and emotional abuse. PAs coming in to people’s homes, to work unsupervised, unvetted and untrained could be a recipe for disaster.
Of course, we are talking about a tiny proportion of cases. And many local authorities and charities run schemes so people can hire ‘approved PAs’ (already vetted and trained). But these are voluntary. And often pre-trained PAs can cost more. A person with a personal budget may decide the trade off is worth it, and go for the cheaper option.
The issue is proving divisive. Social workers and many PAs themselves are calling for regulation. But others worry this will stifle the market and put off otherwise very talented PAs. Given the government’s new ‘common sense’ approach to safeguarding, we may never move from the current compromise of a partial and voluntary system.
The problem with compromises is that they are fragile. It will take just one extreme case of abuse, and related media outcry, for it to collapse. The resulting government backlash could see the imposition of a rigid safeguarding and inspection regime, possibly strangling the PA industry at birth.
This is why we need clarity asap. There is talk of a personal assistant strategy this year – even if the government resists a compulsory PA registration and abuse reporting system, if must at least articulate a coherent voluntary system, raise awareness of it and encourage care users to adopt it. And it would do well to bring together the plethora of guidance and training initiatives being carried out locally, to create a coherent vision of best practice for PAs.
Like all good bottom up movements, the PA market is growing faster than the government can strategise. But if it doesn’t catch up soon (if not with regulation, at least with recognition) then we open the door to over-regulation at the first safeguarding scandal. And that will be a lose-lose for all involved.