Giving government social care funding directly to service users: a film documentary exploring the power of Self-Directed Support.

The goal of this work will be to look at the rise and fall of Direct Payments using a documentary style approach including the key stakeholders in the process. To do this we need to look at how it came to the fore in Northern Ireland and explore some of the opportunities, in Direct Payments, to transform how social care is delivered, and the weaknesses that currently exist within it.

Direct Payments came into existence within the U.K after the Community Care Act (1996) was passed. This was greeted with an abundance of optimism with some scholars viewing it as having "the potential for the most fundamental reorganisation of welfare for half a century" (Oliver and Sapey, 1999 p.175). It was viewed as a great way of providing individuals in need of health and social care support with autonomy of their care and was seen as moving toward the social model and away from the medical model although others like Fruin (2000) expressed concerns regarding 'vulnerable people' managing their own services.

Others felt it was a way of providing services in a more cost-effective manner than service provision from trusts (Pearson, 2000). Glasby and Littlechild (2009) highlighted that the benefit of providing a cash for care service, in this instance Direct Payments would allow individuals in receipt of it to have control over how to best achieve their desired outcomes as well as much control as they choose over their pre agreed budget.

This was seen by some as a move by the conservative government to reduce spent in the health and social care sectors. Jones et al., (2015) found that care givers found that managing budgets while was intended to increase independence added stress due to all the things involved in managing your own funds and trusting someone you employ to be fit to provide the care required.

Despite these concerns', the assembly in Northern Ireland passed their own specific act, The Carers and Direct Payments Act (2002) which gave their health care trusts the responsibility of informing carers of their legal rights to receive a care assessment for the carer and the individual in need of care separately. If there was a need that needs met after the assessment the board would then have the right to provide a personalised budget so the individual can manage their own package.

Since 2002 , at the same time the Carers and Direct Payments Act (2002) was introduced NI started operating as six regional trusts, with the aim of ensuring that local authorities and health care workers are under a single management structure, whilst increasing continuity of care and simplifying the administration involved but as with any business it has its financial challenges and limitations.

Glasby et al. (2009) argued that some who get direct payments do have difficulties at times with managing the logistics of it all including the administration, such as bureaucratic tasks i.e., sending invoices to their relevant trusts every quarter, renewing insurance and so on. Ferguson (2007) went even further to suggest it can be seen as undermining collective provision of services and as a result has a negative impact of social care workforces due to a growing use and demand for "paid but unregulated personal assistants".

Dawson (2000) however, argues for the use of Direct Payments despite challenges, stating that there is growing evidence indicating that if someone can overcome these issues it does increase their independence in how they live their lives'.

There does seem to be both positive and negative arguments for direct payments but although it can be seen in the eyes of professionals to be failing those it was built to serve there is not enough evidence-based research backed to highlight this in a qualitative or quantitative manner to work toward saving this approach.