Cash payments in context: (self-)regulation in the new social relations of assistance

Abstract

Cash payments to meet social care needs offer the possibility for the direct employment of personal assistants using public funds. Empirical work internationally has identified the benefits of cash payments. However, there has been less interest in the relationships between employers and their employees. This article offers some reflections upon the employment relationship from the perspectives of employers who have learning difficulties and their personal assistants. The study involved eight employers, their supporters and their personal assistants in an English city. A grounded theory approach was utilised and interviews were analysed using a framework approach. This article argues that the relational aspects of direct employment arrangements have not been adequately considered in academic literature and the policy framework. These insights can add to debates around how social care support mechanisms can offer responsive assistance whilst questioning the assumed 'empowering' effect of an unregulated market.

The employment conditions of social care personal assistants in England

“…Two (2 per cent) did not know if they had a contract. Some with contracts felt that they were out of date, no longer reflecting the content of their role or were vaguely worded (as reported by the seven PAs in Graham’s, 2015 study). These ambiguities played out in different ways in the workplace, and created some awkward situations:Now, one of my employers believes that […] if I go out for them and we have something to eat, they should pay for the food, but then the other employers argue that I wouldn’t get my lunch paid for in any other job, I should pay for that myself, and I can see both sides of that and I don’t know myself, but the contract has such grey areas, it’s hard to know who’s right […] it’s hard for them because the employer doesn’t have training, in terms of being an employer, in terms of how to make sure we’re treated right as employees a lot of the time, like […] my wages getting paid late; I spoke to ACAS (The Advisory, Conciliation and Arbitration Service) and ACAS said, well, that’s unlawfully withholding of wages, but it makes it difficult for me to then go and say to them you can’t do this, because it’s not like a normal job where they have a HR department or whatever to get that sorted.(DM550138)…”

Lost in translation: implementing personal assistance in an East Asian context

“…Unlike professionally managed, often medicalised social services, a main principle of PA is enhancement of disabled people's self-determination (Brennan et al, 2016;Christensen and Pilling 2014). Thus the most common model for PA is direct payment to users (Askheim 2005;Christensen 2012;Graham 2015) so they can choose where, when, how, and by whom assistance is provided (Ratzka 1996).…”

Skill mix: The potential for personal assistants to undertake health‐related tasks for people with personal health budgets

“…Neither does the local authority, or anyone, necessarily know of care workers employed privately by self‐funders (ibid). Some recent studies have explored the dynamics of PA/employer relationships (Graham, ; Shakespeare, Stöckl, & Porter, ) and PA characteristics (Skills for Care, ). Risks such as neglect, exploitation or misuse of public funds have been weighed against the advantages articulated of choice for people using care services and their empowerment (Ismail et al, ).…”