Self-directed Support (Scotland) Bill - Draft Equality Impact Assessment
Introduction
At the end of most policies, there are people. People are not the same and policies should reflect the fact that different people have different needs. This draft equality impact assessment accompanies the government's proposals for a Bill on self-directed support.
As part of the consultation we want to consider how the proposals might affect all of the people across Scotland. This is where the Equality Impact Assessment (EIA) comes in. The draft EIA is provided below. It includes the following:
- A summary of the aims and purpose of our policy - please see the main consultation document for more information.
- Our initial assessment of what we know (or don't know) about the diverse needs and/or experiences of our "target audience"; in other words the main groups of people most likely to be affected by the Bill.
- Our initial assessment of what else we might need to know so that we can improve the quality of this assessment.
- Our initial assessment as to the impact that our proposals might have on the groups of people who might be affected.
- Whether or not we think that our proposals provide the opportunity to promote equality of opportunity or good relations.
- Our initial assessment about the relevance of the Bill and greater use of self-directed support to the groups identified in the assessment.
Many of the sections are broken down into individual assessments for each of the following:
- Age
- Disability
- Gender
- Lesbian, Gay, Bisexual & Transgender
- Race
- Religion and belief
What do we want to know from you?
Comments are invited on any aspect of the draft EIA however there are five key questions where we would welcome your views:
- What are you views on our initial assessment as to the diverse needs or experiences of the "target audience" for self-directed support and direct payments?
- Do you think there are gaps in our knowledge? If so, where are those gaps and can yo uprovide evidence to fill those gaps? We are looking for views from individuals and views provided by particular groups to organisations. If you are aware of publications such as research, responses to other consultations or evaluations please provide copies or links to those publications. Finally we are interested in any data or statistics which you can provide.
- What do you think about our assessment as to the ways in which our proposals might impact on different groups? Are there other ways in which the proposals might have a positive impact on the groups identified in this assessment? Are there potential negative impacts or concerns about self-directed support/direct payments that might be specific to particular groups of people? If so, what are these and how might these be addressed?
- Do you believe the policy on the whole provides the opportunity to promote equality of opportunity or good relations? If not, why not?
- Do you have any further views on the EIA?
How to respond
This is a draft EIA. It is provided in order that consultees can provide comments alongside their views on the consultation document for the Bill. We will take account of the views and the evidence provided as part of this consultation. We will then complete a final EIA.
As with the main consultation document, comments are invited by Wednesday 23 June 2010. Please send your response along with a completed Respondent Information Form to:
selfdirectedsupport@scotland.gsi.gov.uk
or
Kenneth Pentland
Self Directed Support Team
Adult Care and Support Division
Scottish Government
Edinburgh
EH1 3DG
Further information
To help you to provide a response to this impact assessment you may find it useful to consult the following sources of information
PROPOSALS FOR A BILL ON SELF-DIRECTED SUPPORT: DRAFT EQUALITY IMPACT ASSESSMENT
1. Define the aims of your policy
The first step of the impact assessment is to identify what the policy is designed to achieve. This helps us to consider how best to take account of the needs of all groups of people.
| Policy Title | Self Directed Support (Scotland) Bill |
| Strategic Outcome | Strategic Objective: Healthier We live longer, healthier lives |
| Directorate or Agency | DIRECTOR-GENERAL HEALTH AND CHIEF EXECUTIVE NHS SCOTLAND |
| Group | PRIMARY and COMMUNITY CARE DIRECTORATE |
| Division | Adult Care and Support Division |
| Branch | Self-directed Support (direct payments) |
What is the purpose of the proposed policy (or changes to be made to the policy)? | Self-directed support is a term that describes the ways in which individuals and families can have informed choice about the way that support is provided to them. It has generally been used to describe the delivery of social care. If it is brought forward, the legislation would help to increase the uptake of self-directed support through: consolidating the existing statute related to self-directed support, clarifying the legal duties to service uses, service providers and local authorities; introducing the term 'self directed support' to statute; widening the eligibility for direct payments to carers and other groups, and; amending the duty on councils when offering a direct payment to mean that they are asked if they want to opt out from self-directed support as opposed to being asked to opt in. For more details on the proposals see the main consultation document. For more information on self-directed support and direct payments see the Scottish Government's web pages on self-directed support. |
Who is affected by the policy or who is intended to benefit from the proposed policy and how? | The main group of people affected by the Bill proposals are people in receipt or likely to be in receipt in the future, of a social or health care and support and people who care for people who receive care and support. This is not exclusive to but includes people with disabilities, mental health problems and the elderly. We think that all people in need social care and support, including the groups identified in this EIA can benefit from the positive outcomes of self-directed support which include: greater flexibility, choice and control in care arrangements, better quality care and a more independent lifestyle. |
How have you, or will you, put the policy into practice, and who is or will be delivering it? | The delivery of the legislation would be mainly through local authorities. However health boards also have a role to play in terms of joint funding for individuals eligible for Self Directed Support and Direct Payments.
Support organisations in their various forms are expected to promote Direct Payments and self-directed support whilst ensuring the best support to individuals in receipt of a package.
Other reserved agencies have a role in the delivery of SDS and Direct Payments for those in receipt of these funding streams. |
How does the policy fit into our wider or related policy initiatives? | This policy helps to deliver the independent living agenda - the principle that that disabled people should be valued as individuals, be able to fulfil their potential as active citizens, and have control over their lives and decisions. It also contributes to shifting the balance of care out of the hospital and closer to the patient's home and the wider personalisation agenda.
The type of care and support packages that can be delivered via self-directed support can help to prevent the deterioration of an individual's physical and mental health. This means that it can help to contribute to a healthier Scotland. It will also contribute to a fairer and wealthier Scotland as self-directed support can be used to support a person into employment, in groups that might have higher unemployment rates. |
Have the resources for your policy been allocated? | Initial assessments as to the costs and benefits are underway. Final decisions on the level of resources will be informed by the Regulatory Impact Assessment and Financial Memorandum which will be lodged with the Parliament for consideration. |
2. What do you already know about the diverse needs and/or experiences of your target audience?
It is important to know who will be affected by the proposed changes and how. The evidence (or information) about the diverse needs and or/experiences of the target audience may come from a variety of sources - it may be statistical information, research projects which have collected evidence through discussions, focus groups and interviews with different people, or from recognised equality group organisations. It is also important to identify any information or evidence gaps that we may have and which may need to be addressed in order to successfully complete the assessment process.
| CONSULTATION QUESTION 1: What are you views on our initial assessment as to the diverse needs or experiences of the "target audience" for self-directed support and direct payments? |
Age | Yes |
Evidence | The Scottish Government commissioned a review of Self Directed Support in 2008. The review involved case study participants from every age group.
Statistical data on the age of direct payment recipients is collected by the Scottish Government every year from local authorities.
There is a large amount of evidence on the age of people using SDS. We know that older people account for a growing percentage of SDS users in Scotland, but that it is still small in terms of the overall number of older people receiving social care who could potentially benefit from SDS. |
Consultation | Scotland's SDS National Reference Group with representation from key interests, has discussed legislation and officials have undertaken a number of activities to scope the Bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. The current public consultation on the government's proposals for the Bill - and this draft EIA - will be sent to organisations who represent the interests of older people to ask them to provide their own views and evidence. |
Disability | Yes |
Evidence | The Scottish Government commissioned a review of Self Directed Support in 2008. The review involved case study participants from every disability client group.
Statistical data from different disability client groups of direct payment recipients is also collected on an annual basis by the Scottish Government. It shows that there are clear discrepancies within this group. In particular there are disproportionately fewer people with mental health problems and learning disabilities benefiting from SDS than those with physical disabilities. |
Consultation | The National Reference Group with representation from key interests, has discussed legislation and officials have undertaken a number of activities to scope the bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. The current public consultation on the government's proposals for the Bill - and this draft EIA - will be sent to organisations who represent the interests of people with physical disabilities and mental health users. A series of consultation events will be held with groups who represent the interests of the independent living movement and mental health users. |
Gender | Yes |
Evidence | The Scottish Government collects statistical data on the numbers of men and women accessing SDS.
From informal consultations, gender-based inequality has never been raised as an issue. |
Consultation | The National Reference Group with representation from key interests, has discussed legislation and officials have undertaken a number of activities to scope the bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. |
Lesbian, Gay, Bisexual & Transgender | Yes |
Evidence | The Scottish Government does not collect data on the sexual orientation of direct payment recipients. We have anecdotal evidence that people from lesbian, gay, bisexual and transgender groups may have a particular need for choice and consistency in their care. |
Consultation | The National Reference Group with representation from key interests, has discussed legislation and officials have undertaken a number of activities to scope the bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. The current public consultation on the details for the proposed Bill - and this draft EIA - will be sent to interest groups for lesbian, gay, bisexual and transgender people. |
Race | Yes |
Evidence | The Scottish Government asks for data on the number of direct payment recipients categorised by different ethnic groups however this is not provided across all areas and it is not published as part of the annual statistical publication.
We recognise that more robust evidence is needed and this should be addressed in further research to assist policy development.
There have been studies conducted in England by The Social Care Institute for Excellence and by the Modernising Adult Social Care research initiative. |
Consultation | Scotland's National Reference Group on SDS, with representation from key interests, has discussed legislation and officials have undertaken a number of activities to scope the bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. The current public consultation on the details for the proposed Bill will be sent to various bodies interested in race equality and events will be held with groups who represent a range of the equality strands identified in this assessment. |
Religion & Belief | Yes |
Evidence | The Scottish Government does not collect data on the religion and beliefs of SDS recipients.
However we have anecdotal evidence that older people may wish to spend their final years in the company of people with whom they most identify, which may be people from their own faith communities. |
Consultation | The National Reference Group with representation from key interests, has recommended legislation and officials have undertaken a number of activities to scope the bill. These have included informal discussions with most local authorities and a number of user led and third sector organisations. The current public consultation on the details for the proposed Bill will be sent to a range of faith groups. |
3. What else do you need to know to help you understand the diverse needs and/or experiences of your target audience?
This is to identify if there is a potential issue for an equality group (or strands) that may require further exploration. We want to assess how our policy will affect different groups within our target audience.
| CONSULTATION QUESTION 2: Do you think there are gaps in our knowledge? If so, where are those gaps and can you provide evidence to fill those gaps? We are looking for views from individuals and views provided by particular groups to organisations. If you are aware of publications such as research, responses to other consultations or evaluations please provide copies or links to those publications. Finally we are interested in any data or statistics which you can provide. |
Age | Yes |
Evidence | We have representation from this group on our Ministerial reference group. We regularly seek their views through a number of organisations and work with them to help promote the benefits of SDS. A review of SDS, published in 2008, provided an insight into the benefits of this policy on people of all ages from children to the elderly. |
Disability | Yes |
Evidence | This group is also represented on our Ministerial reference group. We regularly seek their views through a number of organisations and work with them to help promote the benefits of SDS.
We will continue to add to the large body of evidence we have on the needs/experiences of this group. However we have sufficient information to progress with the policy. |
Gender | Yes |
Evidence | The Scottish Government collects statistics on the gender of direct payment recipients.
There have been many reviews of SDS but gender has never been raised as an issue. This suggests the policy may not have a negative impact on subgroups. This is supported by the available national statistics. |
Lesbian, Gay, Bisexual & Transgender | No |
Evidence | There is no specific data collected by the Scottish Government on the sexual orientation of SDS recipients.
This should be addressed in further research to assist policy development. |
Race | No |
Evidence | The Scottish Government has some statistical data on the number of people receiving direct payments categorised by race.
It is recognised that more robust data is needed to assist policy development in the future. |
Religion & Belief | No |
Evidence | There is no specific data collected by the Scottish Government on the religions and beliefs of SDS recipients.
This should be addressed in further research to assist policy development. |
4. What does the information you have tell you about how this policy might impact positively or negatively on the different groups within the target audience?
In this section we want to look at the information we have collected to assess what it is telling us about the needs of different groups of people, i.e. whether their needs would be met by the policy proposals and whether those proposals would affect some groups differently.
| CONSULTATION QUESTION 3: What do you think about our assessment as to the ways in which our proposals might impact on different groups? Are there other ways in which the proposals might have a positive impact on the groups identified in this assessment? Are there potential negative impacts or concerns about self-directed support/direct payments that might be specific to particular groups of people? If so, what are these and how might these be addressed? |
Age | There is a large amount of evidence which suggests that this policy impacts positively on people from every age group. Research commissioned by the Scottish Government in 2008 took into account the views of people from a range of ages including children, adults and the elderly. The research found that clients from every age group could benefit from the positive outcomes of SDS.
Older people make up 28% of direct payment recipients. However this constitutes a small percentage of the overall number of social care service-users from this client group. It is expected that large numbers of older people could benefit from clearer, consolidated legislation and from making SDS the default position following assessment, provided that appropriate safeguards are provided and provided that those safeguards do not discourage local authorities from offering SDS to this groups of people.
Older people may benefit from the extension of eligibility to people currently lacking the capacity to consent, to people wishing to enter residential care and the extension of eligibility to carers. |
Disability | There is a large amount of evidence which suggests that this policy impacts positively on disabled people of every client group. The Scottish Government review of SDS found that self directed support enhances people's quality of life by giving them greater independence and by helping to increase their social participation. The evidence suggests that this policy positively impacts of the lives of people with disabilities.
Within this group there are large discrepancies in the uptake of SDS between different groups. For example, people with mental health problems and learning disabilities are less likely to direct their own support than people with physical disabilities even though evidence clearly suggests that SDS can benefit people from every client group.
The legislation will help reduce the overall low uptake in this group by consolidating legislation making it easier to understand and access SDS at all levels. Making a direct payment/self-directed support the default position should encourage wider uptake from all client groups. The legislation will directly benefit to some within the learning disabled group, through extending the eligibility to people who lack the capacity to consent. A small number of people with mental health problems will also benefit from extending the eligibility to include people who are subject to community treatment orders. |
Gender | The numbers of men and women directing there own support are similar but not the same. Scottish Government statistics show that 52% of direct payment recipients are female and 46% are male. The policy is not expected to impact negatively on either group.
Gender-based inequality was not raised as an issue during informal consultations held in 2009.
There have been several reviews of SDS where the case study participants were of different genders. These reviews did not raise gender-based inequality as an issue indicating that it may not be a significant factor.
|
Lesbian, Gay, Bisexual & Transgender | Data on the sexual orientation of Direct Payment recipients is not collected centrally. Anecdotal evidence suggests that lesbian, gay, bisexual and transgender people may particularly benefit from the continuity of care that a self directed arrangement can have, although further evidence from this group would be useful in order to confirm or deny this.
There is no expectation that the policy would have an adverse affect on this group. |
Race | The Scottish Government has data on the numbers of different racial groups receiving direct payments in 2008. The figures are not published as official statistics but they are provided in this draft EIA. They showed that in 2008: 2,372 (79%) were reported as white, 30 (1%) as black or Asian, 6 (0.2%) were reported as mixed race, 232 (8%) as other and 377 (13%) were reported as not known.
Anecdotal evidence suggests there is perhaps an access issue for people from black and minority ethnic groups who may be eligible for SDS. The Scottish Government will investigate this further through the accopmanying strategy on self-directed support.
The Social Care Institute for Excellence in England identified barriers to BME service users accessing direct payments, including difficulties in recruiting personal assistants who are able to meet the cultural, linguistic and religious requirements of individuals, confusion over the relatives' rules and the meaning of 'independent living.'
We also have anecdotal evidence that problems around accessing direct payments due to a language barrier have been eased by amendments to the rules on employing relatives.
Scottish Government guidance on SDS already advises that appropriate services such as translators, trained care managers and service providers, targeted local support, and Personal Assistants are all available for BME users. |
Religion & Belief | Anecdotal evidence suggests there is perhaps an access issue for people within this group. The Scottish Government will investigate this further through the strategy. SDS however can help people with certain religions or beliefs. For instance, a person may benefit from employing a PA who spoke a particular language or from a particular faith group, where it is difficult for a council to provide a service in this way.
Existing Scottish Government guidance on SDS advises that local authorities should attempt targeted personal assistant training to make PAs available for clients who want services provided by someone of their own faith community. |
5. Will you be making any changes to your policy?
The equality impact assessment process is a policy making tool which allows us to identify ways in which we can improve our policies and make them better suited for their purpose. If a policy is likely to have an adverse impact on a group of people, the presumption should be that the policy should be changed or amended to lessen or remove this adverse impact. It may not be practical or cost effective to make significant changes that will result in minor effects on outcomes for certain groups of people. However, we should be able to justify not taking action if potentially unfair outcomes have been identified through the EQIA process.
| Age | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
| Disability | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
| Gender | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
| Lesbian, Gay, Bisexual & Transgender | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
| Race | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
| Religion & Belief | No |
| Comments | There are no plans at present to change the proposals for the Bill, however learning from the consultation on the draft EIA might help to inform any guidance which would accompany new legislation. |
6. Does your policy provide the opportunity to promote equality of opportunity or good relations?
The main purpose of the EQIA is to identify and mitigate any potential adverse impact. But it also offers the opportunity to consider how our policy can better promote equality of opportunity and good relations. The following is our initial assessment as to how the proposals for the Bill might help to promote equality for each of the key strands.
| CONSULTATION QUESTION 4: Do you believe the policy on the whole provides the opportunity to promote equality of opportunity or good relations? If not, why not? |
Age | Yes |
Evidence | This policy promotes equality of opportunity for older people. Evidence suggests that SDS encourages the wider participation of older people in public life.
By enabling more older people to live independently in their communities, it will also facilitate good relations with other groups. Children and adults who are eligible for SDS through a disability will also benefit in this way.
In particular, the widening of eligibility to include residential home care will promote equality of opportunity among a significant number of older people. |
Disability | Yes |
Evidence | This policy promotes equality of opportunity for disabled people. Evidence suggests that SDS encourages disabled people from every client group to participate in public life. SDS can also be used to support people in to work and education.
There exists large discrepancies within this group. By enabling more people from every client group to direct their own support, this policy will facilitate good relations within and without the client group.
In particular, the widening of eligibility to include people who lack the capacity to consent, people who wish to buy residential home care and people subject to community treatment orders will promote equality of opportunity among a significant number of people within this group. |
Gender | Yes |
Evidence | This policy promotes equality of opportunity for all people in receipt of social care and support services. There is no specific advantage/disadvantage to people of different gender. |
Lesbian, Gay, Bisexual & Transgender | Yes |
Evidence | This policy promotes equality of opportunity for all people in receipt of social care and support services. There is no specific advantage/disadvantage to people of different sexual orientations. |
Race | Yes |
Evidence | This policy promotes equality of opportunity for all people in receipt of social care and support services including people from black and minority ethnic communities. |
Religion & Belief | Yes |
Evidence | This policy promotes equality of opportunity for all people in receipt of social care and support services. There is no specific advantage/disadvantage to people from different faiths or none. |
7. Based on the work you have done - rate the level of relevance of your policy
The following is our initial assessment as to whether the impact is high, medium or low for any of the strands.
A high impact is not necessarily negative. A high impact might refer to a positive or negative impact on an equality group, or even a mixture of both.
For some policies a high impact is entirely appropriate as that is the intended effect of the policy.
If a policy impacts only on a small number of people from a particular equality group, this should not equate automatically to a low impact. It might be that a policy has a highly disproportionate negative (or positive) impact on people from a particular equality group, who are numerically small in number compared to the wider population. This does not mean that the impact is 'low'.
Age | High |
Disability | High |
Gender | Low |
Lesbian, Gay, Bisexual & Transgender | Low |
Race | Medium |
Religion & Belief | Medium |
8. Do you need to carry out a further impact assessment?
Age | No |
Disability | No |
Gender | No |
Lesbian, Gay, Bisexual & Transgender | Yes |
Race | Yes |
Religion & Belief | Yes |
Comments - Yes | There is not sufficient evidence on the effects of this policy on people of different sexual orientation, race or religion and beliefs at this time. Another Equality Impact Assessment should be made when this evidence is available. |
Comments - No | There is sufficient evidence on the effects of the policy on people with disabilities, people of different age groups and people of different gender to make an equality impact assessment at this time. |
9. Please explain how you will monitor and evaluate this policy to measure progress
Good monitoring and evaluation should form part of any policy process, so it is important to ensure that equality is effectively built in to any monitoring and evaluation plans that we have.
Comments | A reference group on Self Directed Support was established in 2007 to assist in the development of the policy and to monitor its effects. The group will continue in this role throughout its implementation. If the Bill is introduced to Parliament plans for the detailed monitoring and evaluation of the legislation will be considered during the parliamentary process, and we will consider how to ensure that equality is built into those plans. . With colleagues from the Analytical Services Department we will review data collection.
Officials will continue to liaise with the Scottish Government Equality Unit on this policy. |
| CONSULTATION QUESTION 5: Do you have any further views on the EIA? |
10. Sign off the assessment
Policy Title | Self Directed Support (Scotland) Bill |
Strategic Outcome | Healthier |
Directorate or Agency | DIRECTOR-GENERAL HEALTH AND CHIEF EXECUTIVE NHS SCOTLAND |
Group | PRIMARY and COMMUNITY CARE DIRECTORATE |
Division | Adult Care and Support Division |
Branch | Self-directed Support (direct payments) |
Name | Flunkert (Craig) |
Position | Bill Team Leader |
Sign off date | 19 April 2010 |