It's the best of times and the worst of times for care and support.
Personalisation has unstoppable momentum. But too many councils still think their challenge is to change the way the money moves about, rather than to enable everyone to pursue an ordinary life, with family relationships, a community and a real job.
How will they make this transformation during a period in which it will seem at times as if the money is all that matters?
Perhaps the area in which there is most catching up to do is market building. There is little point in giving me control of the budget I'm allocated, if Tesco is the only shop in town.
To achieve real choice, we need an explosion in micro-provision. Picture the likelihood of thousands of corner shops springing up to challenge the supermarkets and the challenge becomes clear.
NAAPS is a charity that provides care and support to older and disabled people, and its members are among those demonstrating that a different future for care and support is within our grasp.
Sue has a learning disability. She really enjoys being with older people and has used her personal budget to employ someone to support her to run an afternoon tea club for older people living in nearby sheltered housing.
She gets a little income and loves providing a valued service.
A small group of adults with learning disabilities have, with support, set up a small business providing home help to local older people. Personal assistants, Jane and Mary, realised that the people they supported wanted to do things with their friends, so they worked with them to set up a small day service, based in a local community centre.
They intend to keep the service small so that everyone involved can continue to plan the week's activities together, but demand is growing, so they are exploring 'micro franchising,' to allow them to stay small without excluding anyone.
Many of these innovations rely on informal and family support to get started and survive. Most of us live in and rely on families and relationships, but family life (in its broadest sense) is too often set against independent living.
John lived in residential care for years and lost touch with his family. He had good memories of early childhood living on a farm. Through Shared Lives (formerly Adult Placement), he now lives with a farming family. His new skills have led to work with a neighbouring farmer. He is part of the neighbourhood watch and gave a star performance in the village pantomime.
Of course, innovation isn't exclusive to small services. Some large support organisations are far from 'support supermarkets'.
Macintyre, for instance, is exploring how it can use its large client base to help individuals with personal budgets to exercise more purchasing power.
Maintaining momentum in the face of cuts will require people who use services, family carers, workers, commissioners and providers of all sizes to avoid mud-slinging and instead focus on the creativity in every sector. This will be difficult as competition for funding intensifies, but we have no Plan B.
Alex Fox is the new chief executive of NAAPS:
• Read the Leading Questions interview with Alex Fox on SocietyGuardian
Staff
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