Author: Simon Duffy
People need Tapered Control, different levels of control, depending upon their needs and circumstances. A system of Tapered Control was developed along with Individual Budgets and Self-Directed Support, in order to give people the right kind of control for them.
In the UK, aside from the benefit system, public services have almost always been delivered through publicly controlled professional services. Only since the 1990's has government started to provide services through other organisations and individuals and only since the 1996 Direct Payments Act has it been clearly legal to provide a service by providing an individual with the direct funding to purchase support for themselves. The very limited and relatively recent nature of these reforms may explain why there is often confusion about the different kinds of control options that should be available.
One of the most basic misunderstandings of personalisation has been to assume that it also requires the individual citizen to take full control of their Individual Budget, to employ their own support staff or take other extreme degrees of control over their own lives. This is not true and to take this view would be to build a degree of unnecessary inflexibility into the system.
In fact increased personalisation demands tapered control - different degrees of control to allow for different situations and different individual needs:
These systems of control do not need to remain static. For instance it is possible for people with fluctuating conditions to use ‘living wills’ to shift control dynamically as their condition changes. It is also possible for the lead professional to determine that a particular system is no longer working and to shift control to a different point. However public services often further complicate the questions of control and co-production because those services are themselves complex and people often find they need a number of different kinds of support, entitlement or service. This is particularly true for people with mental health needs who very often receive many different forms of support from some or all of the following:
On of the critical areas of confusion around Tapered Control is the rather confused approach to mental capacity in England. Although the basic law is built upon sound principles - in particular the assumption of capacity for all - the implementation of supports and systems around people is not consistent. Social services, health, benefits and the courts all use different approaches which makes support for people who need some form of appropriate representation unduly complex.
The publisher is the Centre for Welfare Reform.
Tapered Control © Simon Duffy 2011.
All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.
A report setting out a model for integrating health and social care for people with mental health services - designed to promote personalisation, empowerment and citizenship.
Individual budgets can be managed by at least 6 different mechanisms, allowing people to take different levels of control.
An Individual Budget is a system for individualized funding where the person is told, up-front, how much they are entitled to.
This graphic shows that people, using their individual budgets, make better decisions than government.
Talk given to the Social Policy Research Unit in York on the birth of individual budgets and the development and transformation of the innovation.