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As a small, albeit growing part of a bigger system, it’s not always easy to understand how individuals employing their own care and support fits into the wider picture of social care and health delivery.

On this page we’ve included information about key terms and concepts that help to explain the latest thinking for how this part of the sector works.  

Social model of disability and person-centred practice  

The social model is a way of understanding disability. It says that disability is created by barriers in society which generally falls into three categories:  

  • the environment - including inaccessible buildings and services  
  • people’s attitudes - stereotyping, discrimination and prejudice  
  • organisations - inflexible policies, practices and procedures.  

Using the social model helps identify solutions to the barriers that disabled people experience. It encourages the removal of these barriers within society, or the reduction of their effects, rather than trying to fix an individual’s impairment or health condition.  

The social model is the preferred model for disabled people, and encourages society to be more inclusive. 

Personalisation and person-centred care is about individuals being in control of building a system of care and support that’s designed with their full involvement, and tailored to meet their own unique needs.  

 

Direct payments  

Individuals choose to employ their own personal assistants, rather than having care and support arranged for them, because it gives them more control of where and when they have support, as well as control over deciding who will provide this support. 

Most individuals who employ a personal assistant have something called a ‘direct payment’. They receive this direct payment after having an assessment of their needs by either a social services department or the local health service. This money is for individuals to buy their own care and support from care organisations, specialist equipment and/or employ their own personal assistants. Not everyone who employs a personal assistant will have a personal budget. People who are able to, can fund their own care and support needs - they may be called ‘selffunders’.  

Direct payments have been in existence for many years, but their use has increased in recent years.