Gloriously Ordinary Sundays - 7th September 2025

There’s a bunch of arguments being played out at the moment in both the mainstream press and on social media about the supposed danger of unregulated care and support. I wanted to write something, because there seems to be some strange notion that there is this underclass of workers supporting people in ways that are irresponsible and slapdash ...and that couldn’t be further from the truth. Much as I’d like to point out and share some of my personal experiences of where regulated services go bad, I will rein myself in and instead focus on unpicking what personal assistants and micro providers are all about, and how they have worked so beautifully for me and my family. So that’s the theme for today and next week.  

The premise in the press is that support from personal assistants or micro-providers isn’t safe. The arguments are that, particularly for people who are (and I quote) ‘complex’ and ‘vulnerable’, you need registered, regulated, formally trained professional people to, and again I quote, ‘look after and take care of people’. Let’s unpick this a little bit.

First of all, let’s get one fact straight. Since the 1996 Direct Payment Act, we have all had the right to choose, following a Care Act Assessment to (rather than have the local council organise support for us) take our personal budget as a Direct Payment – as ‘cash in lieu of service’, to quote paragraph 56 of the Health and Social Care Act 2008 explanatory notes. Some people whose support is funded by health have the Right to Have a personal health budget and to organise that support through a Direct Payment.  The main use of Direct Payment is to employ support workers – personal assistants, and so, there is a longstanding legal and regulatory framework that acknowledges and supports an unregulated workforce. More recently, there has also been a rise in the number of micro providers, thanks in part to the great work of Community Catalysts. Most councils I work with are trying hard to do a better job of supporting older and disabled people to take and manage Direct Payments to live their Gloriously Ordinary Lives, so they understand and support an unregulated workforce. Why? Because choosing who supports us, based on what matters to us, works.

So, what’s the gripe? Let’s go back to the essence of the argument – the concept of regulated workers having superior knowledge, skills, and expertise, and that the regulatory processes are what keep people safe.

I absolutely want anybody who supports me in any bit of my life to know what they’re doing.

I want a plumber with qualifications, and that certificate they have to have.

I want a car mechanic who knows their way around an engine.

I want a cleaner who understands that skirting boards need wiping.

I even want my hairdresser to have specific training and skills in cutting my wild curly hair (now that lack of specialist skill and training really is a disaster).

Likewise, there are specific things in the world of health and social care support that we want to make sure someone has the skills, knowledge, training and confidence to get right.

If I have a PEG feed, I want someone to know how to help me manage that.

If I’m living with dementia, I want someone who understands how memory loss works and how I might be experiencing it.

If I’m autistic, I really want people to understand how my world looks.

If I don’t use words to speak, I want people who support me to have a forensic understanding of how I communicate.

What is interesting is how we come to get those skills, knowledge, and confidence. I’ve not checked recently, but I’m pretty certain that disabled children are not only born to qualified nurses and social workers. I’m also fairly sure that those of us supporting parents as they age, develop memory loss, dementia, or other physical illnesses mostly don’t have relevant NVQs in care and support. We learn what we have to do, and we might get some specific advice/training if we need it. Oh, and no one checks up on us.

From 2009 until 2024, I employed personal assistants and worked with micro providers both for my two kids and, for some of that time, for my mum (who lived with us). I did a bit of quick maths, and it’s just shy of 30 people. Chatting to friends and colleagues who also employ personal assistants or work with micro providers, I wanted to get clear on what makes it so different and so wonderful, and I think it boils down to two key things.

Firstly, there is permission for a whole different mindset, a different starting point when the first question is,

‘What does really good support look like for ME?

Not, ‘What does my illness/impairment suggest might be needed?’.

That will, of course, lead to the next question, which is about skills and knowledge, yes, but 100% of the time it starts with values, attitudes, interests, and passions, because we all know that skills and knowledge can be learnt – the rest not so much.

Let’s think about The Girl as a specific example. Although she has had some paid support in her life since she was 12 (she’s 26 now), from the age of 19, she would absolutely be described as one of those complex people. She is autistic and uses very few words to speak. She experienced significant trauma as a child before she came to live with us, and she regularly hurts herself, sometimes needing hospital treatment. I can see how easy it would be to take those facts and leap straight to ‘specialist placement’, but let’s just take a beat.

Anybody who works as a personal assistant for The Girl will need to understand and know the nuances of her trauma, her communication, what being autistic means to her, but they don’t need to know that at interview. In fact, they can’t possibly know it at interview because they don’t know The Girl, and as we all (I hope) know, when you’ve met one autistic person who has experienced trauma and doesn’t use words, you’ve met one autistic person...

Here are the critical things about support for The Girl if we go back to my million-dollar question: 'What does good support look like for ME?'

She loves a huge range of music, has eclectic taste (Manga to Pink Floyd), so needs someone who appreciates that and can match her as she goes down YouTube rabbit holes.

She’s got a very dry sense of humour, and one way to make the anxiety and stress that can lead to her hurting herself less likely is to be around people who tap into that sense of humour and help her find the funny things in life.

She creates her own playlists in ways we don’t understand on her Mac, so having a great understanding of Mac computers is a must, alongside the ability to use Photoshop to create a new front image for her playlist (actually you can learn that one).

She picks up people’s energy and needs people around her who are unrufflable, who have a quiet, strong energy, and are able to roll with the punches (sometimes literally).

Can you see how there’s two separate sets of things here - a bunch of ‘social care’ skills and knowledge that is absolutely teachable, and a bunch of human stuff that’s less so?

So, the first key thing is to be really clear about what good support looks like …for ME and what that means for anyone who is going to support me.

The second key thing is the way we find people who might fit the bill, and here’s where the regulation brigade is going to get very twitchy, because 100% of the 30 people I’ve recruited in 15 years of employing personal assistants have had zero experience of working in social care. Yup, just to compound the twitchiness, I’ll say that again:

100% of the 30 people I’ve recruited in 15 years of employing personal assistants have had zero experience of working in social care.

They do, however, have heaps of amazing experience from life and other jobs. I’ve employed:

• Students

• A chef

• A teaching assistant

• Several baristas

• People working in shops

• A nanny

• An ex-policewoman

• A couple of women who had stayed at home to bring their kids up

• Somebody who worked in a boat yard

(and others)

Anyone who has a social care Direct Payment, or through a personal health budget, will be required to DBS check any employee, so that regulatory formality is done. I can’t resist a note to Baroness Jane Campbell though, who will tell the story of her great personal assistants/driver who had done 18 years for armed robbery. I’ll leave that one with you. Maybe a nod as well to the very well-regulated Dr Harold Shipman... sorry.

And here’s a thing – I think my team was really well regulated.

It was regulated by other members of the team, checking in on each other, questioning, supporting, and learning from each other.

It was regulated by my neighbours, who knew my kids, my Mum, and their team, and saw them most days.

It was regulated by shopkeepers, by people in local cafés, pubs, restaurants, and hairdressers - all places where we are known and have a presence.

When Mum or the kids were out and about with their personal assistants, stories would often circle back to me. When I was in our local Tesco Express, Margie on the till would say, ‘The Girl was in yesterday with that blond one. They were having a fine time choosing what to make for dinner, and the blond one did a great job of helping her work out what she could afford - and getting her to buy some veg!’ I’d know about it if someone saw something that didn’t look right, and on two occasions, that led to a difficult but useful formal conversation about the role of a personal assistant and what great support looks like. So, if regulation is about keeping people safe, I’d say we had that covered.

Next week, I’ll reflect on some of the really positive things about being able to employ a personal assistant and work with micro providers. Meanwhile, you might want to think about what keeps you safe.

PS. Did you see? The Gloriously Ordinary Sundays Podcast episode 13 is here. I I chat with Beverley Samways from Unique Connections.

I recently came across the work of Unique Connections online, when exploring how I could help and support The Girl to live a gloriously ordinary life. Beverley and I talk all about the importance and power of seeing the emotional person behind the behaviour, and how being truly present with someone can replace self-injury with connection and words.

* Trigger warning - we talk about self harm *