Do people understand they have a choice? We hear lots about patient choice and there is a lot of buzz about individual care plans for the elderly and disabled. It’s not something anyone would argue with, least of all us - it’s at the core of what we try to do.

But does it happen in reality? It’s not even anyone’s fault – most people requiring care are desperate for some help and advice but where do they turn? If we want to buy insurance most of us these days go and look at it online and choose the cheapest. We want to know where to buy a new dinner service, we go to a search engine (Google in most cases) and and it will give us a number of choices. Those of us less technologically savvy go into John Lewis or Debenhams and have a look to see what’s there. We can handle the goods and compare them and the prices and make a decision.

Care however is rather different. If you are reading this you’ve got to our web site but whilst we hope it gives a flavour of who we are we wouldn’t expect you to “buy” solely on the strength of it. (You can if you want!). We’d expect you to get in contact with us and talk to us. We’d come and see you and discuss what you need. Like any service - comparison is difficult but if we didn’t perform we’d expect to lose your custom – not that we'd let that happen! However there’s still a major flaw here – you are on our web site, what about all those people who haven’t got internet access. 

The immediate need for care normally means you require it urgently, you’ll probably go wherever is recommended be that by a friend, hospital, social workers whomever. The concept of a choice is the last thing on your mind. But you do have a choice – direct payments is supposed to help this happen – it should be a tool to drive up the standards in the industry. But does it work? Here is a subject we need to return to.