Perhaps if the fail aged and or disabled, or their carer/parent/son or daughter, had to sign an annual, posted to them, voucher, with a place for confidential comment, before funding could be made available/or continue to the service provider, and if other service providers were free to offer a superior less costly service?
Stood over oldies/seriously disabled, sometimes sign just for peace sake, rather than indicate they're satisfied with the service, or that the hours are correct/the work done!?
And I reveal my interest, as being both aged and disabled!
Competition for the disabled dollar and real dignity, would force huge improvements in this field, and indeed, in general aged/disabled care!?
I mean there are plenty of able-bodied single mums out there, who would just love to get their hands on some of the hourly rate/annual government supplied budget, charged by some so called aged/disabled care service providers.
And let's not get too complex here; when the basic services should start with the house and garden, sometimes supplemented by a weekly visit by a nursing/podiatry service.
Which in around 70-80% of cases, is enough general care, to keep the frail aged and disabled out of far more costly, government subsidized nursing homes, [$70,000 a year per client,] or already overstretched/over utilized hospitals, [ up to $200,000 a year per patient in rehab! (spinal injury/stroke/heart attack/amputation/stroke related blindness etc.]
Rhrosty.

I've some experience in this area and the simple fact is, it's not possible to give every disabled and/or elderly needy person a personal trainer, in effect.
It's a wonderful idea of course, I've served that role and am again right now, but the costs and administration alone defeat it, let alone the possibility of getting the required numbers of staff to make it possible!
It would indeed be a lovely world where every disabled person was encouraged and given the opportunity to achieve their personal best, but it's not going to happen any time soon, the process of social change is glacial in some circumstances, and this is one of them I'm afraid.
I'm not unsympathetic to the disabled, I'm in the early stages of a progressive physical disability myself, but I am at heart a realist.
I'm not saying to give up trying, just that it's going to be many many moons before any real change is going to be seen.

I hear your frustration in your words Peter, but I am one of your dreaded 'medical model' people and I am frustrated with how you are lumping us all together as one group too.

"Whereas the medical model focuses on the individual as a "patient" by contrast, the social model focuses on the infinite social processes and dynamics of disability. The social model is empathetic to the view that disability discrimination and prejudice is made stronger by a lack of accessible and socially and economically rewarding information, technology, architecture and events."

Really?
You don't think that 'medical' people can look at their patients or clients holistically ?
The thing is Peter, if medical staff are seeing you in a professional capacity, then you ARE a patient, just like everyone else.

Having dealt with people with all sorts of disabilities and illnesses all my working life, I can tell you that I take each person as they come, regardless of their disability.
One doesn't have to be a social support worker, or any other 'social model' supporter to show empathy.

In fact, I have met some really cruel support workers in my time, just as I have met some dreadful medical professionals.......and awful patients!