Individual budgets: impact and outcomes for carers

SPRU research team

• Caroline Glendinning
• Hilary Arksey
• Parvaneh Rabiee
• Nicola Moran

External collaborators

• Ann Netten, Personal Social Services Research Unit (PSSRU), University of Kent
• Karen Jones, Personal Social Services Research Unit (PSSRU), University of Kent

Project summary

Background

Individual budgets were placed at the heart of government policy for improving choice and control for people needing social care support. The effects of these changes on service users were evaluated  in the IBSEN project.

Putting the service user in control of their own budget for social care support may affect the amount and type of care provided to them by family members or friends. Moreover, policy and practices in assessing the help needed by family carers and providing them with appropriate support have largely been developed separately from the implementation of personal budgets; it is therefore far from clear what impacts personal budgets might have on family carers.

Aims

This study examined the impact and outcomes of Individual Budgets on family carers. Specific questions were:

What changes occurred in the level and types of support provided by informal carers as a result of the award of an Individual Budget? 

Were any patterns identifiable in these changes, for example, among particular groups of carers or among carers supporting particular groups of older/disabled people?

Did Individual Budgets affect the well-being and quality of life of carers, compared with carers of disabled/older people who received conventional services;  if so, in what ways, and for which groups of carers?

Design and methods

Structured interviews were conducted with up to 200 carers of service users who took part in the IBSEN evaluation. Half were carers who looked after an Individual Budget holder and half were carers of people using conventional services. This enabled comparison of carers’ health and well-being under the two types of support arrangements.

Semi-structured interviews took place with a sub-sample of carers approximately 6 months after the service user had been awarded an Individual Budget. The interviews focused on carers' expectations of any changes, how these were realised, any difficulties that arose and how they were overcome.

Semi-structured telephone interviews were conducted with Carers Lead Officers in the Individual Budgets Pilot sites.

Findings

Service users’ receipt of an IB was significantly associated with positive impacts on carers’ reported quality of life and also, when other factors were taken into account, with carers’ social care outcomes. Carers’ involvement in and satisfaction with the service user’s support planning was an important predictor of positive outcomes for the carer. Indeed, IBs offered more opportunities than conventional social care support arrangements for carers to be involved in planning how the IB was to be used. Carers of older IB users were more likely than carers of IB users with learning disabilities to report positive experiences of IBs, particularly if they had been able to build some choices over how they used their time into the service users’ support plan.

However, local authorities varied in how the help given by carers was treated in IB assessments and how far carers’ own support needs were also considered.

The positive outcomes for carers that were achieved with no additional public expenditure costs suggest that IBs for service users are cost-effective for carers.