Personalisation of home care for older people using managed personal budgets

SPRU research team

• Parvaneh Rabiee
• Kate Baxter
• Susan Clarke
• Caroline Glendinning

Background

Personal budgets (PBs) are a mechanism for facilitating personalisation of social care services where service users have an allocated amount of money to buy the services that they want. PBs are being rolled out to all adults in England who are eligible for social care. They can be taken as a cash direct payment, but funds can also be held in local authority or other accounts, by service providers, these are known as ‘managed personal budgets’. People can also have a mixture of the two. It is important that people using managed PBs are not excluded from receiving personalised and flexible support, or having control over that support, merely because they do not wish to manage their own budget.

Aims

This study aimed to explore factors affecting the delivery of personalised support to older service users who opt for managed personal budgets. To achieve this, the study:

• identified innovative practices in local authority contracts, reimbursement and monitoring, and explored how effective these changes were in enabling choice, control and flexibility
• explored the roles played by support planners as intermediaries in shaping the expectations that PB holders had and the demands they made on providers
• explored home care provider responses to changes in contracts and user demand
• assessed the effectiveness of new contracting and support planning arrangements in creating opportunities for choice and control, from the perspectives of older managed PB holders.

Methodology

The study used a range of qualitative methods of data collection and analysis from three study sites in England. The methods included documentary analysis; semi-structured interviews with commissioning or contracts managers, home care agency managers and service users; and focus group discussions with support planners.

Policy and practice implications

Managed PBs were in the early stages of development but were thought likely to become widespread as local authorities strove to meet policy objectives for greater numbers of people using personal budgets. The study’s findings are of direct relevance not just for local authority-based practitioners, but for all practitioners of social care (including independent support planners and managers of provider organisations), as well as holders of managed PBs. The research project informed practice about the most effective ways in which commissioning or contracts managers, agency managers and support planners could enable choice and flexibility of social care support for people opting not to manage their own personal budgets.

Professional press

Community Care, 8 October 2013, Red tape and lack of funding limit choice for people on council-managed personal budgets

The Social Care Elf Blog, August 11th 2015, Supporting choice? Older people and personal budgets, by Martin Stevens

Research summary

How far do managed personal budgets offer choice and control for older people using home care services? Short summary available. - Managed Personal Budgets - Research summary (PDF , 196kb)

Additional information