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Managed personal budgets for older people: what are English local authorities doing to facilitate personalized and flexible care?
- Authors:
- BAXTER Kate, RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Public Money and Management, 33(6), 2013, pp.399-406.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper explores how three local authorities in England have tried to facilitate personalized home care for older people through changes in commissioning and market development activities; and how these changes have been experienced by support planners and home care agency managers. Two borough council and one county council were selected. One council offered Individual Service Funds (IFS) and one offered 'virtual budgets'. Overall, it appears that changes are well intended, but the practicalities of implementing them raise some challenges that mean desired objectives may not always be achieved. (Edited publisher abstract)
What skills do older self-funders in England need to arrange and manage social care? Findings from a scoping review of the literature
- Authors:
- BAXTER Kate, WILBERFORCE Mark, BIRKS Yvonne
- Journal article citation:
- British Journal of Social Work, 51(7), 2021, pp.2703-2721.
- Publisher:
- Oxford University Press
Older people in England who pay for social care from their own funds (‘self-funders’) receive little help in seeking and arranging care compared to older people funded by their local council. This suggests an implicit assumption that people funded by local councils need help to manage their care whereas self-funders do not. This article reports findings from a scoping review of published evidence from England, Scotland and Wales on the skills that older people need, and the help they get, to seek, arrange or manage use of social care, and how this help affects outcomes. Searches undertaken in October 2018 resulted in the inclusion of thirty-six empirical papers and seven reviews. Thematic analysis identified the importance of everyday life and specific business skills, and personal attributes including objectivity when evaluating options. The review identified two significant gaps in the evidence: first, how help in seeking and arranging care compensated for lack of, or complemented existing, skills; and secondly, how outcomes for people receiving help in arranging care compared with those not receiving help. The article concludes that a tailored approach to supporting older people arrange and manage care, irrespective of funding, should be considered. (Edited publisher abstract)
What skills do older self-funders in England need to arrange and manage social care? Findings from a scoping review of the literature
- Authors:
- BAXTER Kate, WILBERFORCE Mark, BIRKS Yvonne
- Journal article citation:
- British Journal of Social Work, early cite 23 August 2020, p.bcaa102.
- Publisher:
- Oxford University Press
Older people in England who pay for social care from their own funds (‘self-funders’) receive little help in seeking and arranging care compared to older people funded by their local council. This suggests an implicit assumption that people funded by local councils need help to manage their care whereas self-funders do not. This article reports findings from a scoping review of published evidence from England, Scotland and Wales on the skills that older people need, and the help they get, to seek, arrange or manage use of social care, and how this help affects outcomes. Searches undertaken in October 2018 resulted in the inclusion of thirty-six empirical papers and seven reviews. Thematic analysis identified the importance of everyday life and specific business skills, and personal attributes including objectivity when evaluating options. The review identified two significant gaps in the evidence: first, how help in seeking and arranging care compensated for lack of, or complemented existing, skills; and secondly, how outcomes for people receiving help in arranging care compared with those not receiving help. The article concludes that a tailored approach to supporting older people arrange and manage care, irrespective of funding, should be considered. (Edited publisher abstract)
Self-funders and social care: findings from a scoping review
- Author:
- BAXTER Kate
- Journal article citation:
- Research Policy and Planning, 31(3), 2016, pp.179-193.
- Publisher:
- Social Services Research Group
This paper draws on a scoping review of the evidence base about adults in England who purchase social care services and support using their own money. It presents a selection of the review’s findings relevant to self-funders and key aspects of the Care Act 2014. The review covers the years 2000 to 2015. Searches of electronic databases were complemented by a focused search of the websites of key organisations. After applying inclusion/exclusion criteria, and removing duplicates, details were extracted from 76 references. The majority focused on residential care (33), domiciliary care (12), or both (23). Studies used a range of research methods. The overall numbers and percentages of self-funders of home care and care home places have increased. There are variations across regions but limited evidence about demographic or socio-economic characteristics of self-funders. Self-funders feel they lack advice from local authorities; local authorities have limited knowledge of self-funders in their areas. People struggle to understand fees and the financial implications of long-term care. Providers are beginning to realise the potential of the self-funding market but full use is not yet being made of e-marketplaces. Key gaps in knowledge remain at a time when the number and importance of self-funders is increasing. (Publisher abstract)
Supporting choice: Support planning, older people and managed personal budgets
- Authors:
- BAXTER Kate, GLENDINNING Caroline
- Journal article citation:
- Journal of Social Work, 16(4), 2016, pp.453-469.
- Publisher:
- Sage
Summary: English policy emphasises personalised and flexible social care support using ‘Personal Budgets’ (PB) – preferably as cash direct payments. However, most older people opt for their council to manage personal budgets on their behalf. It is not clear what benefits of personalisation are available to this group of older people. This article reports research into the choices available to older people using managed personal budgets to fund home care services in three councils. It focuses on the roles of support planners, in councils and service provider agencies, who are central to supporting choice on the part of service users. Data were collected from three focus groups with 19 council support planning practitioners and interviews with 15 managers of home care agencies. Findings: The study suggests that new commissioning and brokerage arrangements have the potential to give older people using managed personal budgets greater choice and control over their support. However, new communication barriers have also been introduced and some staff report receiving inadequate training for their new roles. Above all, resource constraints were reported to impede council support planners in encouraging users to plan creatively how to use personal budgets. Resource constraints also meant councils placed constraints on how flexibly home care agencies could respond to changing needs and preferences of older users. Applications@ The paper concludes by highlighting the implications of new arrangements for social work practice and some of the barriers that need to be addressed if the potential benefits of personalisation for older people holding managed personal budgets are to be achieved. (Publisher abstract)
Council-managed personal budgets for older people: improving choice through market development and brokerage?
- Authors:
- BAXTER Kate, RABIEE Parvaneh
- Journal article citation:
- Journal of Care Services Management, 7(4), 2013, pp.136-145.
- Publisher:
- Taylor and Francis
This paper presents findings from interviews with social care service development managers and brokers in three local authorities. It follows an earlier study exploring choice and flexibility in home care services for older people using council-managed personal budgets. That study found that local authorities were limiting the number of providers on framework agreements for home care services so that there were sufficient to encourage competition but not so many that providers risked having insufficient business to remain financially viable. It also found that communication issues were affecting the proper functioning of brokerage systems. The current study therefore revisited the same three local authorities to investigate changes in framework agreements and developments in brokerage systems. The findings showed little change in the number of providers on framework agreements and remaining communication challenges for brokers. However, lessons had been learned from unforeseen consequences of framework agreements, and progress was being made towards encouraging market development and diversification of service provision. (Publisher abstract)
People who fund their own social care: scoping review
- Authors:
- BAXTER Kate, GLENDINNING Caroline
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2014
- Pagination:
- 50
- Place of publication:
- London
Scoping review which identifies research evidence about people who fund their own social care in England. Specifically the review looks at: the size of the self-funding population and its characteristics (age, region, type of care); information, advice and help available and needed by self-funders; the experiences care providers have of people funding their own social care; and gaps in the available evidence. The review comprised: a search of electronic databases; a search of the websites of selected organisations; and contacts with a small number of organisations known to have been active in research about self-funders. A total of 185 relevant pieces of work published since 2000 were identified, and 71 met the inclusion criteria. Information retrieved focussed on residential care, domiciliary care or both. Evidence suggests that the number and percentage of self-funders has increased in both residential and home care; many felt local authorities were unwilling to help them with their information needs and they were often signposted elsewhere; main information needs were in relation to fees and finances, particularly the long term financial implications of care. Gaps in the research evidence identified include: the number and characteristics of self-funders; factors that influence the level of demand; the levels of support needed; how tasks carried out for self-funders might differ from local authority-funded clients; and the experiences and outcomes for self-funder. Recommendations are made on key areas for potential future research. (Edited publisher abstract)