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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)
Choice, competition and care: developments in English social care and the impacts on providers and older users of home care services
- Authors:
- RODRIGUES Ricardo, GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 49(5), 2015, p.649–664.
- Publisher:
- Wiley
This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for-profit and charitable) organisations and local authority providers of long-term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on: a) The commissioning and contracting of home care services by local authorities and individual older people; b) The experiences and outcomes for individual older people using home care services.. Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalised within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalised home care, in which the quality of care-giving relationships can also be optimised. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organisations providing home care services and for individual older service users. (Edited publisher abstract)
Progress and problems in developing outcomes-focused social care services for older people in England
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- Health and Social Care in the Community, 16(1), January 2008, pp.54-63.
- Publisher:
- Wiley
Social care services for adults are increasingly required to focus on achieving the outcomes that users aspire to, rather than on service inputs or provider concerns. This paper reports a study aimed at assessing progress in developing outcomes-focused services for older people and the factors that help and hinder this. It describes the current policy context and discusses the social care service outcomes desired by older people. It then reports on a postal survey that identified over 70 outcomes-focused social care initiatives across England and Wales, and case studies of progress in developing outcomes-focused social care services in six localities. The study found progress in developing outcomes-focused services was relatively recent and somewhat fragmented. Developments in intermediate care and re-ablement services, focusing on change outcomes, were marked; however, there appeared to be a disjunction between these and the capacity of home care services to address desired maintenance outcomes. Process outcomes were addressed across a range of re-ablement, day care and residential services. The paper concludes by discussing some of the challenges in developing outcomes-focused social care services.
Progress in partnerships
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- British Medical Journal, 7.7.01, 2001, pp.28-31.
- Publisher:
- British Medical Association
Primary care groups and trusts are expected to develop partnerships with local authorities, particularly for commissioning services and developing services for older people. Reports on the results of a survey which showed that nearly half of the groups and trusts surveyed do not routinely consult with social services when commissioning community health services, and even fewer consult with social services about commissioning acute care. However, relationships between front line social services staff and community based and practice based health professionals are improving.