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Individual budgets: lessons from early users' experiences
- Authors:
- RABIEE Rarvaneh, MORAN Nicola, GLENDINNING Caroline
- Journal article citation:
- British Journal of Social Work, 39(5), July 2009, pp.918-935.
- Publisher:
- Oxford University Press
Within the context of modernization, there has been a trend towards ‘cash-for-care’ schemes designed to bring choice and control closer to the service user. In England, Individual Budgets (IBs) are being piloted, with the aim of promoting personalized support for disabled people and other users of social care services. This paper reports on the experiences and outcomes of early IB users two to three months after first being offered an IB. The users included adults with physical/sensory impairments, learning difficulties, mental health problems and older people. Semi-structured interviews were carried out with nine service users and five proxies. The findings suggest that IBs have the potential to be innovative and life-enhancing. However, achieving this potential in practice depends on a range of other factors, including changes in the routine practices and organizational culture of adult social care services and ensuring users have access to appropriate documentation and support. Any conclusions drawn from the experiences of these early IB users must be treated with caution. The findings nevertheless indicate some of the issues that will need to be addressed as IBs are implemented more widely to replace conventional forms of adult social care provision.
Increasing choice and control for older and disabled people: a critical review of new developments in England
- Author:
- GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 42(5), October 2008, pp.451-469.
- Publisher:
- Wiley
This paper critically examines new policies currently being implemented in England aimed at increasing the choice and control that disabled and older people can exercise over the social care support and services they receive. The development of these policies, and their elaboration in three policy documents published during 2005, are summarized. The paper then discusses two issues underpinning these proposals: the role of quasi-markets within publicly funded social care services; and the political and policy discourses of consumerism and choice within the welfare state. Despite powerful critiques of welfare consumerism, the paper argues that there are nevertheless very important reasons for taking choice seriously when considering how best to organize and deliver support and other services for disabled and older people. A policy discourse on consumerism, however, combined with the use of market mechanisms for implementing this, may be highly problematic as the means of creating opportunities for increased choice and, on its own, risks introducing new forms of disadvantage and social exclusion.
Path to independence?
- Authors:
- HUDSON Bob, HENWOOD Melanie
- Journal article citation:
- Community Care, 9.11.06, 2006, pp.34-35.
- Publisher:
- Reed Business Information
Cash payments to individuals to purchase their own care are now a key element of government policy, but various programmes have grown in an uncoordinated manner. These include direct payments, Independent Living Fund and individual budget pilots). The author calls for greater coherence across the schemes. This article identifies several key dilemmas that will need to be addressed in any process of rationalisation.
Carers' roles in personal budgets: tensions and dilemmas in front line practice
- Authors:
- MITCHELL Wendy, BROOKS Jenni, GLENDINNING Caroline
- Journal article citation:
- British Journal of Social Work, 45(5), 2015, pp.1433-1450.
- Publisher:
- Oxford University Press
Adult social care in England emphasises the service and support preferences of disabled and older people. Personal budgets play a central role in this development. Carers in England have also secured rights to assessment and support in their care-giving roles. However, these policies have developed largely separately, with little consideration of the interdependencies between disabled and older people and their carers. There is limited evidence detailing current practice. This paper explores current practice, particularly how far social care practitioners recognise and balance the needs and interests of service users and carers, especially those with cognitive and/or communication impairments. The paper reports findings from nine qualitative focus groups (forty-seven participants) conducted in 2012 with practitioners involved in service user personalisation and carer assessments from older people and learning disability teams across three English authorities. Findings indicate inconsistencies in practice. Although practitioners felt they sought to involve carers, practices varied between authorities, teams and colleagues in the same team. Clear and timely links between processes for service users and carers were absent. Practice was discussed most frequently around service user assessments; other stages of personalisation appeared ad hoc. Areas of confusion and tension are identified. Future policy and practice developments and challenges are also considered. (Publisher abstract)
The shifting sands of support planning
- Authors:
- WILLIAMS Val, PORTER Sue, STRONG Steve
- Journal article citation:
- Journal of Integrated Care, 21(3), 2013, pp.139-147.
- Publisher:
- Emerald
Purpose - The aim of this paper is to present a critical analysis of the current issues about support planning within personal budgets (PBs) for disabled and older people. Design/methodology/approach - The paper is based on data from a round of professional workshops in five local authorities, which represented the first stage of a research study about support planning. Focus group discussions were held with participants from voluntary sector organisations (VSOs), as well as social services participants, and the paper is based on a thematic analysis of those discussions. Findings - While there was considerable agreement about the desired outcomes for personal budget users, and the ingredients of good support planning, some major concerns were voiced about current constraints. Budgetary cuts were felt to impinge negatively on support planning, and conflicts were identified for social services between the facilitation of PB users’ choices, and the need to keep budgets limited. Support planning was often being re-colonised by social services, and VSOs felt that their own role was being curtailed. Some suggestions were made about equalising the power relationships between social services, VSOs and PB users themselves. Originality/value - These workshops represent five local authority areas which volunteered to take part in research, building on existing good practices in support for PB users. The obstacles they identified are likely to be very general ones, and need to be addressed by strategic solutions at national and local level. (Publisher abstract)
Personalisation and adult social care: future options for the reform of public services
- Authors:
- DUFFY Simon, WATERS John, GLASBY Jon
- Journal article citation:
- Policy and Politics, 38(4), October 2010, pp.493-508.
- Publisher:
- Policy Press
The authors first provide a brief overview of the development of adult social care in order to place the advent of personal budgets in their historical and policy context. They summarise some of the key concerns and criticisms of personal budgets. The main focus of the article is on the concept of personal budgets as a form of ‘conditional resource entitlement’ (CRE), a situation in between direct service provision and income adjustment in which the individual is given direct access to resources, but with conditions attached. The authors suggest a CRE can be defined using a framework that has five main dimensions: autonomy, flexibility, targeting, support, and conditionality. Other examples of CREs are briefly discussed. The authors argue that, by framing personal budgets as a form of CRE, there is scope to place this specific mechanism in the broader context of the differing strategies available to government when seeking to reform welfare services. They argue that, using this approach it is possible to conceive of a future in which current CREs could become a form of income adjustment; or emerge as the optimal approach to meeting the needs of disabled people; or provide a mechanism for making currently individual resources more conditional.
Self-directed support: watching for the pitfalls
- Author:
- JONES Ray
- Journal article citation:
- Journal of Integrated Care, 16(1), February 2008, pp.44-47.
- Publisher:
- Emerald
In the recent government Comprehensive Spending Review there is a promise of a Green Paper on social care services for disabled and older people. The platform on which any new proposals will be built is likely to be heavily influenced by the Government's personalisation agenda for public services. In light of this the author reflects on the strengths and potential pitfalls of self-directed support for the personalisation agenda in adult social care.
Independent living strategy: a review of progress
- Author:
- MORRIS Jenny
- Publishers:
- In Control, Disability Rights UK
- Publication year:
- 2014
- Pagination:
- 25
- Place of publication:
- Wythall
This report summarises the findings of a review of evidence about the impact of the 2008 Independent Living Strategy and seeks to measure progress against some of the most important specific aims of the strategy. The review found that there is no evidence of significant progress in disabled people’s experiences of choice and control in their lives since 2008. Personal budgets for social care tend to improve outcomes but there is evidence that inadequate funding and restrictions on how personal budgets/direct payments may be used can inhibit choice and control. Disabled people who need support in their daily lives and older people are experiencing diminishing opportunities to participate in family and community life. People with high levels of support needs are at increasing risk of institutionalisation while access to mental health services is becoming more difficult. There have been significant reductions in advice and advocacy services, particularly those funded by legal aid. There is no evidence that current policies to support disabled people into work are improving employment opportunities and large numbers of disabled people have experienced a reduction in their household income since 2010. Disabled people are experiencing a reduction in housing opportunities and an increasing number are living in accommodation which is not suited to their needs and there have been significant reductions in expenditure on important programmes intended to increase transport opportunities. (Edited publisher abstract)