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Choice and control for older people using home care services: how far have council-managed personal budgets helped?
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Quality in Ageing and Older Adults, 15(4), 2014, pp.210-219.
- Publisher:
- Emerald
Purpose: This paper reports the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise. Design/methodology/approach: Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face. Findings: Areas discussed include choice and flexibility over care agency, care workers, tasks, and timing and duration of visits. Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the 'ideal' of user choice and the 'reality of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to 'exit' from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs. Originality/value: The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider. (Edited publisher abstract)
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)
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)