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)
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)
Subject terms:
older people, commissioning, home care, personal budgets, local authorities, personalisation, service brokerage;
This paper updates an earlier extensive review of research into the incidence and management of risk in adult social care in England, and addresses gaps identified in the earlier review. It identifies only empirical research published since 2007, concentrating on research conducted and published within the UK. Three specific areas are of interest: social care service users’ and carers’ experiences and perspectives on risk, including their perspectives on the balances between positive risk-taking and protection from risk; research evidence on the effectiveness of mechanisms to prevent or reduce risk; and evidence on experiences, incidence and the management of risk arising from more personalised approaches to delivering adult social care. Recent research in these areas appears to focus predominantly on the operation and effectiveness of new measures and procedures intended to identify and reduce risk; and also on new challenges in the prevention and management of risk raised by the implementation of personal budgets. There is little research on how users’ experiences or professional strategies are influenced by wider socio-economic factors; new research on issues of gender appear to focus more on practitioner rather than service user perspectives. Studies repeatedly draw attention to the tensions and dilemmas experienced by professionals in balancing a positive approach to risk-taking with their professional and statutory duties to protect service users.
This paper updates an earlier extensive review of research into the incidence and management of risk in adult social care in England, and addresses gaps identified in the earlier review. It identifies only empirical research published since 2007, concentrating on research conducted and published within the UK. Three specific areas are of interest: social care service users’ and carers’ experiences and perspectives on risk, including their perspectives on the balances between positive risk-taking and protection from risk; research evidence on the effectiveness of mechanisms to prevent or reduce risk; and evidence on experiences, incidence and the management of risk arising from more personalised approaches to delivering adult social care. Recent research in these areas appears to focus predominantly on the operation and effectiveness of new measures and procedures intended to identify and reduce risk; and also on new challenges in the prevention and management of risk raised by the implementation of personal budgets. There is little research on how users’ experiences or professional strategies are influenced by wider socio-economic factors; new research on issues of gender appear to focus more on practitioner rather than service user perspectives. Studies repeatedly draw attention to the tensions and dilemmas experienced by professionals in balancing a positive approach to risk-taking with their professional and statutory duties to protect service users.
Subject terms:
literature reviews, personalisation, risk, service users, social care provision, user views, adult social care;
Public Money and Management, 31(2), March 2011, pp.91-98.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
... social care support. It provides an overview of the development of markets in English adult social care and the development of personalised funding. It discusses social care markets (using the findings of research into the potential impacts of personalisation on providers of home care services published in 2008), focusing on the findings relating to 3 key market functions: multiple buyers and sellers,
Using an analytic framework based on the preconditions for effective markets, this article considers how the widespread introduction of personal budgets is likely to affect the market for social care. It looks at the potential responses of the home care provider market to the new conditions that will be established by the widespread introduction of personal budgets for publicly funded adult social care support. It provides an overview of the development of markets in English adult social care and the development of personalised funding. It discusses social care markets (using the findings of research into the potential impacts of personalisation on providers of home care services published in 2008), focusing on the findings relating to 3 key market functions: multiple buyers and sellers, free market entry and exit, and perfect information about the market. The authors conclude that, if the introduction of personal budgets is expected to make social care markets more responsive to client needs, it is not clear from their study how this goal will be achieved. They note that while there are some promising signs of changes that should result in a more responsive market, there are some structural features that may act as barriers, and that there are new roles that local authorities could usefully play in facilitating local markets during the transition period and in the longer term.
Subject terms:
home care, local authorities, mixed economy of care, personal budgets, personalisation, private sector, social care provision;
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 benefits of personalisation for older people holding managed personal budgets are to be achieved.
(Publisher abstract)
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)
Subject terms:
choice, social care, social work, older people, personalisation, personality development, home care, personal budgets;
Social Policy and Society, 10(1), January 2011, pp.55-65.
Publisher:
Cambridge University Press
... by describing the background to the policies of personalisation and PBs, local authorities’ (LAs) and service user involvement. A range of services are covered including home care, supported living, employment agencies, advocacy, day care, specialist support (e.g. for head injuries), carer support and 24-hour live-in support, and 13 pilots were observed. Providers’ perceptions are described as findings from
This article looks at 2 studies which examine the staff-related impacts perceived and experienced by providers of social care following the recent increase in the use of personal budgets (PBs) by service users in England to purchase their social care support. PBs in this paper are also inclusive of direct payments, “in control” allocations and individual budgets (IBs). The paper begins by describing the background to the policies of personalisation and PBs, local authorities’ (LAs) and service user involvement. A range of services are covered including home care, supported living, employment agencies, advocacy, day care, specialist support (e.g. for head injuries), carer support and 24-hour live-in support, and 13 pilots were observed. Providers’ perceptions are described as findings from “outside the IB pilots” and real time experiences from in depth interviews with personnel from 4 of the 13 pilots are labelled “IB pilots". The anticipated and actual impacts on four main themes are discussed, financial and workforce planning, staff retention and recruitment, staff and workplace training, and service user/provider relations, with these authors occasionally quoting comments from participants verbatim. Potential implications for social care providers, service users, LAs and care workers are listed.
Subject terms:
local authorities, personal budgets, personalisation, planning, recruitment, service users, social care, social care provision, staff retention, staff-user relationships, training, care workers, direct payments;