Abstract

Personal budgets (PBs) provide a mechanism for facilitating self-directed support and thus personalisation of social care services. They can be taken as a cash direct payment; as funds held in a local authority (LA) or a provider account; or a mixture of the two. Where some or all of the PB is held in a LA account, it is known as a ‘managed personal budget’. Personal budgets held in provider accounts are known as Individual Service Funds (ISFs). Older people, especially those without informal carers, often do not want what they perceive to be the burden of managing a budget. Evidence suggests that one in five may choose to deploy their personal budgets as managed budgets. In the interests of equity, it is important that people using LA-managed PBs or ISFs are not excluded from receiving personalised and flexible support, or from having control over that support. Relationships may therefore need to change between service users and the third parties who manage their personal budgets in order to ensure that service users enjoy the choice, control and flexibility that is at the core of the personalisation agenda.

This research explores the processes of delivering personalised support to older people who opt for managed personal budgets. This qualitative research is taking place in three local authorities in England that offer some form of LA-managed PBs or ISFs. Stage one involved semi-structured interviews with commissioning managers to investigate whether, how, and why these LAs had changed contracting systems or facilitated market developments to encourage and enable personalisation for LA-managed PB and ISF users. In stage two, LA support planners took part in focus group discussions to explore their roles as intermediaries in shaping the expectations of, and facilitating personalisation for, older people using managed PBs or ISFs. Stage three comprised semi-structured interviews with managers of home care agencies; the purpose was to explore the impact of contracts on the delivery of personalised care, opportunities for providers and older people to work together to personalise support, and the effect of wider market developments. The final stage involves interviews with older people using managed PBs or ISFs to explore how effective new contract and support planning arrangements have been in creating opportunities for choice and control from their perspective.

Findings will be presented from the first three stages of the research, focussing on the role of contracting systems and support planning in facilitating personalised support.

Slides