Social care groups back NAO support for personal budgets
Auditor’s report on benefits of personal budgets and choice in social care markets chimes with care professionals
Groups representing social care professionals have backed the findings of a National Audit Office (NAO) report on user choice and provider competition in England’s care services.
The NAO found that most people who use personal budgets to pay for their social care think this has improved their wellbeing. Ruth Cartwright, manager of the British Association for Social Work (BASW) in England, said the association was strongly in favour of people being able to commission their own care and support.
“This enables people who need care and support to have that in the way that they want and need, rather than being given something off the shelf that has been mass purchased,” said Cartwright.
David Walden, director of adult services at the Social Care Institute for Excellence (SCIE), said it was good to hear confirmation that most people who have personal social care budgets find this method beneficial.
“The evidence has been showing us this for some time,” he said. “Personal budget holders value the choice and control it gives them. They report high levels of satisfaction with the services that they receive and many councils and care providers are adapting well to the new arrangements.”
The NAO report called for more work to ensure that care markets deliver a genuine choice of services for all users and that support is available to help them make choices.
Walden said that SCIE agreed that more needs to be done to provide choice and that people need consistent contact with a worker who understands their circumstances.
“Personal budget holders also say they need clear information about how to use the funding,” said Walden. “People can be enabled to define their own risks and to recognise, identify and report abuse, neglect and safeguarding issues.”
The NAO’s findings reveal that although some local authorities report that personal budgets have led to better value for, the impact on cost overall has not been evaluated.
Cartwright believes “the jury is still out” on value for money. “It was hoped that it would, and one could see right at the beginning that might be the case because people getting a one size fits all type service, were sometimes getting a bit too much service, but it was either that or nothing.”
But she added that in some cases it would also be possible to see that providing the personalised care and support requested by some vulnerable people could be more costly.
Walden called for councils to check that they are offering greater choice and control by overhauling business processes, building community capacity and shaping the market. “So there needs to be a discussion about how to measure value. It shouldn’t just be about immediate costs, but ‘value’ should also be determined by people’s outcomes,” he said.
On the potential for misuse of personal budgets, Cartwright said she did not believe this was a problem. “The amount people are given is decided after a lot of bureaucracy, and usually assessed by a local allocation panel,” she said. “That panel makes clear what the money is for and the conditions on which it is given.
“Monitoring takes place in terms of regular reviews of the care package. So it would probably be apparent if someone was taking it down to the betting shop and spending it all on horses.”
According to Walden: “Anecdotal evidence suggests that people who receive personal budgets are particularly conscientious about how they use the money.”
Out of one million eligible people in England, 340,000 have a personal budget, representing £1.5bn of the total social care budget. The payments are either made directly so they can purchase their own care, or they have a budget managed by the local authority which they choose how it is spent.
The government intends to extend personal budgets to all eligible users by April 2013, as well as increasing the proportion taken as direct payments.
