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Second National Personal Budgets Survey Blog

For many years In Control and others have championed the cause of personalisation arguing that it is not only possible and beneficial to help people direct their own support through personal budgets and good person centred planning, but that it is also financially prudent to do so. Over time this view has become the accepted policy position and personal budgets and self-directed support have been at the heart of our social care policy for some years now. However there remains much debate about the strategy.

Those sceptical about self-directed support argue that the system changes leading to increased choice and control through simple upfront assessment and allocation of resources are just too complex to achieve and  others suggest that the goals of increased choice and control are unaffordable at a time of unprecedented cuts. Some have also argued that the time and energy required to help people plan and manage their own support add to the transaction costs at a time when we need to be reducing such burdens. However it is clear that the direction of travel has been set and personal budgets are here to stay. The Care Bill looks set to place personal budgets on a statutory footing for the first time and so it seems likely local authorities will soon be placed under not just a policy expectation but a legal duty to make personal budgets available to people who need support. The key question question then is how do we make them work best and in a financially sustainable way?

Today Think Local Act Personal publishes the results of the Second National Personal Budgets Survey. The report describes the experiences of some 3,500 people, both family carers and personal budget recipients from 22 different local authorities. The survey was undertaken by In Control and Lancaster University using the Personal Budget Outcome Evaluation Tool (POET) questionnaire and is the biggest survey of its kind to date.

POET looks at people's experience of taking control of a personal budget, the decisions they make as they take control, and the impact that the personal budget has on their life. By looking in detail at the responses of various groups it has been possible to provide a 'State of the Nation' report for personal budgets. The report sets out what is working well and what is not, for who, and sets out the range of experiences and outcomes across different local authorities and different social care groups.

Perhaps most importantly the report begins to define the critical conditions that are at play when people report good outcomes. These conditions seem to powerfully influence the effectiveness of personal budgets and given that they are all conditions that local authorities can readily influence this is clearly very important.

Looking at the findings of the survey it is clear that in some areas of the country personal budgets are working very well whilst in others this is not the case. For example just looking at one outcome area, 'help to remain independent', in the best local authorities more than 8 out of 10 respondents said their personal budget had helped, but elsewhere the figure was just over half. A local authority performing poorly in this outcome area will have both financial and practise concerns.

Whilst the spread of outcomes here is of concern, it is reassuring to note that people's experience of the process was associated strongly with their reported outcome.  Personal budget recipients who said that their views had been fully taken into account in the planning were more than four times as likely to report good outcomes in this area. Similarly, people who said that it was easy to change their support and those who said it was easy to choose from different services were three times as likely to report good outcomes in relation to their independence. So it is clear -there is a clear link between people's experience of the self-directed support process and the outcomes they achieve.

However even if it is possible to set the conditions right for personal budgets to make a big difference to people's lives, local authorities continue to  face on-going demands  and ever increasing budget pressures, so can they really afford to worry too much about the quality of their social care system?  The report suggests that good quality and financial sustainability are not necessarily at odds. Whilst the survey found no correlation between the amount of money in a personal budget and the outcomes achieved, there were other interesting associations between process and outcome that point towards a sustainable self-directed system.

Family carers who said their views had been taken into account in the planning were four times more likely to report personal budgets helped them remain well and carry on caring. People with learning disabilities who reported that it was easy to get the information and advice they needed were more than twice as likely to report personal budgets helped them take part in work or volunteering. Given the financial importance of recognising social capital these are both findings with some significant bearing of sustainability.  The question then is not can we afford to implement personal budgets, but rather how do we do so to best effect and what can local authorities do to understand and create the key critical conditions that lead to better outcomes.

If you want to find out more about the report, read the summary and the full version here. We have also created a recording of a webinar of John Waters explaining the key findings.

In Control is committed to working with local authorities that want to check PB results local with people and families and to use this information to improve local delivery. More than 30 councils have now used the tool. If you are interested in using POET you can read more online or contact me at john.waters@in-control.org.uk

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Last Updated : 22 May 2013. Page Author: Pam Schreier.