This blog post has been written by our associate Andrew
Andrew is a health and social care practitioner based in
Brighton. He works as an independent facilitator, trainer, writer
and speaker and is a registered social worker and accredited
interpersonal mediation practitioner.
The Making it Real markers were launched on 17
May. Martin Routledge blogged
about them here on the same date. The markers were called
'making it real' for a reason, the reason being
that in some places and to some people
personalisation feels anything but real: to some it is a good idea,
poorly implemented or one that has been de-railed by the cuts
agenda; to others it was always regarded with suspicion, a Trojan
horse for privatisation or the end of the welfare state.
In Control firmly believes - alongside Think Local Act Personal
and our many friends and allies in the disabled people's movement,
in provider organisations and in local councils - that we can and
must make personalisation real. We know that when
implemented well it enables people to take control of their lives,
to contribute to the community and to begin to discover what it
means to be human. But we also know that these are tough times and
that everyone is under pressure.
How do we go about doing this? What in particular is it
that councils can do to help? Over the past 12 months we have been
working with councils and others in the North West of England to
engage with those with something to say about personalisation and
personal budgets (personal budget holders, families, staff, senior
managers) to identify the best practice - and by doing this to show
how some of the most challenging issues can be addressed. Our
of the work is published is now available. Here are some top
tips from the report.
Issue One Minimum Process: in some
council areas we have made things more complicated, not simpler.
The process someone needs to go through to get and manage a
personal budget puts many people off. Councils have been
overcautious and have heaped new processes on top of old, instead
of replacing the old with the new.
What should councils do?
- Provide local leadership through promotion of the values of
empowerment, co-production and informed choice and control. Visit
community associations, speak at local events, use the local media
- Invest in, support and quality-assure advice services available
to all. Will need to include both actual buildings-based services,
(CABx, young people's and culture specific advice agencies) and
electronic (web-based) sites and portals.
- Provide seed funding for user-led organisations and for centres
for independent living. Ensure that you support those organisations
that have the passion to empower people; ensure that they do not
- Review the provision and reach of 'basic support services'
(cleaning, shopping etc.) across the council area. Take account of
coverage, quality and pricing. Where services are deficient in any
way, consider what options are open to the council. Make it clear
to all that the capacity to help people to stay in their homes and
communities is everybody's business and the sign of a healthy
community. Help people to feel good about this sort of work.
- Keep under constant review the policies and procedures which
regulate the 'front doors' to council advice and support. Ensure in
particular that contact centres provide an excellent customer
experience and that staff are very well informed about how local
statutory, voluntary and privately provided services operate.
- Ensure that there are also good specialist advice services
available for help with housing, benefits, employment, law
and particularly to assist people to manage their health and social
care needs. There should be a mix of electronic and 'real'
resources available and they should provide a genuinely
personalised response to all.
- Check how easy it is for people to access and obtain simple
equipment and services, basic daily living equipment and basic help
in the home. Where there are difficulties or shortfalls in
availability or access, consider your options.
- Also check how other forms of 'social capital' such as
Timebanks, LETS, Homeshare services, Shared Lives and others work
with and on behalf of (potential) users of the social care system.
Where there are deficits, find ways of stimulating the market.
- Ensure that reablement services are efficient, effective and
provide good coverage of the whole locality.
- Consider how well your local reablement model works: is it
genuinely person-centred, is it effective in getting people
thinking about personal budgets at the right stage and in the right
way, is it confined to older people's services or does it extend
more broadly? Take whatever action is indicated.
- Think about the availability, usage and efficacy of telecare
services. How are new developments evaluated and made available to
people? Do these extend across all need groups? How do councils
know find out about them, signpost people and talk to them about
the cost issues? Is this adequate?
- Look at situations where short-term interventions are required
by council and other statutory services to prevent long-term
service use. Are these effective? Are they multi-agency
(particularly with health and housing colleagues)? Do they cover
the whole of the council area?
- Check that the financial assessment process works well, that
its purpose is clear for all concerned and that there are no
- Check that the process for auditing personal budgets is
proportionate and works well.
- Evaluate the role of care managers and social workers. Are they
making best use of their skills and experience? Are they focused on
complex cases and are they working effectively with these cases?
What role do they take in relation to support planning and
brokerage? Are there differences cross user groups, and if so can
these be justified?
- Ensure that the review process works well for all concerned:
particularly for people using services (to ensure that they get
what they want and need, they are working towards agreed outcomes,
are safe and have the opportunity to make changes as necessary),
and for the council who are getting value for public money.
- Ensure that there are good local services to help people
understand and manage their personal budgets and to think through
and design services that meet need. Where there are gaps
(geographical or in terms of service coverage), consider what
action is necessary.
Issue Two: Managed personal budgets: there has
been increasing public criticism of those personal budgets which
are not direct payments and especially those that are managed by
council staff. Some people say that in some places these
arrangements give no more choice and control than directly provided
What should councils do?
- Review the range of management options available for users of
managed personal budgets. Where there are gaps,
commission/encourage the market to fill them. Ensure that all need
groups are supported. Ensure that managed personal budget
arrangements provide assistance for those who require support to
- Review the impact/effectiveness of each management option using
some simple tests. What do users say, in particular about choice
and control? Take remedial action as necessary.
- Review the use of approved provider arrangements. Do they
remain fit for purpose in relation to the growth in use of managed
personal budgets? In particular do they enhance or inhibit choice
and control? Make changes as indicated by the review.
- Review the use of framework contracts in the same way. Do they
enhance or inhibit choice and control? Consider the merits of
outcome based commissioning.
- Review the use of individual service funds and the
specifications and contract compliance arrangements which support
these. All contracts with providers should now be constructed to
deliver clear personalised outcomes, and monitoring arrangements
need to capture this activity. Providers may need to support to
take on individual service fund requirements and changes to
contracts. Consider commissioning user-led organisations to
- Review arrangements to support user-led organisations and
encourage them to focus their activity on enabling people to manage
personal budgets. Provide additional support to ULOs as
Issue three: the workforce: the success of
personalisation in social care is almost entirely dependent on the
knowledge, skills and confidence of the workers employed to manage
the process as well as those provider staff who work with people on
a day-to-day basis. In some places today morale is low and
some staff find it hard to see that personalisation will make any
What should councils do?
- Refresh and reinforce local leadership and ownership of
personalisation through a programme of clear communications with
staff (face-to-face, written, and electronic) which emphasises the
overarching importance of sticking to core values in tough
- Make use of the Making it Real marker 'I statements' to review
user views of workforce effectiveness and to take action based on
- Review process and practice for 'sign-off' of support plans and
personal budget allocations to ensure that the focus remains
maximum choice and control, whilst taking necessary steps to manage
- Review practice across the council to check that the best
practice in relation to personal budgets is common and available to
- Review induction, training and support arrangements for
professional staff to ensure that these reflect and reinforce
council policy on value-driven personalisation in tough times.
- Work with local private and voluntary providers of social care
to ensure their managers and staff understand key values and
priorities; and that they have access to council training materials
and resources, wherever this is feasible and affordable.
We know that none of this is easy, and that a simple
prescription isn't the answer. But what we also know is that
people are telling us that all of these things are happening in
some places and that they do make a difference. Are you doing