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New data exposes challenges of rolling out Personal Care Budgets

The biggest dataset of care user's opinions about personal budgets, published recently by Demos shows that local councils and care service providers face significant challenges to meet the Government's target of increasing the number of personal budget holders from 13 to 30 per cent by April 2011. Care users look set to use their personal budgets to make radical changes to their care packages, but their enthusiasm is not matched by a knowledge of how to use them.

The report found an appetite for change in care services:

- 55 per cent of council funded care users said they would change their care when they received a personal budget, suggesting a healthy appetite for the choice personal budgets can bring.

- 59 per cent of those already using personal budgets said they had changed their care, suggesting personal budgets had resulted in change for the majority of those who received them.

- Despite this, 45 per cent of council funded care users said they would not change anything about their care if they had a personal budget, highlighting a dual challenge of change and continuity for councils and providers.

- Most care users want more opportunities to socialise, meet new people and more help getting out into the community. They also wanted a wider range of activities on offer, particularly on weekdays.

But there is a risk that in spite of their enthusiasm, people will be unable to make the most of personal budgets due to a lack of information and advice. This, in turn, creates a risk that care users may not spend their money effectively or secure the best package of support to meet their needs.

- 65 per cent of those surveyed still know nothing about personal budgets

- 57 per cent of people said they needed more information on what they could spend their personal budget on

- 52 per cent wanted more face to face advice

- 25 per cent said they would need no help with a personal budget.

Increasing the number of personal budget holders from 13 to 30 per cent by April 2011 will be difficult to achieve with current low levels of public awareness. Government and councils must improve local information and advice services if they hope to meet the target and ensure people get the most out of personal budgets.

The data also found that personal budgets may drive a shift from traditional care services to mainstream and universal services as users swap their day centre and home carer for leisure and community centres and escorted trips out.

Comparing what people used before and after receiving a personal budget, some clear trends emerged:

- Using personal assistants increased from 45 to 76 per cent

- Leisure service use increased from 18 per cent to 73 per cent

- People spending social care funding on holidays increased from 9 per cent to 44 per cent

- People relying on their families for support fell from 39 per cent to 16 per cent

- People going to day centres fell from 46 per cent to 37 per cent.

The Demos survey also found that care users want to use services where staff know you personally, which are locally based and which prioritise continuity and reliability of services. It also exploded the myth that self funders have more choice and control than others due to using their own money – 42 per cent of self funders said they would change their care if they had the chance, and are less happy with their financial situation than others, suggesting lack of resources could be a main obstacle to choice for this group.

Personal Best recommends that local authorities must:

- Ensure local markets have the range and volume of services people need at a good quality and price, in partnership with new GP commissioning consortia.

- Radically improve awareness raising, advice and information regarding personal budgets and what services are available locally, to support care users to plan and purchase their own care with personal budgets.

- Support providers in a challenging dual role of maintaining core services for those who do not want to change their care packages and value continuity; whilst at the same time diversifying their service offer to meet emerging demands around leisure and socialising.

- Broker partnership working between traditional care services and mainstream leisure and community services, transport and home helps to facilitate seamless packages of care for personal budget holders.

- In an era of service budget cuts, look closely at affordability in their areas to ensure new personal budget holders are not priced out of local markets, in the way some self funders might be.

Claudia Wood, a social care expert at Demos said:

'This new data shows how much of a challenge the roll-out of personal budgets will be for both care providers and councils. Surveying both current personal budget holders and those eligible for them in the roll-out gives us a real insight into what the future may hold.

'But there will also be real opportunities for providers to move into new areas of emerging demand. The vital thing is for local councils to ensure that the providers in their areas are prepared to respond to these changes, and that care users know how to make the most of their personal budget.'

 

Notes to editors

Data from 770 care users were analysed for this report; 59 per cent of them were women and 71 per cent described themselves as White British. The rest of the sample was made up of 13 per cent Indian, 4 per cent Black Caribbean, 3 per cent White Irish, 2.5 per cent Pakistani and smaller numbers of many other ethnic groups.

Broken down into needs groups the most commonly represented primary needs were physical impairment (43 per cent, 334 people), old age (23 per cent, 181 people), learning disability (14 per cent, 111 people) and mental health needs (13 per cent, 103 people).

The sample was up of 449 people who had their care wholly funded by their respective local authorities, another 49 people particularly funded by the council, 138 self funders, 93 people using a direct payment or personal budget and 41 who did not know how their care was funded and/or said they received NHS care.

Personal Best by Claudia Wood is published by Demos on Tuesday 16 November 2010. It can be downloaded for free from www.demos.co.uk

 

Media enquiries

Beatrice Karol Burks, Head of Press

beatrice.burks@demos.co.uk

020 7367 6325 or 07929 474938

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