John Bolton (right), the Department of Health’s director of strategic finance, social care, local government and care partnerships, gives a beginners’ guide to what personalisation means in practice
As the personalisation agenda is taken forward, it is the responsibility of local authorities to ensure that everyone gains control over their support. Key to this is giving people the opportunity to co-design their support, based on what’s important to their quality of life and the resources they have available to them. There are two approaches to managing this support: a direct payment, or a directly provided service arranged by the local authority.
One clear finding from all the evidence available is that personal budgets result in a significant increase in the uptake of direct payments. This includes people – especially older people – who have not traditionally taken them up. Once people get the chance to be part of a person-centred planning process, direct payments can be a far more attractive proposition, especially if they get the right support and don’t have to jump through unnecessary bureaucratic hoops. The support that people receive here is vital. Whether it is help from an organisation who will take on payroll and paperwork, or just having someone on the end of the phone to offer a bit of reassurance, no one wants to feel on their own when taking on something new.
People may want to exercise the control over their money in different ways. Some may choose to employ a personal assistant, others may go to an agency to acquire staff but they can still stipulate when and what the staff do when they visit. Others may find imaginative ways of ensuring their needs are met, for example by getting a neighbour to escort them to a social club or a friend to take them to the sports centre. Some people have chosen to have all or part of their care services arranged for them by the council, others have used part of the money to arrange for some of their needs to be met in a different way.
Quality of life
For some people, the changes they might want to make to their support will be small, but important to their quality of life. Home care may be the right option for them, but simply delivered differently so that it is better tailored to their needs. In Bath and North East Somerset Council older people with support work out what they want the home care provider to do with a quarter of the weekly budget able to be carried over into the following month allowing people to have more or less support when it suits them. From being able to bend the hours provided around a family event, say, or have a home care worker put their net curtains in the wash, these small flexibilities can mean a lot.
In local authorities across the country these new ways of giving people control are being worked out. There is a long way to go, not least to make these new arrangements efficient and sustainable. But, through continuing to listen and adapt to what people really want we have a good chance of making personalisation an innovation that improves the quality of support for everyone who uses social care.
Links to other top experts’ views:
Andrew Cozens on why current concepts of personalisation do not go far enough