There are plenty of best practice examples showing how personalisation can be made a reality, writes social care minister Phil Hope ahead of a major conference on the subject
Putting People First sets out a compelling vision for adult social care for the next decade and beyond – where disabled and older people can live their own lives as they wish, with maximum choice, control and power over the services they receive.
A year since the first round of the social care reform grant, the Department of Health is continuing to work with its partners and councils to identify barriers to implementation, and provide examples of where it works.
The evaluation of the individual budgets pilot offered an important insight into the challenges of making personalisation a reality for older people.
One of the key findings suggested many older people and their carers did not want the additional burden that they associated with planning and managing their own support.
Here are some of the top tips for making sure older people, their carers and their families experience the benefits of personalisation have been highlighted by council staff who worked in the pilot sites:
Change the whole system
Older people often approach services at a time of crisis when they feel vulnerable or unwell and can find decision-making difficult. Working with colleagues in other areas may help in finding ways of stabilising the situation in the short term.
This can help older people build up their confidence to think about the longer term support they need. For example, Barking and Dagenham are working with health colleagues to contact people before they reach crisis point. A joint health and social care team visits people at risk of hospital admission (identified through GP records) to work out what would keep them well, including providing personal budgets.
Start from the person
Advice from the pilot sites is to challenge the perception that older people would not want a personal budget or a direct payment. Do this by supporting colleagues to develop person-centred thinking, attitudes and approaches. Support planning allows older people to get involved in determining the outcomes that can best meet their needs and together you can work out how best to achieve these. One pilot site set up a section 64 grant held by Age Concern to establish a social enterprise that will take in the existing direct payment service but will also provide training and peer-to-peer support to older people wanting to develop support plans.
Provide flexibile solutions
People have used their personal budgets for a range of different things including commissioning PAs or agencies to manage personal care and domestic tasks purchasing respite directly from the provider respite in the home purchasing mobility scooters, computers and broadband connections holidays transport days out to specific locations, and more. Encourage local providers to provide the types of products and services that older people are looking for.
In Manchester, the council has reviewed all home care contractors and individual packages. Their new contracts reflect personalisation and providers run localised services with flexible hours.
Choice on managing money
Older people can have their support managed by the council, a direct payment, or a combination of both. An Individual Service Fund can be a way for recipients to relinquish the burden of monetary control but still direct their own support. Bath and North East Somerset has developed individual accounts for homecare. It involves block and spot contracts personalised around each individual, with fortnightly payments made to providers’ accounts to cover services agreed in the individual’s support plan.
As we move into 2009 and the second year of the social care reform grant, it is vitally important that councils maintain their focus on the challenges ahead. We’ll be continuing to work hard alongside our partners who signed up to Putting People First to make sure that progress continues.
Phil Hope is minister for social care at the Department of Health. He will be speaking at our conference in London on 18 March
More information in Making personal budgets work for older people
Published in 5 February 2009 Community Care under the headline ‘Time to Drive Personalisation’