While personal budgets were supposed to liberate social workers to empower service users, many councils seem reluctant to do so. Just 19% of respondents to Community Care’s annual personalisation survey said social workers in their council were able to sign off personal budgets for service users up to a certain level of spend. Instead, most authorities insist practitioners refer service users’ support plans to managers or panels for approval, despite this seemingly making the process longer, more bureaucratic and more remote from the service user.
Tips on signing off support plans
Tell users clearly what information is expected of them to sign off a budget, keep this information simple and make sure users have enough time and support to get the information;
Create a summary sheet for sign-off which focuses on how individuals will meet agreed outcomes without requiring a detailed support plan
Allow social workers to sign-off support plans where people have good support around them, are confident with being able to use their budget effectively and are able to get what they need within budget.
Source: The Centre for Welfare Reform, Groundswell Partnership
This is the wrong approach, says Simon Stockton, director of personalisation consultancy Groundswell Partnership, who would like to see about 70% of sign-off decisions taken by social workers and 30% by managers or panels. Broadly, he says, social workers should be able to sign off when there are no financial or safeguarding risks; when there is a history of the user being able to manage their money; when they have good support networks around them; and when they are coming up to review and circumstances have stayed much the same.
[Read full coverage of our 2012 personalisation survey, sponsored by Unison and The College of Social Work]
If councils were doing this, “we would expect that a significantly higher proportion of social workers would be signing off than Community Care’s survey shows”. And by doing this, decisions would be more straightforward and quicker, and social workers would have improved job satisfaction, he says.
‘Demoralising’ for social workers
Social worker Kelly Hicks, who runs independent brokerage service Personalisation Plus, agrees: “It is demoralising for social workers to have no autonomy to agree even basic support plans with the people they support. Social workers are the best placed and qualified people to engage with the people they support, understand their needs, discuss risks and responses and agree support.”
As well as causing “frustration” and delays in accessing support for service users, she also thinks there is another negative knock-on effect from taking sign-off responsibility away from social workers: “I think it causes reluctance from social workers to seek more creative solutions because of the time constraints and additional pressures in seeking a manager’s or panel’s approval – sometimes it’s just easier to propose a traditional style of service delivery.”
Where social workers are taking on responsibility for sign-off, they need to bear several things in mind: whether people have support networks around them, or are isolated; whether they are confident of where to go if they need advice and support; and whether contingency planning is in place.
However, the more obvious issues of financial management and safeguarding risks can pre-occupy their thoughts, adds Hicks. She says the ethos of personalisation requires social workers to see service users as best placed to manage their finances and to promote “positive risk-taking”.
“Social workers need to guard against taking a paternalistic view by advocating care agencies under the presumption that registration brings a higher quality of care,” she says.
There will be times when support plans need to be referred to a manager for approval, but the decision as to when that happens should still be down to the social worker, says Stockton.
“If you are empowering social workers to make decisions about signing off then you should be empowering them to make a professional judgement about when a manager should do this,” he says.
He says managerial involvement would be appropriate where the proposed final personal budget is higher than the indicative budget, particularly where the overall budget itself is big; where there are concerns over the person’s ability to manage their budget; where they do not have the right support around then, or where they have a fluctuating condition.
“But it may well be that with a reasonable percentage of these cases a short consultation with their manager could mean that the social worker is supported to make the decision for sign off rather than having to go through another stage of the process,” he adds.
Having a panel deciding on sign-off can be even further removed from the service user and, for Hicks, this should only happen when significant risks are identified in how the individual wants to spend their money.
Stockton agrees and says, where used, panels need to be “quick and transparent”.
“It is hard to say that panels are bad full stop, but it is important to say that they are not a good way of managing anything but a small minority of cases.”
Case study: Making social workers responsible for sign-off
In Walsall, personal budgets are currently signed off by a panel – the maximising independence group, consisting of experts in various areas including occupational therapy, assisted technology, community resources and housing.
However, the council is already working towards simplifying the sign-off process so that social workers and team managers take on more of this responsibility. They are still several months from achieving a cultural change in the sign-off process but in preparation, considerable effort is being put into streamlining paperwork.
‘Documentation days’ have been held where a group of key workers from teams from initial assessment through to review have collected all the paperwork and assessed what should and shouldn’t be kept.
“There were about 75 forms which added up to about 500 bits of paper,” says Sean Cook, head of service, access and care management. “They have kept only the significant and mandatory basics. It empowers social workers to feel that they can do a good person-centred assessment and explore options for support but it doesn’t take forever to fill out the forms. For example, the support plan now just includes what is needed to identify outcomes and how they are going to be achieved.”
There will be an agreed level of spend that social workers will be allowed to sign off, though that is yet to be decided.
“We are absolutely committed to working towards this,” says Cook. “If we could get to a point where 70% of sign-off decisions are made by a social worker or manager and 30% by the panel that would be great and that’s the way we want to go.”