Personal budgets are improving outcomes for most service users in most areas of their lives but their impact is being undermined in some areas by excessive bureaucracy in council care management processes.
That was the verdict of the second National Personal Budgets Survey, based on the views of 2,022 personal budget holders and 1,386 carers living in 22 local authority areas, and published today by sector personalisation partnership Think Local Act Personal (TLAP).
As with the preceding survey in 2011, researchers found a strong link between positive outcomes and how simple councils made the process of accessing a personal budget.
Overall, at least half of service users reported that personal budgets had made things better or a lot better in nine of 14 aspects of their lives they were questioned about: being supported with dignity; getting the support they need when they want it; staying as independent as they want; physical health; mental well-being; control over important things in life; control over their support; feeling safe and relationships with paid support.
Less than 10% of respondents reported a negative impact from personal budgets in any of the 14 areas, though in three areas – choosing where you live and who with, getting and keeping a paid job and volunteering – majorities of respondents reported personal budgets making no difference.
Respondents were also quizzed on how they found nine aspects of the personal budgets process. More than half found six of the nine areas easy or very easy, including being in control of how the money is spent (60%), planning and managing your support (60%) and getting the support you want (57%).
Difficulties with process
However, significant minorities of people found core aspects of the self-directed support process difficult or very difficult, including: making changes to support (22%), choosing from different services to find the right one for you (20%) and telling people what you think or complaining (20%).
Researchers also received 488 comments from service users about their experience of personal budgets. While almost all the comments about the impact of personal budgets were positive, most of those submitted about the process were negative. Researchers received 62 negative comments on the complexity of the personal budgets process and no positive ones; all 10 comments on the assessment process were negative, as were 17 out of 18 concerning review, 24 out of 25 concerning the paperwork behind personal budgets and 21 out of 23 concerning timescales for setting up the budget.
Respondents reported delays in setting up personal budgets, said there was too much paperwork, adding to the burden of managing a personal budget, and reported confusion in how their budget was calculated. The negative comments about review reflected concerns about people’s budget being reduced, while researchers also found significant concerns about the level of funding in people’s personal budget, with 58 negative and no positive comments in this area.
Link between easy process and good outcomes
The report also found strong links between councils having simple processes that were easy for families to understand and positive outcomes – reflecting the results of the first National Personal Budgets Survey in 2011.
For example, older people were more than twice as likely to report positive outcomes in 11 out of 13 areas if they felt their council made it easy for them to have their needs assessed or to access information and advice on personal budgets.
Researchers also found strong and robust associations between ease of process and positive outcomes for other client groups.
About the research
The research was commissioned by TLAP from Martin Routledge and John Waters, of In Control, and Professor Chris Hatton of the Centre for Disability Research at Lancaster University.
Twenty two councils volunteered to take part and encourage service users and carers to complete the survey, either online, in paper format or through face-to-face or telephone interviews. Almost half of service users (44.5%) were helped to respond to the survey, 32% answered by themselves and 18% had the survey responded to on their behalf.
The survey had a disproportionately high number of respondents with a direct payment as opposed to a council-managed personal budgets. Official figures from the Health and Social Care Information Centre showed that in 2011-12, 85% of older people receiving self-directed support had a council-managed budget; whereas of the survey sample, just 16% of older people had a council-managed budget and 64% a direct payment paid directly to themselves (42%) or looked after by someone else (22%).
The survey authors suggested that this could be because councils willing to take part in the survey are those who are “more willing to try out innovative forms of personal budget delivery”; and also that people on managed personal budgets are less likely to take part in such a survey as they are less likely to see themselves as having a personal budget.