The original claim made for the present personal budgets system was that it would reduce bureaucracy and increase service users’ choice and control. This is still the official argument. Community Care’s latest survey of social care practitioners, however, adds to the evidence that personal budgets are fundamentally failing to do this.
Service users are not in the lead as was planned and promised:
- Two-thirds of survey respondents said assessment paperwork was too complicated for service users to complete themselves; only 1% that it was suitable for them to complete without support.
- Almost three-quarters (72%) said council staff usually lead on support planning, only 2% said service users and their families usually took the lead, and 1% user-led organisations or peer support.
- Two in five (39%) thought that service users and their families had little or no involvement in the design and ongoing review of the personal budget process in their area.
- Only a minority of respondents, ranging from 40% to just 20%, thought that enough was being done to help groups like older people, people with autism, and people with mental health needs access personal budgets;
- Three-quarters disagreed that resource allocation systems (RAS) were easy for service users and carers to understand.
‘Don’t blame local authorities’
So far the tendency has been to point the finger at local authorities and blame them for the failings of personal budgets. We are told it’s councils who have messed up, not personal budgets’ architects. Speak to people on the ground and this argument becomes increasingly untenable. Not only are local authorities facing worsening funding problems and social care as yet remains unreformed. The essential policy of personal budgets as it has been implemented by government, compared with earlier developments for direct payments as advanced by disabled people, seems to be flawed.
The issue now is when there will be wider political recognition that this is the case; that the policy doesn’t seem to work and is unlikely ever to deliver. The critical question is how much longer are service users and local authorities going to have to stay with this defective system? How much more money, effort and resources are going to be poured into it?
Personal budgets are not routinely delivering personalisation for service users as was promised. As the four-year, Joseph Rowntree Foundation-funded Standards We Expect project on person-centred support found, to achieve this demands something different and much more substantial from a reformed system of social care. This includes adequate funding, a changed culture, transformed workforce, renewed market and much greater user involvement.
Good social work is needed
This study also showed that to engage people in the assessment process you have to start with them. This is not achieved by presenting them with a battery of closed questions to gather information, which is what the RAS does, but rather through listening to them – what good social workers have always done. Real empowerment develops through partnerships between service user and practitioner, not by trying to convert the service user into a ‘consumer’, which seems to have the opposite effect.
There are no short cuts, as the proponents of personal budgets claimed. That is also the lesson from the latest Community Care survey. Adult social care and adult social work must be given the support, priority and the funding that they need if the promise of personalisation is to deliver for service users in the long-term.
Peter Beresford is chair of service user network Shaping Our Lives, professor of social policy at Brunel University, and one of the authors of the Joseph Rowntree Foundation’s Standards We Expect research.
More from this year’s Community Care personalisation survey