A personalisation pilot in the London borough of Tower Hamlets has shown some encouraging interim results.
The trial, overseen by In Control, which supports local authorities to deliver self-directed support, is based at a supported housing project run by Look Ahead Housing and Care.
The Coventry Road service, which has 20 self-contained flats for people with high mental health needs, moved to a new personalised model in July 2009 which aimed to offer an alternative to personal budgets.
Working with people with gambling and substance misuse problems, the project began offering greater choice and control to residents.
That choice was extended to the individual staff members supporting them - which proved to be a revelation.
Before the pilot, half of the residents said their key worker was the main decision-maker in their lives, which reduced to zero by November 2009.
Perhaps the greatest freedom was achieved by offering residents the chance to choose their key worker, and allow staff and residents to spend more "quality time" together.
Residents are now given a greater say in staff schedules, and can ask workers to change shifts so they can be accompanied out on Friday nights.
Some use their cash allocations to go to comedy clubs or buy one-to-one guitar lessons.
One woman said in March 2009: "I don't know what other choices I could make." Eight months later she told the report authors: "I make the decisions and I tell staff."
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