Councils must phase out preferred provider lists for social care in order to provide service users with genuine choice, an independent review for government said today.
Clients should also be freed to spend personal budgets as they see fit so long as they meet broad outcomes agreed at assessment, said the review into barriers to choice in public services by David Boyle, published today.
Boyle, a fellow of the New Economics Foundation think-tank, identified several barriers to effective choice in social care including: the lack of a diverse market of services; the bureaucracy involved in setting up and monitoring personal budgets; inadequate information and advice, and a lack of support services to help people manage direct payments.
The review identified preferred provider lists, identifying organisations assessed by councils as meeting particular standards, as a block on innovative services entering the social care market, particularly those delivered by micro-providers.
“Sometimes, these lists are either closed or the bureaucracy involved in getting onto them is so onerous that it discourages start-ups,” said the review. It said that such lists should be phased out and, in the meantime, should be opened up to new entrants without undue restrictions.
The review also heard that restrictions on the use of direct payments were growing, including by limiting service users to organisations on councils’ preferred provider lists and preventing them from using payments for gym membership.
The assessment system also limited clients’ creativity by basing resource allocations on people’s deficits. It cited the case of a woman who could get dressed by standing between two single beds to keep her upright, enabling to spend her direct payment on a pottery class. But she was told by assessors that her eligibility would be reduced because of her ability to get dressed.
Information and advice on services was also lacking, often missing out vital details about what was available from the voluntary sector, while online only information services restricted access for those without internet access.
Guide to personal budgets and direct payments