Councils have not tackled the bureaucracy that has long undermined personalisation and are failing to equip social workers with the training they need to make a success of the agenda, say practitioners.
Community Care’s sixth annual survey of social care professionals’ views on personalisation found service user involvement in the delivery of personal budgets remained variable. And on the day chancellor George Osborne announces further reductions in government funding for councils in 2015-16, 85% of practitioners said cuts made in the past two years had reduced choice and control for service users.
Yet despite these significant issues, half of practitioners said they thought personal budgets would benefit service users in the medium to long-term, compared with 22% who thought they would not. And most said personal budgets gave service users more choice and control than traditionally-commissioned care packages – particularly when delivered as a direct payment.
View Community Care’s special report with full results of the 2013 personalisation surveyThis year’s survey was answered by 195 social care professionals, all of whom work in English local authorities; 53% defined themselves as social workers.
Training and support gap
More than half of respondents (56%) said they had not received enough training on delivering personal budgets in the past year, while a further 16% said they had not received any training over that time.
Your training concerns
“We are having much more in-house training and our training staff don’t know how to pitch it. There are a lot of people who provide training who seem to be a bit detached and don’t understand the culture of social work.”
Views on the quality of training delivered were mixed with 28% saying it was good or very good, 33% poor or very poor and 39% adequate. There was a similar mixture of views on the quality of support from managers on delivering personalisation.
The gaps in support and training were accompanied by shortfalls in the skills practitioners felt they needed to deliver on personalisation. Forty two per cent said they needed substantially more training in helping service users build personal and community networks, while a further 35% needed a little more training in this area.
Providing social workers with these community development skills is seen as important by government to help develop resilience and independence among older and disabled people, reducing their need for care. In its care White Paper last year, it promised to “work with The College of Social Work to ensure that community development is built into future practice”.
A majority of survey respondents also said they needed at least a little more training in understanding the availability of local care and support services for personal budget users and local sources of support to manage personal budgets; most also wanted some more training in helping service users think creatively about managing their budget and in helping them understand and manage risks.
Training ‘patchy and varied across the country’
“Local authorities have to prioritise this type of training despite reduced budgets and necessary cuts,” said Ali Gardner, author of The College of Social Work’s curriculum guide on personalisation. “Unlike other areas of practice in social work, the personalisation approach is notably different from the approach that many of the current social workers trained under and therefore requires dedicated time to explore the ideological and practical implications of practice.
“Unfortunately training has been patchy across the country and varied in its content, amount and quality,” added Gardner, senior lecturer in social work at Manchester Metropolitan University.
Councils received a dedicated grant from 2008-11, worth £520m, to support the implementation of personalisation, some of which was allocated to training. But from 2011-14, 20% will have been taken out of council adult social care budgets, putting resources for training under pressure.
“Some degree of the pressures on budgets may mean that some councils have reduced money for training,” said Sandie Keene, president of the Association of Directors of Adult Social Services. “That wouldn’t surprise me. Every local authority will invest in continuing professional development and any local authority will have that as part of their core offer for training and development of staff. The issue that has come out of the survey is whether it’s sufficient.”
Keene said that while off-the-job training may have been cut back, budget pressures should not be impacting on the “core function” of supervision.
Respondents identified the bureaucracy involved in assessments and resource allocation systems (RAS) as among the chief barriers to delivering personal budgets effectively – but said councils were failing to tackle the problem.
The need to fill in lengthy forms, the use of separate forms for assessment, resource allocation and support planning, the need to revise inadequate indicative budgets generated by the RAS, and cumbersome panel processes for signing off personal budgets were all cited as sources of red tape.
Your views on bureaucracy
“The RAS never represents true needs and you have to fight through panel for every case which takes a lot of time in producing watertight paperwork in preparation.”
“There has been a significant increase in the processes I have to carry out to set up support for service users, and I spend much more time entering data on a computer.”
Three in five respondents (59%) said they did not have enough time to effectively support service users through the assessment process, while just 12% said social workers were trusted to sign off personal budgets up to a certain value without having to refer them to managers or panels.
One social worker told Community Care that higher-value personal budgets in his area could still be referred to panels for approval even after they had been signed off by three layers of management.
“There must be mechanisms for effective budget monitoring and allocation that still allow social workers to [sign-off personal budgets],” said Bernard Walker, chair of The College of Social Workers’ adults faculty. “The implication [of the survey results] is that it could be a fairly low level of [personal budget] expenditure that is going to managers or panels. That’s not something we’d want to encourage.”
Starkly, 9% of practitioners said their RAS was easy for service users and carers to understand, and only 22% said it was easy for professionals to understand.
“[This means] you’ve got a limited amount of time with someone to explain a process [to service users] that you don’t really understand yourself,” said British Association of Social Workers England manager Ruth Cartwright. “That’s a bit worrying.”
Lack of council action to cut red tape
Yet despite these issues having been raised repeatedly by Think Local Act Personal (TLAP), the sector coalition tasked with supporting the delivery of personalisation, and by the last three Community Care surveys, practitioners said councils had failed to resolve the situation. Just 10% agreed their council had reduced the level of bureaucracy involved in the personal budgets process in the past year, while 78% disagreed.
Sam Bennett, programme manager at TLAP, said the apparent lack of council action to tackle excess bureaucracy was “disappointing”. “It seems very difficult for councils to trust that people will make cost-effective choices that lead to better outcomes,” he said. “That points to a cultural issue was well as to bureaucracy.”
Practitioners’ time with service users was also being squeezed by assessment targets driven by current budget pressures, said some respondents.
“The overwhelming message from management is to raise throughput of assessments, including through assessment targets,” said Helga Pile, national officer for social services at Unison. “It’s just getting the volume through. There are growing waiting lists for assessments, which is leading to more pressure from management.”
Concern over targets
“My role has become more focused on targets, rather than interactions with service users. The period for assessment is not realistic.”
“Trying to help someone with communication difficulties requires more time,” said Cartwright. “But there seems to be an emphasis for many people on churning out the assessments.”
Bennett said a significant part of TLAP’s work this year focused on helping councils reduce bureaucracy in the personal budgets process, and the survey results showed “we are focusing on the right things”.
Keene said senior managers “would not in any way duck the issue of bureaucracy and some of the criticisms levelled”. But she said directors were taking action to reduce process burdens; for example, Adass’s latest budget survey found 36% saw reducing bureaucracy as a significant source of savings for 2013-14.
Keene said she supported senior managers devolving sign-off responsibility for personal budgets to team managers and social workers to reduce the use of panels. But she said this required much better financial information systems to keep track of spending decisions. She added that “in the current environment” councils needed to have in place effective processes and procedures to audit the use of public money.
Lack of service user involvement
Bennett said issues of bureaucracy were also evident in the limits on service user involvement in the personal budgets process.
Almost three-quarters of respondents (72%) said support planning in their area was usually led by council social workers or care managers; just 2% said it was usually led by service users or families, and 1% said user-led organisations took the lead.
This is despite 15% saying service users and families were best placed to lead on support planning, and 34% saying it should be left to whomever the service user wanted to take the lead. A report last year from Groundswell, the social care consultancy Bennett co-runs, argued bureaucracy could be reduced if service users were empowered to support plan for themselves, with the help of family, friends and peer support organisations if necessary.
“I don’t have a fixed view on the best place to do support planning,” said Bennett. “But the aspiration is that people should have a choice and a diverse range of options on how and with whom to plan. A lot of the bureaucracy that comes through the process could be potentially reduced by having that.”
One social worker said practitioners involved service users “as much as we can”. But he warned: “Once you’ve got the money, there’s very little room for manoeuvre; at the point where they say ‘it’s not enough’, you’re in a position of conflict.”
More on this year’s survey
Our previous surveys
Other key research into personalisation