Government to change controversial indicator on personal budgets take-up

Revision follows row between Department of Health and directors over whether councils had hit 70% target for self-directed support take-up

The government has revised the way it measures progress against the personal budget target following a controversy about the statistics.

The Adult Social Care Outcomes Framework (ASCOF) 2014-15 report, published last week, said the government would only measure personal budget take-up as a proportion all people who receive long-term support, the group of people “for whom self-directed support is relevant. Previously, it used the wider definition of all users of community-based services.

The old measure was controversial as the Association of Directors of Adult Social Services (Adass) argued that it included people for whom a personal budget would not be suitable.

Consequently, Adass’s figures suggested that most councils were meeting the government’s target that 70% of eligible service users should have a personal budget as of April 2013; however, the government’s figures found most did not meet this goal.

The ASCOF report, which described councils’ performance for 2012-13, said that most had to meet the 70% target.

The report said the proportion of users of services and carers offered a personal budget rose from 43% in 2011-12 to 55.5% in 2012-13.

Large variations in personal budget take-up

But it also found large variations between councils in their use of personal budgets in 2012-13. For example, in Richmond upon Thames, Nottinghamshire and Islington the proportion of those receiving personal budgets was over 90%; however in Somerset and Swindon, personal budgets were provided to fewer than a quarter of people who received community based services.

In most councils, the proportion of people receiving personal budgets rose between 2011-12 and 2012-13. In 10 councils the proportion of people receiving a personal budget increased by more than 30 percentage points, but in 12 areas there was a fall in the proportion of people receiving a personal budget.

Most other measures in the report showed stability or slight improvement at a national level but wide variations between councils.

The number of service users who were very or extremely satisfied with their care rose to nearly two-thirds, which the report said “clearly leaves scope to do more to ensure that everyone has a good experience”. Less than half of carers reported that level of satisfaction and it was lower among 18- to 64-year-olds at under 40%

The proportions of adults with learning difficulties or in contact with mental health services who lived independently both rose slightly but there were large variations between councils

In Brent, Rochdale, Oldham, Tameside, Salford and Knowsley, over 90% of people with learning disabilities were living independently in “stable and appropriate accommodation” whereas Hounslow, Blackpool, Birmingham, Bromley, Havering, Lambeth and Solihull had the lowest rates, at below 60%

Admissions of older people to residential or nursing homes remained steady but, again, there were variations between local authorities. Nottingham, Isle of Wight and Southampton had more than 1,000 permanent admissions of older people to residential and nursing care per 100,000 population of adults aged 65 or over, while Kensington and Chelsea, Sutton, Croydon and Ealing had a rate of fewer than 300 per 100,000 population.

There was a small national increase in the proportion of adult social care users who said the services they received made them feel safe and secure but there were also significant local variations in this figure, which the report said “highlights the need for local enquiry into the causes of this, and, if necessary, further action”. However, it also pointed out that there were a variety of factors which could have an effect on respondents’ feelings of safety, some of which are not within the control of the council.

The proportion of older people still at home 91 days after discharge from hospital remained stable but just 3.2 per cent of older people leaving hospital had access to reablement services.

The number of delayed transfers to care fell, including those attributable to social care.

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