Most personal budgets are still being managed by local authorities with only one in four people receiving a direct payment, research by directors has found.
The survey of 132 councils by the Association of Directors of Adults Services found that 81% of people receiving community-based social care were supported by personal budgets. Within this group, only 24% had a direct payment.
The local authorities had spent a combined £4.2bn on personal budgets in 2014, about 70% of their total funding for community services. Within the personal budget spending, £2.8bn (66%) was spent on council controlled arrangements, compared to £1.2bn (28%) on direct payments.
Adass found wide regional variation in personal budget investment and the way the money was spent. In the North East, spending on personal budgets amounted to 88% of all investment in community services. In the North West, the figure was 52%. In the East Midlands over a third of personal budget spending went on direct payments, compared to 18.5% in the North East.
Martin Farran, Adass lead for personalisation, told Community Care that a ‘major positive’ from the survey was the fact that personalisation and personal budgets had become a mainstream social care option within a relatively short time period.
“I think we need to recognise the progress that’s been made. Personalisation has radically changed the way adult social care is being delivered across the country. There are issues, as the survey shows, in how it is unfolding in different places but we need to be open to sharing that – it’s a credit to local authorities that they have been open about the challenges,” he said.
“The next period needs to be about shifting the focus from the number of people on personal budgets to the quality of their experience. There are local authorities up and down the country that are doing some incredibly innovative things and we need to capture and learn from that.”
Julie Stansfield, chief executive of personalisation charity Incontrol, said some local authorities were showing good practice but the continued dominance of managed arrangements was a concern that, in part, reflected a ‘cultural’ reluctance within local authorities to cede control.
“Local authorities might see managed arrangements as making it easier for them to control costs, particularly given the current context we’re in, or making it to hit personal budgets targets. But we know that there are also problems with the information people are being given – in a lot of places I don’t think people are getting strong advice about the difference a direct payment can make when it is done well,” she said.
Stansfield said that findings from the third national survey of people’s experiences of having personal budgets, due to be published next week, showed how people’s outcomes were better when they had more control over their arrangements.
The Adass research also asked local authorities to rate themselves against 63 ‘quality statements’ on personalisation progress. This showed that the vast majority of councils (95%) rated themselves as green or amber when asked if their assessment recognised the strengths of service users and felt good progress was made on most indicators. Areas requiring improvement included training for frontline health care workers on personal health budgets and creating an accessible marketplace for support.