Patchy progress on implementing personalisation ‘best practice’, finds survey

There is widespread variation in the way councils are implementing personal budgets with many failing to implement ‘best practice’ approaches, a report has found.

The third annual personal budgets survey, carried out by researchers at the University of Lancaster using the Personal Budgets Outcomes Evaluation Toolkit (Poet), found that people who found the process of getting and managing a personal budget straightforward were nearly three times more likely to report good outcomes. But the research also found that one in four budget holders had found difficulties with several parts of the process and the report concluded that “system and practice cultures are proving hard to change in many places.”

The study gathered feedback from 2,679 personal budget holders and 1,328 carers about their experiences. At least two-thirds of budget holders said their personal budget had made things better in 11 of 15 quality outcome indicators measured. The outcomes included ‘mental health’, ‘dignity in support’ and ‘independence’. People who used their budget for personal assistants and community-based support reported better outcomes than those using the budget for more traditional care services, the survey found.

The research is published by personalisation organisations In-Control and Think Local Act Personal.

Julie Stansfield, chief executive of In-Control, said the survey showed that better outcomes could be achieved by giving people more direct control over their budget but there remains “real frustration with the process” in many areas.

“It is a mixed picture but sometimes the process is too complicated, sometimes it’s quite controlling and also there can be a lot of tick boxes to go through. A lot of it can depend on the relationship that the individual and family have with the key workers and professionals dealing with this, but some people don’t get enough control and flexibility over their budget,” she said.

“For me, this research is a tool for people to be heard. People who need social care or have long-term health conditions gain an expertise by experience. To some extent how people feel should start to control performance mechanisms. People with a personal budget and their carers know what’s working well and what doesn’t work well and they have some fantastic ideas for improvement. This is practice-based evidence but it is very underestimated in a lot of areas.”

Martin Farran, co-chair of the Association of Directors of Adult Social Services’ (Adass) personalisation network, said improvements were needed but stressed that councils had made good progress on personalisation. A survey conducted by Adass of 130 local authorities showed that 81% of eligible people received a personal budget, although a minority (24%) received direct payments.

“To get in a four to five year period from a point of zero to an average of 80% of eligible people getting a personal budget is quite a shift. Would I expect there to be some issues going forward with that? Yes absolutely, so I fully support the Poet findings in highlighting areas for improvement,” he said.

“But there are a lot of people who might be experiencing more choice and personalisation that may not be captured by Poet as it is concerned with personal budgets only. I think we need to move the tool forward so that it’s more flexible. Many local authorities will also have their own version of service user feedback.”

Sam Bennett, director of Think Local Act Personal, said that the organisation would work with partners to “address the challenges of uneven personal budget delivery”.