Ensuring panel decisions on personal budgets are sufficient to meet needs

To achieve good outcomes for individuals and value for money, panels should ensure professional judgments of social workers about impact on wellbeing and sufficiency to meet needs are the cornerstones of decision-making

Photo: Olivier Le Moal/Fotolia

By Pete Feldon

Many local authorities seem to believe that there are good reasons to use ‘funding panels’ in a way that sets aside the intention of the Care Act statutory guidance to limit their scope.

This may be because many panels have a remit that goes beyond funding decisions. In some cases, social workers have found panels with a broader remit very helpful, but most respondents to Community Care’s recent survey experienced negative micro-managing of the care and support planning process, in a way that the statutory guidance cautioned against.

My comments focus on developing a more legally literate approach to making decisions about the amount of the personal budget, by applying the legal rules in a way that is led by good social work practice.

Individual needs

The culmination of the care and support planning process is a conclusion about what resources can be made available to best meet an individual’s needs. For most people a key element of this is a personal budget setting out the amount of money that is required to deliver services for which there is a charge.

As with any public service that allocates resources to individuals there is a tension between what people want and what funding a local authority will provide. Paragraph 11.10 of the Care Act statutory guidance helpfully encapsulates this by stating that although the personal budget “must include the cost to the local authority of meeting the person’s needs”, it must also “be an amount sufficient to meet the person’s care and support needs”.

Statutory guidance exists on establishing the ‘cost to the local authority’ that clarifies the aim is “to ensure that the personal budget reflects local market conditions and that appropriate care that meets needs can be obtained for the amount specified” (paragraph 11.25).

However, the guidance rightly steers clear of defining the relationship between an individual’s care and support needs and what is sufficient to meet their needs – because this is a matter for professional judgement. Likewise no explicit guidance is given on taking into account “reasonable preferences to meet needs” as required by paragraph 11.24.

Professional judgment and impact

I suggest social workers (and other assessors) should make sure a well-argued connection is made between the professional judgment about significant impact on wellbeing in the determination of eligibility, and the subsequent professional judgment about sufficiency to meet needs.

The agreed needs that the personal budget must be sufficient to meet are those inabilities or difficulties deriving from the adult’s physical or mental impairment or illness, that have a significant impact on the individual’s wellbeing. Articulating this link between impact on wellbeing and sufficiency of the personal budget, is particularly important where needs are complex or the impact on wellbeing is not straightforward.

At the point in the process where eligible needs are being determined, social workers should have in mind whether the detail of their professional judgement about impact on wellbeing will be robust enough to make the case that the personal budget is fully sufficient to meet needs. A sound analysis of the unique aspects of an individual’s circumstances at this stage can provide the basis for justifying going beyond the usual cost to the local authority.

Social workers also have a key role to play in achieving the requirement in the statutory guidance that personal budgets “should therefore be based on outcomes and value for money, rather than purely financially motivated”.

In this context value for money is about making the best use of the resources available to sufficiently meet individual needs, and to achieve desired outcomes as far as possible. In addition, value for money is also intended to be about preventing, reducing or delaying needs where this is possible.

This is where social workers can use their knowledge and skills to identify where spending money now will reduce the extent of future expenditure.

Best practice response

Where panels exist, local authorities may consider it advisable to make explicit how they are aiming to support the application of the statutory guidance. This was not the case in JF v the London Borough of Merton, where the judge remarked that he had not been provided with any evidence about how the funding panel operates which would enable him “to distinguish between the significance of decisions by social workers and decisions at a corporate level”.

The response to the survey indicates a significant number of local authorities where panels are not achieving the intention of the statutory guidance, and social work professional judgement is not being satisfactorily considered. I think the research now needs a response from local authorities and the social work profession about how best practice can be developed and shared.

Pete Feldon is a Care Act trainer and author of “The Social Worker’s Guide to the Care Act 2014”

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2 Responses to Ensuring panel decisions on personal budgets are sufficient to meet needs

  1. John March 28, 2018 at 11:43 am #

    I think the article is well written highlighting some of the issues faced. I would add my first concern is picking up on the ‘professional judgement of a Social Worker’ statement, this I believe is the fundamental problem with adult social care. There seems to be a limited scope of what is a Social Worker in ASC, even in this article it states ‘and other assessors’. What is the role of a Social Worker, there is no statutory act that has to be completed by a Social Worker. Care Act guidance states certain things should be completed by a Social Worker, but that is as far as it will go. As a result the role is very convoluted and differs from LA to LA, leaving the role with a limited professional voice.

  2. Colin Slasberg April 4, 2018 at 4:29 pm #

    The article fails to acknowledge that councils work under an imperative to spend within a budget. Indeed, it is surely a right and proper responsibility to spend only the amount the democratic process has made available. Control of spending is delivered by controlling the flow need deemed to be ‘eligible’. The belief that councils can simply pay up whatever practitioners have identified as best value for money to meet needs they believe will have a significant impact on well-being, however well evidenced, is, at best, fanciful. The promotion of such fanciful thinking plays into the hands of the policy makers who drafted the Guidance to the Act. They knew full well that councils will use the extreme looseness of the eligibility criteria not to apply a test of impact on well-being, but impact on budget, to determine eligibility and therefore spend.

    The Guidance, extraordinary as it may seem, is actually silent on the question of how councils should ensure spending is within budget. Value for money is hugely important, but it cannot deliver affordability.