Will personal budgets be the norm in five years’ time? Seminar report

Posted on November 9, 2011 by OPM

Last week OPM hosted the latest in our public interest seminar series, which was a great success: excellent speakers and a really lively debate about vitally important issues. The conversation has continued outside of the debating hall, and one of the participants has already posted his view of the key points. Below is our short report – of course it’s impossible to convey every single contribution, so please do have your say via the comments box! If you’re interested in being put on the mailing list for future seminars, then please contact us at seminars@opm.co.uk.

Personalisation seminar report

Finished at school: where next for young people with autism?

Posted on November 2, 2011 by OPM

By Annie Hedges, OPM fellow

I was interested to read about the Finished at School campaign and report launched by Ambitious About Autism last week. The report highlights the desperate need for more effective education pathways for 16-25 year olds with autism and shows how there is often nowhere for young people with autism to go once they have finished school.

Our work with young people with autism in Essex, a research project to inform the Council’s commissioning strategy, mirrored these findings: specialist provision was often limited and mainstream education providers did not always meet the needs of the young people trying to access it.

The Finished at School report contains the shocking statistic that less than 1 in 4 young people with autism go into further education after finishing school at 16. Anna Marshall, Head of Participation and Information at the organisation told me more about the campaign and its four main outcomes: Continue reading →

A debate: ‘Self-directed support and personal budgets will be the norm in five years’

Posted on October 27, 2011 by OPM

Will self-directed support and personal budgets will be the norm in five years time?

Join us for a lively debate on this topic. This event is part of our long-running series of public interest seminars.

When

Thursday 3 November, 6:00 pm for a 6:30 pm start, finished by 7:45 Continue reading →

Supported personalisation: The example of ecdp pass

Posted on May 23, 2011 by OPM

While recently interviewing users of ecdp pass – a payroll service operating across Essex to help disabled people and their families recruit and employ personal assistants or carers using a personal budget – I was struck by how becoming an employer can be a significant undertaking for individuals and families.

For the users of ecdp pass who had some experience of entirely self-managing the recruitment and employment of personal assistants, it often seemed quite onerous. They had to complete and submit tax returns, pay holiday leave in advance and issue pay slips. In the words of one interviewee:

‘Particularly if you’re employing more than one personal assistant, it can feel like your suddenly running a small company without any experience or training.’

To my mind, these views and experiences underline the importance of organisations and professionals properly supporting the personalisation of social care in a way that does not undermine its empowering potential.

ecdp pass, with funding from Essex County Council, provides a good example, where a ‘process only’ approach – that is, removing much of the administration involved in employing carers without impinging on users’ rights and responsibilities as an employer – was thought to be a success:

‘It [ecdp pass] is like having a supervisor there, providing you with back-up support as the employer.’

At a time when empty mantras about empowerment and personal responsibility are repeated ad nauseam and public servants are cast as ‘enemies’, the example of ecdp pass and others like it, present a more complex reality where organisations and professionals still play a crucial role in properly supporting individuals and families to feel empowered.

To learn more about OPM’s work on personalisation.

By Chris Reed, OPM researcher

How to make services for children and young people truly personalised

Posted on April 11, 2011 by OPM

An exciting new research programme is already uncovering key issues and challenges for providers of children’s services who are looking to adopt a more personalised approach to service delivery.

OPM has been asked by Action for Children – the national charity which helps support and speaks for the most vulnerable children in society – to help them consider how they can continue to develop a more personalised approach in their work, particularly in relation to services for disabled children, young people and their families. This might involve enabling more people to access short break services using a personal budget or direct payment or by creating more personalised family support.

The project involves the team from OPM reviewing the latest policies, research and evidence in relation to the commissioning and provision of personalised services. It also involves interviewing a range of experts involved in commissioning and provision elsewhere in civil society.

The findings of this review will be tested at a workshop with a cross section of staff from Action for Children who will then explore the implications of personalisation for various areas of the organisation’s work and some options for service delivery they could develop in the future.

Key lines of enquiry

The study is already throwing up some interesting issues and challenges for organisations seeking to develop a more personalised approach, for example:

Personalisation needs to focus not just on personal budgets, but also on how universal and targeted services can be personalised. Indeed it may be that in the future, families use their personal budget to access different kinds of short breaks, for example ones provided by mainstream leisure or activity providers, reducing the need for traditional specialist services.
It’s vital to focus on families as potential ‘customers’ and understand what they do and don’t value about an existing or current service. The organisations who procured services in the past will no longer be the only commissioners – service users themselves will be too - and this will change their relationship with statutory services as well as with children, young people and families.
There is a balance to be struck between piloting personalised approaches to a small number of specific services and taking a wholesale approach, whereby personalisation runs through everything an organisation does. Pilots work well in isolation, but the challenge of embedding the change at scale will still stand
Tight finances may tempt commissioners to use personalisation as a way to make savings. But our research highlighted the need to challenge this where cost and not outcomes is driving resource allocation. Commissioners and providers pointed out that often the creativity that personalisation encourages leads to more efficient solutions i.e. meeting outcomes with fewer resources.
The workforce implications of personalisation are significant as they require staff to work in new ways, and having to balance the need to deliver what the customer needs (and is paying for) and the freedom to have a relationship of challenge and honesty with families. This will require staff training, support and supervision, as well as the need for more flexibility in terms and conditions and hours for truly personalised services.
Financial sustainability and ensuring the ongoing viability of a provider is also important. The move to personal budgets on a wholesale level may not allow providers to have a guaranteed income and stability for the future.

Call for evidence

If you are involved in commissioning or providing personalised services for children, please leave a comment below or get in touch. We are particularly interested in hearing about new approaches to providing personalised services to vulnerable children and their families. For those of you who share their experiences, Action for Children will ensure that you receive the topline findings from this research.

You may also want to read a recent paper by OPM about personalising public services, which is available here.

For more information please contact Ayesha Janjua at OPM, 020 7239 7876.

By Ayesha Janjua, OPM fellow, and Ewan King, OPM director.

Why do some people choose cash payments over council-managed services for adult social care?

Posted on October 18, 2010 by OPM

Many people who now receive a personal budget still choose to receive council-managed services.

But the people we’re speaking to as part of a three-year study of personal budgets in Essex have chosen to do things differently and opt for cash payments, which they can spend themselves.

So why did these people choose to take this on when others didn’t? A common motivating factor for taking cash payments – expressed by people in this study and in others – is the desire to exercise greater choice and control. But many people must feel the appeal of this. So what encourages some to go for it and others not to?

Emerging findings

A number of ‘external’ factors appear to influence people’s decisions, including the availability of services through local markets and the role of frontline staff.

But our research has also emphasised the importance of a number of ‘personal resources’ available to service users, including the confidence and skills they are equipped with and the availability of support and advice from close friends and relatives and wider social networks.

Findings so far suggest that a combination of these ‘personal resources’ and external factors play an important role in shaping the degree of choice and control available to service users, the practical decisions they make and ultimately the outcomes they achieve.

As such, contrary to much discussion among practitioners, researchers and policy makers to-date, the appropriateness of cash payments for adult social care does not appear to be determined by age or impairment type. More accurate predictors of take-up of self-managed budgets may be the confidence of service users based on their own sense of rights, their skills and the support they have from relatives and friends.

Relationships matter

There is a clear two-way dynamic in the relationship between personal budgets and social networks. On the one hand, personal budgets can be used to increase opportunities for social interaction; on the other hand, existing networks and close family relationships are important both in encouraging take-up of cash payments and influencing the way they are used.

In addition to the role played by a number of close friends and relatives, confidence and perceived capacity to manage a personal budget is also influenced by whether service users believe they have access to wider social networks through which they can identify people they can pay to provide services. Those who have access to people they can employ appear to be at a distinct advantage to those who do not, both in terms of the ease with which they can find ‘providers’, but also in terms of being able to think more creatively about ways to spend their personal budgets because they do not have to pay agency rates. As such, service users with strong social networks appear, in many cases, to be better placed to get more from their personal budgets than those who do not.

For service users and relatives who seek to identify a company to provide services, one of the major frustrations can be their inability to judge the quality of the services until they are in place. Many service users rely on personal contacts to provide informal recommendations about which service providers they should use. This reliance on informal recommendations and advice, although seeming to work well for those who have access to it, again highlights the advantage people have if they have access to social networks that can provide them with this information.

What next …

In this year’s interviews for the study, now underway, we’re looking at whether the confidence, skills and social networks people said they drew on to set up their personal budgets, have a continuing impact in terms of their experiences of managing their cash payments and ultimately the outcomes they achieve.

The findings so far also raise important questions, which are relevant beyond the personalisation agenda. Broader policy debates – including discussions about how to nurture the government’s aspirations for the Big Society – will need to work through some of the same issues.

Encouraging and enabling us to be more active citizens, where we take responsibility for our own communities and services, will need consideration of how to foster the confidence, relationships, skills and creativity to do this.

By Sally Neville, OPM fellow

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