Personalisation and individual budgets challenge or opportunity

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					Personalisation and individual budgets:
challenge or opportunity?

NOVEMBER 2009
Helena Taylor Knox
Key points                                      Personalisation is here to       Commissioners and
                                                stay:                            providers need to
                                                                                 work together to
   Helena Taylor-Knox                                   Personalisation and      demonstrate a
   is a managing                                        individual budgets       return on investment
   director in her own                                  (IBs) need to be         in outcomes for
   partnership                                          woven into               citizens and greater
   consultancy, which                                   organisational           value for money.
   specialises in the                                   strategy, policy and
   organisational                                       procedures
   development arena,
   and                                                  Organisations need
   an HQN Associate.                                    to test their systems
   With over 15 years'                                  to ensure they are fit
   experience in social                                 for purpose for IBs
   and in
   particular supported                                 Organisations need
   housing, she is part                                 to consider how to
   of HQN's mock                                        position their
   inspection and                                       services to make
   coaching teams. As a                                 them attractive to
   business psychologist                                customers with IBs
   she has a BSc in
   Behavioural                                          Joint working
   Sciences from                                        opportunities should
   Leicester University                                 be exploited and
   and a Master's in                                    encouraged to map
   Mental Health                                        wider revenue
   (Organisational                                      streams to meet
   Psychology and                                       support plans
   Psychiatry) from
   King's College,                                      IBs could provide a
   London.                                              powerful framework
   Helena completed                                     to deliver high
   her clinical training in                             impact support and
   New York.                                            resources to
                                                        individuals and
                                                        families in our most
                                                        deprived areas




2 – Personalisation and individual budgets: challenge or opportunity?
Introduction                                    Personalisation is            throughout. In the
                                                perhaps the most              following pages we will
                                                significant shift in          explore:
                                                transforming social care
                                                and support we have                What IBs are and
                                                seen in the last three             how they differ from
                                                decades. It underlines a           personal budgets
                                                core principle of providing
                                                high quality individually          What are the drivers
                                                tailored services which            behind this cultural
                                                meet the care and                  shift?
                                                support needs of
                                                vulnerable adults. As a            Whether IBs will
                                                concept it implies that            really work
                                                services should no longer
                                                be commissioned en                 How commissioners
                                                masse for a specific               could respond
                                                client or user group, but
                                                that the services,                 How providers could
                                                information and support            respond.
                                                will vary greatly between
                                                individuals.                  Choice, independence
                                                                              and control are the three
                                                This paper seeks to           words that have
                                                explore some of the           watermarked just about
                                                implications for housing      every government policy,
                                                providers and                 guidance note and
                                                commissioners of              research commissioned
                                                supported housing. It         in the last five years. As
                                                aims to provide some          regulation has and
                                                challenge to the sector to    continues to address the
                                                begin weaving choice,         quality and monitoring of
                                                control and                   care and support
                                                personalisation               services which people
                                                throughout our policies,      receive, it has allowed a
                                                procedures and services       greater emphasis on
                                                to position the sector as     understanding the end-
                                                the leaders in finding        user of a service as a
                                                flexible solutions for our    customer who should
                                                customers who require         have rights, choices and
                                                assistance, care and          control over their own
                                                support. In doing so we       lives. Indeed this has
                                                appreciate that readers of    been enshrined in the
                                                this briefing will be at      Welfare Reform Bill
                                                varying levels of both        through the right to
                                                progress and                  control.
                                                understanding of the
                                                implications of
                                                transforming adult social
                                                care services and have
                                                tried to address this

3 – Personalisation and individual budgets: challenge or opportunity?
The personalisation                             safeguarding, quality              A lack of control for
agenda represents a                             assurance and what the             services users to
major cultural shift in the                     move towards choice                shape or change the
way we commission and                           means for the providers            way their care and
plan support services. It                       of services. We must               support was
changes the climate of                          understand that at the             delivered.
services from services                          heart of the
existing because there is                       personalisation agenda is     This was the first time a
a need, to services being                       a cultural shift which        government review had
commissioned because                            requires providers and        fully captured the fact
there is a demand. What                         professionals to be           that until now services
might this mean in the                          accountable to customers      were provided in ways
world of supported                              or risk losing their          which were more
housing? Well, let us ask                       business.                     convenient for providers
how might services look                                                       rather than tailored to
when sheltered residents                        What are the key              offered quality and choice
opt to buy in scheme                            drivers for change?           to customers.
manager support from
another service, perhaps                        Green Paper on social         Putting people first
a private sector provider?                      care
What about if a floating                                                      In 2007 Putting people
support customer                                In 2005 the government’s      first: a shared vision and
chooses to go to the                            Green Paper on social         commitment to
voluntary sector provider                       care set the tone for a       transforming social care,
for their support, rather                       large step change in the      the ministerial concordat
than the local authority                        commissioning of care         was published. In this
in-house service which is                       and support. This             document it was clear
currently working with                          followed several reviews      that the government had
them? What happens                              of assessment, care           recognised that despite
when customers decide                           planning and                  two years of discussing
to work with another                            commissioning                 the personalisation
contractor and liaison                          arrangements which            agenda, pockets of good
officer on their disabled                       highlighted:                  practice were the
facilities grant? These                                                       exception rather than the
are all realities in the new                            Huge regional         rule, due to a lack of a
climate of self-directed                                variations in         strategic commitment
care and support.                                       assessment/support    and direction. The Home
                                                        planning processes    Office set out clearly this
The mere mention of self-                                                     year (2009), what they
directed support, IBs or                                Processes which       believe needs to happen:
personalisation has a                                   were provider/
catalytic ability to divert                             commissioner-         “…the social care sector
conversations off into a                                driven rather than    needs a shared vision:
myriad of positives and                                 user-led              personalisation, including
negatives. Few would                                                          a strategic shift towards
disagree with the                                       Lack of flexibility   early intervention and
principle of providing                                  and options in the    prevention, will be the
people with more choice                                 way which support     cornerstone of public
and control, but in recent                              or care could be      services. 1
years we have heard                                     provided
concerns about

4 – Personalisation and individual budgets: challenge or opportunity?
       A transparent
       allocation of
       resources, giving
       individuals a clear
       cash or notional
       sum for them to use
       on their care or
       support package

       A streamlined
       assessment process
       across agencies,
       meaning less time
       spent giving
       information

       Bringing together a
       variety of streams of                    were left meeting the         more into an hourglass
       support and/or                           needs of only those           shape in reality, as
       funding, from more                       whose needs were              resources at the top and
       than one agency                          ‘critical or substantial’.    universal stages balloon
                                                This in turn breeds a         and the squeeze on
       Giving individuals                       situation where               targeted services for
       the ability to use the                   prevention slips off the      communities and families
       budget in a way that                     agenda and creates a          becomes ever tighter. 2
       best suits their own                     system which becomes
       particular                               purely about responding       The most recent
       requirements                             to crisis. A report by the    development from
                                                Association of Directors      ADASS and the Local
       Support from a                           of Social Services            Government Association
       broker or advocate,                      (ADASS) and                   (LGA) has moved the
       family or friends, as                    Communities and Local         Putting People First
       the individual                           Government (CLG) in           agenda on through their
       desires.”                                2002 identified how an        letter to local authorities
                                                ideal spread of resources     issued in September this
What this extract                               should look when              year. This set out a
illustrates is that in                          commissioning services        series of milestones
addition to a strategic                         (triangle of care, below).    which they will use to
commitment, a shift in the                      When applied to reality, it   inform:
way resources are                               rapidly became referred
allocated is required.                          to as the ‘inverted                Delivery of the
Under the existing                              triangle of care’, where           Putting People First
commissioning                                   we flipped the triangle to         transformation
framework those                                 show that the spread of
accessing social care                           resources is targeted at           The Transforming
services were assessed                          the small group of those           Adult Social Care
against the fair access to                      in crisis to the detriment         (TASC) programme
care services criteria                          of others and ultimately
(FACS). With dwindling                          left out prevention work.          Care Quality
local resources this often                      We might argue that this           Commission
meant that authorities                          is now beginning to turn           judgements and
5 – Personalisation and individual budgets: challenge or opportunity?
       their consistent                         Personal budgets and          Will individual budgets
       contribution to                          individual budgets            really work?
       Comprehensive
       Area Assessment.                         Until recently it was clear   As we have already
                                                that personal budgets         mentioned there has
The first significant                           have solely referred to       been a mixed bag of
milestone will be that by                       services which are            positivity and scepticism
2011, 30% of people who                         directly procured from        around the
are eligible for a personal                     one pot of money,             implementation of IBs.
budget will have taken                          primarily health or social    The University of York
this up. We will provide                        care. These were linked       Social Policy Research
an overview of the other                        into a clear assessment       Unit and the Personal
milestones later in this                        of eligibility and usually    Social Services Research
briefing.                                       service criteria such as      Units of Manchester
                                                the fair access to care       University, LSE and
Supporting People                               system. This was then         University of Kent, and
                                                usually managed through       King’s College, London,
As the second driver for                        one of two processes.         formed in 2006 the
change the introduction                         Either a direct payment,      Individual Budgets
of Supporting People                            where the customer            Evaluation Network
(SP) in 2003 brought the                        would assume the              (IBSEN), which evaluated
opportunity to create a                         administrative control of     the first phase of 13 local
framework for                                   their allocation and          authority pilots.
preventative services and                       procure the service, or
create strategic action                         where the choice would        First, they identified the
plans for support services                      be made by the service        key stages of the process
across local authority                          user but the care             undertaken to achieve on
areas and by user group.                        manager would retain          IBs; this included:
Six years on the success                        responsibility for
and challenges of SP are                        procuring the services. In     Stage Action
well documented, but one                        some instances a               1     A range and
of the key outcomes has                         combination of both                  scope of
been a continual push to                        approaches were used.                assessments
ensure that the spread of                                                            undertaken to
resources meets local                           IBs were created to pool             identify specific
needs and demands and                           together a personal                  support and
a move towards                                  resource allocation from             care needs
measuring the outcomes                          multiple funding streams.      2     Eligibility
of support in terms of the                      So in reality this could             assessments
impact and improvement                          combine money from                   under the FACS
to individuals lives. It                        adult social care budgets,           system
seems obvious looking                           SP, disabled facilities        3     Resource
back, that self- directed                       grant, independent living            allocation and
care and support, IBs                           funds and access-to-work             identifications of
and personalisation was                         funding, to form one pot             funding streams
the next logical step.                          of cash from which to                (could include
                                                procure services which               SP, disabled
                                                fulfilled the personalised           facilities grant,
                                                care and support plan of             independent
                                                the service user.                    living fund,
                                                                                     access to work,

6 – Personalisation and individual budgets: challenge or opportunity?
 Stage Action                                   were four main recurrent            including in staff
       social care)                             questions:                          training
 4     Financial
       assessment to                            1 What could/should be              People using IBs
       ascertain                                  legitimately paid for             were more likely to
       individual                                 as an IB?                         feel in control of
       contribution                                                                 their lives than
 5     Funding agreed                           2 What equipment                    people receiving
 6     IB signed off by                           could be purchased?               conventional social
       co-ordinator/                                                                care support
       care manager                             3 Can/should family
 7     IB implemented                             members be paid to                Satisfaction varied
       with a review                              provide care/support?             between client
       scheduled                                                                    groups: highest
       (usually six to                          4 Who is responsible for            among mental
       eight weeks)                               resolving crisis or               health service users
                                                  conflicts in an IB?               and physically
IBSEN found that cost-                                                              disabled people,
effectiveness varied                            As with most new                    and lowest among
between user groups,                            initiatives, only after             older people
although the pilots had                         testing scenarios out over
been running a relatively                       time will the full answer to        A substantial
short time before the                           such questions be clear.            proportion of older
evaluation was complete.                        Indeed the answer will              people felt that
The main outcomes                               vary from case to case              taking control of
however for users were                          and authority to authority.         their support was a
significant; including:                         As such the Department              'burden'.
                                                for Work and Pensions
       Improved health and                      has requested fresh            Staff encountered
       emotional wellbeing                      pilots, learning from the      significant barriers to
                                                first round to be              integrating funding
       Improved quality of                      undertaken this year with      streams.
       life                                     evaluation due in
                                                summer 2010. The areas         It would be useful for
       Making a positive                        they will specifically be      both local authorities and
       contribution                             looking to address are         providers to factor some
                                                some of the themes             of these themes into their
       Choice and control                       which came out in the          own planning and
                                                pilot evaluation including:    evaluation of
       Freedom from                                                            personalisation initiatives
       discrimination                                   There was little       and ask: what could
                                                        difference in the      make it better?
       Economic wellbeing                               average costs of IBs
                                                        and conventional       Resources
       Personal dignity.        3                       social care support.
                                                        However,               One final note from the
In addition the research                                implementing IBs       IBSEN research was the
also identified a number                                nationwide would       work they completed on
of key concerns from                                    require substantial    resources and costs. This
people and organisations                                investment,            illustrated that the
involved in it, but there                                                      average weekly costs of

7 – Personalisation and individual budgets: challenge or opportunity?
an IB was £280. However                         services (see references
they also identified that                       at end of briefing).
individuals with an IB
came into contact more
with their local authority
social worker and that
support planning took
significantly more time.
Again this presents both
an opportunity and a
challenge in terms of
scrutinising existing
needs assessment and
support planning
procedures. Some
organisations in the pilots
had separate teams
which just focussed on
drawing up the support
plans; others utilised
existing procedures
across agencies. In
addition almost half of the
service users in the pilots
opted to have a personal
assistant to help them
plan, monitor and
administer their IB.
Provider organisations
may wish to think what
role they could play in
supporting customers to
access personal
assistant-type services.

In Control (a social
enterprise that was set
up to transform the
current social care
system into a system of
self-directed support) has
a website full of useful
resources and examples
of positive practice in
terms of policies,
procedures and tools to
help organisations
consider how they might
integrate an IB culture
into their existing


8 – Personalisation and individual budgets: challenge or opportunity?
How can                                         The starting point for any         Safeguarding
commissioners                                   commissioner would be              Authority
                                                to seek to identify how            measures?)
respond?
                                                and where they could
                                                accommodate or develop        7    How can we support
                                                the seven-stage                    local providers in
                                                approach identified from           implementing IBs
                                                the learning during the            and avoid losing
                                                pilots. This would mean            valuable local
                                                looking at both in-house           services?
                                                and external processes
                                                and possibly looking at       In addition local
                                                multi-agency frameworks       authorities will need to be
                                                and protocols which           mindful of the milestones
                                                could support the move        set out by ADASS this
                                                to IBs. This will include     month, which they hope
                                                identifying:                  every council will adopt
                                                                              as key priorities and
                                                1       What are the          which address five
                                                        funding sources       strategic areas:
                                                        which exist locally
                                                        for care and          1    Effective
                                                        support?                   partnerships with
                                                                                   people using
                                                2       What established           services, carers and
                                                        working                    other local citizens.
                                                        relationships and
                                                        protocols do we       2    Self-directed
                                                        have in place to           support and
                                                        pool these funding         personal budgets.
                                                        streams together?
                                                                              3    Prevention and
                                                3       What gaps are there        cost-effective
                                                        which we need to           services.
                                                        bridge?
                                                                              4    Information and
                                                4       What will be the           advice (access to
                                                        agreed assessment          and provision of).
                                                        and allocation
                                                        framework?            5    Local
                                                                                   commissioning
                                                5       How will this be           (expansion of
                                                        monitored and              choice and the use
                                                        reviewed?                  of the third sector).

                                                6       What safeguarding     This will be more of a
                                                        arrangements will     challenge for those
                                                        we have in place      authorities who are
                                                        (how will we ensure   beginning on the journey
                                                        we comply with the    of moving towards more
                                                        new Independent       self-directed systems.

9 – Personalisation and individual budgets: challenge or opportunity?
The advantage, however,                                 Children and young               they work; such
for such authorities is that                            people                           opportunities are well
there are plenty of case                                                                 worth investigation.
studies from which to                                   Special tools for
learn and some useful                                   people with                      We have provided below
tools which have been                                   communication                    the tables from ADASS
tried and tested out with                               impairments                      which set out their
providers. In addition we                                                                milestones for
have seen some local                                    Advocacy schemes.                transforming adult social
authorities launch                                                                       care services, starting
innovation funds and                            In addition there are                    with a target for this year
special time-limited                            some support and                         to ensure that IB is well
grants to pilot IB                              supported housing                        understood locally and,
schemes looking at                              providers who work                       critically, that users are
particular areas of                             cross-authority and are                  involved in developing
concern for them for                            keen to share their                      and shaping the local
example:                                        learning and experience                  practice.
                                                with local authority
       Those with complex                       partners to roll out IBs in
       or multiple needs                        all the areas in which

                                   April 2010                            October 2010           April 2011
 Effective                         That a                                That local service     That every council
 partnerships with                 communication has                     users understand       area has at least
 people using                      been made to the                      the changes to         one user-led
 services, carers                  public including all                  personal budgets       organisation who is
 and other local                   current service users                 and that many are      directly contributing
 citizens                          and to all local                      contributing to the    to the transformation
                                   stakeholders about                    development of local   to personal budgets.
                                   the transformation                    practice               (by December
                                   agenda and its                                               2010)
                                   benefits for them

                                   That the move to
                                   personal budgets is
                                   well understood and
                                   that local service
                                   users are contributing
                                   to the development of
                                   local practice (by
                                   Dec 2009)

                                   That users and
                                   carers are involved
                                   with and regularly
                                   consulted about the
                                   councils plans for
                                   transformation of
                                   adult and social care



10 – Personalisation and individual budgets: challenge or opportunity?
                                   April 2010                            October 2010           April 2011
 Self-directed                     That every council                    That all new service   That at least 30% of
 support and                       has introduced                        users/carers (with     eligible service
 personal budgets                  personal budgets,                     assessed need for      users/carers have a
                                   which are being used                  ongoing support) are   personal budget
                                   by existing or new                    offered a personal
                                   service users/carers                  budget

                                                            That all service
                                                            users whose care
                                                            plans are subject to
                                                            review are offered a
                                                            personal budget
 Prevention and                    That every council       That processes are                  That there is
 cost-effective                    has as clear strategy, in place to monitor                   evidence that
 services                          jointly with health, for across the whole                    cashable savings
                                   how it will shift some system the impact of                  have been released
                                   investment from          this shift in                       as a result of the
                                   reactive provision       investment towards                  preventative
                                   towards preventative preventative and                        strategies and that
                                   and                      enabling services.                  overall social care
                                   enabling/rehabilitative This will enable                     has delivered a
                                   interventions for        efficiency gains to                 minimum of 3%
                                   2010/11. Agreements be captured and                          cashable savings
                                   should be in place       factored into joint
                                   with health to share     investment planning,                There should also
                                   the risks and benefits especially with                       be evidence that
                                   to the ‘whole system’ health                                 joint planning has
                                                                                                been able to
                                                                                                apportion costs and
                                                                                                benefits across the
                                                                                                ‘whole system’
 Information and                   That every council                    That the council has   That the public are
 advice                            has a strategy in                     put in place           informed about
                                   place to create                       arrangements for       where they can go
                                   universal information                 universal access to    to get the best
                                   and advice services                   information and        information and
                                                                         advice                 advice about their
                                                                                                care and support
                                                                                                needs
 Local                             That councils and                     That providers and     That stakeholders
 commissioning                     PCTs have                             third sector           are clear on the
                                   commissioning                         organisations are      impact that
                                   strategies that                       clear on how they      purchasing by
                                   address the future                    can respond to the     individuals, both
                                   needs of their local                  needs of people        publicly (personal
                                   population and have                   using personal         budgets) and
                                   been subject to                       budgets                privately funded, will
                                   development with all                                         have on the
                                   stakeholders                          An increase in the     procurement of
                                   especially service                    range of service       councils and PCTs

11 – Personalisation and individual budgets: challenge or opportunity?
                                   April 2010                            October 2010        April 2011
                                   users and carers;                     choice is evident   in such a way that
                                   providers and third                                       will guarantee the
                                   sector organisations  That councils have                  right kind of supply
                                   in their areas        clear plans                         to services to meet
                                                         regarding the                       local care and
                                   These commissioning required balance of                   support needs
                                   strategies take       investment to deliver
                                   account of the        the transformation
                                   priorities identified agenda
                                   through their JSNAs
4



In March this year
ADASS conducted a
survey of its members
and in terms of progress
on self-directed support it
found that councils
ranged from ‘substantial
progress’ to those who
were just beginning the
change management
process to
personalisation. There
may be significant
opportunities for cross-
fertilisation of learning
between authorities to
build on the successes
and learn from the
pitfalls.




12 – Personalisation and individual budgets: challenge or opportunity?
How can housing                                 Analyse what you have                accepting their
providers make the                              or could develop                     lifestyle choices?
most of
                                                First of all we would           5    Are we prepared to
opportunities?                                  encourage providers to               lose business if we
                                                really scrutinise their              are not able to offer
                                                existing services and ask            and support self-
                                                themselves our top five              directed support and
                                                questions:                           care?

                                                1       What services could     These questions should
                                                        we provide directly     then be explored with
                                                        to customers            your local authority
                                                        through an              partners in adult social
                                                        individual budget?      care, Supporting People,
                                                                                service users and third
                                                        Support services        sector colleagues. The
                                                                                government has made
                                                        Personal assistant      clear its intentions for
                                                        support                 providers to work more
                                                                                closely with third sector
                                                        Handy person            colleagues to reduce
                                                        services                duplication of resources
                                                                                and ensure that care and
                                                        Social                  support is delivered in a
                                                        support/inclusion       way which supports
                                                        officers                choice and diversity
                                                                                within services and local
                                                        IB admin service        communities. There is
                                                                                also merit to exploring
                                                        Support planning        wider partnership working
                                                        team.                   arrangements looking at
                                                                                different funding streams.
                                                2       How would our           For example could the
                                                        systems and             support planning
                                                        processes cope with     mechanism include
                                                        administering these     personal safety advice
                                                        budgets?                supported by the police,
                                                                                or fire safety
                                                3       How robust and          assessments funded by
                                                        outcomes-focussed       the fire service? Are
                                                        are our tools and       there any joint health
                                                        systems in support      initiatives? Could the
                                                        planning?               support planners be
                                                                                trained as trusted
                                                4       How innovative are      assessors for aids and
                                                        we in identifying the   adaptations? The scope
                                                        true wishes and         for innovation and cross-
                                                        aspirations of our      agency working is vast
                                                        customers and           when it comes to IB.


13 – Personalisation and individual budgets: challenge or opportunity?
The support plan                                 What this illustrates is     and what ‘society’ should
                                                that having some key          be paying for. To ignore
This is the second key to                       questions at the heart of     this reality in staff training
effective IBs being                             the process such as:          will result in poor support
implemented. For some                           What are the real goals       planning. We have to
time both SP and the                            for this person? What         understand that for some
Audit Commission,                               matters? What needs to        people a trip to the
through the KLOEs, have                         change? How can the           cinema, a football match
been trying to get                              person keep in control?       or a weekend art class
providers to move                               And what needs to             will mean more for their
towards understanding                           change to make all this       self-esteem and sense of
and demonstrating                               happen? Are essentially       belonging and inclusion
outcomes of support.                            the same good practice        than two hours of
This is moving away from                        methodology you would         cleaning per week. Or
the ‘tick box’ method of                        hope to see in any            that for an older person a
completing lengthy and                          sustainable business          handyperson putting up
standardised form and                           plan.                         their family photos on the
really getting to grips with                                                  wall is more important to
support planning as a                           This also needs some          making them feel at
process.                                        reality checking with staff   home than attending the
                                                in terms of our own           day centre this week.
The following diagram by                        motivation and values.        This is not to suggest that
The Grove Consultants                           There has been some           we don’t empower people
and Helen Sanderson                             interesting media             to evaluate risk, rather
Associates gives a good                         coverage of IBs which         we take a person-
pictorial view of the                           sensationalises the           focussed approach to
support planning                                classic dilemma between       understanding how an
process. 5                                      what a person might feel      individual’s resources
                                                promotes their wellbeing      could be managed to




14 – Personalisation and individual budgets: challenge or opportunity?
meet their needs as a
person. This means
supporting individuals to
ask:

       What do I need to
       have to keep me
       healthy, safe and
       secure in my home
       and community?

       What would improve
       my wellbeing/self-
       esteem and
       confidence?

       What could I do
       differently to help
       me achieve some of
       my longer-term
       ambitions?

       Who is providing the
       right services for the
       right cost in my
       community to help
       me create the right
       support plan
       through an IB?




15 – Personalisation and individual budgets: challenge or opportunity?
What else should                                Housing providers should            Developing ways to
good supported                                  be working closely with             respond to
                                                their local authority               personalisation
housing providers
                                                partners and voluntary              through specialist
be doing?                                       sector agencies to                  housing – it is
                                                understand what IB will             possible to develop
                                                mean locally or                     a core service offer
                                                regionally. Who is leading          and a menu of
                                                on the initiative? Are              options available for
                                                there any pilots                    purchase either as
                                                operating? It may take a            individuals or jointly
                                                while to fully embed IBs,
                                                but the reality is that the         Local authorities
                                                offer of choice, control            can include
                                                and personalisation they            Supporting People
                                                offer to customers is so            money in the
                                                much greater, IBs are               personal budget of
                                                here to stay. The Social            people using
                                                Care Institute for                  services if
                                                Excellence (SCIE) says              applicable
                                                that personalisation for
                                                housing providers                   Ensuring that
                                                means:                              people have access
                                                                                    to information and
                                                        Tailoring support to        advice to make
                                                        people’s individual         good decisions
                                                        needs to enable             about their care and
                                                        them to live full,          support
                                                        independent lives
                                                                                    Finding new
                                                        Housing and the             collaborative ways
                                                        local environment           of working that
                                                        can make a critical         support people to
                                                        difference to               actively engage in
                                                        someone’s ability to        the design, delivery
                                                        live independently          and evaluation of
                                                                                    services
                                                        Housing providers
                                                        need to be able to          Developing systems
                                                        offer people a              and processes to
                                                        choice in how and           enable staff to work
                                                        where they could            in creative, person-
                                                        live and to ensure          centred ways. 6
                                                        that homes are well
                                                        designed, flexible     The potential for
                                                        and accessible – the   providers in getting this
                                                        Lifetime Homes         right could deliver
                                                        design standards       significant results in
                                                        can help with this     terms of successful and
                                                                               sustainable tenancies
                                                                               and new business. This

16 – Personalisation and individual budgets: challenge or opportunity?
has been captured within                        one service, agency, or
the government’s Think                          activity will make us
Family agenda. In Think                         healthier, happier or
Family in 2007 the                              more engaged with our
government published its                        communities: it is the
aspirations: “A vision for                      integration of many
a local system that                             aspects of our own
improves the life chances                       personal motivations, our
of families at risk and                         abilities and
helps to break the cycle                        circumstances which
of disadvantage”. This is                       need to be understood to
where we might argue                            inform what each of us
housing providers have                          needs to achieve
the greater opportunities                       independent,
to impact on and                                empowerment choice
influence service delivery                      and control in our lives.
by looking at individual
budgets within                                   ‘‘Personal budgets and
households to maximise                          self-directed services
the impact of resources                         mobilise the intelligence
on families and                                 of thousands of people to
communities. Perhaps a                          get better outcomes for
housing standard should                         themselves and more
be ‘Think Household’.                           value for public money.’’ 7
Combining the ‘think
household’ model with an
integrated approach to
IBs, mapping and
delivering resources and
opportunities for some of
our most vulnerable
customers in our most
deprived area suddenly
becomes an exciting
challenge and a realistic
opportunity. The
personalisation agenda
represents an opportunity
to understand and
respond to what matters
most to our customers
and communities in a
way that we never have
had before.

The cautionary note is
that this will not work if
organisations stand
alone. The best
examples of joint working
have evidenced that, no

17 – Personalisation and individual budgets: challenge or opportunity?
And finally, what                               The future political            continued fair and full
about the politics?                             climate is uncertain in         implementation of the
                                                terms of a real                 personalisation agenda.
                                                commitment to self-             The challenge for
                                                directed care and               commissioners and
                                                support. Whilst, as we          providers is to work
                                                said at the beginning of        together in the
                                                this briefing, no one could     implementation of IBs
                                                argue with the principles       and carefully monitor and
                                                behind personalisation,         evidence the outcomes
                                                the scope to which this is      and impact on the lives of
                                                evidenced could be up           local citizens and
                                                for debate. Already with        budgets to demonstrate a
                                                discrepancies amongst           return on investment of
                                                local authorities’ progress     the approach and in the
                                                on the matter, we have to       quality of lives for local
                                                question just how high          residents.
                                                IBs are in the strategic
                                                priorities ‘to do’ list. With
                                                predictions of large scale
                                                public spending cuts and
                                                the uncertainty around
                                                changes in government,
                                                it might be tempting for
                                                politicians and
                                                commissioners to focus
                                                on things which appear to
                                                be ‘essential’ care and
                                                support services, rather
                                                than those which could
                                                be deemed as leisurely
                                                pursuits. The danger in
                                                this is that it could
                                                undermine entirely the
                                                very real links between
                                                choice, control and
                                                wellbeing for many
                                                people who require care
                                                and support and neglect
                                                things which are truly
                                                preventative. We are
                                                hopeful that the fact that
                                                the move towards greater
                                                personalisation of
                                                services and individual
                                                budgets has received
                                                high profile debate time
                                                in both houses of
                                                Parliament this year will
                                                signify a cross-party
                                                commitment to the

18 – Personalisation and individual budgets: challenge or opportunity?
References                                      Association of Directors
                                                of Social Services and
                                                the Local Government
                                                Association (2002) All our
                                                tomorrows.

                                                Essex County Council:
                                                Support Planning Policy.

                                                Leadbeater, C, Bartlett J,
                                                Gallagher N: Making it
                                                Personal 2008 demos.

                                                Social Care Excellence
                                                Institute 2009 At a glance
                                                8: Personalisation
                                                briefing: Implications for
                                                housing providers.




19 – Personalisation and individual budgets: challenge or opportunity?
Website references                              http://www.dhcarenetwor
                                                ks.org.uk/

                                                http://www.in-
                                                control.org.uk/

                                                http://www.in-
                                                control.org.uk/site/INCO/
                                                Templates/General.aspx
                                                ?pageid=1056&cc=GB

                                                1
                                                     Home Office: Jan 2009
                                                2
                                                     All our tomorrows 2002
                                                3
                                                     Consultation on
                                                     Independence, well-being
                                                     and choice, Department of
                                                     Health, 2008:
                                                     http://www.dh.gov.uk/en/C
                                                     onsultations/Closedconsult
                                                     ations/DH_4116631
                                                4
                                                     ADASS September 2009
                                                5
                                                     Essex County Council
                                                     support planning policy
                                                6
                                                     SCIE 2009
                                                7
                                                     Leadbeater et al 2008




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