Overhaul Care: the impact of personal budgets
The empowering objectives of Putting People First are no doubt commendable but it is also evident that some people will need considerable support and guidance in order to understand the changing system and manage a budget, especially if they have been accustomed to receiving care services more or less passively. This will involve help from local authorities, charities, family and friends, and in some instances an independent care broker. The market for social care is also set to explode and fragment as the demand for individualised options and new services grows. Plan My Care is an online solution that is being developed in partnership with Health Launchpad at the Young Foundation to support individuals to manage all aspects of their care needs and to help make Putting People First a reality. It will provide tools to simplify what could be a confusing transition and will provide a space for individuals and their helpers to access up-to-date information, assess their needs, create a personal support plan and procure goods and services. It will also have an interactive element allowing users to leave feedback about different providers or to compare how other people with similar needs have created care packages. Plan My Care will be a useful tool for those who receive personal budgets as well as for an estimated three million self-funders who already have to navigate the system with little support. Clifford Hewison is a 37-year-old man who has been diagnosed with MS. He is single and self-funds his care needs. Clifford is reluctant to give up his part time job, “the main reason I still come to work is for human interaction” he says, “without that people can just disappear.” But he says that because he has money to buy services, his needs are often not recognised. “As a self-funder you fall down the cracks. I don’t know where to go to find people to support me. It is more or less by luck. I pay someone independently to do my cleaning and I found her through my builder. I want specialist assistance to do everyday tasks but I have no idea where to go to get that and I have no support to find out what benefits I am entitled to. At the moment there is no one place I can go to plan my care. ” Clifford says that under the current system it can be difficult to access help for changing needs. MS is a progressive condition and over the last three years Clifford’s health has got worse. He now needs a walking aid and it takes him around three hours to get up and dressed in the mornings. However, Clifford is keen to manage certain tasks independently for as long as he is able and is looking for more diverse support services. “I was discussing personal budgets with some friends with care needs recently, and some of us are at the stage where we are managing the washing and the bathing and all the personal care but actually what we really want is a personal assistant. Somebody who can take us out, take us to the shops, go on holiday with us, just do the ‘normal’ things that other people expect to do.“ Many of Clifford’s friends who currently receive support from their local authority are dissatisfied and complain about the lack of continuity of care and poor needs assessments. But he says many people are understandably confused and scared about what is involved in managing their own care. For example, he points to the uncertainty that can arise when people must employ their own staff, in terms of being expected to arrange employee tax and national insurance. Clifford says that having one website where you can access information relating to all aspects of the care cycle, in the way that Plan My Care will do, would be invaluable. He relies heavily on the internet, for example to do his shopping, staying in touch with friends and booking trips and holidays. But he also says many people he knows with MS are not online or only use the internet to access their email. He is keen to see more people supported to take control over their lives, realise that they are entitled to have their needs met and use a variety of services to improve their wellbeing. “I went to an MS group recently and I said we should buy a Nintendo Wii because it is fun and it provided me with an excellent physical and mental workout. But no one knew what it was and some of them were younger than me. Many of them only want to do ‘day centre’ stuff. A lot is down to fear as well as lack of awareness and support. People need to know that life is for the living. What most people need are support networks. Without that we’re doomed.” More than 8 percent of the UK population use social care services. The government push towards individual care brings new challenges to the sector. Clearly a lot of work and collaboration between different stakeholders needs to be done for personal budgets to become accessible and meaningful to everyone. Inevitably some people may feel it is simply easier to carry on receiving care as normal, but the potential for fresh possibilities is also extremely positive and exciting. “The current focus for social care is mainly on washing and bathing.” Clifford says. “That is crucial but it is only a tiny percentage of your day. I’d also like to know which college courses are accessible for people with disabilities or what new leisure activities I can try. There are no websites that do that.” “Personal budgets can give us options, it is not either/or, you can do everything now.” |
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Last December the government announced Putting People First, setting out its aims to transform adult social care. At the forefront of the directive is the desire to give people choices to live their lives in the way they wish through self-directed services and personal budgets. This means that rather than receiving standard, non-tailored care packages from local government, people with care needs will be given a budget to spend on services they want and will be able to create an individual package that suits their lifestyles and supports their goals. Zenobia Talati reports.