This March marks a milestone for the number of people using personal budgets in England. But as budgets are cut, can the personalisation of services still be achieved?
In recent years, the personalisation of social care services has been heavily promoted by central government, disability charities and, crucially, users of social care services. Creating a tailored package of care around the individual is the logical conclusion to the process of moving away from the dark days of institutionalisation.
At the centre of personalisation are personal budgets. By deciding which services to spend their personal budget on, an individual can create their own bespoke care package. If the personal budget is given as a direct payment, the money is put in the person's bank account for them to control directly.
But do personal budgets actually give people real choice, along with a higher quality of services? Or are local authorities simply using them as a way to cut the cost of social care?
‘Putting People First', published in 2007, set a target to give a personal budget to 30% of those eligible in England by the end of March this year. A recent report from the Association of Directors of Adult Social Services said that councils are on track to meet this target. In fact, the number of people using personal budgets has doubled each year since 2008 (6.5% in 2008-09 and 13% in 2009-10).
In January, ‘Think Local, Act Personal' set out an agreement between local authorities, health bodies and social care providers to work together to ensure that personalisation is delivered.
‘Think Local, Act Personal' continues the momentum of ‘Putting People First' and the learning disability strategy ‘Valuing People Now'. It also supports the government's ‘Vision for Adult Social Care', which was published in November. It highlights research that shows that personal budgets, taken as direct payments, make people happier with the service they receive. While acknowledging that people with a learning disability may need support to manage a direct payment, it says: ‘The time is now right to make personal budgets the norm.'
By April 2013, the government plans to give personal budgets to all those who are eligible - around one million people. "Personal budgets can make an incredible difference to people's lives," says Care Services Minister Paul Burstow. "They give people choice, control and independence."
No legal right
Despite these measures, there is currently no legal right to a personalised service. Sue Bott, chief executive of the National Centre for Independent Living, is concerned. "There needs to be a legislative framework," she says. "All the time that there is not, local authorities are free to interpret things in a way that they see fit."
This June, the Law Commission is due to submit its final report on adult social care and is expected to recommend that a right to a personal budget should be included in law. Sue hopes that the government will follow this advice, but warns: "The message from government at the moment is that they're reluctant to legislate for anything."
Under the 2007 comprehensive spending review, local authorities were required to sign up to a minimum of 35 national indicators. One of these focused specifically on personal budgets and direct payments, and 81 local authorities picked it.
While not a perfect system, the indicators gave specific targets for those local authorities and provided data. But they were scrapped by the coalition government. Eric Pickles, the Communities and Local Government Secretary, said the indicators were a burden on local authorities. "National targets tend to mean that councils are constantly working on things which matter to Whitehall, regardless of what local residents think."
According to Sue Bott, however, this removal of national indicators, alongside the lack of legislation, means local authorities are not accountable for rolling out personal budgets in a meaningful way. "They're just running roughshod over the normal procedures for making decisions." She's concerned that personalised services can vary hugely in format and quality.
Rossanna Trudgian, a Mencap campaigns officer, agrees that personal budgets are only useful if they are implemented properly. "It's brilliant that everyone is getting the opportunity to have a personalised care plan, but they have to be good quality."
She cites some examples of people who have used their personal budgets creatively. These include a young man with autism who no longer needs three hours' support each day to travel to and from work. He used his personal budget to buy an iPhone and uses the map function to find his way to work. And, as he doesn't like talking on the phone, he can also use it to email his mother if he does get lost.