Research published this month has given a qualified thumbs-up to the use of personal budgets in delivery of social care,” writes Lisa Gillespie. The majority of 2,000 people questioned for the National Personal Budget Survey reported that they “have a positive impact on people’s lives, meaning they are supported with dignity and respect, stay independent, in control of their support and get that support when they need it.”
The findings of the research commissioned by the Think Local, Act Personal Partnership are to be broadly welcomed, both for the many positives identified – and the significant negatives from which lessons may be learned.
Among key concerns was access disabled and elderly people had to information and advice, an issue which is close to our hearts here at Fish Insurance. The report’s authors note access is not easy although an important caveat was the “substantial variation” in perceptions of local authority performance in this and other areas. Whilst the respondents and participating councils are anonymous this finding does highlight the need to identify and replicate best practice. Some councils generate greater satisfaction; we need look at their systems, processes and culture to see why.
Reading the report I noted what I see as a related finding; that the experience of employing and retaining personal assistants and support staff can be testing. Significantly more negative than positive comments were received. This is disappointing but to a degree understandable. Service users, who overnight move from passive consumers of their care to becoming active commissioners of it, assume new and onerous responsibilities in law. They need swift and easy access to good quality advice on their responsibilities as an employer. But who is on hand to provide this? Social workers have neither the time nor training to tackle the minutiae of, say, the Equality Act. Moreover, it is not a responsibility they should assume; they are highly trained in a highly specialised field. Similarly, advocacy and user-led service support groups can provide brilliant and wide-ranging advice (they scored terrifically well in the research) but, with the best will in the world, are not equipped to advise on employment law. Indeed providing advice could open them up to legal action should it prove incorrect.
It was these fundamental concerns which informed the design of our pioneering full cover Independent Living Insurance. We saw the pitfalls. We saw that employer responsibility could present a disincentive to service users taking up direct payments and other personal budget options. That’s why we built in as a policy benefit 24 hour telephone access to the UK’s leading employment law specialists. Yes, seeking out the best providers of such expert advice added cost, but we saw it as essential in giving service users the confidence to manage their own care. It’s clearly appreciated as our hotline now handles many hundreds of enquiries monthly, helping to prevent disputes arising or escalating and minimising the risk of often vulnerable people being dragged before an employment tribunal – a risk which more widely appears to be increasing.
Another key and related research finding is how empowerment yields greater satisfaction. Direct payments as opposed to council managed budgets delivered “significantly more positive outcomes.” The report summary argues that positive impact is maximised by, among other things, a process that “puts people in control of the personal budget and how it is spent.” That’s a point which is surely at the very heart of the personalisation agenda? Denying choice by, for example, artificially capping funds for vital ancillary products and services like employers’ insurance is surely counter to the whole ethos of that agenda? Is it worth cutting relatively small costs at the front end of the process at the expense of the very purpose of personalisation – and potentially much greater future cost?
* Lisa Gillespie provides free half and full day training sessions to local authorities, advocacy and user-led service support groups on the impact of employment law on personalised social care . Please email us for further details.
