The system set up to give service-users their own social care budgets is wasting hundreds of millions of pounds a year on bureaucracy, despite having no impact on people’s well-being and independence according to new research.
The two new studies cast fresh doubt on the way successive governments have put their weight behind the drive towards personalisation, giving people greater control over their care and support.
The model that has been used is one in which a “personal budget” for each service-user is awarded through a process called “self-directed support”, with the individual’s care budget allocated “up front”, at the start of the process.
The three co-authors of the studies – including Peter Beresford, chair of the user-led Shaping Our Lives network – say services are mostly still managed and controlled by local authorities under self-directed support, with no positive impact on service-users’ well-being and independence.
They argue that personal budgets are likely to be at their most effective “when used as an opportunity to create a unique support system outside the mainstream, traditional market of commissioned and regulated services”.
Usually this means the service-user taking the personal budget as a direct payment – allowing them to choose and buy the services they need themselves – but only a minority decide to do this.
The research appears in two articles, one in Disability & Society, and the other in the journal Research, Policy and Planning.
The authors – Colin Slasberg, a consultant and former assistant director of social services, Dr Peter Schofield, a senior research fellow at Kings College London, and Beresford, professor of social policy at Brunel University – say there has been too much emphasis on how personalised care and support is delivered, rather than the level of resources available for social care.
They point to the growing bureaucracy around self-directed support, with council staff levels up by 10 per cent, while they say the number of assessments, reviews and people supported by social workers has fallen by even more than 10 per cent.
They say this means the £0.5 billion development money allocated between 2008 and 2011 is “being spent to create systems that do not work”, while “as much as a further £0.5 billion a year is being lost to service a bureaucracy which has no actual benefit”.
And they add: “There have been major reductions in reviews and people getting professional support despite increases in staff numbers.”
Money that should be spent on providing support to disabled and older people is instead being wasted on the bureaucracy set up to deliver personal budgets, say the authors.
They conclude that “self-directed support” is not only “failing to deliver its intended function, it is having a seriously deleterious effect on social care field work services”.
But they also conclude that the “successful delivery of personal budgets and personalisation is not only possible, but remains the basis for a future of authentic promise”, although this will not be achieved through self-directed support.
They call on the government to scrap the current system of self-directed support and focus instead on providing individuals with the support they need for independence and well-being.
Beresford said: “In the short term, there must be a new system where older and disabled people work in authentic partnership with the state to make the best use of currently available resources, with the state committed to finding all the resource needed for real independence and well-being.”
16 January 2013
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