By Debbie le Quesne

Personalisation: ‘It’s not a cap that fits for everyone’

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We all like choice: What we eat and what we wear, when we get up and when we turn into bed; where we go to shop and what we buy . . . it’s a normal pattern of life.

For those needing social care, personal budgets indeed do hugely increase client choices.

But research by Coventry University suggests that the system is not quite the ideal it was intended to be.

Putting choice at the centre of caring, direct payments were seen as the gold standard of personalisation, where assessed needs and outcomes could be better met.

Published in the Guardian online, John Woolham, Katrina Ritters, Nicole Steils and Guy Daly of Coventry University, say in their article that advocates who have control of spending can enable and empower people to live more fulfilling and productive lives. I agree,

But seven years on down the direct payments route, their research suggests that the idea “doesn’t always live up to expectations for older people.”

Indeed, the article adds “that older people were still a long way from a personalised nirvana” with 25 per cent of direct payment users reporting that decisions about when they ate, went to bed or had a bath/shower were compromised.

With bigger packages I can understand there is always going to be compromise. Many PAs have several clients and those who are deemed to be good at their job are going to be popular.

It stands to reason that there will always be some juggling and that everyone cannot expect to get their get-up calls at the same time.

Using recognised, validated scales, the university examined general health, levels of stress and social care-related quality of life for those with a direct payment compared to those who had a managed budget.

In the Guardian report it says: “We found very little difference between the two groups on these measures. One particularly concerning finding was that many people – again, similar proportions in both groups – reported a lack of control over daily life, social contact with others, and opportunities to participate in meaningful leisure activities.”

There’s a lot of other information in the piece www.theguardian.com/social-care-network/2014/may/09/personal-budgets-older-people-expectations and if you’re involved in this loop it’s well worth a read.

For me, government-driven austerity in care funding will have a big part to play in the choices arena. With less to spend – and ultimately shorter call times – direct payments choices will forever be compromised.

Add into the mix day centre closures and the higher bars now set for social care intervention, this problem will not go away quickly.

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