Sector leaders, working with the Department of Health, are publishing a number of tools and materials alongside this proposed agreement

Personal budgets – checking the results

Councils need to be able to understand the outcomes achieved at an individual level for people taking up personal budgets and their families and to make use of this information to drive change.

Interest from the Coalition Government and regulatory bodies in the critical question of whether and how people’s lives have actually been improved during this transformation process is rapidly increasing, and so far there is little to feed the growing appetite for evidence.

Finding robust ways to understand and measure the success of local implementations of personal budgets and self-directed support is therefore a major challenge for the sector and is set to become one of the key questions which councils will be expected to answer in the next phase of transformation.

Personal budgets – checking the results

Currently the information and intelligence that is harnessed to drive spendingdecisions tends to focus on the delivery of services typically measuring activity and volume, driven largely by the requirements of regulators and government departments. This focus is not a good proxy for quality because it misses the experience of people receiving services and support where value is received.

Without information on the outcomes of activity, it is impossible to assess value for money accurately. Information from people receiving support on the outcomes achieved is therefore urgently needed to understand the real returns on investment and tosupport better financial decision-making. The business case for self-directed support is that people can have better lives with costs being the same or less than for under previous arrangements. This makes it essential to check that good outcomes are actually being achieved.

an opportunity exists for the sector to develop and own its own approaches todemonstrating accountability to its local community and to evolve ways of capturing and using information from people using services to drive the future direction of local care systems.

Personal budgets – checking the results

there is a risk that the benefits will not always be realised. It is therefore essential for councils to check that personal budgets are authentic – that they are actuallyresulting in greater choice and control for individuals.

Personal budgets – checking the results

http://www.in-control.org.uk/evaluationreports

Over 600 people from 11 evaluations : Ongoing and active live count 75 local authorities

Who is accessing self directed support where ?

To what extent is choice and control becoming a reality ?

How much is it all costing ?

Are some groups benefiting more than others ?

How many people and where are they ?

How are people experiencing the self directed support process ?

Do people understand the deal ?

What impact is Self directed support having on peoples lives ?

Some Important variables

Demographics (Age, ethnicity, gender) Social care groupHelp to plan (and who from)Deployment of budgetTime in receipt of budgetReceiving traditional support before personal budgetNumber of hours in caring role

◆ had support from their family and/or friends to plan their Self-Directed Support◆ did not have support from a social worker to plan their Self-Directed Support.

Overall, people were more likely to report improvements in time spent with people they liked if they:

Just over two thirds (70%) of the 90 reporting Local Authorities included a breakdown by social care group.

The Self-Directed Support process

Almost everyone reported that they felt they had control over how their Personal Budget was spent (97%[91%])

Vast majority felt they understood what they were supposed to be achieving with their Personal Budget (91%[92%]).

Most people (82% [91%]) also reported that they had changed how money for their support was spent, with no differences across social care groups or according to the length of time they had been using Self-Directed Support.

How well is SDS being implemented

Phase ii evaluation (2003-5)Barnsley (2009)

Measuring the effect of SDS using a simple 3 point scale

•Yes•More than before•Improved•Better•Helped•Got better

•Not sure•Same as before•No difference•Stayed the same

•No•Less than before•Worse•Fewer•No difference•Got worse

Better Same Worse

To what extent if any has the personal budget had on your [area of enquiry]....

The exact wording of the scale is sensitive to the context of each question, and has in some cases has changed slightly as the framework has been adopted in different local authority areas.

What effect is self directed support having on peoples lives ?

Your health & well being (1)Being with people you want Quality of life (2)Taking part in your local community (3)Choice and control over important things (4) Feeling safe (5)Dignity from those who support you (7)Standard of living. (6)

•People who need support•Family Carers•Staff working closely with people

2007 Our health, our care, our say.1. Improved health and emotional well-being.2. Improved quality of life.3. Making a positive contribution.4. Increased choice and control.5. Freedom from discrimination or harassment.6. Economic well-being.7. Maintaining personal dignity and respect.

People who need support

People who need support

More than two-thirds of people using personal budgets reported that the control they had over their support (66%) and their overall quality of life (68%) had improved since they took up a personal budget.

A majority of people reported spending more time with people they wanted to (58%), taking a more active role in their local community (58%), feeling that they were supported with more dignity (55%), and feeling in better health (51%) since they took up a personal budget.

More than half of people reported no change after they took up a personal budget, in the domains of feeling safe (58%) and standard of living (52%),

Less than 10% of people reported any domain of their life getting worse after they took up a personal budget.

Between 399 and 522 people from 11 evaluations

Family Carers

Family Carers

Between 68 and 74 family cares from five local authorities

More than three quarters of family carers reported they had become more of an equal partner in planning (77%) since their relative had taken up a personal budget.

A majority of family carers also reported improvements in their quality of life (63%), the support they got to carry on caring and remain well (62%), their choice and control over their lives (57%), their health and wellbeing (57%), their finance situation (55%), and their relationship with a significant other (54%).

Around equal numbers of family carers reported either improvement or no change in their relationship with their relative (48% improved; 46% no change); and their leisure and social life (49% improved; 44% no change).

Most family carers reported no change in their capacity to undertake paid work (60%).

Less than 10% of family carers reported any domain of their life getting worse after their relative took up a personal budget.(Except for the domains of their capacity to undertake paid work (19%) and their health and wellbeing (10%)

Staff working closely with people

Staff working closely with people

Between 55 and 73 professionals involved in implementing personal budgets from five authorities

Around three quarters of professionals reported that people had more control and choices about their lives with personal budgets (79%), supports were more tailored to individuals (77%), personal budgets had made a positive difference to lives of people using them (75%) and that professionals could plan more creatively (74%). More than half of professionals reported improvements in people maintaining their existing support networks (59%), people taking a more active part in their local communities (58%) and getting the right amount of help to people (53%).

Around equal numbers of professionals reported either improvement or no change in getting help to people in a timely way (46% improved; 34% no change), their professional skills and knowledge (45% improved; 48% no change), allocating resources fairly (42% improved; 44% no change) and them staying motivated in their work (38% improved; 39% no change).

Less than 10% of professionals reported things getting worse in 9 of the 12 domains;

More substantial minorities of professionals reported things getting worse with regard to allocating resources fairly (15%), getting help to people in a timely way (20%) and staying motivated in their work (23%).

Capturing information

◆ One off retrospective evaluation: Richmond Worcestershire ULO Input ◆ Ongoing sampling: Richmond ◆ Adapting review tools: Lincolnshire

◆ Specific evaluation (Cambs follow up, Richmond MH focus)

Sharing and Understanding the findings

◆ Analysis of data Chris H ◆ Seminars ◆ Public Reports

National Personal Budget Survey

National Personal Budget Survey

National Personal Budget Survey

National Personal Budget Survey

National Personal Budget Survey

Size: 129 (32 LA’s)

Carers' SurveyPersonal budget survey - carers' version

Where next

•Continue to Gather data and understand the change•TASC Board Endorsement•Letter to DASS invite participation•Active support •Regular Reporting National and Local •Embedding into quality systems, contract monitoring and commissioning•Increased Local accountability •Inform the develop advice guidance and support offered