Supporting those with personal budgets

You are more likely to be satisfied with the support you receive if you get a personal budget (PB) or Direct Payment (DP) rather than a council organised day or home care. This supports the popular and Government led drive to increase the use of personal budgets.

However, if you delve in the results from the survey of adult social care users, a different story emerges. People in residential care are actually the most satisfied with the services they receive and they score highest on most of the questions answered, going against common perceptions.

But the real surprise is that people receiving council organised day care or home care are more likely to say they have adequate control over their daily lives compared to people using personal budgets or Direct Payments. Remember, the whole point of PBs and DPs is that they are meant to give people more control.

Furthermore, people in day care are more likely to have desired levels of social contact than holders of personal budgets or Direct Payments. They are also more likely to be spending time doing they want to. The question is how can you read these results and still assert that day care centres were ok for the 1950s, but people have moved on and want something different in the 21^st century.

One answer I heard was that day care centres have moved on too, and are radically different from what they were like in the 1950s. Another possibility is that the value of personal budgets people are receiving does not allow them to purchase services similar to what they were getting from the council. One council recently offered a personal budget of £700 p/a when previously they were providing 12 weeks of residential nursing care, which would cost at least £7000.

I put the results from the survey to Paul Burstow MP (Minister for Care Services), asking how we should reflect upon these. I wondered whether they would knock his confidence in the benefits of people having a personal budget. They didn’t. His explanation for the results was that there needs to be greater choice of support providers meaning personal budget holders would have more choice about what they do with their PB and would therefore lead to improvements in satisfaction, levels of control and doing what you want to be doing.

My own opinion is that there is something in all three answers, but it has led me to believe that people must still have the opportunity to take part in group activities such as day clubs and that we must work harder to support those with personal budgets.

What do you think?

Gordon

David Cameron requests investigation into NHS support for carers

The Prime Minister, David Cameron has written to the Department of Health asking them to investigate how the money

David Cameron has been talking about establishing a right to respite for carers

committed to providing breaks for carers is being allocated and used by Primary Care Trusts. He has advised that this is an “issue of personal importance to me” and that “we must support carers who do the most valuable work often at great personal cost to themselves. We must ensure that carers are provided with the support they need.”

Cameron’s intervention came about after a letter from Theresa Villiers MP, who attended our Give Carers a Break campaign launch earlier this year. It also comes after previous Department of Health action on this issue and we await the Department of Health’s response to this request.

Previously, the Department of Health did act after our report detailed the failure of PCTs to develop plans and budgets to support carers with local carers’ charities, as Government requested. They requested that all PCTs advise by 2^nd September if they had published plans and budgets to support carers. It was expected that PCTs missed this date only in exceptional circumstances.

Government is now clarifying some of the information returned, and we have also started our review of whether PCTs have published plans and budgets and how much is being allocated.

Government have also said that they will release guidance next month giving clear expectations of how Primary Care Trusts (and Clinical Commissioning Groups, successors to PCTs) should support carers in the next financial year 2012/13.

I hope these are steps forward to real change.

Take care

Gordon

Bins and council tax trump social care for Tories

Whereas Labour are still deciding their priorities, the Conservatives appear to have nailed theirs to the mast. And social care isn’t there.

Eric Pickles MP, Secretary of State for Communities and Local Government began their conference by announcing that

Eric Pickles MP with David Cameron

£250m had been found which would be given to councils for weekly bin collections. Funding for social care comes from councils, and funding for local authorities comes from the Department of Communities and Local Government. So rather than giving this money to councils to spend on social care, the Government are saying it has to be spent on bin collections.

This Government, and Pickles in particular, has been adamant that decisions must be made at the local level, and councils given freedom to decide. Yet, Pickles is not making this £250m available for whatever councils think it could best be spent on; it is only available for councils who want to move to weekly bin collections.

Of course, some councils already run weekly bin collections, and a couple of councillors at the Conservative conference were left wondering whether they should stop that so that they can claim some of the £250m to reintroduce what they are already doing.

This was followed by George Osborne’s announcement that Government had found an extra £800m to give to councils who committed to freeze their council tax rates. Again, this newly found money is not available for councils to spend as they see best but can only be used to compensate councils who do not increase council tax rates.

Compare this focus on bins and council tax to social care. I asked Lord Freud (DWP Minister) and Greg Hands MP (Parliamentary assistant to George Osborne) about how important it was to implement the Dilnot Commission’s recommendations on social care but received no answers. I asked Maria Miller MP (Minister for Disabled People), who said meeting the challenge of our population’s changing demographics was one of our biggest, but instead of discussing Dilnot’s report, focussed on how introducing the right to request flexible working for all will help carers trying to juggle work and care.

Andrew Lansley in his speech did mention the £400m given to the NHS to support carers, but there was no mention of social care or Dilnot. When asked about it, no firm commitments were forthcoming. Understandably, Lansley is focussed on getting his Health Bill through Parliament but we must get the Conservatives to see social care as a priority.

Instead of commitment to reforming social care, there is a reticence emanating from Conservatives. It usually starts with talk of implementing Dilnot being very expensive and a lot of work still to be done. Implementing Dilnot is £1.7bn per annum; the Tories have just found, out of nowhere, £1.05bn for bins and council tax.

Take care

Gordon