Personalisation – making it work for carers

Today I went to get my hair cut. Nothing special about that, absolutely nothing at all. But stop a minute and think about the choices I made – the choices most of us take for granted. I went to a place which I knew I could afford which let me have an appointment to fit round my ever changing work and life schedule. It’s easy to get to on public transport, and  I know they generally do a good job and listen to me and cut my hair how I like it. These factors are important to me, otherwise I would simply go somewhere else.

These are the choices we all make all the time. So why can’t carers and people with care needs make these choice about care, when they often can’t just go somewhere else? Surely, with something as important as care services it should be no different?  This is the personalisation agenda – ideally making sure people with care needs and carers can have the services they want, the way they want them.

So what’s the problem? Well, despite all the intentions to deliver personalised support, it’s not as straightforward as this.  If the person who the care package is for isn’t able to manage it themselves, this often becomes the carer’s responsibility whose life is often complicated enough, thank you. For those  of you who’ve had the experience of becoming the direct employer of personal assistant, this  can be liberating but also can be a real headache, without the right kind of support.

Worse, in practice, “choice” sometimes doesn’t mean that much. Some local authorities place random rules around how money can be spent  – completely defeating  the point of personalisation.  Like the authorities who dictate that carers who have personal budgets for their own breaks can’t use these to pay fo replacement care. You might have  a budget to pay for your gym membership, or doing up your garden  or your trip to your sisters – whatever is a break for you – but you can’t actually do this because you can’t get away because, you can’t pay for someone to look after the person  you care for.  Where do the national guidelines actually say this? Nowhere.

The other thing is there often aren’t a range services to buy either. If the only service available for someone with dementia during the day is the same day centre there has always been, why make everyone go through the bother of managing it through a personal budget? And the sneaky thing is that sometimes people find they are moved onto a budget and find they aren’t given enough money to buy the service they had in the first place. Hm… does that sound like a cut to you? It does to me.

Bearing all of this in mind, I like to stay optimistic. The principle of personalisation has got to be right even if the mechanisms and support aren’t quite there, but it needs to make people’s lives easier, not more complicated.

At Carers Trust we’ve been working on a programme, together with carers, on how this can all be made a bit less stressful. There’s a film here – it’s great – have a look! The carers involved show it can work, it really can.  But there needs to be proper investment in information, training and support  for all carers faced with managing a personal budget, to make sure this is a positive experience, not a stressful extra complication.



April 20, 2012 - Posted by | Uncategorized | , ,


  1. Having a PA is wonderfully freeing but a personal budget doesn’t cover them going off sick, having holidays, having to be sacked for theft etc. because the social workers don’t appear to be trained well enough to understand about having to pay employer’s NI, holiday pay, holiday cover, sick cover etc, as far as they’re concerned the PA gets £x per hour they work so that’s how much is in the budget. And on top of that the person who needs the care and is vulnerable is legally liable as the employer and has to fix it all if it goes wrong – with no support from SS? Having done it myself for a couple of years I now refuse point black to go back to employing a PA and insist on using an agency. SS tell me it’s more expensive, it isn’t, it’s just that SS don’t factor in employer’s costs so the person in receipt of the budget gets fewer hours of care than the budget calculations and care plan imply – essentially a cut in care services cynically disguised as ‘putting them in control’.

    Comment by 'disgusted of tunbridge wells' | April 20, 2012 | Reply

    • Totally agree. And worse, social workers have no knowledge of employment law but do offer ideas sometimes that would not be legal. There is little understanding – from politicians down – of employment law and liabilities. So this support is “extra”.

      Comment by charles47 | April 22, 2012 | Reply

  2. The complexities of personalisation ,direct payments etc put them out of reach of most carers.Further, when once a Local Authority goes over to tendering, respite care organisations have to focus on cost cutting rather than quality of service in order to survive . Accordingly, the quality of respite care offered to carers who desperately need a high quality service is declining remorselessly throughout the country. The nurses’ and doctors’ orgnisations are protesting against the current government’s dreadful policies in relation to the NHS, The Carers Trust should be protesting against the appalling respite care policies of this Government which is continuing the appalling policies initiated the previous Labour Government. It is time forthe Carers Trust to WAKE UP and tell the Government that their respite care policies are based on ignorance of the real situatiion whuch faces carers,

    I write this as a director of respite care orgnisations for the last twenty five years

    Comment by Peter Senker | May 17, 2012 | Reply

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