SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers
Assessment and resource allocation
Helen, who has mental health problems, lives by herself. Although she gets support from her mother and her niece, she wanted her community psychiatric nurse to help her through the personal budget process. She explained that she had been quite ill for some time and it was her nurse who suggested that a personal budget might help improve her quality of life. She described how she had felt before doing the assessment, saying she was
filled with fear and anxiety but that her nurse had been very supportive and the assessment process had actually proved to be straightforward. She recalled:
I answered questions and ticked different boxes to say what help I needed. He [the nurse] ticked what he thought and I ticked what I thought … some questions we disagreed on and then we discussed them to understand the questions better … so I understood a bit more and it became clear. She felt she had greatly benefited from doing her assessment with her nurse who was:
with me all the way and discussed it at good length. The relationship is very important, when you do need support with everything.
Positive practice example
In Council C the assessment is carried out initially assuming no informal carer support. Carer support is then factored in and the monetary allocation adjusted to take account of the support the carer is willing and able to provide. The points allocated for need are never amended regardless of carer support. This system means that if a personal budget holder's circumstances change and the carer is incapacitated or unable to provide care for a period, then the council can adjust the personal budget without the need for further assessment.
Hilary has mental health problems and physical impairments which mean that she needs a high level of support from personal assistants and other services. She felt quite strongly that the issue of risk and contingency planning needed to be addressed thoroughly. She explained that she discussed this with her social worker and they identified the potential risks to her, one of which was what would happen if her personal assistant or her husband was not able to provide care. She said:
to ensure I was able to minimise this risk I was provided with £500 for emergency cover with Rapid Response. I also have alarm systems which I can use in the house in case of emergencies. She said that discussing risks and making contingency plans for dealing with them was reassuring.
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- SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers