SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers
Managing the personal budget
Rachel cares for her mother who has dementia and needs care day and night. She is the main carer but to enable her mother to stay living at home (over 50 miles away), her husband and daughter provide some care too. She explained that when her mum's personal budget first began, her care was provided by staff from a local third–sector care provider. After six months her mum's condition deteriorated and around the same time Rachel was made redundant. Although she was eventually offered another job, the new job had irregular hours which were incompatible with caring for her mum and so she decided to ask the county council if she could provide the paid care for mother.
Life was getting very difficult for me so I said to them, Rachel explained that as she is now 'employed' to care for her mum she no longer gets Carer's Allowance but she felt fine about this as the personal budget pays her enough to be able to live on, which the Carer's Allowance did not. Rachel believes that being employed as her mum's personal assistant has helped provide the quality and consistency of care her mum needs and prevented her mum from having to go into a care home.
we're paying all this money out on different care [workers], what would you do if I give up my job to look after my mum? … That's when the personal budget changed … now my mum pays me instead of [the care agency] and the county council gets more for their money.
At the end of the day it has enabled us to keep mum living in her own home which has always been her wish. If I hadn't been able to take some of the personal budget I don't know how I would have managed because of the amount of hours my mum needs.
Positive practice example
An extra care facility located in Council C was established two years ago. It is a large complex with mixed tenure accommodation, developed and managed by a third–sector organisation. Council C's social services department provides the community care element of the support where required. Some residents are fully independent and do not require any community care support. Care workers are employed by the home and there is low staff turnover. A dedicated community social care practitioner is responsible for the support needs assessed by the social services department and is on site full time. In addition, one of the social services teams responsible for ongoing case management/review is also based at the complex, which can aid communication about individual residents. The 'package' of support that residents receive can be used flexibly. For example, if people want to reduce/adjust their personal care hours they can spend the 'time' saved on personal assistant support for shopping/external activities or other on site activities (e.g. the gym).
A number of residents had personal budgets in the form or managed accounts. While making personal budgets available to people living in extra care housing is a positive development, personal budget holders from the extra care facility suggested a number of things which would have enabled them to get more out of their personal budget, including:
- ensuring personal budget holders are fully informed about different deployment options and are supported to take their personal budget as a direct payment if they wish to
- giving personal budget holders with managed accounts more flexibly in the way they are used (e.g. providing 'monthly statements' so that people know what they have left to 'spend'; improving the range of activities available)
- changing thinking among practitioners to ensure that extra care housing is not seen as an end in itself and that support plans look beyond the move into extra care.
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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