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

Changing circumstances

Generally personal budget holders with mental health problems and their carers understood that their personal budget would be reviewed each year and most could recall having a review or, if they had only had their personal budget for a few months, knew roughly when their review was due to take place. For a number of personal budget holders, reviews were incorporated in their regular sessions with their community psychiatric nurse or social worker, so they did not see them as distinct.

The picture was less clear for older personal budget holders, with roughly half of those involved in the study saying that they had not had a formal review of their personal budget or could not recall having one. Carers had also had a somewhat mixed experience. Generally older personal budget holders and carers seemed unclear about when reviews should take place, and the division of responsibility between the LA and the support provider (if they used one) was not always clear to them. There was also anxiety about the practice of 'closing' cases because personal budget holders and carers wanted to be able to contact a social worker who knew their circumstances. This continuity was highly valued by many personal budget holders and carers, especially where they felt they had established a good relationship with their social worker or community psychiatric nurse.

LA/trust staff often felt frustrated by the national requirement of a six-week and annual review. In mental health services, having to do a formal review at six weeks sometimes seemed unnecessary if staff were seeing the personal budget holder regularly anyway, and some personal budget holders found it irritating to have to 'fill in more forms'. There was also a view that because personal budget holders are usually given their personal budget for 12 months, it would be better to hold a formal review at nine or 10 months, so that people are aware of what will happen to their personal budget well before the end of the year.

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