SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers
Support planning and setting up services
For most personal budget holders with mental health problems, the assessment and support planning stages seemed to be merged more or less into one continuous stage and for younger people in particular this worked well, as it kept a sense of momentum and 'things happening'. As with the self-assessment process, some personal budget holders began by developing their ideas for their support plan themselves and then discussed them with their community psychiatric nurse or social worker. While most of the case study areas used a support planning template, other approaches were used. A few personal budget holders said that they found it liberating to use different forms of expression, such as essays and videos, to demonstrate what they wanted and why it would help them. A few expressed frustration about how long it took to get their support plans approved and were unhappy about having to 'negotiate' the use of their personal budget.
Older personal budget holders had far more mixed experiences of support planning. Again the assessment and support planning stages often seemed to merge but the process was not always seen as being positive. A number of personal budget holders could not remember their support plan being discussed with them, and/or felt that they did not have much say in what was included (e.g. if previous packages of care simply were being converted into their personal budget).
However, a significant proportion of older personal budget holders were very clear about what they wanted in their support plan and felt that this was respected. Most older personal budget holders had developed their support plans with their social worker or with help from a local support provider organisation, and they found this extremely valuable, as again it encouraged them to consider different options and/or to explore ways in which support could be arranged to fit with their lifestyle or family circumstances.
- personal budget holders' experiences suggest that there are a number of ways to ensure that the support planning process is positive and flexible:
- the option of a 'fast track' from assessment to support plan, where it is clear what the personal budget holder wants to put in place and there are no major concerns about safety for the individual or financial risks for the local authority
- the opportunity to agree a short-term or temporary support plan, which gives people time to think about what they want before their full support plan is developed
- although support planning 'templates' are clearly helpful, they need to be flexible and personal budget holders should be encouraged to use different ways to express their views, such as essays, or short audio or video recordings
- continuity in terms of the staff involved in the (self-)assessment and support planning processes
- offering the personal budget holder the opportunity to involve an support provider or user-led organisation in the support planning process, especially if the organisation concerned is likely to be supporting the personal budget holder in the management of their personal budget
- the active involvement of staff or support provider organisations in encouraging people to think beyond traditional service models and develop innovative ideas about how to meet their needs
- where service users are 'transferred' to a personal budget from a conventional package of care, and/or their care needs are relatively prescribed, the development of the support plan should still be used as an opportunity to give them maximum choice and control over how they are supported.
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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