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
Using personal budgets
Most, but not all, personal budget holders who had mental health problems had received their personal budget as a lump sum, and had used it in a variety of ways. Some had purchased one-off items to enable them to pursue an activity. Others had bought computers which they used to help them keep in touch with friends and family, and also to learn new skills or undertake training which they hoped might eventually help them back into work. Many used their personal budget for social activities such as attending a gym. Those who received their personal budget in instalments were more likely to use it to provide regular support to help them get out and about, either by employing a personal assistant or purchasing support worker time.
Older personal budget holders were much more likely to use their personal budget to pay for regular personal care or help with getting out and about. A significant proportion were employing personal assistants, usually with the help of a support provider organisation. A few personal budget holders employed family members (usually a son or daughter) or friends as personal assistants. Some held their personal budget in the form of a direct payment but then contracted directly with a care provider agency, while others had a managed account with a support provider.
In most of the case study sites, domestic tasks such as cleaning and gardening could be funded by a personal budget without a problem, but a few personal budget holders and carers said that they had needed to 'negotiate' in order to spend part of their personal budget on these services. Transport, especially the use of taxis, was another area of expenditure that personal budget holders often felt unsure about. This was particularly the case for older personal budget holders who sometimes viewed taxis as a luxury rather than a necessity. In rural areas particularly, for personal budget holders who could not drive and did not have access to a regular bus service, taxis were often the only way they could get out and about.
Where the level of the personal budget allowed, older personal budget holders and their carers were using their personal budgets to fund a variety of support and services including residential respite, day services and warden call systems. In addition, some quite creative support arrangements had also been put in place. For example, several personal budget holders were using their funds to have a short break with their family rather than going into residential respite care. Although this had worked well, some carers almost felt 'guilty' that they were benefiting indirectly from the personal budget and needed reassurance that this was quite acceptable.
personal budget holders and carers often described how the way the personal budget was used had changed over time. Older personal budget holders and carers also described how their personal budget had been reviewed and the support they received adjusted, usually as their needs increased. They felt strongly that right from the outset personal budget holders needed to be reassured that the use of the personal budget could change as their needs changed, and they saw social workers, community psychiatric nurses and provider workers as key to conveying this message.
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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