SCIE Report 36: Enabling risk, ensuring safety: Self-directed support and personal budgets

Studies

'Research suggests that there should be a clear link between the adult protection and personal budget systems and some of the existing mechanisms for direct payments could be built on'

This section analyses some of the UK and international research relating to risk enablement and safeguarding in the context of self-directed support and personal budgets. The focus is on facilitating good frontline practice and the promotion of choice and control. The research identified looked at issues for:

• older people
• people with physical or sensory disabilities
• people with learning disabilities
• people with mental health problems.

While this section is not a systematic review of all the evidence, it provides an overview of international research and gives key messages for practice.

Because it is a very new approach for the UK, little investigation into risk enablement practice for personal budgets has been undertaken. To date there have been no empirical studies from the UK published in peer reviewed journals which evaluate particular strategies.

There are important limitations to be aware of when assessing how far research findings from international sources can be applied to the UK. The findings will be dependent on the national context and the design and regulation of the particular personal budget or self-directed support scheme.

It is also important to note that very few studies have looked at long-term outcomes of personal budget and self-directed support schemes.

The most recent systematic review of UK, US and Australian research on 'consumer directed support', which focuses on older people with complex needs, has positive conclusions (see quote above).

Similarly, other research has found that, at least in the initial stages, 'consumer-directed support does not increase the risk to vulnerable consumers' although certain smaller studies did reveal some instances of theft and abuse.

Despite the present lack of specific research on risk enablement, safeguarding and personal budgets, there are clear lessons also to be learned from:

• the initial IBSEN study
• the development of person-centred planning and self-directed support
• the implementation of direct payments in the UK
• recent research into the relationship of care management and self-directed support to risk management.

Further reading

• Ottmann, G., Allen, J., Feldman, P. (2009) Self‐Directed Community Aged Care for People with Complex Needs: A Literature Review. UCCO/Deakin University QRN, Melbourne.