SCIE Report 36: Enabling risk, ensuring safety: Self-directed support and personal budgets
'...arrangements leads to more independence. There are no detectable increases in risk to quality, trustworthiness, reliability and safety when compared with agency-directed services.' (Ottmann et al 2009).
The IBSEN study: Adult safeguarding perspectives
During the IBSEN study, researchers interviewed adult protection lead officers in the 13 pilot sites. They examined the links between personal budgets and work in adult protection and how the personal budget process fitted with adult safeguarding. The adult protection leads raised the subject of risk at a number of levels:
- At a 'micro level': where people using services could potentially be at risk when family and care workers are providing paid support in the context of other relationships with the individual
- At a 'macro level': where a number of issues relating to consumer-led care need to be accounted for. This includes providing individual 'safety nets' and the willingness of public services to tailor levels of monitoring to risk assessment. This could jeopardise the flexibility and freedom that personalised services are designed to enhance.
- At a collective level: where there are concerns about the impact of personal budgets on the collective user voice in commissioning, which could mean social care services being purchased on less favourable financial terms or with restrictive options.
The researchers concluded that adult protection lead officers can have unique insights from balancing the demand for safety and assurances about spending public money with the increased demand for choice and control in social care.
However, they found that, in some pilot sites, their expertise was not being sought or used consistently with personal budget implementation.
Many practitioners have concerns about safeguards which should be addressed at early stages. The 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.
Adult protection lead officers suggested the following actions could enhance safeguarding for personal budgets:
- incorporating IBs [personal budgets] in adult protection training
- developing audit trails
- improving complaints procedures for people being supported by family members
- enhancing advocacy services to support people in decision-making
- multi-agency training and public awareness training to ensure people know what counts as abuse
- identifying any risk factors for abuse and how these could be recognised in an individual's support plan
- preparing a guide for social workers about co-working issues, protection and risk management
- Glendinning C et al (2008a) Evaluation of the individual budgets pilot programme: final report York: York University SPRU
- Manthorpe J, Stevens M, Rapaport, J, Harris J, Jacobs S et al (2008) Safeguarding and system change: early perceptions of the implications for adult protection services of the English Individual Budgets Pilots: a qualitative study, British Journal of Social Work