SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers
Assessment and resource allocation
Staff perspectives on assessment
All the case study sites had introduced some form of self-assessment questionnaire, although implementation in practice varied considerably - not just between sites but within sites. It was difficult to judge what the balance was between self-assessment, supported self-assessment and practitioner assessment. However, it was clear that some practitioners were far more comfortable than others in leaving the person using services to complete their own self-assessment questionnaire and there was a tendency to assume that older people were less able to undertake self-assessment. Staff reported that assessment for personal budgets (especially outcomes-based assessment) demanded more time, with these pressures being particularly acute for older people's teams where there is normally higher 'throughput'.
There were a number of reasons for these additional time pressures. Where personal budgets were relatively new, staff were still learning about and adjusting to new systems, and in some areas they were having to complete or at least process two sets of assessment paperwork for new people using services – the 'single assessment' (or 'care programme approach' in mental health) and the personal budget assessment. However, several of the case study sites had involved frontline staff in designing personal budget paperwork and all were working towards integrated assessment paperwork, although none had completely achieved this. Information technology systems were often not geared up for personal budgets, which led to additional work (e.g. entering information into two systems or having to keep both paper- and computer-based records), a point echoed in the recent Audit Commission report (2010: 16). A number of the local authorities had commissioned changes to their main social services information system to accommodate the data collection and storage needed for personal budgets.
All the study sites had undertaken staff training as part of the introduction of personal budgets and some had provided specific training on outcomes-based assessment, which sometimes involved staff from local support provider organisations and in a few cases personal budget holders as well.
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