Spotlight on : Council-managed personal budgets

As a major provider of services to older people, Age UK is interested in what research tells us is known to work. In this book we've asked experts to write jargon-free summaries of the latest evidence they have of the most effective practice. We hope it will inform and further the debate about how services can enhance the lives of older people today. In his foreword Lord Filkin says, 'The key question is how to make these years as healthy, happy and meaningful as possible and improve the quality of later life whenever we can. This sounds a heroic, even utopian, ambition but this excellent Age UK publication makes crucial points about how to realise this vision. It tells us that service designers and providers should listen to what older people say they want and value, and co-design services with them, rather than doing things to them. We should also need to recognise the huge diversity among older people, and make the best use of the evidence of what works best.' 'Services for Older People - What Works' is a valuable and accessible guide to current best practice in the care and support of older people. It makes essential reading for service providers, commissioners, and others who fund or deliver services for older people

Supporting older people and carers

As a major provider of services to older people, Age UK is interested in what research tells us is known to work. In this book we've asked experts to write jargon-free summaries of the latest evidence they have of the most effective practice. We hope it will inform and further the debate about how services can enhance the lives of older people today. In his foreword Lord Filkin says, 'The key question is how to make these years as healthy, happy and meaningful as possible and improve the quality of later life whenever we can. This sounds a heroic, even utopian, ambition but this excellent Age UK publication makes crucial points about how to realise this vision. It tells us that service designers and providers should listen to what older people say they want and value, and co-design services with them, rather than doing things to them. We should also need to recognise the huge diversity among older people, and make the best use of the evidence of what works best.' 'Services for Older People - What Works' is a valuable and accessible guide to current best practice in the care and support of older people. It makes essential reading for service providers, commissioners, and others who fund or deliver services for older people

What can England learn from the German approach to long-term care funding?

There's much England could learn from German long-term care funding, argue Caroline Glendinning and Mathew Wills. They explain how, over the past two decades, Germany has rolled out a universal and equitable funding model, supported by both main political parties

COVID-19 and social care funding: a window of opportunity for reform

Mathew Wills and Caroline Glendinning argue that COVID-19 is increasing the political cost of sticking with the social care status quo, and highlights the need for significantly higher and more sustainable funding. They explore what the sector could do to maximise the chances of achieving successful reform

Choice, competition and care : developments in English social care and the impacts on providers and older users of home care services

This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for-profit and charitable) organizations and local authority providers of long-term care services aimed to create a 'mixed economy' of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on: * The commissioning and contracting of home care services by local authorities and individual older people * The experiences and outcomes for individual older people using home care services. Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalized within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalized home care, in which the quality of care-giving relationships can also be optimized. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organizations providing home care services and for individual older service users

Carers' roles in personal budgets: tensions and dilemmas in front line practice

Adult social care in England emphasises the service and support preferences of disabled and older people. Personal budgets play a central role in this development. Carers in England have also secured rights to assessment and support in their care-giving roles. However, these policies have developed largely separately, with little consideration of the interdependencies between disabled and older people and their carers. There is limited evidence detailing current practice. This paper explores current practice, particularly how far social care practitioners recognise and balance the needs and interests of service users and carers, especially those with cognitive and/or communication impairments. The paper reports findings from nine qualitative focus groups (forty-seven participants) conducted in 2012 with practitioners involved in service user personalisation and carer assessments from older people and learning disability teams across three English authorities. Findings indicate inconsistencies in practice. Although practitioners felt they sought to involve carers, practices varied between authorities, teams and colleagues in the same team. Clear and timely links between processes for service users and carers were absent. Practice was discussed most frequently around service user assessments, other stages of personalisation appeared ad hoc. Areas of confusion and tension are identified. Future policy and practice developments and challenges are also considered

Personalisation, personal budgets and family carers: Whose assessment? Whose budget?

SUMMARY The policy of personalisation in English adult social care prioritises choice and control by service users over the support they receive. Carers also have rights to assessments and support, but these rights have developed separately, so interdependencies between carers and service users may be overlooked. Moreover it may be difficult to reconcile these divergent policies in routine practice. This paper reports findings from a study examining the roles played by carers in England in the processes of assessment, support planning and management of personal budgets for disabled and older people. The study was conducted between January 2011 and February 2013. It involved a survey of sixteen adult social care departments across two English regions, and interviews with personalisation and carers lead officers in three local authorities. The Framework approach was used to manage the data, and analysis was done thematically. FINDINGS Practice was fragmented and inconsistent. Carers were reported to be involved in service users' assessments, and also asked about their willingness and ability to continue caring, but not necessarily about their own needs. Separate carers’ assessments were reported to be usually offered, but take-up was low and lead officers’ opinions about their value varied. Any help given by carers reduced the level of service users’ personal budgets, but there was no evidence that carers’ own needs (as identified in carers’ assessments) were taken into account. APPLICATIONS Greater clarity and consistency is needed, especially the linking of service users’ and carers’ assessments and finding appropriate ways to meet both. These changes will become increasingly urgent with the implementation of the 2014 Care Act

Personalisation : where do carers fit?

This unique book brings together, for the first time, advocates and critics of the personalisation agenda in English social care services to debate key issues relating to personalisation. Perspectives from service users, practitioners, academics and policy commentators come together to give an account of the practicalities and controversies associated with the implementation of personalised approaches. The conclusion examines how to make sense of the divergent accounts presented, asking if there is a value-based approach to person-centred care that all sides share