School for Social Care Research Improving the evidence base for adult social care practice Personalised Home Care Services for Older People Using Managed.

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School for Social Care Research Improving the evidence base for adult social care practice Personalised Home Care Services for Older People Using Managed Personal Budgets Parvaneh Rabiee, Caroline Glendinning, Kate Baxter SPRU, University of York SSCR Insights from Research on... Personalisation - LSE 12 th June 2013

School for Social Care Research  Mechanisms for managing Personal Budgets (PBs)  Cash direct payments (DPs)  Managed personal budgets  Local authority-managed  Provider-managed (known as ISFs)  Most older people prefer managed PBs  Most managed PBs used for home care Q: Do older people using managed personal budgets have opportunities for choice and control similar to DPs? Context

School for Social Care Research  Explore factors affecting the delivery of personalised support to older people who opt for managed PBs  Commissioning, contract and market development  Support planners’ roles in shaping older people’s expectations and demands  Home care provider experiences  Older people’s experiences  Interviews and focus groups in three local authorities  Known to be innovative Aims and methods

School for Social Care Research Commissioning, contracting and market shaping  A shift from block contracts to Framework agreements  Brokers  Individual Service Funds  Market development officers/Innovation funds

School for Social Care Research Support planners’ roles and responsibilities  LA support planners - draw up basic plan based on identified needs  Agency staff - draw up more detailed support plan with service user Brokers

School for Social Care Research LA support planners’ experiences  Training and knowledge of roles  Shaping demands  Knowledge of budget level  Thinking ‘outside the box’  Limited choice/availability  Experiences of brokerage  Communication  Reviews and monitoring  Delays - putting up with care

School for Social Care Research Agency experiences  Training and knowledge of roles  Shaping demands  Detailed support plans but little scope for change  Time banking  Restrictions on range of expenditure  Lose money  Experiences of brokerage  Communication difficulties  Reviews and monitoring  Too much bureaucracy

School for Social Care Research Service users’ experiences – evidence of choice and flexibility  Choice over agency  No choice BUT general satisfaction with agency  How would I choose?  Choice over Carers  Continuity of carers (small teams)  Choice over content/tasks  Limited flexibility  ‘Off care plan’ activities  Little opportunities for time banking  Choice over timing of care  Limited choice

School for Social Care Research Summary and conclusions  Health warnings  Generalisability?  Resource constraints  Intentions good but communication problems  Time banking  Trust

School for Social Care Research Contact details For further information see: Acknowledgements These slides present independent research commissioned/funded by the NIHR School for Social Care Research. The views expressed in this publication are those of the authors and not necessarily those of the NIHR School for Social Care Research or the Department of Health, NIHR or NHS. Contacts and acknowledgements

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