1. Market intelligence Latest findings from the Demos Personal Budget project

2. The background – a step change By March 2011, all local authorities are required to have at least 30% of publicly funded adult social care users using personal budgets. Around one-third of local authorities are aiming to have all publicly funded care users using personal budgets by March 2011. An unprecedented shift in how care users plan and purchase their care – significant implications for commissioners and providers

3. Existing evidence – what do we know about the impact of personal budgets on local markets? InControl, Phases I&II Ibsen pilot site study Local studies (e.g. Worcestershire, Herefordshire, Cambridgeshire and Northamptonshire)

4. Interesting early insights – personal budgets might generate: A move from residential care into own tenancies A commensurate increase in home help and personal assistants Increased demand for leisure and education A large proportion keeping their existing package, including sustained demand for day centres BUT – small sample sizes, using the “vanguard” and focus on learning disabilities mean limited wider application

5. At Your Service, the Demos Personal Budgets Market Intelligence project 6 participating local authorities returning data on a combined sample of 428 care users: We ask: About the types of services people receive now, how happy they are with them and what is important to them What council funded users might spend a personal budget on and what they would change about their current care packages What current PB/DP holders were spending their budgets on and how they had changed their packages

6. The sample

7. Who pays for support?

8. What’s important to achieve in life? Top answers across all care users Keeping healthy and well (76 per cent) Good quality of life (37 per cent) Personal dignity and respect (57 per cent) Choice and control (47 per cent)

9. What did people want to change about their lives? - Areas of difference Older personPhysical impairment Learning disability Enough money13%22%47% Make a contribution7%13%37% Being treated fairly7%9%35%

10. What did people want to change about their lives? Top answers across all care users physical health (43 per cent) opportunities for holidays (37 per cent) more control over life (29 per cent) money (28 per cent)

11. What did people want to change about their lives? - Areas of difference Older personPhysical impairment Learning disability Home I live in9%18%26% Paid work4%20%23% Volunteering3%11%31% Evening activity17%21%32% Relationships with friends 6%14%27%

12. What support would people need to make these changes? More information about things they can do (46 per cent) Having someone to talk to for advice (45 per cent) Less bureaucracy (40 per cent) Those with learning disabilities were more likely to select better transport and help from peers to plan support All options were selected by at least 20% of the sample

13. What do people know about personal budgets?

14. Would people change about their care package if they had a personal budget?

15. What services would people want if they had a personal budget? Top answers across all care users Personal Assistants (48 per cent) Home helpers (41 per cent) Holidays (36 per cent) Day centres (34 per cent) Leisure services(34 per cent)

16. What services would people want if they had a personal budget? - Areas of difference Older personPhysical impairment Learning disability Holidays15%37%56% Public transport22%27%44% PAs57%45%31% Leisure30%25%53%

17. What help would people need if they had a personal budget? help to know what to spend it on (57 per cent) extra help managing it (44 per cent) extra help knowing the cost of options (47 per cent) help to spend it appropriately (36 per cent). Many people ticked multiple options. Older people most commonly responded that help was required.

18. Personal budget holders – did they change their care packages?

19. A disparity?

20. Personal budget-holder spending patterns – implications for the market the use of day care centres fell the use of residential homes remained the same participation in education and training increased the use of leisure services increased substantially the use of public transport increased the number of holidays increased substantially the employment of personal assistants increased substantially the use of family members and friends fell

21. Market impacts of working age adults Working age adults are moving out of residential services and maintaining their own tenancies This is in part driving a large growth in the demand for personal assistants. Working age adults want to participate in leisure services. The most common are health and fitness training. There was a sustained increase in the use of services which help people develop personal and professional skills, for example accessing employment, training programmes and debt management A small but growing number of working age adults want to use small parts of their personal budgets on things unrelated to social care. There is some indication that the longer people have a personal budget, the more radical they will become in considering ways of spending their budget money.

22. Market impacts of older people Older people will change the services they use more slowly. They spend more on mainstream services than working age adults, and less on leisure services, education and training. Older people want more personal support services. Older people want to remain in their homes with support around the house. This suggests a large growth in the demand for personal assistants. Older people want to spend more on leisure services and transport. The demand for leisure services was still evident for older people, even though it was less pronounced than in other groups. Older people want more weekday and day-care centres. A large number of older people would not change anything. There is a danger of focussing too much on the changes that people will make. Older people are the most likely to need help managing personal budgets

23. What does this mean for providers and commissioners? Maintaining care packages for some clients whilst providing new services for others – a dual role Changing not just what but how things are done Offering a more diverse and flexible range of services – implications for staff skill set Dealing with a more fragmented client base Joint working with other (non-care?) providers to deliver a broader range of services Ensuring universal services are accessible for care users Niche for new management/brokerage services

24. 5 more authorities joining the project National dataset biggest of its kind Watch out for updates Claudia.wood@demos.co.uk