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Interests of users must be paramount in new approaches to care

8 June 2016

The Public Accounts Committee reports warns that stronger measures are needed to safeguard the interests of adults receiving personal budgets for social care.

Report findings

The Committee's report says: "We are not assured that local authorities can fully personalise care while seeking to save money, and are concerned that users' outcomes will be adversely affected."

Personal budgets are sums of money allocated by a local authority to service users to be spent on services to meet their care needs. They can be managed on behalf of users by the authority or a third party, or given to users as direct payments to spend themselves.

From April 2015, the Care Act requires that all users receive personal budgets but the Committee is concerned some people with personal budgets "may not be receiving care that is genuinely personalised".

Adults who receive social care "are not yet getting the support they need consistently"

The Report states the Department of Health "does not believe that everyone counted by local authorities as having a personal budget does actually have genuine choice and control over the services they receive".

The Committee warns that while some groups of users are more capable of trying new approaches to care, others are likely to need greater support—for example "older adults, those in residential care, those with learning disabilities and those who lack mental capacity".

It finds that adults who receive social care paid for by their local authority "are not yet getting the support they need consistently in order to get the most out of personalising their care".

Real threat that many care providers will not survive

The Committee calls for greater clarity on how local authorities can implement personal budgets to maximise benefits to users and shares local authorities' concerns that funding cuts and wage pressures "will make it hard to fulfil their Care Act obligations".

Among its other findings, the Committee highlights the fragile nature of the social care market in many areas, warning of "a real threat" that many care providers will not survive.

The Committee calls on the Department of Health to set out clearly to local authorities and providers "what high-quality and proportionate support looks like" and how much it costs, and recommends a range of analytical and other measures to safeguard users' interests and the social care market.

Chair's comments

Meg Hillier MP, Chair of the PAC, said today:

"The need for adult social care is increasing but in recent years the amount spent on such care by English local authorities has fallen in real terms.

Against this backdrop there are clearly risks in pursuing new approaches to providing care. Personal budgets have great potential but the interests of users are paramount and must be protected.

It is vital people receiving care do so through the form of personal budget that best suits their circumstances. They should also be supported to make best use of it.
In this time of real funding pressures, central government must work with local authorities to safeguard the market for social care, including assessing the impact of the National Living Wage and other factors on provision.

The Department of Health and its partners must also show they are learning from available evidence and data so that care users can be confident of getting best value from the resources available."

Report summary

When implemented well, personal budgets allow adults to try new ways to meet their social care needs, give them more choice and control over the care they receive, and give them the opportunity to achieve the outcomes they want from their care.

The Department of Health (the Department) has demonstrated the potential of personal budgets to transform care and improve quality of life for most groups of social care service users, but it is not doing enough to ensure that all can reap the benefits, and it has not set out how it will judge success.

Challenge supporting sustainable local care markets

We are not assured that local authorities can fully personalise care while seeking to save money, and are concerned that users' outcomes will be adversely affected.

Local authorities face a substantial challenge supporting sustainable local care markets which offer the diverse range of provision needed for users to personalise their care, while care providers are struggling to recruit and retain appropriately qualified staff as financial pressures increase.

Further information

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