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Gaining Independence
An Evaluation of Service Users’ Accounts of
        the Individual Budgets Pilot
Gaining Independence

An Evaluation of Service Users’ Accounts of the
            Individual Budgets Pilot

                   Guy Daly

      Faculty of Health and Life Sciences
              Coventry University

            g.daly@coventry.ac.uk
Aims of the Evaluation
• whether and to what extent service users are engaged in the
  Council’s Individual Budgets scheme
• barriers to service user participation
• effective mechanisms in promoting service user involvement
• other barriers to the effectiveness of the promotion of
  Independent Budgets
• general views of those involved in Individual Budgets Pilot
Context
• 13 local authorities chosen to pilot the introduction of individual
  budgets during 2006-2008.
• national pilot programme evaluated through the Individual
  Budgets Evaluation Network (IBSEN).
• national research project aims:
     experiences and outcomes for service users
     resourcing and management
     cost effectiveness, workload management, training, legal
       and professional issues
     Randomised Controlled Trial - hard data with nationwide
       validity.
Context
•   choice
•   independence
•   personalisation
•   outcomes-based care
•   direct payments
•   individual budgets
•   personal budgets
Learning From Previous Studies
              (1)
• develop and manage social care markets
  effectively
• commission social care effectively
• develop effective partnership working
• develop an understanding and raise the
  profile of individual budgets
Learning From Previous Studies
              (2)
• overcome various barriers including attitude
  of certain local authorities and social care
  professionals
• promote outcomes focused social care
• ensure users are empowered
• ensure real choice is provided
METHODOLOGY (1)

Aims
• capture service users’ and carers’ thoughts
  and experiences
• empower the service users to tell their own
  stories in ways that were meaningful to them.
METHODOLOGY (2)
Sample
• all service users were ‘in transition’ from one care
  setting to another
• 44 service users in the Pilot
• 30 service users participated in the evaluation
• 19 male, 11 female
• third – 16-18 years, third 19-25, third over 25
• vulnerable individuals with additional communication
  needs
METHODOLOGY (3)

Approach
• action research
Methods
•   one-to-one support sessions with researchers
•   use of computers to create ‘blogs’
•   dictaphones
•   PowerPoint presentations
•   posters and artwork
•   group artwork project
•   film
•   observation of service users
Evaluation Findings
Benefits
• service users able to set the agenda
• increased choice and autonomy over how their needs
  were met
• able to grow and develop holistically
• Increased flexibility of service provision
• service users are more fully part of the community
Setting the agenda (1)
The Individual Budget pilot has allowed [my]
needs and aspirations to be understood in a
way that a traditional assessment would not
allow. In the past [my] ability to perform tasks
would be the main focus of an assessment
and the consequences of doing the task
would not be considered. (service user)
Setting the agenda (2)

So we intend to employ a personal
assistant who will support him in a
person-centred way, putting his needs
first, and promoting his well-being
(family)
Setting the agenda (3)
The Individual Budget gives us the flexibility to use
the resources we have as and when we need them
(parents)
For example E does not always go out for the same
number of hours every week – social lives are not
always predictable (parents)
Holistic Growth - physical, emotional and spiritual
                        (1)
I prefer living in the new house because I do not have
to do everything in a group and I am also allowed to do
more things for myself. I feel like more of an individual.
(service user)
The money from the Individual Budget means I can live
here …. I’m much happier here than where I lived
before because … this is my flat and I am supported to
live here independently. (service user)
Holistic Growth - physical, emotional and spiritual
                        (2)

My sister and I get on better now since I have
moved into my new house because we spend
more quality time together and she is not just
my carer now. (service user)
Challenges
• varied levels of knowledge and awareness of Individual Budgets
• difficulties experienced by some service users in obtaining an
  Individual Budget or available services
• difficulties in securing adequate supply of good care staff
• need to be skilled up in order to take on the responsibilities of
  being an Individual Budget holder
• need for supply to become more flexible and responsive
• need for professionals to recognise to a greater extent that their
  roles are changing
Suggested Developments
• effective advocacy services and support
• database of available care staff*
• support/assistance for service users and families in
  taking on roles of an employer
• effective communication between departments
• agencies work in partnership
• aligned funding streams
• real work opportunities developed
• appropriate housing supply
Overall Findings
Coventry City Council’s Individual Budgets Pilot has
been a very positive development:
• independence
• family roles
• promoting person-centred, outcomes focused support


the process of getting an IB….has been hard at times
…. But having it has helped me to become more
independent

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Ccc ib evaluation 07 05-08

  • 1. Gaining Independence An Evaluation of Service Users’ Accounts of the Individual Budgets Pilot
  • 2. Gaining Independence An Evaluation of Service Users’ Accounts of the Individual Budgets Pilot Guy Daly Faculty of Health and Life Sciences Coventry University g.daly@coventry.ac.uk
  • 3. Aims of the Evaluation • whether and to what extent service users are engaged in the Council’s Individual Budgets scheme • barriers to service user participation • effective mechanisms in promoting service user involvement • other barriers to the effectiveness of the promotion of Independent Budgets • general views of those involved in Individual Budgets Pilot
  • 4. Context • 13 local authorities chosen to pilot the introduction of individual budgets during 2006-2008. • national pilot programme evaluated through the Individual Budgets Evaluation Network (IBSEN). • national research project aims:  experiences and outcomes for service users  resourcing and management  cost effectiveness, workload management, training, legal and professional issues  Randomised Controlled Trial - hard data with nationwide validity.
  • 5. Context • choice • independence • personalisation • outcomes-based care • direct payments • individual budgets • personal budgets
  • 6. Learning From Previous Studies (1) • develop and manage social care markets effectively • commission social care effectively • develop effective partnership working • develop an understanding and raise the profile of individual budgets
  • 7. Learning From Previous Studies (2) • overcome various barriers including attitude of certain local authorities and social care professionals • promote outcomes focused social care • ensure users are empowered • ensure real choice is provided
  • 8. METHODOLOGY (1) Aims • capture service users’ and carers’ thoughts and experiences • empower the service users to tell their own stories in ways that were meaningful to them.
  • 9. METHODOLOGY (2) Sample • all service users were ‘in transition’ from one care setting to another • 44 service users in the Pilot • 30 service users participated in the evaluation • 19 male, 11 female • third – 16-18 years, third 19-25, third over 25 • vulnerable individuals with additional communication needs
  • 11. Methods • one-to-one support sessions with researchers • use of computers to create ‘blogs’ • dictaphones • PowerPoint presentations • posters and artwork • group artwork project • film • observation of service users
  • 12. Evaluation Findings Benefits • service users able to set the agenda • increased choice and autonomy over how their needs were met • able to grow and develop holistically • Increased flexibility of service provision • service users are more fully part of the community
  • 13. Setting the agenda (1) The Individual Budget pilot has allowed [my] needs and aspirations to be understood in a way that a traditional assessment would not allow. In the past [my] ability to perform tasks would be the main focus of an assessment and the consequences of doing the task would not be considered. (service user)
  • 14. Setting the agenda (2) So we intend to employ a personal assistant who will support him in a person-centred way, putting his needs first, and promoting his well-being (family)
  • 15. Setting the agenda (3) The Individual Budget gives us the flexibility to use the resources we have as and when we need them (parents) For example E does not always go out for the same number of hours every week – social lives are not always predictable (parents)
  • 16. Holistic Growth - physical, emotional and spiritual (1) I prefer living in the new house because I do not have to do everything in a group and I am also allowed to do more things for myself. I feel like more of an individual. (service user) The money from the Individual Budget means I can live here …. I’m much happier here than where I lived before because … this is my flat and I am supported to live here independently. (service user)
  • 17. Holistic Growth - physical, emotional and spiritual (2) My sister and I get on better now since I have moved into my new house because we spend more quality time together and she is not just my carer now. (service user)
  • 18. Challenges • varied levels of knowledge and awareness of Individual Budgets • difficulties experienced by some service users in obtaining an Individual Budget or available services • difficulties in securing adequate supply of good care staff • need to be skilled up in order to take on the responsibilities of being an Individual Budget holder • need for supply to become more flexible and responsive • need for professionals to recognise to a greater extent that their roles are changing
  • 19. Suggested Developments • effective advocacy services and support • database of available care staff* • support/assistance for service users and families in taking on roles of an employer • effective communication between departments • agencies work in partnership • aligned funding streams • real work opportunities developed • appropriate housing supply
  • 20. Overall Findings Coventry City Council’s Individual Budgets Pilot has been a very positive development: • independence • family roles • promoting person-centred, outcomes focused support the process of getting an IB….has been hard at times …. But having it has helped me to become more independent