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Evaluation Methodology Basics: The Nuts and Bolts of Sound Evaluation

Our health, our care, our say.

Fair share

Extending choice and control to the users of publicly funded services is a cornerstone in the personalisation agenda. It is assumed that giving service users greater choice and control will promote users’ independence. As service users are increasingly given the responsibility to determine their support, social work practitioners need to work differently with service users in order to provide personalised support in exercising choice. This requires practitioners having a nuanced understanding of people’s concepts of independence, how people make choices about support services and how those choices can impact on their perceived independence in the longer term. This paper reports new findings from a longitudinal qualitative study of choice and control over the life course in England. Semi-structured interviews were carried out with fifty adults and older people experiencing fluctuating support needs and/or a sudden deterioration in health. The paper discusses the relationships between choice and independence as experienced by disabled and older people. The findings show that independence is not a fixed concept, but is relative and multidimensional. There are multiple relationships between the choices people make and the consequences of those choices for people’s subjective views of their independence. The paper concludes by highlighting the implications of findings for the role of social work practitioners.

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Exploring the Relationships between Choice and Independence: Experiences of Disabled and Older People

The Costs and Benefits of Personal Budgets for Older People: Evidence from a Single Local Authority

This is a report on the published literature on the barriers and facilitators of self- directed support. It was undertaken to inform a research study funded by the Scottish Government 2009-2011 that is evaluating initiatives in three local authorities. These initiatives aim to improve take up of self-directed support for people eligible for social care and other public funds. The three test site areas are working to reduce bureaucracy; to make the processes easy and 'light touch'; and to provide training and leadership to people working on these developments. Scottish Government has provided extra money to assist these three authorities and to help people in other areas learn from their experiences.

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Self-Directed Support: A Review of the Barriers and Facilitators

■ Those who accessed SDS packages during the test sites, were positive about their support and satisfied with the flexibility and choice that SDS had provided. ■ The test sites improved access to SDS especially for people with learning disabilities, but did little to promote SDS to other groups, for example, those with mental health problems, from Black or Minority Ethnic groups, older people, those who have addictions or homeless people. ■ In spite of considerable Scottish Government investment in SDS test sites, fewer than 150 new individual SDS arrangements were set up. This suggests that significant time and investment in infrastructure are needed to implement major policy initiatives. ■ None of the test sites had directly addressed issues around mixed funding packages, so the potential to integrate or join up funding streams e.g. with the NHS, could not be assessed. ■ The paradox at the heart of SDS was a (mis)perception by staff, service users, and carers of SDS as an alternative to, direct services and even, Direct Payments (DPs). New and parallel SDS systems to those delivering DPs were created by the test sites. ■ Active promotion of SDS, including DPs, increased the numbers of people opting for payments instead of direct services to pay for more flexible, individualised care and support. ■ All test sites invested in specialist SDS teams and project managers to support development of new systems and administrative processes, as well as generating a body of practice expertise. Consequently, some service users, carers and professionals perceived SDS as separate to both Social Work support and DPs. ■ None of the test sites was able to cut ‘red tape’ or reduce bureaucratic or administrative requirements. Instead, by designing new support systems for SDS, they experienced a (possibly temporary) increase in bureaucracy associated with assessment and resource allocation. ■ Only one of the test sites used test site monies to invest in strategic service development. ■ By the end of the test site period the 3 local authorities had resolved to move towards mainstreaming SDS with support from their senior management and Councillors. Evaluation of Self-Directed Support Test Sites in Scotland

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Evaluation of self directed support test sites in Scotland

■ Those who accessed SDS packages during the test sites, were positive about their support and satisfied with the flexibilityand choice that SDS had provided. ■ The test sites improved access to SDS especially for people with learning disabilities, but did little to promote SDS to othergroups, for example, those with mental health problems, from Black or Minority Ethnic groups, older people, those who haveaddictions or homeless people. ■ In spite of considerable Scottish Government investment in SDS test sites, fewer than 150 new individual SDS arrangementswere set up. This suggests that significant time and investment in infrastructure are needed to implement major policyinitiatives. ■ None of the test sites had directly addressed issues around mixed funding packages, so the potential to integrate or join upfunding streams e.g. with the NHS, could not be assessed. ■ The paradox at the heart of SDS was a (mis)perception by staff, service users, and carers of SDS as an

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Bill Gray

Papers

Self-Directed Support: A Review of the Barriers and Facilitators

Evaluation of self directed support test sites in Scotland

Health and Community Care