Putting People First: a shared vision and commitment to the transformation of Adult Social Care

Direct Payments and Personal Budgets: Putting Personalisation into Practice

Direct payments (DPs) are cash-payments that eligible individuals can receive to purchase care services by themselves. DPs are central to current social care policy in England, but their advantages remain controversial. This controversy is partly due to their lack of historical visibility: DPs were deployed in stages, bundled with other policy instruments (first individual budgets, then personal budgets), and amidst increasing budgetary constraints. As a result, little unequivocal evidence is available about the effectiveness of DPs as an instrument for older people’s care. This study aims to partially fill that gap using data obtained during an early evaluation of DP’s that took place between 2005 and 07. Semi-structured 81 face-to-face interviews with older people (and their proxies) using DPs are analyzed. DPs contribution to outcomes was measured using a standardized utility scale. Data on individual characteristics (dependency, unpaid care) and received services (types and amount of services) was also gathered. Multiple regression analyses were performed between measured outcome gains and individual and service characteristics. A Poisson log-functional form was selected to account for the low mean and positive skew of outcome gains. Levels of met need compared very favorably to average social care outcomes in the domains of social participation, control over daily living and safety, and user satisfaction was high. Benefit from DPs was particularly affected by the role and function of unpaid care and availability of recruitment support. The freedom to combine funded care packages with self-funded care enhanced the positive impact of the former. The ability to purchase care that deviated from standardized care inputs improved service benefits. Large discrepancies between total care input and that supported through DPs negatively affected outcomes. The results offer clarity regarding the benefit derived from receiving DPs. They also clarify contested aspects of the policy such as the influence of unpaid care, types of care received, funding levels and the role of wider support arrangements. Tangible benefits may results from direct payments but those benefits are highly dependent on policy implementation practices. Implementation of DPs should pay special attention to the balance between DP funded care and unpaid care.

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Influences of service characteristics and older people's attributes on outcomes from direct payments.

The Student’s companion to social policy

ABSTRACT As a key driving force in adult social care policy in both the United Kingdom and internationally personalisation has wide-ranging implications for the social work profession. Yet its meaning can be elusive and is often contested. This article explores findings from a doctoral study which sought to explore the current meanings associated with the notion of personalisation, by asking those with lived experience how it is experienced by them. Unique features of the study’s participatory and psychosocial research design, which placed lived experience at its centre, are outlined. Original findings from the study explored in this paper include a range of themes related to dependence, independence and interdependence, depersonalisation and reciprocity. Risks associated with contemporary practice models in adult social work, including strengths-based approaches are explored. Based on the findings a reorientation towards ‘contribution-focused practice’ within a relationship-based practice model is proposed.

Personalisation as contribution-focused social work practice

With the objective to eradicate disability related discrimination and promote choice, control, independence and inclusion for all individuals, the personalisation agenda paved the way for a transfo...

Personalisation as vision and toolkit. A case study

ABSTRACT ‘Personalisation’ is nowadays a very popular concept in disability policy and this article – drawing on my PhD research project in the English and Lombardian context of social care services for disabled people – aims to explore the translation of personalisation from policy into practice; hence the ways in which personalisation policy makes its way into disability services. In particular, drawing on street-level-bureaucracy, policy practice and network theories, personalisation is analysed here through the lenses of professional actors. The application of a mix of qualitative research methods brought me to two main conclusions: 1) narrow approaches to personalisation coexist with broader ones, leading to very different roles for professionals charged with translating personalisation policy into practice; 2) power differences and asymmetries are at play among different professional actors, with some having stronger discretional and policy steering capacity compared to others when it comes to informing person-centred care practice.

Personalisation in disability policy and practice: an analysis through the lenses of professional actors

The extensive efforts made by individuals and institutions to publicize factual information about the vaccines and to debunk the related misinformation, therefore can be credited for the increased uptake of the vaccines and consequently the steady decline of the impact of the virus. The pandemic has been instrumental in bringing some global issues to the fore, creating endless opportunities for global communities to launch initiatives to promote public education through reliable sources. [...]of the pandemic and all the challenges associated with it, the world was presented with complex problems that require critical thinking and creativity to adapt, particularly when these challenges presented in disparate proportions across genders.

Francesca Pozzoli

Papers

Personalisation as vision and toolkit. A case study

Personalisation in disability policy and practice: an analysis through the lenses of professional actors

Editorial