Training for Change: Early Days of Individual Budgets and the Implications for Social Work and Care Management Practice: A Qualitative Study of the Views of Trainers
TL;DR: In this article, the authors focus on the role of those responsible for training in managing the demands upon social workers/care managers, in responding to their concerns and aspirations, and their possible responsibilities for training people using services in their new consumer roles.
Abstract: Individual Budgets are central to the implementation of English government policy goals in social care. Like other consumer-directed or self-directed support programmes operating in parts of the developed world, they are envisaged as a way of increasing individuals' choice and control over social care resources provided by the public sector. While the opportunities they provide for people using services have been identified prospectively in the English context and reflect positive outcomes internationally, little attention in England has been paid to the potential impact on the redesign of social workers' and others' current roles and practice and the training that might be necessary. This article draws on the Department of Health-commissioned evaluation of the thirteen pilot Individual Budget schemes, which aims to evaluate outcomes and identify the contexts and mechanisms of those outcomes. The article focuses on a sub-set of the study that comprised an exploration of early training activities for social workers/care managers and wider stakeholders around the introduction of Individual Budgets. It is based on interviews with representatives from all thirteen pilot local authorities. What happens to social work in adult social services departments in England may be determined in part by these pilots; however, the article also highlights the role of those responsible for training in managing the demands upon social workers/care managers, in responding to their concerns and aspirations, and their possible responsibilities for training people using services in their new consumer roles.
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01 Oct 2008
TL;DR: This evaluation is the first robust UK study of the implementation and impact of personalisation approaches in social care.
Abstract: Individual budgets (IBs) were piloted as a new way of providing support for older and disabled adults and people with mental health problems eligible for publicly funded social care.
The Department of Health set up IB pilot projects in 13 English local authorities, running from November 2005 to December 2007, and commissioned a national evaluation.
This evaluation is the first robust UK study of the implementation and impact of personalisation approaches in social care.
240 citations
Cites background from "Training for Change: Early Days of ..."
...…a first round of interviews with IB project leads; details of the implications of IBs for staff training, care management practice and adult protection (Manthorpe et al., 2008a; 2008b); interviews with 14 early users of IBs (Rabiee et al., forthcoming); and details of the costs of implementing IBs....
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TL;DR: The English Department of Health initiated a pilot form of personalised support for adults (Individual Budgets) in 13 local authorities that aimed to extend opportunities for users of social care services to determine their own priorities and preferences in the expectation that this will enhance their wellbeing as discussed by the authors.
Abstract: Cash for care or consumer-directed services are increasing in scope and size in Europe and North America. The English Department of Health initiated a pilot form of personalised support for adults (Individual Budgets) in 13 local authorities that aimed to extend opportunities for users of social care services to determine their own priorities and preferences in the expectation that this will enhance their well-being. This article reports on and discusses interviews undertaken with adult protection leads in the 13 Individual Budgets sites about the linkages to their work, their perceptions of the launch of the pilots and the policy s fit with safeguarding and risk agendas. The interviews were undertaken as part of the national evaluation of the pilots, which aims to evaluate outcomes and identify the contexts and mechanisms of those outcomes. Findings of this part of the study were that the adult protection leads were not central to the early implementation of Individual Budgets and that some of their concerns about the risk of financial abuse were grounded in the extent of this problem among current service users. The implications of their perceptions for the roll out of Individual Budgets are debated in this article with a focus on risk and the policy congruence between potentially competing agendas of choice and control and of protection and harm reduction.
64 citations
01 Jan 2011
TL;DR: The social care evidence base reveals a distinct preference for qualitative methods covering a broad range of social care topics and some of the reasons why it has been successful in identifying under-researched areas, in documenting the experiences of people using services, carers, and practitioners, and in evaluating new types of service or intervention as discussed by the authors.
Abstract: The social care evidence base reveals a distinct preference for qualitative methods covering a broad range of social care topics. This review provides an introduction to the different ways in which qualitative research has been used in social care and some of the reasons why it has been successful in identifying under-researched areas, in documenting the experiences of people using services, carers, and practitioners, and in evaluating new types of service or intervention. Examples of completed research on a selection of topics are chosen to give an understanding of some of the differing underpinning approaches to qualitative research, including grounded theory, case studies and ethnography. These are used to illustrate the advantages and disadvantages of the methods of data collection used most frequently in qualitative research, including in-depth interviews, focus groups and observation as well considering issues such as sampling and data analysis. The review ends with a discussion on how qualitative social care research might be improved in terms of its quality and in extending the repertoire of research methodologies on which it draws.
57 citations
Cites background from "Training for Change: Early Days of ..."
...In addition, interviews with a wide range of other stakeholders, such as training managers and Individual Budget project leaders (Manthorpe et al. 2009) were also undertaken, to provide multiple perspectives, which contextualised the findings from the randomised controlled trial....
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TL;DR: In this article, the authors report new findings from a longitudinal qualitative study of choice and control over the life course in England and discuss the relationships between choice and independence as experienced by disabled and older people.
Abstract: 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.
56 citations
Cites background from "Training for Change: Early Days of ..."
...However, less attention has been paid to the training that might be necessary to transform social workers’ current roles and practices, or to the evidence on which that training is based (Manthorpe et al., 2009)....
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47 citations
References
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TL;DR: In this paper, three approaches to innovation in the public sector in the post war period are identified and analysed for their implications for policy-makers, managers and citizens, and various relationships are identified between innovation and improvement in public services.
Abstract: Three approaches to innovation in the public sector in the post war period are identified and analysed for their implications for policy-makers, managers and citizens. Various relationships are identified between innovation and improvement in public services. The traditional bias of the literature that innovation is necessarily functional is undermined. Important lessons for policy, practice and research include the need to develop an understanding of innovation which is not over-reliant on the private sector manufacturing literature but reflects the distinctive contexts and purposes of the public sector.
855 citations
TL;DR: Consideration is given to what would be necessary to make services more person-centred, including changes in power relations, funding arrangements and staff training and supervision.
Abstract: Background This critical review considers the nature and importance of person-centred planning in the context of current British policy and service development in intellectual disability The difference between person-centred planning and other kinds of individual planning is discussed
Materials and method The scale of the task of implementing person-centred planning as a national policy initiative is considered The limited evidence base for person-centred planning is reviewed and the reasons for the failure of previous attempts at individual planning are analysed The assumption that person-centred services will be produced by a new kind of individual planning is questioned
Conclusions Consideration is given to what would be necessary to make services more person-centred, including changes in power relations, funding arrangements and staff training and supervision
211 citations
TL;DR: In this paper, the authors use the example of direct payments to demonstrate how modernization also requires flexibility of "the person" in order to meet the needs of the modern citizen, and the implications for the users of adult social care are discussed.
Abstract: Since coming to power, New Labour has embarked on a programme of modernization. Few areas of state activity have been more visibly subjected to New Labour’s modernization agenda than the personal social services. Local authority social services departments have largely ceased to exist as separate organizational entities. However, modernization has also required that the relationship between state and citizen be reconstructed. This is evident in New Labour’s vision for adult social care which envisages a move towards individual budgets. The individualizing nature of such schemes may be thought hard to reconcile with the discourse of integration and partnership prominent elsewhere. However, a key linking concept is that of ‘person-centredness’. It is often assumed that this simply means that public services become more flexible to meet the needs of ‘the person’. This paper uses the example of direct payments to demonstrate how modernization also requires flexibility of ‘the person’. It would appear that inherent in New Labour’s project of modernization is the assumption that the modern citizen should be both managerial and entrepreneurial. What were once public responsibilities are being transferred to the individual. The implications for the users of adult social care are discussed.
144 citations
124 citations