Individualisation of services — a scoping study

Introduction

Social care policy currently emphasises the importance of ‘personalisation’. This approach ensures that people have choice and control to enable them to obtain the care and support that suits them best. PBs are part of this approach, and give people the opportunity to plan and manage their own care and support.

Objectives

This study was funded to begin to address the need for research evidence for those involved in personalising social care. The overall aim was to identify the type of research evidence needed to support social care practice in this area. The project aimed to identify:

• barriers and facilitators to the putting personalisation into practice;
• areas of people’s lives where they have difficulties in achieving the outcomes they want, such as being clean and comfortable, feeling safe, or being socially involved;
• examples of successful innovative personalised services.

Methods

This research was conducted between October 2009 and May 2011 and involved interviews and focus groups with 77 participants in three local councils and two Shared Lives (adult placement) schemes and a telephone survey of personalisation leads in 20 councils.

Findings

• Participants felt it was still too early to properly assess the impact of personalisation on the type of services provided and on providers, practitioners, service users and carers
• Financial resources were becoming a critical issue for councils, as the extent of cuts to funding was being recognised
• One of the most frequently mentioned challenges to personalisation was the change in culture needed among frontline staff, providers and across the council
• Personalising services for some groups, in particular older people and those with mental health problems, was challenging. Some participants highlighted ways in which they were addressing these challenges
• Managers and practitioners identified problems they were having with the use of outcomes to assess services users’ quality of life. These included problems defining and measuring outcomes
• Service users valued having control over what to spend their personal budget on and how to organise their care and support
• Social participation and occupation were the most difficult areas of outcome to achieve. However, these were also where the most promising services identified in our study were making progress: delivering solutions to meeting individuals’ goals, potentially at low cost
• Although innovative services are important routes to achieve individuals’ goals, participants also valued existing mainstream services and suggested that more people were choosing to access these than before
• Service users and carers reported a number of difficulties with the new system, mainly to do with the process of setting up and managing a personal budget (PB). Despite this, they were clear that personalised services were preferable to traditional services
• Areas where we identified a need for more evidence included: effectiveness of different models of support planning; brokerage and management of personal budgets; innovative personalised interventions, particularly for day time activities and support; and effective use of the workforce.