Choice, control & care homes: the implications of personal budgets in care home work

1. Choice, control & care homes:the implications of personal budgets in care home work Jill Manthorpe Social Care Workforce Research Unit King’s College London care home congress 2009

2. Not just personal budgets but self-directed support Not just direct payments but many forms of deployment Generally applicable to adult social care+ Transforming adult social care Personalisation is care home congress 2009

3. But looking at personal budgets • The local authority Resource Allocation System works out that Mrs James is eligible for £5,000 a year to meet her needs for social care. She spends half on a personal support worker (her niece Maureen) and a quarter on going to church (taxi). While Maureen is on holiday Mrs James stays at Claremont Court. care home congress 2009

4. Will people be able to stay at home longer? Higher levels of disability/ illness on admission? Will people wish to purchase more from care providers such as homes? Care homes in a crisis – their role as a safety net Possible demand sideeffects on care homes care home congress 2009

5. Holiday horror averted • Maureen has broken her leg on a camel ride…(telephone calls to Marrakech) • Mrs James stays another month • Council involved – only later when family sorting out funds – but not with Claremont care home congress 2009

6. What is on offer to non-residents? Do you really want their business? Marketing approaches Can you manage individual provider accounts? Etc Who is your link? action care home congress 2009

7. Mrs James • Has budgeted for 2 weeks stay not six • Will need to manage this – with broker or care manager • Carers can be care managers • Familiar position of self-funders care home congress 2009

8. Effects on staff • Will staff take on extra work for people at home? (Cash? Not regulated?) • Will staff leave to become personal assistants? Why? (no H&S?) • Will personal assistants be attracted to care homes? Why? (better behaviour) • Will new pools of staff be attracted to care work? (how to attract them?) care home congress 2009

9. The attractiveness of Maureen • Experienced in care work… • May have time to spare… • May like to talk about work plans… • May lack confidence… • May want a change from one to one employment… care home congress 2009

10. Experience of choice and prioritising Familiarity with risk assessment & management Assertiveness? A consumer culture Changing expectations among users and carers? care home congress 2009

11. More personalised care • Familiar calls within care homes – person-centred, relationship–centred… • A good barometer • Thinking about other elements of personalisation eg intergenerational work, prevention, safeguarding, and ensuring care homes are part of this care home congress 2009

12. Mrs James • Makes more use of Claremont, may consider moving in • Recommended it to a fellow worshiper who did • Provided the men’s sports group (student supported) with her husband’s snooker set • Maureen is planning another adventure… care home congress 2009