Do Personal Budgets Increase the Risk of Abuse? Evidence from English National Data

Abstract

With the continued implementation of the personalisation policy, Personal Budgets (PBs) have moved to the mainstream in adult social care in England. The relationship between the policy goals of personalisation and safeguarding is contentious. Some have argued that PBs have the potential to empower recipients, while others believe PBs, especially Direct Payments, might increase the risk of abuse.This paper provides empirical evidence about levels of uptake of PBs and safeguarding referrals in England based on in-depth analysis of national data at aggregate, local council level in England, covering 152 Councils. This is complemented by analysis of 2,209 individual referral records obtained from three purposively selected study sites. The aim is to explore whether available data could provide evidence of association between the uptake of PBs and safeguarding referrals. Analysis of the national dataset found no significant relationships between PB uptake and the level and type of alleged abuse. However, analysis of individual-level referral data, from the three selected sites did find some significant associations particularly with financial abuse; and found the main perpetrators of the alleged abuse to be home-care employees. The findings are discussed within the context of current policy and practice.terms of use, available at https://www.cambridge.org/core/terms. https://doi

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“…(p. 1018) This finding, O'Rourke concludes, "also challenges the idea that the award and use of [DF] will inevitably lead on to the actual experience of personalisation" (ibid., p. 1019); instead, it appears that experiencing personalised care, in which the client can most fully exercise choice and control, is intimately tied to the relation between client and care worker. San Antonio et al (2009) make a similar conclusion in their study of older DF clients in Arkansas, noting that "Arkansas elders chose DF care because of the benefits of hiring and supervising their own family or nonfamily directly hired caregivers" (p. 8).Furthermore, they note that "consumers felt that their directly hired family and nonfamily care-givers took good care of them and provided warm, sensitive care" (ibid., p. 13), particularly when contrasted to care in institutional settings Woolham et al's (2017). study compares the outcomes of older DF clients and those receiving care via a managed personal budget in England.…”

Skill mix: The potential for personal assistants to undertake health‐related tasks for people with personal health budgets

“…Some recent studies have explored the dynamics of PA/employer relationships (Graham, 2015;Shakespeare, Stöckl, & Porter, 2018) and PA characteristics (Skills for Care, 2017). Risks such as neglect, exploitation or misuse of public funds have been weighed against the advantages articulated of choice for people using care services and their empowerment (Ismail et al, 2017).…”

Consumer expectations of self‐managing aged home care packages in Australia

“…International reports found little evidence of heightened risk to consumers in self‐management programs. Two English studies found that adverse events did occur, however, their prevalence was no higher than in agency‐managed programs (Ismail et al., 2017; Manthorpe & Samsi, 2013). The authors cautioned against imposing safeguards that would infantilise older consumers and stifle their agency and self‐determination.…”