Personalisation and Austerity in the Crosshairs: Government Perspectives on the Remaking of Adult Social Care

Abstract

Personalisation has now become centre-stage in adult social care and continues to have an enduring level of political commitment and on-going appeal for many disabled people. And yet its roll-out has taken place during a time of austerity where central governments in many neo-liberal countries are re-imagining (read: shrinking) their role in social care provision. This paper reports on findings from an empirical study of relevant government officials from different countries which have advanced personalisation: Canada, England and the US. It reports on their views on personalisation and the remaking of adult social care, and managing expectations for change. Despite the relative success of personalisation, the findings reveal a tempered, cautious account, with respondents aware of the pitfalls and risks inherent in self-led support, government limitations in changing systems and an end to the primary involvement by the state in the creation of a social care market. With this in mind, the study's findings make a strong case for forms of 'progressive localism', as imagined by Featherstone et al. (2012), in galvanising local community resources alongside more radical politics in order to make self-led support achieve its desired outcomes on the ground.

Changing the culture of social care in Scotland: Has a shift to personalization brought about transformative change?

“…Scotland's problems with personalization are by no means unique. As well as being replicated in England (Slasberg et al, , ), personalized social care across Europe (Hauben, Coucheir, Spooren, McAnaney, & Delfosse, ) and North America (Power, ) has been beset with similar concerns. Austerity, reduced funding, and cutbacks in service provision have limited the impact of personalization (Pearson & Ridley, ).…”

‘Any one of us could be among that number’: Comparing the Policy Narratives for Individualized Disability Funding in Australia and England

“…It can be argued that a shared personalization narrative is emerging, across countries, which is that disability services should be person‐centred, offering choice and control through individualized funding (Glasby and Dickinson ; Foster et al . ; Power ). Approaching personalization as a narrative draws attention to its role as a story about how services can and should change (and are changing) that itself draws on a range of storylines (sub‐narratives) to assure its plausibility and authenticity (Needham ).…”

“…The tensions between these two strands has surfaced in the UK in debates over the degree to which person‐centredness and individualized funding aim to develop consumer rights or citizen rights (Scourfield ; Ferguson ; Power ). Consumer rights are typically conceived as being concerned with affording people with disabilities the right to make individual choices within a free market.…”

‘There’s a lot of places I’d like to go and things I’d like to do’: the daily living experiences of adults with mild to moderate intellectual disabilities during a time of personalised social care reform in the United Kingdom

“…Since the global financial crisis in 2008 several nations, including the UK, have adopted economic austerity measures, which have reduced available spending for health and social care (Slay 2012;Power 2014). The combination of reduction of budgets and increasing pressure on intellectual disability services caused by the increasing numbers of people with intellectual disabilities Hatton 2004, 2008) has resulted in many local authorities tightening eligibility criteria in order to manage resources (McInnis et al 2011).…”

“…Individuals were assessed by social workers within local government authorities and if eligible, would be offered services funded by that authority, which were often provided to large groups and were criticised for failing to meet individual needs or offer substantial choice (Sims and Gulyurtlu 2014). The past two decades have Adults with intellectual disabilities and personalised social care 2 care (Duffy, Waters and Glasby 2010;Needham 2014;Power 2014), in which professionals identified the needs of individuals who, as passive recipients, were given a 'one size fits all' service (Boxall, Dowson and Beresford 2009). Instead, a personalised system is influenced by the human rights and social justice ideologies of the independent living movement (Glasby and Littlechild 2009;Sims and Gulyurtlu 2014); individuals contribute to the identification of their needs, and local government authorities devolve their purchasing responsibility to individuals so that they can choose, purchase, and manage their own care in the form of a personal budget or direct payment (Slasberg and Beresford 2014).…”