Self directed support and personal
budgets: enabling risk, ensuring
safety
Personalisation: new risks, old systems?
 Risk averse or avoidant
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practice puts people
at risk
Risk of people losing independence, choice
and control
An example
Putting people not organisations first
Personalisation: old risks, new systems?
Risk management dilemmas existed before
personalisation and personal budgets:
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Balancing empowerment and protection; selfdetermination, independent living and safeguarding
Service quality and regulation
Financial abuse and misuse of funds
Abuse or neglect
Contingency planning and back-up arrangements
Personal budgets: a popular myth
 Personal budgets are not just direct

payments or ‘cash for care’
They can also be taken by way of:
• An ‘account’ held and managed by the council in
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line with the persons wishes
An ‘account’ placed with a third party (provider)
and ‘called-off’ by the user in direct negotiation
with the provider
As a mixture of the above.
IDeA/ADASS/DH/LGA 2009
Independence, choice and risk
‘The governing principle behind good approaches to
choice and risk is that people have the right to live
their lives to the full as long as that does not stop
others from doing the same...Person-centred
planning approaches identify what is important to a
person from his or her own perspective and find
appropriate solutions. We commend person-centred
approaches for everyone.’
Department of Health 2007
Putting People First
‘One of the core components of a personalisation
system is an effective and established mechanism to
enable people to make supported decisions...It needs
to be recognised that organisations and professionals
need to move away, wherever possible, from making
decisions for people and towards a role that informs,
facilitates and empowers people to think about how
they wish to live their lives...the goal is to get the
balance right moving away from being risk averse
while still having appropriate regard for safeguarding
issues.’
Department of Health 2008
No Secrets
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‘Safeguarding must be built on empowerment – or
listening to the victim’s voice. Without this,
safeguarding is experienced as safety at the
expense of other qualities of life, such as selfdetermination and the right to family life.
Everyone must empower individuals but
safeguarding decisions should be taken by the
individual concerned. People want help with
options, information and support. However, they
wanted to retain control and make their own
choices.’
Department of Health 2009
Mental Capacity Act 2005
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‘Empowering people to make decisions for
themselves wherever possible, and by protecting
people who lack capacity by providing a flexible
framework that places individuals at the heart of the
decision-making process
Allowing people to plan ahead for a time in the future
when they might lack the capacity, for any number of
reasons, to make decisions for themselves.’
SCIE 2009
Risk enablement and personal budget
schemes: what does the research say?
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Perspectives of people who use services are largely
absent in research about social care and risk
Practitioners and families have greater influence in
defining risk and risk management approaches
Too early for findings on risk enablement strategies
for personal budgets in UK - no evaluation of risk
enablement panels published yet
Lessons to be learned from US ‘Cash and
Counselling Program’, direct payments, personcentred planning and the relationship of care
management and risk management
Risk enablement and personal budget
schemes: what does the research say?
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IBSEN study did not present evidence of increased
risk in the pilot implementation of personal budgets
Emerging research suggests that a rebalancing of
social work resources towards frontline activity could
enhance overall organisational risk management and
safeguarding.
Practitioners need to be supported by local
authorities to incorporate safeguarding and risk
enablement into relationship-based, person-centred
working.
Risk enablement and personal budget
schemes: what does the research say?
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People using services should be enabled to define their own
risks and empowered to recognize, identify and report abuse,
neglect and safeguarding issues with the support of frontline
staff. This approach should be an integral part of self directed
support, including assessment and regular outcome review.
One indication of a supportive system is one which clearly
incorporates self directed support with safeguarding policy and
practice, with abuse detection and risk enablement training for
staff, people using services, carers and families.
It appears that risk enablement in the context of self directed
support and personal budgets should be approached as an
integral part of the transformation process, rather than relying
‘bolt on’ solutions to existing systems which do not place the
person using the service at the centre.
Risk enablement and personal budget
schemes: what does the research say?
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Research evidence is showing that if frontline practitioners
are disproportionately engaged in protecting organisations
from fraud when administering direct payments, this will
impact on the capacity of those practitioners to engage
with individual service users to identify safeguarding
issues and enable positive risk taking.
Emerging research suggests that a rebalancing of social
work resources towards frontline activity could enhance
overall organisational risk management and safeguarding.
Practitioners need to be supported by local authorities to
incorporate safeguarding and risk enablement into
relationship-based, person-centred working.
Emerging practice
 An intergrated personalisation and
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safeguarding framework
The role of the social worker
Risk enablement panels
Personal budgets, risk management and
organisational transformation
Two key messages
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‘Rather than try to calculate the incalculable, social
workers need to regain their former status as experts
in uncertainty. They should develop mutually trusting,
respectful relationships with their clients, make fine
judgements about risk and dare to work creatively
and innovatively.’ (Stalker 2003)
‘Care management processes and workforce skills,
we were told, needed to be refocused on
communication, empowerment and enabling people
to take considered risks.’ (Department of Health
2009)