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Personal budgets workbook
1.
How to use this workbook
This work book forms part of the suite of learning materials that have been
developed to support the implementation of part one of the Care Act 2014. These
materials summarise and explain the ‘Care and Support Statutory Guidance’
(October 2014) [“the guidance”] and are designed to help those involved in care and
support services to understand and implement the Act.
The suite of learning materials contains workbooks, PowerPoint presentations and
other material for each of the following topic areas:
1. Introduction and overview
2. Information and advice
3. First contact and identifying needs, including assessment and eligibility, and
independent advocacy
4. Charging and financial assessment, including deferred payment agreements
5. Person centred care and support planning, including personal budgets,
direct payments and review
6. Transition to adulthood
7. Integration, cooperation and partnerships
This workbook is about the personal budgets requirements of the Act and its
statutory guidance. It has been written for learning facilitators and includes
exercises, suggested group discussions, points of reflection and case studies that
facilitators can use either in their entirety or to pick and choose from as they see fit
when designing a learning programme based on the PowerPoint presentation.
The workbook can also be used by individuals who wish to learn more about this
topic area. You can watch the presentation, read the notes below, and undertake the
exercises at a pace and time to suit you.
As well as this workbook and PowerPoint presentation, there are also handouts and
a shorter, overview presentation on this topic area. Handouts provide easy to print
resources that summarise key factual information from the guidance.
The implementation of the Act requires whole systems change and underpinning this
is a need for cultural change. These learning materials alone will not affect such
change, but they are one tool that can be used to support people along the journey.
In many instances, implementing the Act successfully will require those involved in
the care and support system to change the way they work i.e. behaviour change.
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Research suggests that the way people behave is influenced by their knowledge,
skills and attitudes:
Knowledge
Skills
Behaviour
Attitudes
The PowerPoint presentation and handouts are designed to increase knowledge
about the Act or guidance. The questions and exercises in the workbook are
designed to spark conversations that encourage people to reflect on their own
attitudes and the attitudes of others. They aim to give learners the opportunity to
discuss the complexities of implementing the changes in practice, and/or provide a
safe way of challenging attitudes that go against good practice. The case studies are
designed to provide an opportunity for people to analyse and practice their skills.
Key learning point
These are used in the workbook as a way of highlighting changes that are likely to
have a significant impact on practice i.e. the major changes that the Act brings in.
The facilitators’ hints and tips in the workbook signpost facilitators to existing good
practice resources on this topic area and/or highlight key changes that are likely to
have the most significant impact on practice. The aim is to help facilitators to design
interactive learning programmes that are appropriate for their audience.
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Facilitator’s hints and tips
To successfully facilitate this module we suggest that you need to:
 have read the relevant sections of the Act, regulations and guidance
 have a good understanding of best practice in this topic area
 remember that there are various modules available and you need to choose
the most suitable ones for your learning programme
 also remember that you can pick and mix questions, exercises and case
studies from this workbook or from other topic areas
 design your training session in a way that accounts for the learning pyramid
so as to maximize the experience and learning outcomes for your participants
Average retention rates
Lecture
5%
Reading 10%
Passive teaching
methods
Audio visual 20%
Demonstration 30%
Discussion 50%
Participatory
teaching methods
Practice by doing 75%
Teach others 90%
Source: Adapted from National Training Laboratories, Bethel, Maine
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2.
Who is it for?
This workbook is about personal budgets. It explores section 26 of the Care Act and
chapter 11 of the statutory guidance. It is intended to be used to develop learning
programmes for:
 people who have a role in care and support planning and the deployment of
personal budgets.
 staff employed by local authorities and other organisations who are
responsible for care and support planning and the administration and
monitoring of personal budgets.
 managers of people undertaking care and support planning and the
deployment of personal budgets.
3.
Contents
This workbook starts with an overview, which summaries the topic area, and
identifies relevant key words. It then contains the following sections that match the
slides in the PowerPoint presentation:
 Introduction
 Elements of the personal budget
 Calculating the personal budget
 Agreeing the final budget
 Use of a personal budget
 Use of a carer’s personal budget
 Appeals/disputes
 Summary
Appendices: links to key resources; handouts
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4.
Overview
Personal budgets are a key part of the government’s aspirations for a personcentred care and support system. The Care Act places personal budgets into law for
the first time, making them the norm for people with care and support needs.
Personal budgets are designed to enable people to exercise greater choice and take
control over how their care and support needs are met. This in practice will mean
that people will know from the outset how much money is available to meet their
needs including the proportion the local authority will pay and the amount (if any)
they will pay. They will be able to choose from a range of options as to how the
money is managed, they will have choice over who is involved in preparing the care
and support plan jointly with the local authority and a greater choice and control over
the way the personal budget is used to purchase care and support, and from whom.
When calculating the personal budget, local authorities should ensure that the
method used produces equitable outcomes to ensure fairness in care and support
packages. However, whatever the method used, the most important principles in
setting the personal budget are: transparency, timeliness and sufficiency.
The personal budget that the local authority calculates must be sufficient to meet the
person’s needs that the local authority is required to meet and must also take into
account any reasonable preferences to meet needs as agreed and detailed in the
care and support plan, or support plan.
This should ensure that the person, their carer and, where applicable, their
independent advocate, is fully aware of how the budget was calculated, know the
amount so they can plan their care and support accordingly and can have
confidence that the amount includes all relevant costs that will be sufficient to meet
their identified needs as set out in the plan. The costs of intermediate care and
reablement to meet eligible needs, however, must be excluded from the personal
budget. The person, carer or advocate must be able to challenge the local authority
on the sufficiency of the final amount.
The Act sets out that the personal budget must be broken down into: the amount the
person must pay (following the financial assessment) and the remainder of the
budget that the authority will pay. The personal budget must reflect the cost to the
local authority taking into consideration quality and local market conditions. It is not
intended that direct payments are less than is required to purchase care and support
on the local market. The final budget should be finalised at the end of the care and
support planning process.
There are three main ways in which a personal budget can be deployed: through a
managed account held by the local authority with support provided in line with the
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person’s wishes; through a managed account held by a third party (often called an
individual service fund or ISF) with support provided in line with the persons wishes;
or a direct payment. In addition a mix of all three of these approaches can be used.
What is essential is that the person is given choice and flexibility in how they use and
manage their personal budget and that the local authority does not limit or constrain
the person’s options and choices, for example with a restricted list of providers. Local
authorities must ensure that whatever way the personal budget is used, the decision
is recorded in the plan and they have an ongoing duty to keep the person’s plan and
personal budget under review - see the review workbook.
Those overseeing personal budgets must also be alert to the risks of abuse when a
service user has taken their personal budget as a direct payment, particularly by the
personal assistant to a direct payment holder who is also their employer. However,
personal budgets are a good way of helping people protect themselves from harm as
evidenced by examples in the Making Safeguarding Personal programme. See
‘safeguarding through direct payments’ in the Direct Payments module.
The personal budget for carers must be used to meet their caring needs and help to
ensure continuation of their caring role, taking into account agreed outcomes as part
of the support plan. Local authorities must have regard to the wellbeing principle of
the Act as it may be the case that the carer needs a break from caring
responsibilities to look after their own physical/mental health and emotional
wellbeing. Decisions on which services are provided to meet carers’ needs, and
which are provided to meet the needs of the adult for whom they care, will impact on
one of their personal budgets to include the costs of meeting those needs.
Where local authorities are meeting the needs of both the carer and the adult
needing care concurrently, they should consider joint plans and aligned or joint
personal budgets, providing all parties agree.
5.
Key words
The suite of learning materials contains a glossary of key words used in the
statutory guidance. The following key words, which are defined in the glossary, are
relevant to this topic area: care and support plan, carer’s assessment, direct
payment, eligible needs, individual service fund, independent advocate, needs
assessment, outcomes, personal budget, reablement, support plan, top-up and
wellbeing.
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6.
Introduction
Slide 1
Notes
1. This work book forms part of the suite of learning materials that have been
developed to support the implementation of part one of the Care Act 2014.
These materials summarise and explain the statutory guidance and are
designed to help those involved in care and support services to understand
and implement the Act.
2. This presentation is about personal budgets. It is intended for:
 people who have a role in care and support planning and the deployment
of personal budgets
 staff employed by local authorities who are responsible for care and
support planning, administering and monitoring personal budgets
 managers of people undertaking care and support planning and the
deployment of personal budgets.
3. The aim of the presentation is to help you reflect on the implications of the Act
for your role, so that you will know what you must do differently and what you
may need to do differently.
Slide 2
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Slide 3
Notes
1. Personal budgets (PBs) are a key part of the government’s aspirations for a
person-centred care and support system. Why? PBs have been part of
government policy for a while and the Care Act guidance states that “independent
research shows that where implemented well, personal budgets can improve
outcomes and deliver better value for money.”1
2. The key point is that the allocation of a clear upfront indicative (or ‘ball-park’)
allocation at the start of the planning process will help people to develop the plan
and make appropriate choices over how their needs are met.
3. It is vital that the process used to establish the personal budget is transparent
and the method used robust so that people have confidence that the personal
budget allocation is correct and therefore sufficient to meet their care and support
needs.
4. The personal budget is the mechanism that, in conjunction with the care and
support plan, or support plan, enables the person (and their advocate if they have
one) to exercise greater choice and take control over how their care and support
needs are met.
5. What does exercising greater choice and achieving more control mean?
 Knowing, before care and support planning begins, roughly how much money
is available to meet needs and having clear information about the proportion
the local authority will pay, and what amount (if any) they will pay
 Being able to choose from a range of options for how the money is managed,
e.g. taking a direct payment, or the local authority managing the budget
 Having a choice over who is involved in preparing the care and support plan
for how the personal budget will be spent, including from family or friends
1
C Glendinning et al (2008) Evaluation of the Individual Budgets Pilot Programme Audit Commission
(2010) Financial Management of Personal Budgets. Audit Commission (2011) Improving Value for
Money in Adult Social Care. Ipsos Mori (2011) Users of Social Care Budgets.
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
Having greater choice and control over the way the personal budget is used to
purchase care and support, and from whom.
Key learning point
The allocation of a clear upfront indicative (or ‘ball-park’) allocation at the start of the
planning process will help people to develop the plan and make appropriate choices
over how their needs are met.
Example: Making it Real – how it feels when I am in Control
 “I know the amount of money available to me for care and support needs, and I
can determine how this is used (whether it’s my own money, direct payment, or
a council managed personal budget)”
 “I can get access to the money quickly without having to go through overcomplicated procedures”
 “I am able to get skilled advice to plan my care and support, and also be given
help to understand costs and make best use of the money involved where I want
and need this”
Facilitator’s hints and tips
One of the key issues that it might be worth discussing here is the need to raise
awareness of personal budgets. At a basic level there is a need to provide clear
information in different forms, but this in itself is not enough. Along with local
authority staff, primary care and hospital staff involved in discharge, care agencies
and voluntary and community sector organisations have a key role in signposting
people to further information and advice about personal budgets.
 It might be useful to facilitate a discussion about the degree to which this
currently happens.
For minority groups there is a need for a more proactive approach which works
through trusted networks and groups to explain personal budgets and the scope
they provide for setting up support which is in tune with people’s cultural needs.
 You could ask participants to discuss the degree to which this currently
happens.
 You could get participants to think about how they could do this better for
specific minority groups (e.g. Muslim women with mental health problems).
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Slide 4
Notes
1. The piloting of personal budgets was first proposed in the Prime Minister’s
Strategy Unit report ‘Improving the Life Chances of Disabled People’ in 20052
and repeated in the Adult Social Care Green Paper in the same year.
2. Individual budgets were piloted by 13 local authorities in England between 2005
and 2007, the original model intending to combine the various funding streams
people with care and support needs draw upon in their lives into one pot,
including social care but also a range of other funding. The evaluation of the
individual budget pilots concluded that they were cost-effective in relation to
social care outcomes and were welcomed by budget holders because they
offered greater opportunities for choice and control.
3. Personal budgets, including those with only social care funding, were
subsequently rolled out from 2007 and have had the support of successive
governments from all sides of the political spectrum.
4. Personal health budgets were announced by the Minister of State for Care
Services Norman Lamb on 30 November 2012. This follows the three year pilot
programme in the NHS, which ended in October 2012, and the publication of an
independent evaluation report, led by the University of Kent3.
5. Personal health budgets are initially available for people who are eligible for NHS
Continuing Healthcare, who have had a 'right to ask' for a personal health budget
since April 2014 and this became a 'right to have' a budget from October 2014.
Clinicians can also offer personal health budgets to others that they feel may
benefit from the additional flexibility and control. The NHS Mandate commits to a
further roll out of personal health budgets to people who could benefit from April
2015.
2
3
PMSU (2005) Improving the Life Chances of Disabled People
Personal Health Budget Evaluation
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6. The Care Act confirms personal budgets in law for people with eligible assessed
needs and carers, including the right to direct payments.
Key learning point
The Care Act confirms personal budgets in law for people with eligible assessed
needs and carers, including the right to direct payments.
Slide 5
Notes
1. At the end of March 2014, 648,000 people or 62% of all those eligible for
community based services, were accessing care and support through a personal
budget across England; this represents a continued increase year-on-year, from
29.2% in 2010-11, to 43% in 2011-12, to 56.2% in 2012-13.
2. Of these numbers, 23.6% of people have their personal budget managed through
a direct payment. Other personal budgets are either managed accounts where
the council continues to arrange services for the person, or Individual Service
Funds.
3. Experiences vary from poor to excellent, area to area and in take up between
different groups of people, with more than 80% of people with a learning disability
having personal budgets as opposed to less than 30% of people with a mental
health problem. This is despite evidence that suggests people with mental health
problems can be amongst the groups most likely to benefit.
4. The Personal Budgets Outcomes and Evaluation Tool (POET)4 Survey for
personal budget holders and for carers of personal budget holders have been
developed over several years as a way for people to report their experiences of
personal budgets.
4
http://www.thinklocalactpersonal.org.uk/_library/POETSummaryFINAL.pdf
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5. The latest survey in 2012-13 was undertaken with 22 volunteer councils across
England. The POET survey tool gathers views and experiences from personal
budget holders and their family carers. The tool is designed to measure how well
the council is managing to implement personal budgets and to what effect.
Specific questions investigate people’s experience of the personal budget
process and the impact of the personal budget on their everyday life.
6. The tool aims to provide councils with a way of examining the outcomes and
experiences of people using personal budgets and use the learning to review and
improve local delivery of PBs.
7. In total, 2,022 personal budget holders completed the 2013 POET survey (with
20 councils having more than 50 respondents). As well as responding to the main
survey questions, 488 of these personal budget holders also wrote comments
about their experience of personal budgets.
8. In total, 1,386 carers completed the POET survey (with 15 councils having more
than 50 respondents); 490 of these carers also wrote comments about the impact
of personal budgets on their own lives.
9. Personal budget holders and carers varied in how long they or the person
supported had held a PB, whether they received social care support before their
personal budget, how their PB was managed, what support people used in
planning their PB and whether the views of PB holders and carers were reflected
in the support plan.
10. Over 70 per cent of people who hold a PB reported a positive impact on being
independent, getting the support they need and want and being supported with
dignity.
11. Over 60 per cent reported a positive impact on physical health, mental wellbeing
and control over their support.
12. A further 50 per cent reported a positive impact on feeling safe in and outside
their home, and in their relationships with paid supporters. The survey found only
small numbers of people reporting any negative impact.
13. There were some areas where holding a PB had made little or no difference for
example getting and keeping a paid job (working-age adults) or volunteering;
and over 50 per cent of personal budget holders reported that their budget made
no difference in: choosing where to live/who to live with, relationships with family
and relationships with friends.
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Facilitator’s hints and tips
It might be useful to get participants to complete a mini self–assessment exercise or
the full care and support planning self-assessment tool. Please read each of the
statements and tick those statements that apply to you, your team or your
organisation.
Personal budgets and self-funding
Can the people who use your service:
decide the kind of support they need and when, where and how
to receive it
know the amount of money available to them for their care and
support needs
determine how this is used (whether it is their own money, direct
payment, or a council managed personal budget)
get access to the money quickly without having to go through
over-complicated procedures
get skilled advice to plan their care and support, and also be
given help to understand costs and make best use of the money
involved, where they want and need this.
Can you:
describe the elements of a personal budget
explain how a personal budget is calculated within your
organisation
describe the system your local authority currently uses to
calculate personal budgets
explain any charges that the local authority imposes for putting in
place arrangements to meet a person's eligible needs but whose
financial resources are above the financial limit
list any elements of care and support that are excluded from the
personal budget
identify the organisations within your local area who are able to
provide support for people to help manage their personal budgets
describe the process in place within your local authority for
agreeing and signing off a personal budget allocation/plans
list the main ways that personal budgets are allocated to the
individual
explain the arrangements that your organisation has in place for
people to hold an individual service fund (ISF) or an account
managed by a third party
describe any situations where the use of pooled budgets would
be beneficial
Tick
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Slide 6
Notes
1. This diagram illustrates the main elements of the care and support planning
process.
2. If the local authority has a duty to meet a person’s needs (because it is required
to or decides to meet needs) it must help the person decide how their needs are
to be met, through the preparation of a care and support plan for those with
ongoing needs or support plan for carers. The plan must describe what needs
the person has, and which needs the local authority is to meet.
3. Everybody whose needs are met by the local authority will have a personal
budget as part of the care and support plan/support plan that identifies the cost
of their care and support and the amount that the local authority will make
available.
4. An indicative amount should be agreed with the person at the start of care and
support planning, with the final amount of the personal budget confirmed through
this process.
5. At all times the wishes of the person must be considered and respected.
6. The person can choose for the personal budget allocation to remain with the local
authority to arrange care and support on their behalf, and in line with their wishes,
or be placed with a third-party provider on the same basis, often called an
individual service fund (ISF). Note that where an ISF type arrangement is not
available locally, the local authority should explore arrangements to develop this
offer and be receptive to requests from personal budget recipients to create these
arrangements with specified providers.
7. When someone has a personal budget they can take some or all of the budget as
a direct payment, i.e. people can choose how much control they wish to take
over the arrangement of their care or support. Note there is a learning module on
direct payments for more detail on this.
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8. The local authority is under an ongoing duty to keep the person’s plan and
personal budget under review, to ensure that their needs continue to be met;
they will review the plan periodically, involving the person and agreeing any
necessary changes.
Key learning point
Everybody whose needs are met by the local authority will have a personal budget
as part of the care and support plan/support plan that identifies the cost of their care
and support and the amount that the local authority will make available.
Facilitator’s hints and tips
Personalisation is primarily an ethos requiring profound cultural change and
different ways of thinking and working. Much of the early story of personalisation
revolved around designing the Resource Allocation System. Getting the process
right is important but shifting the culture of care should be the primary goal and this
requires changes in attitude and thinking.
If you have not already done so you might want to ask participants to complete the
self-assessment in the person-centred care and support planning workbook.
You might want to use the following table to discuss culture change:
Drivers
What are the
policy,
economic and
good practice
drivers for
personal
budgets?
Current
practice
Describe
current
practice in
your
organisation
Barriers
What are the
barriers
preventing
current
practice from
delivering the
vision?
Potential
solutions
What might
some of the
potential
solutions
be?
Vision
What outcomes
do people who
need support
and their families
and carers want
(see the Making
it Real ‘I
statements’)?
You could complete this table in discussion with the participants, and if you do, we
suggest that you start with the ‘drivers’ followed by the ‘vision’, then complete
‘current practice’ followed by ‘barriers’ and finally ‘potential solutions’.
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7.
Elements of the personal budget
Slide 7
Notes
1. The personal budget must always be an amount sufficient to meet the person's
care and support needs and must include the cost to the local authority of
meeting the person’s needs which the local authority is under a duty to meet, or
has exercised its power to do so.
2. It is vital that the process used to establish the personal budget is transparent
and the method used robust, so that people have confidence that the personal
budget allocation is correct and therefore sufficient to meet their care and support
needs.
3. The personal budget may be an integrated one which sets out other amounts of
public money that the person is receiving, such as money provided through a
personal health budget or benefits.
4. Integrated health and care, and integration of other aspects of public support are
the long-term vision of the Government. This will provide the individual with a
seamless experience, and can help to remove unnecessary bureaucracy and
duplication that may exist where a person’s needs are met through money from
multiple funding streams.
5. Local authorities should take a lead in driving the integration of support services
for their population, e.g. this may involve agreeing with partner organisations, a
lead organisation that agrees to oversee monitoring and assurance of all budgets
the person is receiving, while still allowing each body to fulfil their statutory
obligations.
Key learning point
The personal budget may be an integrated one which sets out other amounts of
public money that the person is receiving, for example personal health budgets.
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Example
Akram has severe learning disabilities and has a history of self-harm. He previously
lived in a long-stay in-patient unit. He now receives an integrated personal budget
allowing him to live in his own flat supported at times of his choice by people he has
chosen. Akram is now a part of his community and his incidents of self-harm have
reduced in frequency and intensity.
Questions
 What other public monies might a person be eligible for?
 To what degree does the local authority currently provide integrated personal
budgets?
 What are the barriers?
 What are the opportunities?
Facilitators hints and tips
The PB myth-buster tool is taken from NHS England (2013) Integrating Personal
budgets – myths and misconceptions (online). It is a helpful tool in discussing the
challenges to developing integrated personal budgets. As a facilitator it is
imperative that you have read the report and some of the resources referenced in it,
as this will give you the necessary information to successfully facilitate the
discussion.
Key learning point
The local authority should take the lead in agreeing with partner organisations a
lead organisation that agrees to oversee monitoring and assurance of all budgets
the person is receiving, while still allowing each body to fulfill their statutory
obligations.
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Questions
 Thinking of your answers to the previous questions what things might need to
be done differently, to achieve integrated personal budgets, by:
 Your local authority?
 You?
Slide 8
Notes
1. The brokerage fee that a local authority may charge when putting in place the
necessary arrangements to meet eligible needs of a person whose financial
resources are above the financial limit, but who has requested the local authority
meet their needs, is not part of the personal budget, since it does not relate
directly to meeting needs, but it may be presented alongside the budget to help
the person understand the total charges to be paid.
2. An additional payment or a “top-up” a person makes in order to be able to secure
the care and support of their choice (where this costs more than the local
authority would normally pay for such a type of care) does not form part of the
personal budget.
3. The Care and Support (Personal Budget Exclusion of Costs) Regulations 2014
set out that the provision of intermediate care and reablement to meet eligible
needs, must be excluded from the personal budget. This will mean that where
either intermediate care or reablement is being provided to meet eligible needs
(i.e. needs under section 18, 19 or 20 of the Care Act) the cost of this must not
be calculated in the personal budget.
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4. Reablement is one of four categories (crisis response, home-based intermediate
care, bed-based intermediate care and reablement) identified by the National
Audit of Intermediate Care; historically the other three have been provided by
health staff.
5. Because there is a tendency for the terms “reablement”, “rehabilitation” and
“intermediate care” to be used interchangeably, the Guidance clarifies the
differences. “Intermediate care” is a structured programme of care provided for a
limited period of time, to assist a person to maintain or regain the ability to live
independently at home. “Reablement” is a particular type of intermediate care,
which has a stronger focus on helping the person to regain skills and capabilities
to reduce their needs, in particular through the use of therapy and training. It is
defined as services to help people live independently, provided in the person’s
own home, by a team of mainly social care professionals.
6. In cases where intermediate care/reablement is provided to meet needs, either in
isolation or combined with longer-term care and support, the plan should describe
what the package consists of and how long it will last.
Key learning point
Where either intermediate care or reablement is being provided to meet eligible
needs the cost must not be included in the personal budget.
Facilitator’s hints and tips
One of the key issues to explore here is the interface between reablement and the
take-up of personal budgets. Much of the difficulty is a result of organisations trying
to bolt together an existing reablement process with a new personal budget
process. Good practice suggests that there may be a need to rethink the customer
pathway based on the principle that reablement is not a particular service but a
journey that everyone should be supported through.
For further information see the report by Helen Anderson Associates. There is a
useful graphic on page 10 that might be a useful tool to structure the discussion on.
Questions
 Thinking about the key learning point above; does this have any implications
for your local authority?
 Does your local authority currently use the PB to show ‘other’ amounts such
as top-ups?
 What are the implications for your local authority, and also service users?
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8.
Calculating the personal budget
Slide 9
Notes
1. Good practice in personal budgets demands that the agreed budget is sufficient
to enable the individual to achieve active citizenship. It is vital that the method
used to calculate the personal budget is robust so that people have confidence
that the personal budget allocation is correct and therefore sufficient to meet their
assessed eligible unmet needs.
2. There are many variations of systems used to arrive at personal budget amounts,
ranging from complex algorithmic-based resource allocation systems (RAS), to
more ‘ready-reckoner’ or non-points based approaches.
3. Regardless of the approach used, the following specific elements are key.
 A mechanism for understanding needs and/or outcomes (often through a
supported self-assessment questionnaire – but not always).
 A mechanism for scoring/weighting these needs and/or outcomes (often
through a scoring framework, or ready reckoner).
 A mechanism for translating these scoring/weightings into an indicative
upfront resource allocation (often through a financial framework).
 A mechanism for arriving at a final resource allocation (or personal budget).
4. Complex RAS models of allocation may not work for all client groups, especially
where people have multiple complex needs, or where needs are comparatively
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costly to meet, such as for deaf-blind people. It is important that these factors are
taken into account, and that a ‘one size fits all’ approach to resource allocation is
not taken.
5. Regardless of the process used, the most important principles in setting the PB
are:
 Transparency: Authorities should make their allocation processes publicly
available as part of their general information offer, or provide this on a
bespoke basis for each person the authority is supporting in a format
accessible to them. This will ensure that people fully understand how the
personal budget has been calculated, both in any indicative amount given and
the final personal budget allocation. Where a complex RAS process is used,
local authorities should pay particular consideration to how they will meet this
transparency principle, to ensure people are clear how the personal budget
was derived
 Timeliness: It is crucial when calculating the personal budget to arrive at an
upfront allocation which can be used to inform the start of the care and
support planning process. This ‘indicative allocation’ will enable the person to
plan how their needs are met. After refinement during the planning process,
this indicative amount is then adjusted to be the amount that is sufficient to
meet the needs which the local authority is required to meet under section 18
or 20(1), or decides to meet under section 19(1) or (2) or 20(6). This adjusted
amount then forms the personal budget recorded in the care plan
 Sufficiency: The amount that the local authority calculates the personal
budget to be must be sufficient to meet the person’s needs which the local
authority is required to meet under section 18 or 20(1), or decides to meet
under section 19(1) or (2) or 20(6) and must also take into account the
reasonable preferences to meet needs as detailed in the care and support
plan, or support plan.
6. These principles should ensure that the person, their carer, and their independent
advocate if they have one:
 are fully aware of how their budget was calculated
 know the amount at a stage which enables them to plan their care and
support accordingly
 can have confidence that the amount includes all relevant costs that will be
sufficient to meet their identified needs in the way set out in the plan.
7. This should prevent disputes from arising, but it must also be possible for the
person, carer or advocate to challenge the local authority on the sufficiency of the
final amount.
Page 22
8. The Care Act emphasizes the need for carer blind assessment which
predetermines the need for carer neutral allocation systems.
Example
The assessment is carried out initially assuming no informal carer support. Carer
support is then factored in and the monetary allocation adjusted to take account of
the support the carer is willing and able to provide. The points allocated for need
are never amended regardless of carer support. This system means that if a
Personal Budget holder’s circumstances change and the carer is incapacitated or
unable to provide care for a period, then the council can adjust the Personal Budget
without the need for further assessment.
Key learning point
Regardless of the process used, the most important principles in setting the
personal budget are: Transparency; Timeliness; Sufficiency.
Facilitator’s hints and tips
To ensure that a personal budget is sufficient it is important to accurately cost a
support plan. There are two critical issues that need attention when trying to
develop accurately costed support plans.
 Information: really good and easily accessible accurate information about the
availability of support in someone's locality, and its cost – which enables
people to make informed choices and prioritise alternative support
arrangements – with help to do this if required.
 Culture: It is vital to have a process of agreeing and signing off support plans
that makes it absolutely explicit how much an aggregated support plan will
cost. This is probably less about technology and spreadsheets and more
about a culture of support planning that knows the importance of including
cost information - and that without it no decisions can be made.
It will be important to keep in mind the two key issues above when discussing the
questions below. The focus is often on the technicalities of budget setting when
actually there is once again a need for cultural change. In trying to tease out
current practice and the attitudes that sit behind it you might find it useful to have
some worked examples of costed support plans that use different approaches, e.g.
complex RAS system versus a ready reckoner approach.
Page 23
Questions
 What systems does your local authority currently use to calculate personal
budgets? Is it a ‘one size fits all’ approach?
 How transparent, timely and sufficient are the current systems?
 What issues may you need to consider going forward?
Slide 10
Notes
1. The Act sets out that the PB must be an amount that reflects the cost to the local
authority. In establishing the ‘cost to the local authority’, consideration should be
given to the cost of the service at an appropriate quality, through local provision
to ensure that the personal budget reflects local market conditions.
2. There may be concern that the ‘cost to the local authority’ results in the direct
payment being a lesser amount than is required to purchase care and support on
the local market due to local authority bulk purchasing and block contract
arrangements. For example: a local authority has a block contact with a care
agency whose charge per hour to the local authority is £12.50 per hour. The
charge for an individual purchasing the same care is £17.50 per hour. By basing
the personal budget on the price of quality local provision, i.e. the £17.50 per
hour, this concern should be allayed.
Page 24
Example
Andrew has chosen to meet his needs by receiving care and support from a PA.
The local authority has a block contract with an agency which has been providing
support to Andrew twice per week. Andrew would now like more flexibility in the times
at which he receives support in order to better meet his needs by allowing him to
undertake other activities and consider employment. He therefore requests a direct
payment so that he can make his own arrangements with another agency, which is
happy to arrange a much more flexible and personalised service, providing Andrew
with the same carer on each occasion, and at a time that works best for him. The cost
to the local authority of the block contracted services is £12.50 per hour. However,
the more flexible support costs £17 per hour (inclusive of other employment costs).
The local authority therefore increases Andrew’s direct payment from £62.50 to £85
per week to allow him to continue to receive the care he requires. The solution
through a direct payment delivers better outcomes for Andrew and therefore the
additional cost is reasonable and seen as value for money as it may delay future
needs developing. The local authority also agrees it is more efficient for them to
allow Andrew to arrange and commission the hours he wants to receive support
and handle the invoicing himself.
3. However, a request for needs to be met via a direct payment does not mean that
there is no limit on the amount attributed to the personal budget and there may
be cases where it is more appropriate to meet needs via directly provided care
and support, for example:
 Where there is no local market for a particular kind of care and support that
the person wishes to use the direct payment for, except for services provided
by the local authority.
 Where the costs of an alternate provider arranged via a direct payment would
be substantially more than the local authority would be able to arrange the
same support for, whilst achieving the same outcomes for the individual.
4. In cases such as these, the care plan should be reviewed to ensure that it is
accurate and that the personal budget allocation is correct. The authority should
work with the person, their carer and independent advocate to agree on how best
to meet their care and support needs. It may be that the person can take a
mixture of direct payment and local authority arranged care and support, or the
local authority can work with the person to discuss alternate uses for the personal
budget.
5. The focus on wellbeing in the Care Act requires personal budget allocation
systems to focus on funding outcomes. Currently there is insufficient
consideration given to:
 Harnessing community capital and resources
Page 25


Use of assistive technologies
Sharing resources across services by placing them directly in the community
Example
An example of a tool that can help people think more innovatively by summarising
what the areas of difficulty are and the levels of support needed is the 247 Grid.
Below is an example of a 247 Grid. James is a 28 year old man with Autism. He
currently lives at home with his Mum and Dad. James’s aspirations are to live in his
own flat and this is something that his parents would like as they know James will
not be able to live with them forever. Two of the skills James needs to develop to be
able to live in his own flat are shopping and cooking. James and his circle of
support have used the 247 grid to map out his week, including the support he
needs. James receives a small personal budget and he pools this together with a
friend who also needs support around shopping. Pooling their budget means that
they have enough left over to support them to do a social activity together on a
Saturday. James has managed to access a cookery course at his local college and
his Mum helps him to practice his cookery skills twice a week.
9-11
11-12
12-2
Mon
Fri
Housework &
Cooking
Gym
Volunteering
Plan
shopping
FE Course
6-8
8-10
Pub
Qui
Lunch
Thurs
Getting up and Breakfast
Weds
4-6
Gardening &
Cooking
FE Course
Tues
2-4
Gym
Volunteering
Weekly
shopping
Swim
Out with friend
Church
Visit brother
Evening Meal
7-9
Astronomy
club
Sat
Sun
Support Code:
Blue = Independent
Purple = Family support
Green = Community
Orange = Personal Assistant support (pooled with friend)
Page 26
Case study
Florence Brown is 75 years old and lives alone in a house that she used to share
with her husband (who died six months ago) and her two daughters.
She suffers from COPD5, is frail and has restricted mobility. She has been admitted
to hospital several times for short-periods because of respiratory infections. She
used to smoke heavily but gave up when she was first diagnosed five years ago.
She receives practical and emotional support from one of her daughters (Mary) who
lives nearby, who is divorced with no children. She also has supportive neighbours.
The other daughter (Jane) is willing to do what she can, but lives 100 miles away
with her husband and three young children and works full-time.
Assessment summary
Florence has two eligible needs:
 Maintaining a habitable home environment – Florence is unable, without
assistance, to keep her home sufficiently clean to make it safe for her given
her respiratory condition.
 Maintaining and managing nutrition – Florence is able to consume food and
drink, and do some food preparation with assistance, but she would be
unable to access it without assistance.
The first need is an unmet need. Even after pulmonary rehabilitation Florence is
unable to meet this outcome. The second need is currently being met by Mary who
prepares her Mum’s evening meal every night and takes her shopping.
Florence has one ineligible need:
 Accessing necessary facilities or services in the local community – Florence
is unable to meet this outcome without assistance but accessing the
community is not something Florence is bothered about and hence it does
not have a significant impact on her wellbeing.
Mary also has eligible needs:
 Engaging in work, training, education or volunteering – it appears that Mary’s
caring responsibilities are preventing her from training to be a teacher.
 Engaging in recreational activities – it appears that Mary’s caring
responsibilities are preventing her from engaging in recreational activities
Florence and Mary agree a combined care and support plan.
The assessor (Joe) explains that the next step is for a personal budget to be
determined that can pay for all of the services needed except for those provided
5
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases
including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD
have difficulties breathing.
Page 27
directly by Mary. Joe explains that budget will be based on what it would cost the
Council to provide these services, and that to begin with Florence will pay the full
cost as she has savings that are above the upper capital limit, but as paying for
care and support will mean that her savings will drop below the limit in the near
future the charge will move from full-cost to means-tested.
Mary has read what it says on the Council web site and is concerned about how the
sum allowed is calculated. She also worries what would happen if she were taken
ill – would her Mum have to go through the whole process again to access support?
Questions
1. What could you do to reassure Florence and Mary and give them the confidence
that their personal budget is sufficient?
2. What could you do to safeguard against the need to repeat the whole process
should Mary be taken ill?
Suggested answers
1. The key issue here is ensuring that the allocation process is transparent and
that the information is clearly communicated to Florence and Mary. All too often
allocation processes are complex and the information about how the budget is
calculated is not clearly presented to budget holders.
2. The Care Act emphasises the need for carer blind assessment which
predetermines the need for carer neutral allocation systems. This means that if
a carer is incapacitated then the council can adjust the Personal Budget without
the need for further assessment.
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9.
Agreeing the final budget
Slide 11
Notes
1. The personal budget should be finalised at the end of the care and support
planning process – to ensure that there is scope for it to increase (should the
budget prove insufficient during support planning) or decrease (should the budget
prove to be more than is required, for example, where unpaid support such as
agreed carers support or universal services have been identified as appropriate
to meet some needs during the support planning process).
2. Some local authorities are devolving responsibility for finalising budgets
anticipated to come out at a fairly low level to frontline staff and/or social work
team managers so as to avoid unnecessary delays and minimise the use of
panels.
3. Generally, the agreement of the final budget and support plan should not involve
scrutiny of specific elements of the plan on the basis of their cost alone.
Consideration should be given to the cost of meeting needs as part of a wider
evaluation of other aspects, such as value for money and anticipated outcomes.
4. Due regard should be taken to the use of approval panels in both the timeliness
and bureaucracy of the planning and signing-off process. In some cases, panels
may be an appropriate governance mechanism to sign-off large or unique
personal budget allocations and/or plans. Where used, panels should be
appropriately skilled and trained, and local authorities should refrain from creating
or using panels that seek to amend planning decisions, micro-manage the
planning process or are in place purely for financial reasons.
Key learning point
Some local authorities are devolving responsibility for finalising budgets anticipated
to come out at a fairly low level to frontline staff and/or social work team managers
so as to avoid unnecessary delays and minimise the use of panels.
Page 29
Example
This is one example of how a local authority has addressed the issue. Care
managers can agree Personal Budgets with support plans costing up to £200 per
week and team managers can approve Personal Budgets up to £400 per week.
Personal Budgets with higher cost support plans have to go to team meetings or an
authority-wide practice development meeting for approval.
Questions
 Thinking about the key learning point above, is this an approach your local
authority has taken yet?
 If no, what might be some of the implications of implementing such an
approach?
 If yes, what issues, if any, have arisen as a result?
 How might these issues be addressed?
10. Use of a personal budget
Slide 12
Notes
1. The person should have the maximum possible range of options for managing
the personal budget, including how it is spent and how it is used. Directing spend
is as important for those choosing the council-managed option or individual
service fund as for direct payments. Evidence from the POET survey suggests
Page 30
that people using council-managed personal budgets are currently not achieving
the same level of outcomes as those using direct payments, and in too many
cases do not even know they have been allocated a personal budget or, if they
do, do not know the amount that has been allocated.
2. The survey also noted the importance of ensuring that help is available to the
person to plan their budgets. Over 80 per cent of respondents reported having
help, older people were less likely to get help, and people with council-managed
budgets or direct payments looked after by someone else were most likely to get
help to plan their budgets. Getting support to plan was associated with better
outcomes for people from all social care groups except people with mental health
issues.
3. For all social care groups, councils making the personal budget process easier
was robustly associated with better outcomes for personal budget holders, and
similarly for carers. These findings suggest that:
 Councils need to get aspects of the process close to the principles of selfdirected support
 They need to personalise their processes as well as the support people get at
the end of the planning process, as different people have different
preferences and needs and these should be reflected in the ‘customer
journey’ for each person – for example, the type and level of assistance in
planning support, the mechanism for managing the budget, e.g. DP, ISF, etc.
 The process needs to be streamlined, timely and clear, with only those
limitations on flexibility that are really necessary.
4. Local authorities should take care not to inadvertently limit options and choices,
e.g. “pre-paid cards” must not be used to constrain choice or be only available
for use with a restricted list of providers.
5. There are three main ways in which a personal budget can be deployed:
 managed account held by the local authority with support provided in line
with the persons wishes
 managed account held by a third party (often called an individual service
fund or ISF) with support provided in line with the person’s wishes. Where
ISF approaches to personal budget management are available locally, the
local authority should provide people with information and advice on how
the ISF arrangement works, how the provider(s) will manage the budget
on behalf of the person, and advice on what to do if a dispute arises
 direct payment.
6. In addition a person may choose a ‘mixed package’ that includes elements of
some or all three of the approaches above
Page 31
Facilitator’s hints and tips
It is important to ensure that people can make informed decisions about which
deployment option would be best for them and the support they would need to
make that option work. Below are some suggested exercises you could use to help
explore the issues.
 Give some scenarios and get people to break down assumptions about
which deployment option may ‘suit’ that particular person.
 Get participants to think through what information they give out and the
opportunities they provide for people to discuss different deployment options.
 Discuss (particularly in relation to older people) whether there is currently a
flexible interface between reablement and personal budgets.
 Discuss how easy it is within their current practice for personal budget
holders to move between deployment options.
7. Local authorities must ensure that whatever way the personal budget is used,
the decision is recorded in the plan and the person is given as much flexibility as
is reasonably practicable in how their needs are met. The mixed package
approach can be a useful option for people who are moving to direct payments
for the first time. This allows a phased introduction of the direct payment, giving
the person time to adapt to the direct payment arrangements.
8. Local authorities should give consideration to how choice could be increased by
pooling budgets together, for example people living in the same household such
as an adult and carer, or people within a community with similar care and support
needs or aspirations.
Facilitator’s hints and tips
ISFs should be an important part of any local strategy to increase the uptake of
personal budgets. Providers can lead the way in individualising support
arrangements and extending choice and control. There are incremental steps that
providers and local authorities in partnership can take, for example:
 Partial disaggregation
 Micro-commissioning
 Full disaggregation
Depending on the experience of your participants it might be useful to discuss
approaches to ISFs. The report Choice and Control for All by Groundswell
Partnership is a useful resource that could help you structure this discussion.
Page 32
Key learning point
The person should have the maximum possible range of options for managing the
personal budget, including how it is spent and how it is used. Directing spend is as
important for those choosing the council-managed option or individual service fund
as for direct payments.
Questions
 What evidence do you systematically collect on the outcomes people are
achieving (for example, use of the POET tool)?
 Does the evidence you collect allow you to compare the outcomes for
different groups?
 What further data on outcomes and use of personal budgets might it be useful
to collect?
Facilitator’s hints and tips
An added issue here is that even in local authorities where personal budgets have
been well established, the supply of services is not keeping up with changing needs
and preferences. Local authorities, in their role of market facilitation, need to take a
more active role in encouraging the development of provider services.
Depending on the level of experience and key learning needs of your participants, it
might be useful to have a discussion about market facilitation. For further resources
to help frame this discussion see the report What is Market Facilitation by IPC.
Page 33
11. Use of a carer’s personal budget
Slide 13
Notes
1. The assessment of the carer’s desired outcomes must include their wishes
and/or aspirations concerning paid employment, education, training or recreation
if the provision of support can contribute to the achievement of those outcomes.
The carer is entitled to have their eligible unmet needs met in the same way as
the service user. The manner in which the personal budget will be used to meet
the carer’s needs should be finalised as part of the planning process.
2. Examples of “replacement care”:
 To enable them to attend their own health appointments
 To go shopping and pursue other recreational activities
 It might be that regular replacement care overnight is needed so that the carer
can catch up on their own sleep
 In other circumstances, longer periods of replacement care may be needed,
for example to enable carers to have a longer break from caring
responsibilities or to balance caring with education or paid employment.
Example
Making it Real – What do carers want?
 “I want space to be someone other than a carer”
 “I want time to pursue my own hobbies and interests”
 “I want access to flexible support in the evenings and at weekends”
 “I want someone I can call on in an emergency any time day or night”
 “I want a sensible approach to managing risks that don’t stop me and my family
having a life”
3. Local authorities must have regard to the wellbeing principle of the Act as it may
be the case that the carer needs a break from caring responsibilities to look after
their own physical/mental health and emotional wellbeing, social and economic
wellbeing and to spend time with other members of the family and personal
relationships. Examples of wellbeing:
Page 34







a course of relaxation classes
training on stress management
gym or leisure centre membership
adult learning
development of new work skills or refreshing existing skills (so they might be
able to stay in paid employment alongside caring or take up return to paid
work)
pursuit of hobbies such as the purchase of a garden shed
purchase of a laptop so they can stay in touch with family and friends.
Example
Divya has four young children and provides care for her father who is nearing the
end of his life. Her father receives a direct payment, which he uses to pay for a
family member for a period of time to give his daughter a break from her caring role.
Divya received a carer’s direct payment, which she uses for her children to attend
summer play schemes so that she get some free time to meet with friends and
socialise when the family member provides care for her father. This gives Divya
regular breaks from caring which are important to the family unit.
Questions
 Again, what information might it be useful to collect in relation to outcomes
achieved and use of personal budget?
 How do the provisions in the Act affect the way you provide support to carers?
What needs to change?
Page 35
Slide 14
Notes
1. Decisions on for whom a particular service is to be provided may affect issues
such as whether the service is chargeable, and who is liable to pay any charges.
It is therefore important that it is clear to all individuals involved whose needs are
intended to be met by a particular type of support, to whom the support will be
provided directly, and therefore who may pay any charges due.
2. Decisions on which services are provided to meet carer’s needs, and which are
provided to meet the needs of the adult for whom they care, will therefore impact
on which individual’s personal budget includes the costs of meeting those needs.
3. Local authorities should consider how to align personal budgets where they are
meeting the needs of both the carer and the adult needing care concurrently.
4. Local authorities should consider joint plans and joint personal budgets.
5. Despite the Act allowing carers to be charged, local authorities should be very
cautious of this so as not to disrupt the caring relationship and therefore shift
costs to the authority in the longer term. Evidence on the cost implications of
supporting carers can be found in pages 48-52 of the Impact Assessment.
Key learning point
Local authorities should consider how to align personal budgets where they are
meeting the needs of both the carer and the adult needing care concurrently.
Page 36
Questions
 Thinking about the key learning point above, what might be some of the
difficulties with doing this?
 How might you overcome them?
Slide 15
Notes
1. In situations such as these, the carer could request a direct payment, and use
that to commission their own replacement care from an agency, rather than using
an arranged service from the local authority or a third party. The local authority
should take steps to ensure that the wishes of the adult requiring care are taken
into account during these decisions. For example, the adult requiring care may
not want to receive replacement care in this manner.
2. If such a type of replacement care is charged for (and it may not be), then it
would be the adult needing care that would pay, not the carer, because they are
the direct recipient of the service. This is in part why it is so important that the
adult needing care is involved in the decision-making and agrees to receiving that
type of care. The decisions taken by the carer and adult requiring care should be
agreed and recorded in the support plan.
3. If a dispute arises and the person refuses to pay the charge, the local authority
must, as far as it is feasible, identify some other way of supporting the carer.
Page 37
Example
David has been caring for his wife, Elaine, who has dementia, for the last 2 years.
He does all the cooking, driving and general household duties for her. David
receives a personal budget which he receives in the form of a direct payment.
David wants to use his direct payment to pay for membership at the golf club. He
had planned on finding a ‘sitter’ to look after Elaine so that he could play golf. The
problem is that Elaine does not want anyone she doesn’t know coming into the
house and so she will not agree to the support plan.
Question
 Thinking about the example above; what could you do to support David and
Elaine to find a solution and agree on a joint support plan?
Question
 What safeguarding issues may you need to consider?
Page 38
12. Appeals/disputes
Slide 16
Notes
1. The local authority should take all reasonable steps to limit appeals or disputes
regarding the personal budget allocation.
2. Reducing appeals and disputes will include thorough effective care and support
planning, and transparency in the personal budget allocation process.
3. Additionally, many disputes may be avoided by informing people of the
timescales that are likely to be involved in different stages of the process.
Keeping people informed how their case is progressing may help limit the number
of disputes.
4. As at July 2014, complaints provision for care and support is set out in Local
Authority Social Services and NHS Complaints Regulations 2009. The Act will
introduce new rights to appeal certain decisions in 2016 (consultation on this due
end 2014).
Page 39
13. Summary
Slide 17
Facilitator’s hints and tips
What is important here is to get people to think outside their own role and that of
their organisation. Links need to be made across organisations for example the
personalisation agenda creates opportunities for the Voluntary and Community
sector to be at the forefront of driving radical change in how care is designed and a
key role in supporting people to access personalised support. Think Local Act
Personal (TLAP)’s work suggests that there are benefits in taking a strategic
approach combining a range of linked activities such as:
 Building mutual support and self-help
 Facilitating connections between individuals and resources
 Enabling inclusion in community activities
 Strengthening community ownership
 Reshaping services
You may wish to use the list above and the information in the resource that is
referenced to help structure the conversation in response to the questions below.
Questions
 What has struck you most about this session?
 Thinking about what you have learnt about personal budgets (and on any
other modules you have completed so far).
 What links can you make between topic areas?
 How might the necessary changes impact on your current arrangements?
 What might the key challenges be?
Page 40
Exercise
 What are your top three priorities in relation to personal budgets?
 Complete the action plan to identify the next steps for each priority
Page 41
Appendices
Links to key resources
Audit Commission (2010) Financial management of personal budgets. This report
examines personal budgets in adult social care and considers the financial
management and governance implications for councils. It reviews the approaches to
transition from providing services to providing personal budgets, the choices for
allocating money, and how councils can plan for the financial implications. It is aimed
at finance staff and staff in adult social care departments interested in personal
budgets.
Healthcare Financial Management Association (HFMA) (2012) Practical Guide Direct Payments for Healthcare. This is a practical guide produced by members of
the HFMA’s Commissioning Finance Group working closely with the Department of
Health’s personal health budget pilot sites. The guide provides an overview of the
approach and focuses on the practical issues involved in the financial management
of direct payments for healthcare.
Carers Trust (2012) Progressing personalisation – A review of personal budgets and
direct payments for carers. This review explores implementation of personalisation
for carers, focusing specifically on personal budgets and direct payments in relation
to support provided to carers. It reviews evidence on current implementation and
identifies areas for further policy and practice development in view of proposed
changes to the law in the draft Care and Support Bill.
Department of Health (2008) Managing the money – resource deployment options
for personal budgets. The term ‘resource deployment’ is used within this paper to
describe the ways in which an individual or their appointed representative can decide
how to manage their financial allocation within a personal budget .The paper reflects
the experiences and illustrates the examples of resource deployment drawn from the
current system of community care, in particular direct payments, the work of In
Control and the work of the thirteen individual budgets pilots.
Department of Health (2010) Practical approaches to safeguarding and
Personalisation. This briefing paper sets out how personalisation of support and
more effective safeguarding can be mutually supportive. It shows how self-directed
support can help to prevent or reduce the risk of harm and abuse.
Local Government Association and Association of Directors of Adult Social Services
(2014) Making Safeguarding Personal 2013/14: Selection of tools used by
participating councils. A very useful collection of practical ways to actively involve
adults in their own assessment, planning and control.
Page 42
Local Government Association Knowledge Hub: Adult Safeguarding Community of
Practice Group. Interactive site where those working in adult safeguarding can post
helpful documents and exchange information to improve practice. You need to
register to access this site.
In Control (2005) The seven steps to being in control of my support. This guide in a
poster format outlines the seven steps to being in control which includes: my money,
making my plan, getting my plan agreed, organising my money, organising my
support, living life, and seeing how it worked.
Association of Directors of Adult Social Services (ADASS) (2010) Putting People
First: Making resource allocation work in a financial environment. Good practice for
personalised financial resource allocation.
Social Care Institute for Excellence (SCIE) (2010) Enabling risk, ensuring safety:
Self-directed support and personal budgets. This shortened report contains an
outline of some of the most recent research and emerging documented practice on
risk enablement and frontline practice in the context of self-directed support and
personal budgets.
SCIE (2011) Keeping personal budgets personal: learning from the experiences of
older people, people with mental health problems and their carers. This report is a
summary of people’s experiences of using self-directed support and personal
budgets. The national evaluation of the Department of Health individual budgets
pilots concluded that while individual budgets could enhance people’s sense of
control and satisfaction with services, there was substantial variation in the benefits
and experiences of older people and people with mental health problems. The aim of
the research was to identify good practice in the area.
NHS England (2012) Personal health budgets guide: Integrating personal budgets –
early learning. This guide is one of two focusing on the integration of personal
budgets across health and social care. Improving the experience and quality of care
for people and supporting them to achieve better health and social care outcomes
are the most important aspects of integration. This early learning guide focuses on
the customer journey for integrated personal budgets. It draws out the central
messages from the pilot programme and describes the six stages of the journey, with
pointers to support successful local delivery.
NHS England (2012) Personal health budget guide: Integrating personal budgets –
myths and misconceptions. This guide is the second of two intended for local use by
those delivering personal health budgets and personal budgets in social care, as a
concise guide to current learning about integrating personal budgets, and as a
prompt for local policy and practice development. It touches on issues relating to the
wider challenge of integrating health and social care systems and services only as
necessary context for its primary focus – integrating personal budgets. The guide
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sets out the most common real and perceived barriers to personal budget integration
as a series of myths. For each myth, a response explains the issue where
necessary, refutes the myth where possible/appropriate, and presents a practical
way forward.
NHS England (2012) Personal health budgets – ways in which money can be held
and managed. This good practice guide is for people working in the NHS who are
implementing personal health budgets. It describes the different ways a person can
receive a personal health budget and manage their money, details the different
options available and provides examples of how these can work in practice.
Groundswell (2012) Choice and control for all. This report looks at the role of
individual service funds in delivering fully personalised care and support.
Think Local Act Personal (2013) Improving personal budgets for older people. This
report was requested by ADASS in order to explore challenges, identify positive
practice and make recommendations for central and local government action on
improving personal budgets for older people.
Think Local Act Personal (2013) 2nd National personal budgets survey. This is a
summary of the Personal Budgets Outcomes and Evaluation Tool (POET) survey
which was run with 22 volunteer councils in England in 2012-13. It follows on from
the first POET survey published in 2011. The POET surveys for personal budget
holders and for carers of personal budget holders have been developed over several
years as a way for people to report their experiences of personal budgets. The report
contains main findings and next steps.
Think Local Act Personal (2013) Making it Real for Carers. Includes a guide to help
assess what is working and what needs to work better. This can also be used as a
checklist to inform an organisation’s business planning processes and frameworks.
Think Local Act Personal (2012) Making it real – marking progress towards
personalised, community based support. This is a framework, led and developed by
a partnership with members of the National Co-production Advisory Group, made up
of people who use services and carers. It draws attention to a new phase in which
we use a citizen-focussed agenda to change the kind of information that the sector
values, and the way in which we judge success.
National Development Team for inclusion (NDTi) (2012) Paths to personalisation in
mental health. This guide has been produced to help all those involved understand
how things will need to be done differently to make personalisation a reality for
people with mental health needs. This is a whole system guide, so hopefully it will
give some information, guidance and signposts for people, whoever and wherever
they are. The guide provides information about what personalisation means for
mental health services and supports, offers examples of what needs to be in place to
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make things work, and provides pointers to good practice and sources of advice and
information.
Think Local Act Personal (2011) Personal Budgets: Taking Stock, Moving Forward.
This paper provides an overview of the latest evidence – giving the clearest picture
yet of how the sector is progressing with the delivery of personal budgets. There has
been some important progress made, with encouraging evidence showing improved
outcomes for people. However, research also suggests action is needed in a number
of key areas. As an immediate first step, this paper points to where to go for further
information to help address some of the challenges that have been identified and
lists a number of useful documents for further reading.
Think Local Act Personal (2013) Self-Directed Support: Reducing process,
increasing choice and control. Self-Directed Support is a tool which disabled people
can use to support their inclusion as a valued member of our society, with roles and
responsibilities to help with functioning of their community. Self-Directed Support is
part of the journey to reach Independent Living.
Handouts
Handouts, exercises and case studies relevant to this topic area:

Handout: Sufficiency of the personal budget

Exercise: Personal Budgets Myth Buster Tool

Case study: Florence and Mary (person-centred care and support
planning)