This report presents the findings from a qualitative research study commissioned by the National Audit Office to examine the users’ experiences with personal budgets in adult social care.
Personal budgets only offer users genuine choice and control over their care when they receive the money for their care package directly to spend how they see fit, the research found.
Managed budgets, where the local authority or a third party manages the finances on users’ behalf, do not lead to real choice for users. The research showed users tend not to realise they could exercise choice and control over their care, often continuing as under the previous system without being aware they receive a personal budget.
Users of adult social care services are primarily interested in getting good quality care, rather than focusing on choice per se, but they do not necessarily know what they miss out on by not having choice and control over their care.
Personal budgets, and direct payments in particular, can enable those within the social care system to use their budget in innovative ways, but effective support planning and a well developed market of providers are instrumental in helping them get the most out of their personal budgets.
The research was conducted using a qualitative methodology, including 48 face-to-face depth interviews with people receiving personal budgets and/or their carer, and a further 6 telephone depth interviews with the professional lead on personal budgets in each of the local authorities involved.