Personal budget users 'denied genuine choice over care'

Some people using personal budgets for their care are not getting genuine choice or control and there are concerns that councils cannot fully personalise services while seeking to save money, MPs have said.

Since April 2015, the Care Act has required that all service users receive personal budgets, which are allocated to them by local authorities to be spent on meeting their care needs.

The cross-party Public Accounts Committee said that implemented well, personal budgets all people to try new ways of meeting their needs, increase choice and control over the care they receive and gives them the opportunity to achieve the outcomes they want.

However, its report states the Department of Health "does not believe that everyone counted by local authorities as having a personal budget does actually have genuine choice and control over the services they receive".

People who receive social care paid for by their local authority "are not yet getting the support they need consistently in order to get the most out of personalising their care".

MPs said the department is not doing enough to ensure the benefits of personal budgets are maximised and has not set out it will judge success.

The committee also shared the concerns of local authorities that funding cuts and wage pressures from the introduction of the National Living Wage "will make it hard to fulfil their Care Act obligations".

It warned that the social care market is "fragile" in many areas, warning of a "real threat" that many providers will not survive.

The report calls on the DoH to set out clearly to councils and providers "what high quality and proportionate support looks like", how much it costs and to recommend a range of analytical measures to safeguard the interests of both users and the social care market.

Committee chair Meg Hillier MP said: "The need for adult social care is increasing but in recent years the amount spent on such care by English local authorities has fallen in real terms. Against this backdrop, there are clearly risks in pursuing new approaches to providing care.

"Personal budgets have great potential but the interests of users are paramount and must be protected. It is vital people receiving care do so through the form of personal budget that best suits their circumstances. They should also be supported to make best use of it."

A Department of Health spokesperson said: "Through the Care Act, we have put personalisation at the heart of care to give people more choice, control and flexibility. Personalised care and its costs vary from person to person and local authorities are responsible for ensuring people get the right care.

"We are giving local authorities more money for social care - up to £3.5bn by 2019-20 - and working across Government to make sure care providers have strong contingency plans in the current challenging market."

Responding to the report, LGA community wellbeing spokeswoman Cllr Izzi Seccombe said: "Despite the financial pressures faced by local authorities, councils and their partners aspire to see that people's needs and wishes remain central to their care. Satisfaction with care and support remains high, and councils continue to learn from each other about how to deliver innovative and personalised services.

"But to really ensure that individuals receive the care they need and deserve, we need social care to be properly funded by government.

"The Government should, as a starting point, bring forward the £700m Better Care Fund money earmarked for the end of the decade to 2016-17 to help alleviate growing social care pressures."