Key messages:
Many older people see personal budgets as offering them more independence, as well as choice and control. The biggest concerns are managing the money and understanding what it can be spent on.
Personal budgets can be held in several ways. Personal budget holders need clear information about what is involved – including risk and safety and help with assessment and planning. Knowledgeable staff are particularly important.
Even with managed accounts and directly commissioned services, every effort should be made to maximise choice and control for the personal budget holder.
Older people need to have flexible support plans that can change if their circumstances change. Assumptions should not be made about what care and support older people need and want.
Practitioner continuity, relationship-based working, staff training, peer support and allocated time to work with personal budget holders are important for achieving good self-directed support. User-led and support provider organisations can help with support planning.
Carers play a central role in enabling many older people to take up and manage a personal budget. Resource allocation should be worked out on the basis of no carer input and adjusted depending on how much support the carer can provide.