Needy to get personal care budgets

Thousands of people who need social services support are to get personal budgets to decide the types of care they want - but that could spell the end of the road for some day services.

Bosses at Age Concern say they have concerns over whether the switch will really benefit elderly people or ultimately curtail choice if services cease to operate.

Norfolk County Council is switching from 'block-booking' traditional day services to giving people who need help a sum of money, following assessments, which they can spend on the support they need.

The personal budget scheme has been piloted for the past two years, but will now be rolled out to a further 4,000 people this year and 13,000 the following year, with all 35,000 service users offered the scheme by 2011.

While the switch has been hailed by many users, who say it gives them more freedom and increases their sense of self-worth, the way the county council funds voluntary organisations to provide services will be radically transformed.

And, if the service users decide they no longer want to pay for what those organisations have to offer and would prefer to spend their budget elsewhere, they could cease to exist because of the lack of cash.

County Hall officers and councillors said they wanted to retain a balance of options, but acknowledged some voluntary organisations, such as those which run luncheon clubs in day centres, could find themselves struggling to survive.

James Bullion, assistant director of community care in adult social services, said the changes were the county's attempt to meet the govern-ment's personalisation agenda and consultation had taken place with service users.

He said: 'For the individuals who want the personal budgets, it will give them freedom, but it is a delicate balance between giving enough money to voluntary groups to exist, but not all the money, so we can pass that money on to the people who need support.

'For bigger organisations, this is do-able, but for smaller organisations, if you take away grants and people do not choose to go to them, it puts them at some risk.

'We have taken the decision to continue funding some and offer transitional help for one or two years to others to keep them going.

'The challenge for them is that, in about half the cases who have already got personal budgets, people do not choose to go where they used to go, so they may have to change what they offer.'

He stressed the motivation for the change was not to save money, but said the pilot project had shown people did spend less when they were responsible for their own budget.

Phil Wells, chief officer of Age Concern Norwich, said: 'From a philosophical point of view, I am all in favour of it because it always has to be better to offer people more choice. The county council is trying to do it the right way. Some authorities have gone straight into it and it has just become deregulated.

'They are trying to do it slowly and carefully and I think that is brilliant. We have had lots of discussions about it and we are working with them as we go along.

'But I have got big concerns over how it will work for a lot of elderly people. Personal budgets can be great for those people who will get large amounts to pay for their care, but in the case of elderly people they might end up only getting about �20 a week, so I am sceptical that will give them a lot of choice.

'If they do use the money they get to employ personal assistants, then who is liable if they happen to fall over while doing that work? Is it the elderly person or is it the county council? I think this is quite untested.

'Another worry is that, from the elderly people involved in the pilot project who come to Marion Road Day Centre, the amount the personal budget comes to is less than the cost of the service they are now getting.

'That means we have to find more money to run the centre, so our worry isn't that people won't want to come, but that we would have to offer less of a service because of the lack of money.

'Choice is a brilliant thing but it has to be based on the day centres actually existing for people to go to.'

Jonathan Dunning, spokesman for union Unison at County Hall, said: 'The principle of giving people more power over their services is a good one, but the question is, is it going to work?

'The service users will become the employer - will that mean they are responsible for the minimum wage, or if somebody falls over at work?

'And what happens if they fall out with their personal assistant? Pres-umably they can't just sack them, and proper procedures will need to be followed. We have concerns over how all that will work.'

The county council is set to inform which providers and organisations will still receive funding within the next week or so.

David Cook, spokesman for Voluntary Norfolk, the umbrella organisation for the county's voluntary organisations, said: 'Voluntary Norfolk is continuing to consult with Adult Social Services on behalf of voluntary and community organisations across the county in order to emphasise their importance to the health and wellbeing of people in Norfolk, and we will continue to put the case for a robust and thriving third sector while these plans are being implemented.

'We understand that budgetary constraints mean some organisations are likely to see a reduction in funding and that some services may not be re-commissioned.

'Where that happens, Voluntary Norfolk will work with the affected organisations to try to minimise the negative impact of these changes. '

David Harwood, cabinet member for adult social services, said: 'The county council has looked very carefully into the services we provide and how we can meet the govern-ment's personalisation agenda.

'Personal budgets are already proving very popular with people who have taken them up, giving them the chance to think differently and choose day activities of their liking.

'Already, around half of these people are opting for more creative and individual activities, rather than traditional day services.

'Delivering more choice and better quality services means some changes are needed to update services and make them more sustainable.

'But at the same time, we recognise there is still a place for some traditional day services and our challenge is to provide a balance of both options, supporting providers through these changes as much as possible.'