Are personal budgets the only way?

As the deadline towards having a 100% uptake on Personal Budgets looms closer, it becomes apparent that personalisation can not help all care users. So is there a better way of giving more independence to those in residential care? The Guardian (www.guardian.co.uk) expored this issue in a recent article…
“Dee View Court, a Sue Ryder home for patients with neurological conditions in Aberdeen has undergone something of a democratic revolution, with residents making decisions about everything from which staff are recruited to how communal space is used. But it’s clear that when personal budgets were first conceived, they were seen as an individual consumer tool and a path to independence. This is perhaps demonstrated by the fact that direct payments (the cash form of personal budgets) are not yet available in care homes (a legal anomaly that the Law Commission has proposed to close as part of its single care statute).
So the big question for government now is how to square the circle – how to push forward the personalisation agenda, while recognising that some care populations, including those in collective care settings, palliative care and others – may not adapt easily to the primary method of achieving personalisation: the personal budget.
The answer seems self-evident. Personal budgets are life-changing, no doubt, but they are a fundamentally individualistic tool. They work best when an individual is co-ordinating a single package of care without the constraints of group living or sharing of services. Rather than trying to retro-fit personal budgets into collective care settings, therefore, we must embrace alternative paths to personalisation.
Co-design of services, democratic structures, imaginative use of collective spaces to encourage greater independence within care homes are all viable ways of turning care homes from sites of collective disempowerment and passive service use into “micro-communities”, which, very much like housing co-operatives, are run by a powerful residents’ association to ensure services are organised and meet the needs of the collective. Such settings could even be compatible with the pooling of personal budget funds. Of course, individuals may have to give way to the majority now and then – but this natural give and take of human society is a far cry from sacrificing one’s individual preferences due to management diktat and organisational routine.
Until the government shakes its fixation with personal budgets as the only and most effective method of achieving personalisation, however, these alternatives will remain fatally under-developed. And as personal budgets are rolled out, personalisation will increasingly become an exclusive right to be enjoyed by the few, rather than the many.”

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