Personal Budgets and Paid Work

NDTi has just published research looking at the extent to which personal social care budgets are being used to help people gain and retain work – and the answer is hardly at all. Despite the study getting very broad coverage of recognised employment support providers across England, we only found 104 people using PBs to gain or retain work in 2012/13, and 131 people in 2013/14. Two thirds of employment support agencies had no one using a personal budget. The average (median) number of people using personal budgets in the remaining third was 3.

So the research went on to ask - why? It identified four interconnected reasons:

1. We already know that society has conditioned many disabled people to expect not to have real work for real pay. If you add to that a lack of knowledge and understanding among people about personal budgets and in many cases a belief that personal budgets cannot be used to help gain work, then people are often not demanding work as an outcome when being ‘assessed’ by services.
2. Work is not being seen by many social workers and indeed some local authorities as a valid social care outcome. Some believe JobCentre plus is responsible for supporting people into work (and indeed it does have an important role). Others do not believe people with complex disabilities can achieve work. In some authorities, current financial cuts mean there is a perception that basic personal care and safeguarding the only things social services should be delivering. Work is a 'luxury'. Taken together, these are creating a lack of drive from social workers to identify work as an outcome.
3. Given points 1 and 2, assessments are not identifying work as an outcome, therefore no money is identified through the RAS process to help achieve paid work. Thus when support planning takes place there is no money to purchase employment support. Where work is considered as an outcome, the comparatively higher costs of employment support compared to basic personal care costs is deterring both local authorities and disabled people from providing adequate funding to get good employment support-despite the evidence that investment of this higher amount will achieve financial savings in the medium-term.
4. To the extent that funding from personal budgets could be used to help gain work, there was a paucity of evidence-based employment supports in the local area. When they did exist, key players were unaware of their availability.

Is it any wonder therefore the personal budgets are not being used to help people gain and retain work? Interestingly, where we did find significant usage, was almost entirely around families using them to support young disabled people into employment. In these cases, a substantial proportion were going outside traditional employment support services to find different ways of gaining support and work. Almost universally, families told of how they had to 'battle' the social care system to win the argument to have a personal budget for the purposes of finding employment for their son/daughter.

So, what is to be done? There are four very simple answers - but all four require a cultural shift.

1. Local authorities need to invest in information, advice and guidance to people and families that highlights how paid work is an achievable outcome and that personal budgets can be used for this.

2. Local authorities need to be clear to social workers that work is a valued social care outcome. (After all, it is explicitly included as a well-being outcome of the new Care Act.) Helping people to achieve paid work should be measured as a key PB indicator by all local authorities.

3. Person centred assessment systems should include a default starting position of exploring work as an option. There should be a recognition that higher than average investment in employment support is a valid PB expenditure, as it will pay back in the medium-term.

4. Commissioners, as part of their market development function, need to ensure a robust and evidence-based market of employment support provision is available. As part of this, some of the existing investment in block contracts should be converted into core funding with the direct support elements being converted into personal budgets.

Simples?

Finally, came across a strong view from some in employment support sector that personal budgets should not be used for employment support. Our research evidence does not support that view. The reasons why personal budgets were not being used were primarily a function of attitudes to work and the overall personal budget system, rather than employment services and support being intrinsically inappropriate for the personal budget system. Where local people had decided to try and make it work, people using personal budgets were overwhelmingly positive about it. To exclude employment support from the process that is being used to fund housing, leisure, community relationships and personal care, would seem extremely strange.

We know that work benefits disabled people, that disabled people working benefits society, and that it is cost-effective to services for people to be in work. If personal budgets are to be the future, then local authorities need to look long and hard about why people are not using them to gain and retain work at the moment.