Progress on personalised care is patchy, says new report

Many people who use social care services are not receiving care and support that fully meets their needs. Care services in many areas do not meet the vision for 'transformation' set out in the Department of Health's 'Putting People First' concordat.

'Personalisation' means putting people at the centre of the design and delivery of services, acting to respect their rights and choices, and providing support to enable people to live their lives the way they wish. A year on from the publication of 'Putting People First', and despite steady improvements, most people still experience a 'one-size-fits-all' model of care that is not geared towards people's individual needs.

Today's report states that too few people with complex needs are experiencing personalised care as a reality. While there are some excellent examples of people receiving the support they need, too many people are not benefiting from the full intention of the Government's policy on personalisation. For those people with complex needs, who depend on ongoing support and flexible services, they are unable in many parts of the country to get care that matches their specific needs.

Launching the report, CSCI Chair Dame Denise Platt said: "People who need social care should be seen as individuals, first and foremost. The support they receive should be tailor-made, allowing people to live their lives as they choose. If we get it right for people with complex needs, it is likely that we'll get it right for everyone.

"The Government's ambition to transform care services is to be commended. However, there is still a long way to go to turn policy into practice. Whilst some councils and care providers are doing truly excellent work, others have been reluctant, for whatever reason, to make personalised care a reality for the people they serve. Many people do not get the information, advice or support they need to help them make informed choices about their care.

"If CSCI were continuing our work, we would be watching closely to see whether the 'personalisation' agenda really does make a difference for people. I hope that our successor organisation will maintain this focus."

CSCI Chief Inspector Paul Snell said: "It is clear that with the right help and support, people want to make decisions about their own care and support, and prefer to be in control of their own destiny.

"However, if all councils are going to deliver truly personalised care, all of their staff will need to really understand and support this new way of working.

"A change of culture is needed in many councils, with stronger leadership on the real benefits and possibilities of personalised care, based on a commitment to promoting real equality and upholding human rights."

In summary, CSCI's report found:

• There has been steady improvement in the overall performance of councils and in regulated care services meeting national minimum standards.
• There have been some tentative steps to address the new personalisation agenda, which means that more people are able to control and choose their support through, for example, direct payments, individual budgets and good person-centred assistance.
• There are some outstanding examples of people's lives being radically improved where they have been able to direct their own support, including people with multiple and complex needs.
• However, councils are at an early stage in transforming social care and developments are patchy and vary between different groups of people. There are different understanding of - and commitment to - 'personalisation' by councils, partner agencies, people who use services and carers, as well as difficulties in extending pilot schemes.
• Regardless of whether they pay for their own care or are publicly funded, people are not always receiving the individualised help that they need to make decisions about their support, which in the long-term can be costly to individuals, family carers, councils and the NHS.
• People are not always getting quality personalised support, particularly those with multiple and complex needs, some of whom may have little, if any, choice about their care.
• Concerns remain about people who are 'lost to the system' because they are ineligible for publicly funded support or are 'self-funders'.
• In the current situation of resources pressures and increased demand, there continues to be tension between resourcing support for those people with highest levels of needs and investing in a raft of services, including universal, open access and rehabilitative services, which can maintain people's independence and improve their quality of live.

Report dated 27 January 2009 by CSCI (Commission for Social Care Inspection).