Personal budgets effective but care market under-monitored, report finds

Personal budgets for social care improves people's lives but 'shortcomings' over user support and market oversight must be tackled before they are rolled out widely, an official review has found.

Most people using personal budgets to purchase social care reported better well-being and control over their lives, according to the National Audit Office report.

But monitoring of the market for social care services must improve to ensure the system  provides safe and good value care, it concluded.

England funds 340,000 personal budget holders with £1.5 billion of public money. One million people will be eligible for the scheme from April 2013 under government plans.

The DoH sets overall social care policy but local authorities provide the funding for personal budgets and oversee the market of service providers from which holders can choose their care.

The report, Oversight of User Choice and Provider Competition in Care Markets, found 72% of budget holders felt they were in control of their own support.

Personal budgets place the duty of identifying and buying care on the holder. But many found the process of purchasing care difficult: only 50-58% of users found it easy or very easy to get service information.

Although local authorities have made efficiency improvements by implementing them, the proportion of budget holders offered support by their local authority in planning their care varied widely, from 38% to 85%.

The oversight and monitoring of the social care provider market must improved if they are to provide effective care and good value for money when rolled out to all eligible users by 2013, it concluded.

Local authorities are responsible for people who self-fund if they run out of money, but 60% do not know how many ‘self-funders’ are in their area.

The report estimated that supporting self-funders who had run out of money may cost the taxpayer £1 billion per year by 2035.

More should be done to protect people if a provider faces financial trouble, it said.

'The recent financial problems faced by Southern Cross illustrate the need for government to develop a system to address serious provider failure,' it said.

Amyas Morse, head of the National Audit Office, said: ‘As the population ages and more pressure is put on social care, the department must ensure that its oversight of the care market is robust, that people have access to the information and support that they need and that it has arrangements in place in the event of large providers getting into financial difficulty.’

The NAO recommended that the DoH should identify where market monitoring is insufficient, and whether more central oversight is necessary.

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