Do direct payments improve outcomes for older people who receive social care? Differences in outcome between people aged 75+ who have a managed personal budget or a direct payment

John Woolham, Guy Daly, Tim Sparks, Katrina Anne Ritters, Nicole Steils

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Direct payments – cash for people eligible for adult social care and spent by them on care and support – are claimed to enable care to better reflect user preferences and goals which improve outcomes. This paper compares outcomes of older direct payment users and those receiving care via a managed personal budget (where the budget is spent on the recipients behalf by a third party). The study adopted a retrospective, comparative design using a postal questionnaire in three English councils with adult social care responsibilities in 2012–13. Included in the study were 1,341 budget users aged 75+, living in ordinary community settings. The overall response rate was 27.1 per cent (339 respondents). Three validated scales measured outcomes: EQ-5D-3L (health status), the Sheldon–Cohen Perceived Stress Scale and the Adult Social Care Outcomes Toolkit (social care-related quality of life). The study found that direct payment users appreciated the control conferred by budget ownership, but in practice, for many it did not ‘translate’ into improved living arrangements. It also found no statistically significant difference in outcomes between direct payment and managed personal budget users. The paper argues that despite policy and other guidance and research evidence about effective implementation of direct payments for older people, the absence of evidence for better outcomes may at least in part be attributable to values underpinning policies relating to personalisation and personal budgets.
Original languageEnglish
Pages (from-to)961-984
JournalAgeing and Society
Volume37
Issue number5
Early online date22 Jan 2016
DOIs
Publication statusPublished - May 2017

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Budgets
budget
Ownership
personalization
life situation
Health Status
Older People
health status
evidence
Quality of Life
quality of life
recipient
responsibility
questionnaire
Research
community
Values

Bibliographical note

The full text is currently unavailable on the repository

This article is currently in press. Full citation details will be uploaded when available.

Keywords

  • adult social care
  • older people
  • personal budgets
  • direct payments
  • outcomes

Cite this

Do direct payments improve outcomes for older people who receive social care? Differences in outcome between people aged 75+ who have a managed personal budget or a direct payment. / Woolham, John; Daly, Guy; Sparks, Tim; Ritters, Katrina Anne; Steils, Nicole.

In: Ageing and Society, Vol. 37, No. 5, 05.2017, p. 961-984.

Research output: Contribution to journalArticle

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