Support services for people who receive direct payments, allowing them to organise their own care, are only reaching a proportion of the people they are set up for. If they were to be used by all eligible direct payment recipients, they would struggle to cope.
This is one of the main findings of Schemes Providing Support to People Using Direct Payments the first UK-wide survey of the state of direct payment support, led by a team of academics in the Personal Social Services Research Unit (PSSRU) at LSE.
Direct payment support services, mainly funded by local authorities and often run by voluntary or not-for-profit organisations, are part of the government's plan to make personalised care the cornerstone of public services.
Yet the services have a limited capacity, high staff caseloads, and receive very variable amounts of funding - highlighting varying commitment to the scheme from local authorities.
Vanessa Davey, lead author of the report, said: 'Were support to be provided to the estimated 27,700 direct payment users in England without increasing the supply of support workers, their caseload would increase by more than 60 per cent.
'Since the time of the survey the government has announced plans to mainstream personal budgets potentially leading to a massive increase in the need for support services. Whether or not the current system could cope with a rise in users depends much on the capacity of individual schemes to respond and how local authorities work with the schemes to plan for this.'
The researchers also found that many local authorities focused on funding services that promote uptake and support users to set up payments and meet the basic statutory requirements instead of funding support for the ongoing management of a self-directed budget.
This is despite evidence showing the significance of ongoing support in ensuring access to and the success of direct payments for some users, and is probably a factor in the extent of variation in direct payments uptake.
Key findings include:
Around half of English support schemes employed only three workers or fewer
Staff caseloads were, on average, at the high end of the recommended maximum level. Staff in local schemes had higher caseloads that schemes run by large national voluntary organisations
Around 20 per cent of service users in England had to wait to receive services for an average period of just under five weeks
Direct payment support schemes income ranged from under £10,000 to nearly £1 million per year
Around three-quarters of total expenditure was due to staff costs
Direct payments support workers were earning on average £16,372 per year, a salary far lower than in comparative social care positions and likely to be of relevance to reported difficulties in recruiting staff
Variations in income related mainly to numbers of staff employed, rather than the number of users supported. Schemes run by large national voluntary organisations tended to receive greater income and consequentially have more staff than purely local support schemes
Vanessa Davey said the research also highlighted positive developments: 'The survey results also show that a notable proportion of local authorities did support and fund a wider interpretation of direct payments support. For example, indirect payment schemes (sometimes called third-party schemes), a potentially vital resource for some clients, were available in 42 per cent of support schemes in England.
'Moreover, support schemes clearly provide much more of a service than they are contracted to. Aside from providing intensive levels of support in the initial stages of setting up a direct payment, and various levels of continuing care, they provide regular reviews of users (as often as three per year), a fact that is likely to reduce the demands placed on local authority care managers.'
Vanessa Davey at firstname.lastname@example.org
Esther Avery, LSE Press Office on 020 7955 7960 or at email@example.com
The report, Schemes Providing Support to People Using Direct Payments: a UK survey, is published by PSSRU at LSE on behalf of a consortium of research teams funded by the Department of Health, the Economic and Social Research Council and the Department of Health's Modernisation of Adult Social Care Initiative.
The full report and the executive summary are available to download at www.pssru.ac.uk/dps.htm