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«The Use of Personal Budgets for Employment Support, NDTi, May 2014 National Development Team for Inclusion First Floor 30-32 Westgate Buildings Bath ...»

-- [ Page 1 ] --

The Use of Personal Budgets for

Employment Support

May 2014

Rich Watts, Naomi Harflett, Carol Robinson and Rob Greig

The Use of Personal Budgets for Employment Support, NDTi, May 2014

National Development Team

for Inclusion

First Floor

30-32 Westgate Buildings

Bath BA1 1EF

T: 01225 789135

F: 01225 338017

www.ndti.org.uk

Table of contents

List of figures

List of tables

Acknowledgments

PART 1: FINDINGS FROM THE RESEARCH

1. Background

1.1. The research questions

1.2. About this report

1.3. Limits of this research

2. Policy context

2.1. Employment rates for disabled people

2.2. National government policy and practice

2.3. Local government policy and practice

3. Methods

3.1. Phase One: Online survey

3.1.1. Survey response

3.2. Phase Two: Qualitative fieldwork

3.3. Phase Three: Use of Personal Budgets beyond employment support providers

3.4. Research ethics

4. The extent to which Personal Budgets are being used, by who and for what

The Use of Personal Budgets for Employment Support, NDTi, May 2014

4.1. The extent to which Personal Budgets are being used for employment support

4.1.1. Number of employment support providers receiving funding through Personal Budgets

4.1.2. Number of people using Personal Budgets to purchase employment support 17 4.1.3. Current and future demand for employment support via a Personal Budget 18

4.2. Income received by organisations through PBs

4.3. Where Personal Budgets are being used and by who

4.3.1. Type of employment support organisation

4.3.2. Size of employment support organisation

4.3.3. Who uses Personal Budgets for employment support

4.3.4. Employment support type purchased through Personal Budgets... 22 4.3.5. How support funded through PBs compares to support funded in other ways

5. Factors that prevent or encourage greater use of Personal Budgets for employment support

5.1. Demand from the individual and/or their family for employment........... 25

5.2. Professionals’ attitudes towards employment

5.3. The Personal Budget process

5.4. Availability of good, evidence-based employment support

PART 2: DISCUSSION and RECOMMENDATIONS FOR THE FUTURE.... 34

6. Discussion

7. Key recommendations

7.1. Encouraging demand for employment

7.1.1. Key recommendations for national organisations

7.1.2. Key recommendations for local authorities and providers.............. 36 7.1.3. Key recommendations for individuals

7.2. Professional engagement with employment

7.2.1. Key recommendations for national organisations

7.2.2. Key recommendations for local authorities and providers.............. 37 7.2.3. Key recommendations for individuals

7.3. Improving the Personal Budget process

The Use of Personal Budgets for Employment Support, NDTi, May 2014 7.3.1. Key recommendations for national organisations

7.3.2. Key recommendations for local authorities and providers.............. 38 7.3.3. Key recommendations for individuals

7.4. Ensuring good, evidence-based employment support is available....... 38 7.4.1. Key recommendations for national organisations

7.4.2. Key recommendations for local authorities and providers.............. 38 7.4.3. Key recommendations for individuals

Appendix 1: Survey on Personal Budgets for employment support....... 40 Appendix 2: Fieldwork topic guides

A2.1: The use of Personal Budget for employment support: Questions for family members

A2.2 Questions for social workers / care managers / brokers

A2.3 Questions for commissioners

A2.4 Questions for providers / support services

Appendix 3: Full set of recommendations

A3.1. Encouraging demand for employment

A3.1.1. Recommendations for national organisations

A3.1.2. Recommendations for local authorities and providers.................. 53 A3.1.3. Recommendations for individuals

A3.2. Professional engagement with employment

A3.2.1. Recommendations for national organisations

A3.2.2. Recommendations for local authorities and providers.................. 54 A3.2.3. Recommendations for individuals

A3.3. Improving the Personal Budget process

A3.3.1. Recommendations for national organisations

A3.3.2. Recommendations for local authorities and providers.................. 55 A3.3.3. Recommendations for individuals

A3.4. Ensuring good, evidence-based employment support is available..... 56 A3.4.1. Recommendations for national organisations

A3.4.2. Recommendations for local authorities and providers.................. 56 A3.4.3. Recommendations for individuals

The Use of Personal Budgets for Employment Support, NDTi, May 2014 List of figures Figure 1: Proportion of employment support providers who have received funding via PBs in the last 18 months

Figure 2: Type of employment support organisation receiving PB funding.... 21 Figure 3: Type of employment support purchased through PBs





Figure 4: Personal Budgets for employment support: what are the barriers? 24 Figure 5: Putting in place effective supported employment

List of tables Table 1: Number of people using PBs to purchase employment support...... 18 Table 2: Income received via PBs

Table 3: Size of employment support provider receiving PB funding............. 21 Acknowledgments We would like to thank everyone who took part in the survey and fieldwork as part of this research, especially people who shared their experiences of using their Personal Budget for employment support.

Thanks also to NDTi’s administration team who supported the organisation and delivery of this work.

Finally, our thanks go to the organisations that funded this research:

Remploy (https://www.remploy.co.uk/) In Control (http://www.in-control.org.uk/) Northamptonshire County Council (http://www.northamptonshire.gov.uk/) Think Local Act Personal (http://www.thinklocalactpersonal.org.uk/) Wolverhampton City Council (http://www.wolverhampton.gov.uk/) Whilst the funding organisations were kept up-to-date with the progress of the research, none were involved in the analysis or design of the research, in order to help ensure the independence of the research from any perception of influence from funding bodies.

The Use of Personal Budgets for Employment Support, NDTi, May 2014

PART 1: FINDINGS FROM THE RESEARCH

1. Background In March 2014 the National Development Team for Inclusion (NDTi) published research into employment support for disabled people, focusing particularly on people with learning disabilities or mental health conditions. The research covered Local Authority- and NHSfunded employment support in England.

As part of the research, information was sought about the use of adult social care Personal Budgets (PBs) to purchase employment support.

Two key findings emerged:

Only 28% of local authorities knew that people were using PBs to help them gain or retain paid work; 17% of authorities knew people weren’t using PBs and the remainder didn’t know or didn’t respond.

Of those who knew PBs were being used for employment support, 44% had no information about how people were actually using their budget and only one in eight (12%) said they knew how people’s PBs were being used for employment support.

A 2013 national survey of 2,022 PB holders found that 82% of people with learning disabilities, 86% of people with mental health problems and 88% of people with physical impairments said that their PB made no difference to getting or keeping a job. Together this evidence suggests a risk that the introduction of PBs in adult social care is not paying attention to, or giving priority to supporting people to gain or retain paid work.

If this is the case, despite paid work repeatedly being identified by disabled people as being a priority for them, as well as more generally a policy priority for national and local government, the move to PBs may result in a reduction, rather than increase, in people achieving the desired outcome of paid work.

Given the significant policy and delivery implications of this, NDTi has undertaken a short study to understand this issue further and, as a result, help to promote a debate about how PBs can be a way of supporting people to enter or remain in the world of paid work. Whilst this work has focused on the policy and delivery context in England, we believe that the findings will have relevance to other parts of the UK.

NDTi (2014), The Cost Effectiveness of Employment Support for People with Disabilities:

http://www.ndti.org.uk/major-projects/current/employment-support-for-disabled-people1/ Please note: throughout this report we use “Personal Budgets” to specifically mean Personal Budgets available through adult social care only Hatton, C., Waters, J. (2013), The Second POET survey of Personal Budgets holders and Carers 2013, London: Think Local Act Personal The Use of Personal Budgets for Employment Support, NDTi, May 2014

1.1. The research questions

The research explores two questions:

1. To what extent are people using PBs to purchase support into paid work?

2. What factors encourage and discourage the use of PBs to help people gain or retain a job?

As such, it aims to provide significant added benefit to the social care and employment field

by:

Providing, for the first time, robust evidence on the extent to which Personal Budgets are being used to gain access to paid work Providing evidence on the processes through which people are using Personal Budgets for this purpose and thus develop learning and advice on how to do this more successfully Influencing English national policy in relation to the use of Personal Budgets to help people gain and retain work.

1.2. About this report

This report draws together data and information from three key sources:

1. Data from commissioners obtained through NDTi’s original employment support study

2. Data collected through a specific provider survey regarding the use of adult social care Personal Budgets

3. Site visits and interviews with a sample of adult social care Personal Budget users, their families, the employment support providers, local commissioners and social care staff who have worked with personal budget holders.

First, we set the context within which employment support operates at both a national and a local level. Second, we describe how we went about this work and the methods adopted.

Third, we share findings about the extent to which adult social care PBs are being used for employment support, by whom and the type of support they are being used to purchase.

Fourth, we discuss what factors prevent or encourage the use of Personal Budgets for employment support. Finally, we make recommendations for the future based on what we have found.

1.3. Limits of this research We believe this is the first piece of research dedicated to the question of the use of adult social care Personal Budgets for employment support.

We have clearly detailed in Section 3 the methods used and samples achieved through this research. All data and conclusions presented should be interpreted within the context of these The Use of Personal Budgets for Employment Support, NDTi, May 2014 methods and sample size. We do not necessarily consider the results to be representative of the whole picture of the use of PBs for employment support. The findings and conclusions should be seen in the context of the small numbers of people and organisations that we were able to study and visit.

However, as that small number is a direct consequence of the limited use of Personal Budgets for employment support, we nonetheless think the results found present important, useful and reflective information to inform debate on the subject and to promote discussion on considering what should be done next on this topic.

Though this report focuses on Personal Budgets in adult social care, the advent of Personal Health Budgets suggests these findings and our recommendations should be of interest to the NHS as well as to colleagues in social care.

The Use of Personal Budgets for Employment Support, NDTi, May 2014

2. Policy context

2.1. Employment rates for disabled people Increasing the numbers of disabled people in paid work, including people who have a learning disability and/or mental health problem, has been a policy priority for successive Governments, most recently through the Disability and Health Employment Strategy (2013).

Disability Rights UK provides a detailed picture of the current employment picture facing disabled people in the UK, summarised below.

Progress has been made over the last 20 years in reducing the gap between the employment rate of disabled and non-disabled people. Recent statistics for England show that 48.9% of disabled people are in employment compared to 78.0% of non-disabled people - an employment gap of 29.1%. The employment gap in 2002 was 36.2%.

Beneath these average rates are significant variations. For example, people with physical or sensory impairments typically have employment rates of between 47%-57%. Only 6.9% of people with learning disabilities are in paid employment and 7.2% of people with mental health problems on the Care Programme Approach are in employment.

Disabled people’s age also affects their employment chances. The employment rate of disabled people aged over 50, which is 41.0%, has increased at a faster rate than for nondisabled people. Yet younger disabled people have seen their chances of employment decrease since 2001: their employment rate has reduced from 46.0% in 2001 to 36.0% in

2012. Disabled young people aged 16-17 and aged 18-24 are far more likely not to be in For example: Department of Health (2001), Valuing People: A New Strategy for Learning Disability for the 21st Century, Department of Health (2009), Valuing People Now: A New Three-Year Strategy for



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