Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T08:31:10.624Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessing the Role of Increasing Choice in English Social Care Services

Published online by Cambridge University Press:  21 January 2011

MARTIN STEVENS ,
CAROLINE GLENDINNING ,
SALLY JACOBS ,
NICOLA MORAN ,
DAVID CHALLIS ,
JILL MANTHORPE ,
JOSÉ-LUIS FERNANDEZ ,
KAREN JONES ,
MARTIN KNAPP  and
ANN NETTEN
...Show all authors
MARTIN STEVENS
Affiliation:
Social Care Workforce Research Unit, King's College London email: [email protected]
CAROLINE GLENDINNING
Affiliation:
Social Policy Research Unit, University of York
SALLY JACOBS
Affiliation:
Personal Social Services Research Unit, University of Manchester
NICOLA MORAN
Affiliation:
Social Policy Research Unit, University of York
DAVID CHALLIS
Affiliation:
Personal Social Services Research Unit, University of Manchester
JILL MANTHORPE
Affiliation:
Social Care Workforce Research Unit, King's College London email: [email protected]
JOSÉ-LUIS FERNANDEZ
Affiliation:
Personal Social Services Research Unit, London School of Economics
KAREN JONES
Affiliation:
Personal Social Services Research Unit, University of Kent
MARTIN KNAPP
Affiliation:
Personal Social Services Research Unit, London School of Economics
ANN NETTEN
Affiliation:
Personal Social Services Research Unit, University of Kent
MARK WILBERFORCE
Affiliation:
Personal Social Services Research Unit, University of Manchester
Get access Rights & Permissions [Opens in a new window]

Abstract

This article aims to explore the concept of choice in public service policy in England, illustrated through findings of the Individual Budgets (IB) evaluation. The evaluation tested the impact of IBs as a mechanism to increase choice of access to and commissioning of social care services around the individual through a randomised trial and explored the experiences and perspectives of key groups through a large set of interviews. The article presents a re-examination of these interview data, using three ‘antagonisms of choice’ proposed in the literature – choice and power relations, choice and equity, and choice and the public nature of decisions – as organising themes. The randomised trial found that IB holders perceived they had more control over their lives and appreciated the extra choice over use of services, albeit with variations by user group. However, problems of power relations, equity and the constraints implied by the public nature of decision-making were complicating and limiting factors in producing the benefits envisaged. The focus on choice in policy, especially as implemented by IBs, emphasises an individualistic approach. The findings suggest that addressing broader issues relating to power, equity and an understanding of the public nature of choice will be of value in realising more of the benefits of the policy.

Type
Articles
Information
Journal of Social Policy , Volume 40 , Issue 2 , April 2011 , pp. 257 - 274
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnes, C. (2007), ‘Disability activism and the struggle for change: disability, policy and politics in the UK’, Education, Citizenship and Social Justice, 2: 3, 203–21.CrossRefGoogle Scholar
Baxter, K., Glendinning, C. and Clarke, S. (2008), ‘Making informed choices in social care: the importance of accessible information’, Health and Social Care in the Community, 16: 2, 197–207.CrossRefGoogle ScholarPubMed
Beattie, A., Daker-White, G., Gillard, J. and Means, R. (2005), ‘“They don't quite fit the way we organise our services” – results from a UK field study of marginalised groups and dementia care’, Disability and Society, 20: 1, 67–80.CrossRefGoogle Scholar
Blair, T. (2003), ‘Progress and justice in the 21st century’, Fabian Society Annual Lecture, Fabian Society, 17 June.Google Scholar
Boyle, G. (2008), ‘Autonomy in long-term care: a need, a right or a luxury?’, Disability & Society, 23: 4, 299–310.CrossRefGoogle Scholar
Brodsky, J., Habib, J. and Mizrahi, I. (2001), Long Term Care Laws in Five Developed Countries: A Review, Jerusalem: JDC-Brookdale Institute of Gerontology and Human Development.Google Scholar
Burton, M. and Kagan, C. (2006), ‘Decoding valuing people’, Disability & Society, 21: 4, 299–313.CrossRefGoogle Scholar
Carey, M. (2008), ‘What difference does it make? Contrasting organization and converging outcomes regarding the privatization of state social work in England and Canada’, International Journal of Social Work, 51: 1, 83–94.CrossRefGoogle Scholar
Clarke, J., Smith, N. and Vidler, E. (2006), ‘The indeterminacy of choice: political, policy and organisational implications’, Social Policy and Society, 5: 3, 327–36.CrossRefGoogle Scholar
Clarke, J., Newman, J. and Westmarland, L. (2007), ‘The antagonisms of choice: New Labour and the reform of public services’, Social Policy and Society, 7: 2, 245–53.CrossRefGoogle Scholar
Department of Health (2003), Direct Payments Guidance: Community Care, Services for Carers and Children's Services (Direct Payments) Guidance England 2003, London: Department of Health.Google Scholar
Department of Health (2005), Independence, Well-being and Choice, London: Department of Health.Google Scholar
Department of Health (2006), Our Health, Our Care, Our Say: A New Direction for Community Services, London: Stationery Office.Google Scholar
Department of Health (2007), Putting People First: A Shared Vision and Commitment to the Transformation of Adult Social Care, London: Stationery Office.Google Scholar
DiCicco-Bloom, B. and Crabtree, B. F. (2006), ‘Qualitative interviews’, Medical Education, 40: 9, 314–21.CrossRefGoogle Scholar
Ellis, K. (2007), ‘Direct payments and social work practice: the significance of “street–level bureaucracy” in determining eligibility’, British Journal of Social Work, 37: 3, 405–22.CrossRefGoogle Scholar
Glasby, J. and Littlechild, R. (2006), ‘An overview of the implementation and development of direct payments’, in Leece, J. and Bornat, J. (eds.), Developments in Direct Payments, Bristol: The Policy Press.Google Scholar
Glendinning, C. (2008), ‘Increasing choice and control for older and disabled people: a critical review of new developments in England’, Social Policy and Administration, 42: 5, 451–69.CrossRefGoogle Scholar
Glendinning, C., Challis, D., Fernandez, J.-L., Jacobs, S., Jones, K., Knapp, M., Manthorpe, J., Moran, N., Netten, A., Stevens, M. and Wilberforce, M. (2008), Evaluation of the Individual Budgets Pilot Programme: Final Report, York: Social Policy Research Unit, University of York.Google Scholar
Hanlon, N., Rosenberg, M. and Clasby, R. (2007), ‘Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada’, Health and Social Care in the Community, 15: 4, 343–51.CrossRefGoogle Scholar
Knapp, M. (2007), ’Social care: choice, money, control’, in Hills, J., Le Grand, J. and Piachaud, D. (eds.), Making Social Policy Work: Essays in Honour of Howard Glennerster, Bristol: Policy Press.Google Scholar
Knapp, M., Hardy, B. and Forder, J. (2001), ‘Commissioning for quality: ten years of social care markets in England’, Journal of Social Policy, 30: 2, 283–306.CrossRefGoogle Scholar
Law Commission (2008), Adult Social Care: Scoping Report, London: The Law Commission.Google Scholar
Leece, D. and Leece, J. (2006), ‘Direct payments: creating a two-tiered system in social care?’, British Journal of Social Work, 36: 8, 1379–93.CrossRefGoogle Scholar
Lipsky, M. (1980), Street-Level Bureaucracy: Dilemmas of the Individual in Public Service, New York: Russell Sage Foundation.Google Scholar
Manthorpe, J. (2008), ‘Managing risk in social care in the United Kingdom’, Health, Risk and Society, 9: 3, 237–9.CrossRefGoogle Scholar
Manthorpe, J., Stevens, M., Rapaport, J., Jacobs, S., Challis, D., Wilberforce, M., Netten, A., Knapp, M. and Glendinning, C. (2010) ‘Individual budgets and adult safeguarding: parallel or converging tracks? Further findings from the evaluation of the individual budget pilots’, Journal of Social Work (published online September 2010), http://dx.doi.org/10.1177/1468017310379452CrossRefGoogle Scholar
Morris, J. (2006), ‘Independent living: the role of the disability movement in the development of government policy’, in Glendinning, C. and Kemp, P. A. (eds.), Cash and Care: Policy Challenges in the Welfare State, Bristol: Policy Press.Google Scholar
Oliver, M. (2004), ‘If I had a hammer: the social model in action’, in Swain, J., French, S., Barnes, C. and Thomas, C. (eds.), Disabling Barriers – Enabling Environments, London: Sage.Google Scholar
Prime Minister's Strategy Group (2005), Improving the Life Chances of Disabled People, London: Stationery Office.Google Scholar
Scourfield, P. (2007a), ‘Implementing the Community Care (Direct Payments) Act: will the supply of personal assistants meet the demand and at what price?’, Journal of Social Policy, 34: 3, 469–88.CrossRefGoogle Scholar
Scourfield, P. (2007b), ‘Social care and the modern citizen: client, consumer, service user, manager and entrepreneur’, British Journal of Social Work, 37: 1, 107–22.CrossRefGoogle Scholar
Stevens, M., Manthorpe, J., Martineau, S., Hussein, S., Rapaport, J. and Harris, J. (2008), ‘Making decisions about who should be barred from working with adults in vulnerable situations: the need for social work understanding’, British Journal of Social Work, Advance Access, doi:10.1093/bjsw/bcn135.Google Scholar
Ungerson, C. (2004), ‘Whose empowerment and independence? A cross-national perspective on “cash for care” schemes’, Ageing and Society, 24: 2, 189–212.CrossRefGoogle Scholar