Title: Shaping Personalised Outcomes - how is the Care Act promoting the personalisation of care and support?
Funder: Department of Health and Social Care

Abstract: Background: Whilst local authorities have been tasked with personalising their care services since the Putting People First concordat of 2007,1 the Care Act 2014 sets out an approach to care services in which the principles of choice and control are paramount.2 Local authorities (LAs) are known to be at very different points in moving towards personalised care services.3,4 This project will enable a better understanding of how LAs are implementing the Care Act in relation to care planning and support that facilitates personalisation, choice and control. It will also learn from good practice and share that with the care sector. The project aims to assess LA progress in implementing care planning and support services that enable people to have personalised services, which deliver choice, control and good care outcomes. It will do this nationally and in eight case study local authorities, through: - Developing a theory of change logic model to understand the relationship between more personalised support and better care outcomes. - Identifying LA activities in relation to the provision of more personalised care and more individualised forms of funding - Mapping LA behaviour onto a typology of personalised approaches (using measures such as take-up of direct payments, market diversity) - Evaluating the experiences of people using services and their families and carers, including people who move to a new local authority - Measuring the relationship between the LA approach to personalising care, the cost of service provision and the individual outcomes achieved - Sharing learning about approaches to personalisation, choice and control in care services through peer support. Research Plan and Methods of Investigation: A national survey of local authorities, national and local stakeholder interviews and secondary data analysis will be used to understand how personalisation, choice and control are being delivered under the Care Act. Case study research will be undertaken in eight English local authorities, purposively sampled to have different profiles in their approach to personalising care services. The project will also undertake qualitative interviews with people who run and use care services, as well as carers, to assess the quality of information and care services, the sorts of choices people can and want to be able to make within their localities. The Research Team brings academic rigour and the ability to translate findings into practice for frontline services and to support positive change. The same team is currently undertaking closely-related research into market-shaping under the Care Act on behalf of the DH Policy Research Programme, ensuring close synergies between the projects. Needham, McKay and Brant worked on ESRC-funded research evaluating micro-enterprises in social care. Mangan was commissioned by the DH, LGA, TLAP and ADASS to develop Commissioning for Better Outcomes,5 to guide Care Act implementation. Brant is a service user co-applicant with experience of co-producing research. Goranitis is a Research Fellow in health economics at the University of Birmingham, specialising in the economic evaluation of health and social care interventions. McKay has extensive experience of undertaking large-scale quantitative analysis of secondary and primary data. Potential impact/influence on the relevant policy field, users, carers and wider stakeholders: This is a mixed methods study with the breadth and rigour to generate findings which national policy makers can use in developing effective approaches to personalisation and personal budgets, with clear benefits for users, carers and providers. The final six months of the project are implementation-focused, using a peer review methodology to share research around the eight sites and within regions, which should facilitate rapid take-up of findings. Our project advisory board, which includes key national stakeholders in the sector, will use their influence to encourage wider impact.

Lay abstract: The Care Act 2014 says that people with care needs should have clear information and advice to help them find support, and they should have access to a diverse, high quality range of support to choose from to meet their needs. In this project we will find out what works best when making care services more personalised, to help improve performance, quality and choice. The research will focus on people in England as this is where the Care Act applies. The project focuses on answering the following questions: How is the Care Act working in practice? Are people receiving personalised support which increases their choice and control and leads to better outcomes? Are people getting a personal budget (which gives more financial control over care choices to individuals and families) and are they using that money to get the support they want? What happens when people move to a new area: does their care and support continue? Do care services that are personalised to the individual cost more or less than services that are not personalised? To answer these questions we will look at national information on care and support services, and then focus in depth on what support and services are available in eight local authorities. We will look at existing information on people's experiences of care services, and also interview people who design, support, run and use care services to find out whether services are diverse, good quality, and easily accessible. We will also speak to family carers. Talking to users and carers is likely to be particularly effective when other service users and carers do the interviews, as they can often establish a rapport with interviewees. The project will include people with this lived experience of care services as co-researchers, involved in designing the research, doing the interviews, identifying key findings and telling people about the research findings. Standards of good practice in conducting ethical research will be followed. The research will keep to the University of Birmingham policies on the conduct of research and the Data Protection Act. Reports from the project will be publicly available.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE