Kirstein Rummery, David Bell, Alison Bowes, Alison Dawson, Elizabeth Roberts
University of Stirling
ISBN 978 1 78045 686 7 (Web only publication)
ISSN 2045 6964
DPPAS 12653
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CONTENTS
ACKNOWLEDGEMENTS
EXECUTIVE SUMMARY
1 INTRODUCTION AND BACKGROUND
Introduction to the study
The history and development of SDS
SDS in the Scottish context
The implications for this study
Structure of report
2 OVERVIEW OF STUDY
Aims and design of the study
Methods
The participating Local Authorities
Costings data
3 FINDINGS 1 - LOCAL AUTHORITY/SERVICE COMMISSIONER PERSPECTIVES
Introduction
Variation
History, structures and responsiveness
Quality and cost
Local Authorities as care commissioners
Summary
4 FINDINGS 2: PROVIDER AND ADVISOR PERSPECTIVES
Introduction
SDS: Empowerment or cost cutting?
Cost and quality
Variation, flexibility and costs
The role of care managers, carers and advocates
Summary
5 FINDINGS 3: SURVEY OF DP USERS
Introduction
Results and discussion
Users' perspectives
Summary
6 FINDINGS 4: COSTS AND MODELLING THE FUTURE
Introduction
Microsimulation
What did we learn from the DP user survey?
What did we learn from the Local Authority sample?
The effects of SDS on contract structure
Interviews with Local Authority informants
What can we learn from elsewhere about the effects of personal budgets on care providers?
What does the model tell us?
Summary
7 DISCUSSION AND ISSUES
Introduction
SDS in the policy and practice context
Issues for commissioners of services
Issues for service providers
Issues for SDS users and family carers
Future trends
Conclusions
8 REFERENCES
9 APPENDICES
APPENDIX 1: METHODOLOGY AND ANALYSIS
APPENDIX 2: SURVEY OF DP USERS
List of tables
Table 5.1 Respondents' weekly financial value of SDS (DPs)
Table 5.2 Respondents' weekly time value of SDS (DPs)
Table 5.3 Support services purchased with DPs
Table 5.4 Services and support purchased with money other than DP package
Table 5.5 Sources of funds other than DPs used for purchasing services or support
Table 5.6 Paying for activities associated with setting up and maintaining support received as part of a DP package
List of figures
Figure 1.1 Rate of sds (direct payment) per 10,000 population
Figure 1.2 number of people in receipt of sds (direct payments) by user group
Figure 6.1 Distribution of durations of direct payments from user survey
Figure 6.2 Distribution of Local Authority sample of users by user group
Figure 6.3 Distribution of Local Authority sample users by age group
Figure 6.4 Relationship between costs and volume for different types of care contract
Figure 6.5 Local Authority charges per hour for social care Scotland 2011
Figure 6.6 1% and 5% changes in take-up rates of SDS
Figure 6.7 Alternative cost drivers
The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.