Welfare consumerism, disability and social care

Researchers: Hilary Arksey, Peter Kemp, Sue Clarke

Funder: Department of Health Policy Research Programme

Duration: January 2006 – September 2006

Aims

This narrative review was undertaken to inform the subsequent development of the DH Programme on Choice and Independence across the Lifecourse, and particularly the longitudinal Panel Study on Choice and Change. The review aimed to:

• critically appraise existing research on choice for its relevance to disabled and chronically ill young people, adults, older people and carers; and to choices about social care and related personal support services that can contribute to experiences of independence
• identify gaps in empirical evidence
• develop theoretical and conceptual frameworks relating to choices about social care and related services on the part of disabled young people, adults, older people and carers:
  • the preconditions for choice
  • the consequences (benefits and ‘costs') of choice.
  These frameworks were to inform, and be further developed by, the empirical research within the DH programme.

Scope and methods

Literature on choice and consumerism relating to other public sector services such as education and housing, and to privately-purchased welfare services was included, along with publicly-funded adult social care. The literature was appraised to assess its transferability to publicly-funded social care services and to choice in the context of experiences of long-standing and/or complex disability and chronic illness.

Findings

The review identified the preconditions for choice – the arrangements and facilities that need to be in place so that users of ‘cash-for-care’ schemes are able to exercise effective choice over their support arrangements. It also identified a number of important methodological weaknesses in the evidence base on the outcomes of ‘cash-for-care’ schemes, particularly the lack of comparative studies; the predominance of self-selected samples of cash-for-care users; the predominance of small scale qualitative studies; and the lack of longitudinal evidence.

Publication

Show Abstract...

2008

Dimensions of Choice: A narrative review of cash-for-care schemes, 2008
Arksey, H. and Kemp, Peter A..

Professional press

Community Care, 9 July 2009. Proven Practice: Individual and personal budgets: The Social Care Institute for Excellence gauges research findings behind the development of personal and individual budgets.