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Older People, Personalisation and Self: an alternative to the consumerist paradigm in social care

Published online by Cambridge University Press:  27 February 2015

GARETH O'ROURKE
GARETH O'ROURKE*
Affiliation:
School for Policy Studies, University of Bristol, UK.
*
Address for correspondence: Gareth O'Rourke, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK E-mail: [email protected]
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Abstract

Personalisation of social care for adults is a key policy objective in the United Kingdom (UK), as in many other welfare states, having gained wide acceptance as essential for the empowerment of service users and as a means of managing increasing population demand. The system of personal budgets being established in the UK pursues twin objectives: aiming to ‘empower’ individuals to achieve ‘more for less’. However, there is mixed evidence that either objective is being achieved in practice. This is especially so in respect of older people who are less likely to accept a personal budget and more likely to be dissatisfied with their experience of using one. A qualitative study of eight cases in two local authority areas in England explored older people's experience of using a personal budget taken in the form of a direct payment. Data were elicited through a series of three in-depth interviews with each participant. The study was concerned with understanding the relationship between participants' experience of ‘Self’ and personalised services. Participants experienced personalisation when paid carers perceived and accommodated their ‘special requirements of Self’. In most cases this was achieved despite the consumerist aspects of personalisation rather than because of them, and often gave rise to risk and dilemma. The findings emphasise the importance of holistic assessment, and commissioning for quality over maximising choice.

Keywords

personalisationdirect paymentsconsumerismchoice
Type
Articles
Information
Ageing & Society , Volume 36 , Issue 5 , May 2016 , pp. 1008 - 1030
Copyright
Copyright © Cambridge University Press 2015 

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References

Arksey, A. and Kemp, P. 2008. Dimensions of Choice: A Narrative Review of Cash for Care Schemes. Social Policy Research Unit, University of York, York, UK.Google Scholar
Atchley, R. 1991. The Influence of Aging or Frailty on Perceptions and Expressions of the Self: Theoretical and Methodological Issues. In Birren, J, Lubben, J, Cichowlas Rowe, J, Deutchman, D. (Eds). 1991. The Concept and Measurement of Quality of Life in the Frail Elderly pp. 207–225. London. Academic Press.Google Scholar
Baier, A. 1994. Moral Prejudices: Essays on Ethics. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Bannister, D. and Fransella, F. 1980. Inquiring Man: The Psychology of Personal Constructs. Second edition, Penguin Books, London.Google Scholar
Barnes, C. 1998. The Social Model of Disability: A Sociological Phenomenon Ignored by Sociologists? In Shakespeare, T. (ed.), The Disability Reader: Social Science Perspectives: 65–78. Continuum, London.Google Scholar
Barnes, M. 2008. Is the personal no longer political? Soundings, 39, 152–9.CrossRefGoogle Scholar
Barnes, M. 2011. Abandoning care? A critical perspective on personalisation from an ethic of care. Ethics and Social Welfare, 5, 2, 153–67.CrossRefGoogle Scholar
Barnes, M. 2012. Care in Everyday Life: An Ethic of Care in Practice. The Policy Press, Bristol, UK.Google Scholar
Barnes, M. and Shardlow, P. 1996. Effective consumers and active citizens’ strategies for users’ influence on services and beyond. Research, Policy and Planning, 14, 1, 33–8.Google Scholar
Beresford, P. 2008. Whose personalisation? Soundings, 40, 8–17.Google Scholar
Briggs, C. 1986. Learning How to Ask: A Socio-linguistic Appraisal of the Role of the Interview in Social Science Research. Cambridge University Press, Cambridge.Google Scholar
Campbell, J. and Oliver, M. 1996. Disability Politics: Understanding Our Past, Changing Our Future. Routledge, London.Google Scholar
Carr, S. 2012. Personalisation: A Rough Guide. Social Care Institute for Excellence, London.Google Scholar
Clark, H., Gough, H. and McFarlane, A. 2004. It Pays Dividends: Older People and Direct Payments. The Policy Press (for Joseph Rowntree Foundation), Bristol, UK.Google Scholar
Clarke, J. 2005. New Labour's citizens: activated, empowered, responsibilized, abandoned? Critical Social Policy, 25, 4, 447–63.Google Scholar
Coleman, P., Ivani-Chalian, P. and Robinson, M. 1998. The story continues: persistence of life themes in old age. Ageing & Society, 18, 4, 389–419.Google Scholar
Cottam, H. 2009. Only the lonely: public service reform, the individual and the state. Soundings, 42, Available online at http://www.participle.net/images/uploads/Only_the_Lonely.pdf [Accessed 21 September 2013].CrossRefGoogle Scholar
Cutler, T., Waine, B and Brehony, K. 2007. A new epoch of individualization? Problems with the ‘personalization’ of public sector services. Public Administration, 85, 3, 847–55.CrossRefGoogle Scholar
Department of Health 2010. Personalisation Through Person Centred Planning. Department of Health, London.Google Scholar
Duffy, S. 2010. The citizenship theory of social justice: exploring the meaning of personalisation for social workers. Journal of Social Work Practice: Psychotherapeutic Approaches in Health, Welfare and the Community, 24, 3, 253–67.CrossRefGoogle Scholar
Etzioni, A. 2000. The Third Way to a Good Society. Demos, London.Google Scholar
Evans, J. 2003. The Independent Living Movement in the UK. Gladnet Collection, Cornell University ILR School. Available online at http://digitalcommons.ilr.cornell.edu/gladnetcollect [Accessed 1 September 2013].Google Scholar
Ferguson, I. 2007. Increasing user choice or privatizing risk? The antinomies of personalization. British Journal of Social Work, 37, 3, 387–403.CrossRefGoogle Scholar
Flick, U. 2009. An Introduction to Qualitative Research. Fourth edition, Sage, London.Google Scholar
Fransella, F. (ed.) 1977. Personal Construct Psychology. Academic Press, London.Google Scholar
Gilligan, C. 1982. In a Different Voice: Psychological Theory and Women's Development. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Glasby, J. and Littlechild, R. 2009. Direct Payments and Personal Budgets: Putting Personalisation into Practice. The Policy Press, Bristol, UK.Google Scholar
Glendinning, C., Challis, D., Fernandez, J., 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. Social Policy Research Unit, University of York, York, UK.Google Scholar
Greenwald, A. 1980. The totalitarian ego: fabrication and revision of personal history. American Psychologist, 35, 7, 603–18.Google Scholar
Hatton, C. and Waters, J. 2011. The National Personal Budget Survey June 2011. Think Local Act Personal. Available online at http://www.thinklocalactpersonal.org.uk/_library/Resources/Personalisation/Personalisation_advice/2011/POET_survey_summary_June_2011_-_EMBARGOED.pdf [Accessed 21 September 2013].Google Scholar
Hatton, C. and Waters, J. 2013. The Second POET Survey of Personal Budget Holders and their Carers. Think Local Act Personal. Available online at http://www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=9503 [Accessed 14 May 2014].Google Scholar
Held, V. 2006. The Ethics of Care. Personal, Political, Global. Oxford University Press, Oxford.Google Scholar
Henwood, M. and Hudson, B. 2007. Here to Stay? Self-directed Support: Aspiration and Implementation. A Review for the Department of Health. Melanie Henwood Associates, Towcester, UK. Available online at http://tuk.coopa.net/uploads/pdf/personalisation/useful%20documents/selfdirectedsupportaspirationandimplementation.pdf [Accessed 4 July 2014].Google Scholar
Houston, S. 2010. Beyond homo economicus: recognition, self-realization and social work. British Journal of Social Work, 40, 3, 841–57.Google Scholar
Hudson, B. and Henwood, M. 2008. Prevention, Personalisation and Prioritisation in Social Care: Squaring the Circle? Social Care Institute for Excellence, London. Available online at http://www.melaniehenwood.com/documents/CSCI_FACS_Squaring_the_Circle.pdf [Accessed 14 May 2014].Google Scholar
Kaufman, S. 1986. The Ageless Self: Sources of Meaning in Late Life. University of Wisconsin Press, Madison, Wisconsin.Google Scholar
Kelly, G. 1955. The Psychology of Personal Constructs. Volume 1, A Theory of Personality; Volume 2, Clinical Diagnosis and Psychotherapy. Norton, New York.Google Scholar
Kelly, G. 1977. Confusion and the clock. In Fransella, F. (ed.), Personal Construct Psychology. Academic Press, London, 209–32.Google Scholar
Keohane, N. 2009. People Power: How Can We Personalise Public Services? New Local Government Network, London.Google Scholar
Kittay, E. 1999. Loves Labour: Essays on Women, Equality and Dependency. Routledge, New York.Google Scholar
Kvale, S. 1996. Interviews: An Introduction to Qualitative Research Interviewing. Sage, Thousand Oaks, California.Google Scholar
Kvale, S. and Brinkmann, S. 2009. Interviews: Learning the Craft of Qualitative Research Interviewing. Second edition, Sage, London.Google Scholar
Land, H. and Himmelweit, S. 2010. Who Cares: Who Pays? A Report on Personalisation in Social Care Prepared for UNISON. UNISON, London.Google Scholar
Leadbeater, C. 2004. Personalisation Through Participation: A New Script for Public Services. Demos, London.Google Scholar
Lloyd, L. 2010. The individual in social care: the ethics of care and the ‘personalisation agenda’ in services for older people in England. Ethics and Social Welfare, 4, 2, 188–200.Google Scholar
Lloyd, L., Calnan, M., Cameron, A., Seymour, J. and Smith, R. 2014. Identity in the fourth age: perseverance, adaptation and maintaining dignity. Ageing & Society, 34, 1, 1–19.Google Scholar
Lymberry, M. 2010. A new vision for adult social care? Continuities and change in the care of older people. Critical Social Policy, 30, 5, 5–26.CrossRefGoogle Scholar
Lymberry, M. 2012. Social work and personalisation: fracturing the bureau–professional compact? British Journal of Social Work, 42, 4, 783–792.Google Scholar
McAdams, D. 1993. The Stories We Live By: Personal Myths and the Making of the Self. William Morrow, New York.Google Scholar
Means, R. 2012. A brave new world of personalized care? Historical perspectives on social care and older people in England. Social Policy and Administration, 46, 3, 302–20.Google Scholar
Morris, J. 1994. Community care or independent living? Critical Social Policy, 14, 24, 24–44.Google Scholar
National Council on Independent Living and in-Control [2007] 2009. Joint NCIL/in-Control statement: Our goal is independent living. Recreated in Glasby, J. and Littlechild, R. Direct Payments and Personal Budgets: Putting Personalisation into Practice. The Policy Press, Bristol, UK, 185–8.Google Scholar
Needham, C. 2011. Personalising Public Services: Understanding the Personalisation Narrative. The Policy Press, Bristol, UK.Google Scholar
Newman, J., Glendinning, C. and Hughes, M. 2008. Beyond modernisation? Social care and the transformation of welfare governance. Journal of Social Policy, 37, 4, 531–57.CrossRefGoogle Scholar
O'Rourke, G. 2014. Older people, personalisation and personhood: Towards user informed theory. (Doctoral dissertation). School for Policy Studies, University of Bristol, Bristol, UK.Google Scholar
Oliver, M. 1983. Social Work with Disabled People. Macmillan, Basingstoke, UK.CrossRefGoogle Scholar
Oliver, M. 1990 a. The Politics of Disablement. Macmillan, Basingstoke, UK.Google Scholar
Oliver, M. 1990b. The Individual and Social Models of Disability. Paper presented to the joint workshop of the Living Options Group and the Research Unit of the Royal College of Physicians, July. Available online at http://disability-studies.leeds.ac.uk/files/library/Oliver-in-soc-dis.pdf [Accessed 24 August 2013].Google Scholar
Oliver, M. and Zarb, G. 1989. The politics of disability: a new approach. Disability, Handicap and Society, 4, 3, 221–39.CrossRefGoogle Scholar
Orellana, K. 2010. Personalisation in Practice: Lessons from Experience. Age-UK, London.Google Scholar
Parasuraman, A., Berry, L. and Zeithaml, V. 1991. Understanding customer expectations of service. Sloan Management Review, 32, 3, 39–48.Google Scholar
Parker, S. and Heapy, J. 2006. The Journey to the Interface: How Public Service Design Can Connect Users to Reform. Demos, London.Google Scholar
Polkinghorne, D. 1991. Narrative and self concept. Journal of Narrative and Life History, 1, 2/3, 135–53.Google Scholar
Poll, C., Duffy, S., Hatton, C., Sanderson, H. and Routledge, M. 2006. A Report on in Control's First Phase 2003–2005. Control Publications, London.Google Scholar
Pollack, B. 2008. The nature of the service quality and satisfaction relationship: empirical evidence for the existence of satisfiers and dissatisfiers. Managing Service Quality, 18, 6, 537–58.Google Scholar
Powell, J. and Steel, R. 2012. Policy, governmentality and governance. Journal of Administration and Governance, 7, 1, 1–10.Google Scholar
Rostgaard, T. 2006. Constructing the care consumer: free choice of home care for the elderly in Denmark. European Societies, 8, 3, 443–64.Google Scholar
Roulston, K. 2010. Considering quality in qualitative interviewing. Qualitative Research, 10, 2, 199–228.Google Scholar
Roulstone, A. and Morgan, H. 2009. Neo-liberal individualism or self directed support: are we all speaking the same language on modernising social care? Social Policy and Society, 8, 3, 333–45.Google Scholar
Routledge, M. and Carr, S. 2013. Improving Personal Budgets for Older People: A Review – Phase One Report. Think Local Act Personal and Social Care Institute for Excellence, London. Available online at http://www.thinklocalactpersonal.org.uk/_library/PersonalBudgets/TLAPImprovingPersonal_BudgetsforOlder_PeoplePhaseOne_D4.pdf [Accessed 21 September 2013].Google Scholar
Rowe, D. 1982. The Construction of Life and Death. John Wiley and Sons, New York.Google Scholar
Schwartz, B. 2004. The Paradox of Choice. HarperCollins, New York.Google Scholar
Scourfield, P. 2007. Social care and the modern citizen: client, consumer, service user, manager and entrepreneur. British Journal of Social Work, 37, 1, 107–22.Google Scholar
Sevenhuijsen, S. 1998. Citizenship and the Ethics of Care: Feminist Considerations on Justice, Morality and Politics. Routledge, London.Google Scholar
Skills for Care 2009. ‘We're Helping to Create Well Trained Care Staff’: Adult Social Care Personalisation Success Stories in the South West. Skills for Care, Leeds, UK.Google Scholar
Slasberg, C., Beresford, P. and Schofield, P. 2012. How self-directed support is failing to deliver personal budgets and personalisation. Research, Policy and Planning, 29, 3, 161–77.Google Scholar
Slasberg, C., Beresford, P. and Schofield, P. 2013. The increasing evidence of how self-directed support is failing to deliver personal budgets and personalisation. Research, Policy and Planning, 30, 2, 77–89.Google Scholar
Spall, P., McDonald, C. and Zetlin, D. 2005. Fixing the system? The experience of service users of the quasi-market in disability services in Australia. Health and Social Care in the Community, 13, 1, 56–63.Google Scholar
Strauss, A. and Corbin, J. 1990. Basics of Qualitative Research. Second edition, Sage, London.Google Scholar
Swain, J., Finkelstein, V., French, S. and Oliver, M. 1993. Disabling Barriers – Enabling Environments. Sage/Open University Press, London.Google Scholar
Tilly, J. and Wiener, J. 2001. Consumer-directed home and community services programs in eight states: policy issues for older people and government. Journal of Aging and Social Policy, 12, 4, 1–26.Google Scholar
Timonen, V., Convery, J. and Cahill, S. 2006. Care revolution in the making: a comparison of cash-for-care programmes in four European countries. Ageing & Society, 26, 3, 455–74.Google Scholar
Tronto, J. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. Routledge, London.Google Scholar
Turnbull, A. 2003. Speech to launch The Adaptive State: Strategies for Personalising the Public Realm. Demos, London, 12 December.Google Scholar
Ungerson, C. 2004. Whose empowerment and independence? A cross-national perspective on ‘cash for care’ schemes. Ageing & Society, 24, 2, 189–212.Google Scholar
Ungerson, C. 2006. Direct payments and the employment relationship: some insights from cross national research. In Leece, J. and Bornat, J. (eds), Developments in Direct Payments. The Policy Press, Bristol, UK, 205–20.Google Scholar
Union of Physically Impaired Against Segregation 1974. Founding Statement. Union of Physically Impaired Against Segregation, London. Available online at http://disability-studies.leeds.ac.uk/files/library/UPIAS-UPIAS.pdf [Accessed 21 September 2013].Google Scholar
Walker, B. and Winter, D. 2007. The elaboration of personal construct theory. Annual Review of Psychology, 58, 453–77.Google Scholar
Woolham, J. and Benton, C. 2013. The costs and benefits of personal budgets for older people: evidence from a single local authority. British Journal of Social Work, 43, 8, 1472–1491.Google Scholar
Zamfir, M. 2013. Personalisation through personal budgets: its effectiveness for older adults in social care services. Findings from an English-based literature review. Research, Policy and Planning, 30, 2, 77–89.Google Scholar
Zeithaml, V., Berry, L. and Parasuraman, A. 1996. The behavioral consequences of service quality. Journal of Marketing, 60, 2, 31–46.Google Scholar