Shifting Shapes: how can local care markets support quality and choice for all?
In conjunction with colleagues across the University of Birmingham and the Universities of Lincoln and Middlesex, the Health Services Management Centre was commissioned by the Department of Health’s Policy Research Programme to research the quality and availability of care services provided by local councils in England.
The first part of this project assessed how far choice and good quality was available, looking at national information on the diversity of the care market, and then focusing in depth on what support and services was available in eight local authorities. This project looked at existing information on people's experiences of care services, and also interviewed people who design, support, run and use care services to find out whether services are diverse, good quality, and easily accessible. Some people who use care services pay some or all of the costs of care (and are called self-funders), whereas other people's costs are paid for by the local authority because they do not have enough money to pay for care themselves. The research included both of these groups, recognising that they may have different experiences of care.
The second part of this project focussed on finding out what works best when making care services more personalised, to help improve performance, quality and choice in England. The project focused on answering the following questions:
- How is the 2014 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 national information on care and support services was analysed, focusing in depth on what support and services was available in eight local authorities. The project looked at existing information on people's experiences of care services, and also interviewed people who design, support, run and use care services to find out whether services are diverse, good quality, and easily accessible. This project also spoke 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. Therefore, throughout both parts of this project, service users and carers were the co-researchers, involved in designing the research, doing the interviews, identifying key findings and telling people about the research findings.
The project began in November 2016 and ended in July 2019.
Professor Catherine Needham (Principal investigator) Health Services Management Centre, University of Birmingham
Dr Kerry Allen, Health Services Management Centre, University of Birmingham
Dr Kelly Hall, Department of Social Policy and Social Work, University of Birmingham
Catherine Mangan, Director, Institute of Local Government Studies, University of Birmingham
Professor Jon Glasby, School of Social Policy, University of Birmingham
Professor Stephen McKay, Distinguished Professor of Social Policy, University of Lincoln
Dr Sarah Carr, University of Middlesex
Dr Melanie Henwood, Health Services Management Centre associate
Ms Isabelle Brant, Co-investigator with experience of care services
Emily Burn, Research Fellow
Dr Hareth Al-Janabi, Health Economics, University of Birmingham
Warda Tahir, Health Economics, University of Birmingham