Personal Budgets in residential settings

Blog by Ann Macfarlane OBE, Disability Equality and Independent Living Consultant and Social Care Institute for Excellence (SCIE) Trustee.

" I am an Expert-by-Experience and undertake inspections with Care Quality Commission (CQC) inspectors. Inspectors have a duty to ensure that all medical and social care facilities and services meet a set of mandatory regulations that focus on Standards.

I usually accompany inspectors who inspect residential, nursing home and hospice settings and all visits are unannounced. The buildings, environments, together with the services that people may need and receive, may vary greatly. For example, some homes offer en suite facilities and single and double bedrooms, others either no or just one or two en suite rooms and only single occupancy. The services, too, vary and the choices people can make may rest on how much they can afford to pay, the home's location, their network in terms of relations and friends. Where relatives live and how much control they have over a person's ability to control their own lives, particularly in terms of their financial position, can make a significant difference to where they will reside and what services and support they can expect.

On inspections I am charged and want to focus on the quality of peoples' lives within these settings. As a disabled person, people are generally pleased to communicate with me because they recognise I may have some understanding related to their experience. One of the main topics of conversation is around ordinary, day-to-day living and how it has changed for them. Tasks, such as the ability to make decisions and act upon them spontaneously, include buying and writing greetings cards, making a telephone call, sorting and hanging clothes in their wardrobe, changing their mind over what to eat for lunch or eating an additional snack. Repeatedly people say they feel 'imprisoned' because they cannot go out through the front door without assistance and days can go by without feeling fresh air on their skin or being in touch with nature. People say they feel isolated from family and friends and from their local community, enjoying leisure activities they once enjoyed and even having the services from a familiar GP...."