Safeguarding and system change: early perceptions of the implications for adult protection services of the English individual budgets pilots--a qualitative study

Cash for care or consumer-directed services are increasing in scope and size in Europe and North America. The English Department of Health initiated a pilot form of personalised support for adults (Individual Budgets) in 13 local authorities that aimed to extend opportunities for users of social care services to determine their own priorities and preferences in the expectation that this will enhance their well-being. This article reports on and discusses interviews undertaken with adult protection leads in the 13 Individual Budgets sites about the linkages to their work, their perceptions of the launch of the pilots and the policy s fit with safeguarding and risk agendas. The interviews were undertaken as part of the national evaluation of the pilots, which aims to evaluate outcomes and identify the contexts and mechanisms of those outcomes. Findings of this part of the study were that the adult protection leads were not central to the early implementation of Individual Budgets and that some of their concerns about the risk of financial abuse were grounded in the extent of this problem among current service users. The implications of their perceptions for the roll out of Individual Budgets are debated in this article with a focus on risk and the policy congruence between potentially competing agendas of choice and control and of protection and harm reduction.