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PurposeThis paper describes an evaluation of 19 extra care schemes allocated funding from the Extra Care Housing Fund.Design/methodology/approachInterviewers collected information about the expectations and experiences of 1,182 new residents, and demographic and care needs information for those who received a care assessment (817 individuals) to correspond to previous surveys of care homes. Follow‐up information was collected at six, 18 and 30 months. Comprehensive costs were estimated for individuals based on capital costs, care and support costs and living expenses.FindingsEntrants to extra care were much less physically and cognitively impaired, on average, than entrants to care homes, although residents in several schemes had high levels of physical disability. Overall, residents appeared to have made a positive choice to live in a more supportive and social environment ("pull" factors) rather than responding to a crisis ("push" factors). Outcomes, in terms of physical and cognitive functioning, for residents with similar characteristics to care home residents were better, and costs were no higher, while mortality rates were lower.Research limitations/implicationsOutcomes could not be measured for those who dropped out, and residents with deteriorating mental health were more likely to drop out.Practical implicationsExtra care can provide a positive option for people planning ahead, but appears to be less suitable for crisis moves. Further work is needed on supporting those who are more dependent.Social implicationsTo encourage downsizing, extra care needs to be sufficiently attractive to those making a lifestyle choice.Originality/valueThis was the first major study of costs and outcomes in extra care housing.

EVOLVE is a tool for evaluating the design of housing for older people. It is used to assess how well a building contributes to the physical support and personal well-being of older people. Developed from research into extra care housing, it can be used for a variety of building types, including sheltered housing and individual private houses. The tool can be used by architects, housing providers, commissioners, researchers and individual tenants or home owners. EVOLVE can be used as a briefing document or an aid to design. It can provide a rational basis to the selection of proposals in a competitive procurement process. The EVOLVE tool can also be used to evaluate existing housing stock, including schemes where remodelling is under consideration. © Pier Professional Ltd.

• Summary: The transformation of adult social care in England is underway, with the aim of promoting greater control and choice among people eligible for publicly funded social care services. A key part of personalization is the policy move to promote personal budgets. This article aims to investigate the inter-relation of personal budgets with another policy goal, adult safeguarding. A pilot programme of the predecessors of personal budgets, individual budgets, took place 2005–2008 and was evaluated by an independent research team. This article presents findings from the team's second round of interviews with adult safeguarding coordinators (ASCs) in the 13 pilot sites held early 2008 which are discussed in the context of proposed adult safeguarding reforms in England. • Findings: This second round of interviews with ASCs revealed greater engagement with social care transformation than previously. However, their detailed expertise in adult safeguarding and their local intelligence and experiences were not regularly accessed. This may constitute a missed opportunity to address some of the tensions of personalization in practice. • Application: The interviews reveal that the personalization of social care is often interpreted as relating to greater use of Direct Payments and has yet to consider other facets of this policy transformation that are central to social work practice, including safeguarding.

As in other countries, improving collaboration between health and social care services is a long-established objective of English social policy. A more recent priority has been the personalisation of social care for adults and older people through the introduction of individualised funding arrangements. Individual budgets (IBs) were piloted in 13 English local authorities from 2005 to 2007, but they explicitly excluded NHS resources and services. This article draws on interviews with lead officers responsible for implementing IBs. It shows how the contexts of local collaboration created problems for the implementation of the personalisation pilots, jeopardised inter-sectoral relationships and threatened some of the collaborative arrangements that had developed over the previous decade. Personal budgets for some health services have subsequently also been piloted. These will need to build upon the experiences of the social care IB pilots, so that policy objectives of personalisation do not undermine previous collaborative achievements.

AbstractIn common with many advanced welfare states, England has increasingly relied on consumerist principles to deliver both greater quality and improved efficiency in the long‐term care system. The Individual Budget (IB) pilots marked the next step in this process, through a new system of funding whereby greater control of resources is given to service users, in lieu of direct in‐kind care provision. IBs have the potential to transform the market for care services as well as the relationships between key stakeholders within it. Purchasing will increasingly be shaped by the demands of IB holders, with providers expected to deliver a wider range of personalized services. What will this mean for providers, and what can they do to prepare for these changes? These questions are relevant not just in England but in many other countries adopting similar mechanisms for devolving control over the design, delivery and funding of care to the end‐user. The article explores the early impact of IBs on providers' services, on their workforces, and on the administrative implications for providers of managing IBs. The study finds that providers were positive about the opportunities for better‐quality services that IBs can bring about. However, participants highlighted a number of obstacles to their effectiveness, and reported a range of potentially adverse administrative and workforce consequences which have the potential to jeopardize the consumerist policy objectives of increased choice and efficiency.

• Summary: This study examines the early impact on care coordinators' (care managers') work activity patterns of implementing the current personalization agenda within English local authorities. The Individual Budget (IB) pilots operated between 2005 and 2007 and provided a basis for personalization that, ultimately, sought to give personal care budgets to every eligible service user in England. Of particular interest was how the pilots impacted upon the roles, responsibilities and activity of care coordinators, who are expected to play a key role in this transformation of social care. A self-administered diary schedule was completed by 249 care coordinators, including teams directly involved in delivering IBs and a comparative sample of teams not involved in the pilots. These data were supplemented by semi-structured interviews with 48 care coordinators and 43 team managers. • Findings: The study found that on most measures there were no differences in working patterns between care managers with and without IB holders on their caseload. However, the results do show that – contrary to expectations – more time was spent assessing needs, and that more time generally was required to conduct support planning activities. • Application: The findings are necessarily dependent upon the early experiences of the pilot phase of IBs. As personal budgets are rolled out across all eligible service users, it will be interesting to examine whether the time-use of frontline staff, and indeed the wider organization, structure and function of local authority frontline teams, changes further.