Local authorities and the NHS are being urged to drop traditional approaches to social care for older and disabled people and to move towards ideas such as social enterprises and family-based care. The call comes in a report from the National Association of Adult Placement Services, which argues that the introduction of personal budgets and direct payments has not created greater choice and control for people because they still have only a narrow list of care providers to choose from.

The report, ‘Cuts Or Putting People First?’ says councils and the Health Service should develop a wider range of care providers and NAAPS wants the Department of Health to mark a departure from more traditional care providers in its new vision for social care which is being drafted ahead of next year’s White Paper.

It particularly wants to see councils develop their Shared Lives provision. Under Shared Lives carers agree to include a vulnerable or frail adult in their family and community life. The report shows Shared Lives can make 60 per cent savings compared to residential care.

Alex Fox, the charity’s chief executive officer, said: “In some cases, the introduction of personal budgets has made it harder, rather than easier, for niche providers to survive, particularly where funding is being cut to all but the most well-established kinds of provision.”