Improved personalisation in older persons' housing with care?

What impact, if any, do you think the use of personal budgets in housing with care for older people is having on the characteristics and quality of the care provision?

The discussion paper attached at the bottom of this message explores some of the issues. I would really welcome feedback on any of the following questions:

1. Did the traditional approach of block contracting the care provision generally - and genuinely - enable a flexible and responsive service?
2. In procuring the care in HWC, is the "core-and-add-on" approach, with Personal Budgets covering individual care and support plans gaining in popularity?
3. Is care and support delivery becoming less flexible, responsive and personalised, making it more difficult to respond to unpredictable needs such as those arising from dementia?
4. If so, is this purely the result of the procurement and delivery approach, or also a function of other things – reduced budgets, loss of SP funding etc
5. What other trends in care and support procurement and delivery are you seeing?
6. Have you any positive or negative case examples?