In the last two decades, advanced welfare states have introduced `cash-for-care' schemes whereby eligible individuals receive money or vouchers to purchase care rather than receive in-kind help at home. Evidence suggests that such schemes give recipients greater choice and control. In England, direct payments, individual budgets and personal budgets are different types of cash-for-care. This article reports new empirical research which takes a longitudinal perspective about the use of direct payments. Study participants were interviewed three times between 2007 and 2009. The findings are organised into six themes: journeys in and out of direct payments; on-going contact with social services; changing service user circumstances; self-development and learning through time; impact of direct payments on families; and changing relationships. The findings show that direct payments recipients need support in understanding the long-term issues that might arise, as well as on-going monitoring and advice from knowledgeable practitioners as their situations, needs and capabilities change through time. On the basis of the evidence, suggestions are made to help boost take-up rates and subsequent levels of satisfaction. The findings have implications for the future roll-out of personal budgets, since direct payments are likely to be a common form of deployment.
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