I would be most grateful for any thoughts on this asap:
If someone has been asessed for self directed support and subsequently had a care plan and annual budget amount decided, is it incorrect that they are in the direct payment system (which gives them a set amount of money each month for the sole purpose of employing a PA for a stated number of weekly hours)?. If they are in the self directed support system, should the direct payment system even be involved, or should the person be free to choose however and whenever they spend their annual budget (based on their agreed care plan, and within the law)?
D: I would be most grateful for any thoughts on this asap: If someone has been asessed for self directed support and subsequently had a care plan and annual budget amount decided, is it incorrect that they are in the direct payment system (which gives them a set amount of money each month for the sole purpose of employing a PA for a stated number of weekly hours)?. If they are in the self directed support system, should the direct payment system even be involved, or should the person be free to choose however and whenever they spend their annual budget (based on their agreed care plan, and within the law)?
I have no idea but Im willing to bet millions that the answer is basically which ever is cheapest
My understanding is that SDS personal budgets can be used as either a virtual budget or DP, whichever the S/U prefers and is agreed by management. It is also my understanding from training we had recently, that budgets can be used to pay for what is most important for the service user and this does not necessarily have to include what we have assessed e.g personal care. Have yet to see this happen!
The issue of direct payments is confusing.
You have the 'old' system of Direct Payments and the new system of personal budgets paid as a direct payment confused. Really, there is no longer such a thing as a 'Direct Payments System' (although at the same time technically there is but it is being phased out) although it is possible to have a direct payment from your council.
Maybe they should have chosen different terminology.
Self Directed Support is about giving choice to service users, although the word choice could be considered to be very loosely used. You are not 'assessed' for self directed support, self directed support is the choice given to you to decide how you want your care to be organised
Generally the only way to receive council services now is via self directed support. Every service user will be expected to be given a 'personal budget' - based on the answers given on their 'self rating questionnaire' they will have a score that will then be translated by a 'resource allocation system' (RAS) into a personal budget. The service user will be informed of this estimated amount of money that *may* be available for their care.
The service user is then given the choice, have some or all of your self directed support personal budget given to you as a direct payment that you can *choose* how you use it (more about that later) OR allow the council to continue to manage your care, i.e by paying a care agency to come in at set times. There are various variations on these two options but essentially it amounts to the same choice.
So back to that 'choosing' how you use the direct payment you have received of your self directed support personal budget.
This element of choice isn't often explained very well to service users. The council will assess their needs, i.e. they will decide how much money they would spend to meet their basic needs i.e. washing and dressing, eating, taking medication if the council were paying for it. If the service user opts to have this money as a direct payment they then must spend this money on meeting those needs, they just get to choose how they spend it, so for example, the council would pay a care agency who may only be able to come at certain times, but the service user using direct payments can use that money instead to pay a friend or family member who doesn't live with them or to employ a PA to do those tasks instead.
The big misunderstanding comes when service users go, great! My friend/ family member is actually willing to do these tasks for free so I will use this money to meet my social and communication needs to go on cultural trips out, to go swimming, to buy a new computer and broadband connection, pay my petrol to go to the day centre or group meetings. Well, no. Yes they may well be needs that you have, but that they are not necessarily needs that the council would pay for in other circumstances. We should only give the direct payment out to meet the needs that the council has said it would meet, and in the age of austerity that is frequently only absolutely essential needs. Yes there are 'points' available for social activities and communication under the self rating questionnaire but the council does not have to provide money to meet these needs, they only have to provide money to meet your basic personal care needs. Even if a need has been identified in the care plan the council does not necessarily have to pay the money to meet that need, and the direct payment cannot be used to meet a need that we would not fund in other circumstances. Yes the person if free to use their budget however and whenever they please, as long as they use it to meet the needs that it is intended for.
It is not only people who who get a direct payment of their personal budget who will have a support plan and a designated annual budget, those people that wish for the council to continue to arrange their care will also be given this. The only difference is that it is the individual that will be holding the budget for their care and not the council.
In these circumstances I feel choice is ever increasingly a dangerous word for the local authority to use.
D please feel free to ask some more questions if you haven't understood what I have said. I am guessing from the way you have phrased the question that you are writing from a lay perspective?
Yes, I'm a P.A and find the financial aspects quite confusing. Much of my employer's paperwork - care plan etc - states 'self directed support' so we were wondering why she doesn't get the personal budget to use as she needs (eg broadband for grocery shopping to be done and delivered). She is restricted to using the money to pay a P.A (ie me) for a limited amount of hours (decided by her social worker) weekly; she is not allowed to do anything other than this with her 'budget', which seems odd when I've read about people being allowed to use theirs for short breaks, exercise classes, computer courses etc. Thankyou for providing so much information, it's v kind of you.
This is a good description of SDS, however I disagree with your points around the restrictions of usage (only Personal care) If this is happening, it shouldn't be and goes against the guidence and indeed whole ethos of SDS.
The Fair Access to Care Services (FACS) criteria is used to access whether someone is eligible for Local Authority support, (this will determine basic needs and whether those needs are severe enough for LA input) if this is the case then the Resident led Assessment (RLA) will determine the areas where support is needed and using a points system will generate a budget. The use of that budget CAN meet ALL outcomes identified in this RLA document within the budget restraints. So if one chooses to pay for (and I set one of these up recently as an SDS Advisor) driving lessons as it allows a person independance and improved quality of life while keeping them safe, then this should be agreed or a case presented as to why not!
I have found that if you don't use the right terminology and don't link your needs/ personal outcomes with the 7 outcomes of the white paper written below, then the budget will get refused. I hope this is not the case everywhere, as it pretty much shuts the door on people who want to write their on Support Plan but do not know the jargon.
1. Improved health and emotional well-being;2. Improved quality of life;3. Making a positive contribution;4. Exercise of choice and control;5. Freedom from discrimination or harassment;6. Economic well-being;7. Personal dignity and respect;
Personal outcomes are the things that a person wants to achieve or change in their life, as a direct result of being able to get the support that they need.These may be quite different for different people and in my experience do not stop at personal care.
Examples of what has been included on some of the residents I work with is: Laptop, mobile phone contract, horse riding, crafts, gig ticket, cooking lessons, college courses, cinema and theatre. All of which linked into the individuals needs and personal outcomes. I'm not denying though that this is easy because we are often up against resistance or 'old school' thinking about how Social Care is delivered but it is worth pursuing and using independant agencies or advocates to help with Support Planning. If all else fails use the complaints process to get answers and put your case forward formally.
Hi
Thank you for this........very helpful :O)
sprinkle:This is a good description of SDS, however I disagree with your points around the restrictions of usage (only Personal care) If this is happening, it shouldn't be and goes against the guidence and indeed whole ethos of SDS.
Oh I completely agree, as a social worker a lot of what I am told to do by my authority goes against their own policies on SDS.
The fact of the matter is though that budgets have been cut and only basic care needs will be met. If they can be met using broadband, cinema tickets or laptops within budget then fine, but if not then those items will not be provided as extras on top of basic care needs.
The ethos of SDS is not law. I say that as a sympathiser not a challenger.
i'm a social work student trying to get my head around all this stuff and finding it quite difficult, so thanks for all the info provided here, found it very useful.
i run a dom care service, i had a conversion with a s/w about someone who has a personalised budget .
i asked the s/w what would happen if a service user chooses to spend their budget on something other than their personal care, resulting in them not having enough money to pay for the care they had received.
The answer was tough that's their choice.