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Budgets? Fudge It

September 30, 2013

That’s it. I give up. I hereby put on record that I have absolutely no idea how direct payments/personal budgets/individual budgets/FACS budgets actually work. Are they as completely random as they seem to me?

I keep reading wonderful stories in the press and online of how people use their budgets in extremely “creative” ways. I keep seeing events advertised that promote the “innovative” use of budgets. Personalisation is where it’s at man, and your budget will open doors that have remained firmly shut up until now. Last week I read the story of the young autistic man who loves going to war reenactment events and used his budget to attend them across the country and pay for a support worker to accompany him. They applied to use their budget to buy a camper van to save on the hotel bills. The whole story was presented through the prism of a real personalisation success story. There is an “Inclusion” group on Facebook who regularly post stories of using their budgets for big adventures – canoeing weekends in Iceland (the country, not the shop); ballet dancing lessons; season tickets to watch their favourite teams.

I read these stories with a degree of incredulity because they run alongside stories of people who cannot a budget at all, or people (like myself) for whom the budget is rigidly controlled by the LA. It may because I’ve been programmed over the years by Hillingdon but I also feel a trifle uneasy about the money being spent on white water rafting holidays. I don’t feel uneasy about the person having the holiday, or spending their personal budget on the holiday. BUt surely, the holiday is a one off – what do they do for the rest of the year? How are they supported? What does the rest of their week look like if the budget is going on one weekend activity?

Regardless of what the budgets are used for, there seems to be a hugely inconsistent way in which they are calculated. My LA calculates its direct payments using an hourly rate – £10.72 an hour. That is fine if you are using the budget to pay for a support worker and pay them by the hour. BUt the purchase of a camper van doesn’t come in hourly rate packages – one van: one price. So, do the ballet dancers get one amount to cover the cost of support to their classes and then a further amount to pay for the class itself. If not, how is it worked out?

There is also a confusing inconsistency within the same LAs. Steven started receiving direct payments towards the end of his time in Children’s services. He was allocated 6 hours per week (approx £63). We employed a support worker for three hours a week to take Steven to the Mencap Pool on a Friday night. This was at the time, shortly after going onto medication that Steven’s weight started shooting up. I asked his social worker if I could use the other £30 to pay for a personal trainer for Steven. I still have his written reply, that this was “an excellent, imaginative use of resources”. Fast forward two years and Steven was “transitioned” into adult services, where I was told in no uncertain terms that direct payments could not be used to fund a personal trainer. It was quite threatening actually, with the slight hint that I had been defrauding them for the previous two years.

The same thing happened a couple of years ago. We were in the middle of their respite game, where Hillingdon were insisting that the only respite option they would consider funding was the place where Steven had been unlawfully deprived of his liberty the year before. During the protracted game, I used a tiny amount from the direct payment budget to pay a support worker to do an overnight shift once a fortnight, enabling me to have two nights a month off. My knuckles were rapped again and I was told “the budget hadn’t been agreed for this purpose, nor would it be agreed for this purpose”. The budget was immediately reduced by three hours per week.

The bottom line is that my experience of direct payments in Hillingdon is that they are rigidly calculated and controlled and can only ever be used to purchase the services of a support worker. As a wheeze, I am tempted to tell them that I am reducing Steven’s “community support ratio” from 2:1 to 1:1 and using the saved money to purchase a Winnebago. Just to see how outraged their reaction will be.

Because of the rigid adherence to calculating budgets using an hourly rate, I get very confused during the “Fairer Access to Care Services Assessment”. The focus in the assessment is on need – not on a timetable. We’ve not been RASd yet but I know the council have calibrated (?) their resource allocation system using the current direct payments rates. It will be interesting to see how the identified needs are converted into a budget using the same payment rates as have been used for years. Surely, as Steven’s needs haven’t significantly changed, his new personal budget should come out at exactly the same amount as his old budget. Somehow, I don’t think it will be like that! And that brings me back again to how the camper van requests are fed into this process. In the highly unlikely event that Hillingdon identified a camper van as a need, I can’t begin to see how the RAS will cope with converting the cost of the van into the overall budget. I suspect this may be a mission for Panel.

Lastly, from our research for the Carers Solidarity group last year, it transpired that some LAs are awarding carers a direct payment following a carers assessment. On the whole, they tended to be small, one off payments (or as one commentator put it – “buy you off payments”) for things like “pampering days”. Treats rather than needs. I’m not entirely convinced that a carers assessment is even remotely interested in identifying a need – it seems to have an altogether different purpose. I’d be very interested to hear from any carer who has received a regular direct payment for themselves – what was the need that was identified? How was it calculated?

So, as I said at the beginning, I am retiring from trying to make sense of the whole personal budget business. Not because it is too complicated – but because it is haphazard. As I’ve shown, there are different rules within the same authority, so it’s pointless trying to compare schemes across the country.

Rant over. I’m off to “We Buy Any Car Dot Com” to check out their latest in camper vans. And if I get one, I might just christen it Priscilla.

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From → Social Care

14 Comments
  1. I read your blog with interest as I have an adult son going through the transition process not very successfully. I also work in the voluntary sector for a carers charity.
    I did some training last week that highlighted some of the issues you talked about in relation to the carers assessment. It does appear that you are “at the mercy” of the individual performing the assessment . Adding to the budget of the “cared for” person can in fact fulfil a carers need. This extra money to be used to purchase respite for example so that the carer can have a break. The one off payments that you talk about can also be used to purchase respite or more support hours but as you note they are a one off payment so not useful if there is a regular need.
    We had great difficulties as a family navigating the direct payments system and never managed to make it work for us as a family. I have no idea how people make this system work for them as I have only been able to get some extra help since I have been working in the sector and have met the right people. Good luck in everything you do and happy future for you and yours 🙂

  2. Surely direct payments are for assistance and personal care only? I live in Staffordshire and they only just allow my daughter hours to cover access to the community and any fees for food, entry or holidays are paid for out of her own pocket, perhaps we should move to these forward thinking authorities, however I suspect they will soon become bankrupt when we all ask for money to visit the caribbean !!

  3. Sally permalink

    I too distrust accounts by those trying to sell the DP idea. Remember Hilingdon put out that horrible newsletter quoting the mother of a lucky soul who had had her day center closed as saying “now almost every day’s a holiday” as the replacement DP paid for her to-um, go to the library.
    They go on about lucky disabled people being able to go surfing etc etc. Well and good perhaps for people who are capable of looking after themselves in all other ways at all other times, .For the rest, the money can’t be spent like that-and even if it was allowed, what do they do for the other 364 days a year with no support? A reasonable amount of support every week costs far more than a once off holiday, but the holiday, given maximum publicity, makes the LA look like Father Christmas.

    I was once at a meeting in which a LA person suggested we all pool our children’s DP’s and set up our own Day Centre. We calculated that all our DP’s for the year wouldn’t run a day center for a day. Undaunted, she spoke of a young man who had used his DP to go skydiving. I have no idea who was looking after him once he was back on earth…but I am sure if I suggested spending it like that our LA would feel that we didn’t really need the money and reduce it accordingly.
    I don’t understand it either, Mark, and I am frightened to ask them.

  4. Liz. permalink

    In theory, parents have no legal obligation to provide free care for adult children, and if a LA identifies a need, they are obliged to fund it being met. I do know parents who have pushed this, but I was never brave enough. Presumably, if you do you end up with a substantial personal budget you could then decide to provide some “free” care and re-allocate the funds to more fun projects.

    My negotiations consisted of a kind of cat and mouse as to what hours of care I would continue to do (most of them) and an hourly rate for what was left over.

    Respite care is a service for the carer, and should NOT come out of the caree’s budget. (I think. It is a bloomin mindfield.)

    • That’s exactly what I did! My daughter was offered 4 hours a week which I got up to 14 and this year for the first time (she is 23) I had help whilst I worked which didn’t come out of taxed income. She now has 30 hours and we have 6 weeks respite agreed though I have yet to see any “paperwork” and have booked a week away in October!! She has a managed account and there is no way that they would pay for a holiday.

    • Weary Mother permalink

      Liz

      LA’s are fully aware that families do not have to pick up the care of their adult learning disabled son’s and daughters/siblings etc. But the alternative for the family is to watch son’s and daughters deteriorate into ill health and misery. So guess what families do…and problem solved!

  5. swanarchie07 permalink

    I took part in a pilot scheme of personal budgets for my son who was 4 at the time I blogged about it. Its very difficult and hard to get your head around things and still now our LA is still trying to prescribed things. Spending some of the allocated budget in a more creative away is about the person not just having traditional care but about having a purpose in life and opportunities like anyother person so going on holiday with some of the money to support them is agreed as a poaitive outcome. Its all about need and outcomes. I think it is a wonderful idea but it is just that because in reality it doesnt happen and isnt easy and you get told a lot of bull shit . My budget we might as well of not bothered to work or engage over 2years ago as it was great while they wanted to prove to goverment we are great look what we are doing but once we got creative and I had control they restricted it so much that its no longer a personal budget its just a direct payment with lots of crap that comes with it. But never mind for now it will do and like you mark I have give up as its bollocks really xxx

  6. Liz. permalink

    Carers are being short changed, because the Government does make funds available for separate “personal budgets” and respite. Whether these are means tested is down to the LA, I think. Mine is not one of the worst, but a while back they tested the idea of means-testing funds for carers. They called a meeting where this was discussed, and out of a group of about 40 carers, hardly anyone had been offered a Carer’s Assessment, and none knew there WERE funds available.

    The solicitor Luke Clements has some (lengthy) documents on his website which explain the various laws and regulations – as well as his rather jaundiced views on Personalisation, and the sleight of hand of RAS systems.

  7. Weary Mother permalink

    Some of this I have already posted.
    But on assessments/direct payments etc:
    Because of the years of struggle with our LA, first to be heard and then after yet more years, where the very serious long ‘neglect’ of my son was proved and reluctantly admitted, we refused direct payments, Direct payments were met by puzzled non understanding by our sight impaired, seriously physically and learning disabled ‘independent’ living son. He has no idea what ‘direct payments’ mean in reality. He was told by a new care assistant who ‘assessed him’ and asked him to sign for direct payments by stealth, (document and pen in hand), that if he took direct payments he could buy his recently redundant LA worker back. (He had known her for over 20 years, she was his home support for three good years, and he was grieving hard for her.) This ‘. buying back ….” was not remotely a possibility and so was a lie. He would have done anything to get …. back. Also, because of long hard experience we did not trust the LA to monitor his care ( with good reason it has since been shown) by the contracted agency who replaced the competent redundant LA care.

    We refused direct payments because we are in our late seventies, and though very apprehensive we believed the LA would have to ‘safeguard ‘ our son if they retained their primary and statutory duty of care!!

    Out of the long and desperately hard complaints processes, (where my health failed and my son’s father (also in late 70’s ) had heart attacks from stress) we had three years of respite. Where this very competent LA employed carer did a brilliant job. This was backed up by a wonderful care manager. When we had an issue she, care manager, advised us ”please leave it to me”, ”if you ask for more help they will reduce support”. She left after long sickness leave, and (allegedly) went to the employments tribunal for reasons including bullying. Since she went we have had three assessments, the last has been excellent (no result yet) because the care manager treated us as human beings. The first two were by locums, (plus aforementioned stealthy care assistant one) all were cold and awful. None had met my son before the ‘assessments’.

    When I challenged the outcome by the first locum, which was massive and dangerous reduction in home care,with no support at all for health or crises, ‘they’ the LA ……….. REDUCED support.

    payments, support ………direct or otherwise…….all an inhuman lottery.

    • Liz. permalink

      And there are people out there who think we are all living the life of Riley! I am getting increasingly angry that what is done to us is so well hidden.

  8. Sasson Hann permalink

    Here’s my recent experience concerning direct payments.

    I fought for quite a few years to obtain true personalisation of my direct payments. I was able to formulate a daily plan that covered anything that I needed doing in the home and outside. And yes, I was told that it could pay for a holiday or day trips, but I was too ill to be able to do these things. What it did fund was certain hobbies and equipment (like paint and brushes to do art, and certain gardening equipment for the carers), plus occasional meals out including the transport and carers time equivalent to £40 per week. This made an enormous difference to my quality of life. It was a bit of a pain keeping track of all the receipts however!

    Then this government came to power. Last year I had a reassessment which not only ruled out anything to do with hobbies, access to the community, social activities, but also carers mileage, bus fares, taxi fares (when accompanied by them), but just about everything apart from making sure I ate and personal care.

    I already paid over £3000 for my care package and as a result of the cuts to things that I actually needed doing like ironing, cleaning, shopping I had to pay a further £1500. Add the bedroom tax of over £1000 per year to that and I’m left with little more than someone claiming JSA. So now I hardly socialise at all and if it wasn’t for my family buying my meat and seeing to small repairs and other things, I wouldn’t even be able to have the smallest treat. There is no money left out of DLA for transport now either. It has also meant that I am no longer able to save to pay for larger house hold items which has meant that I’ve had to use an expensive credit card over the last year to buy various things from a bed to a washing machine. I’m worried sick in case my money is stopped and also that I’ll only ever be able to pay off the interest on this loan not the capital.

    Ironically, on Staffs CC web page speaking about the care packages on offer it is entitled ‘Living your life, your way’, and it gushes about personalisation. This should not be allowed and is a complete lie when they know full well that the care packages are now minutely prescriptive and petty. They wouldn’t even allow a carer to brush the path in the autumn which takes just a few minutes (I am surrounded by trees); they said that this was classed as ‘gardening’. I argued that it was a health and safety issue for the 3 carers who attend, and how was I supposed to get a gardener to come here for a few minutes each day? I knew that I certainly wouldn’t afford to pay a carer to do this for a half hour each week, not on top of everything else I would have to pay out.

    Another lie that they told that was when I had my next financial assessment, the things that I now have to pay privately for would be put against my contribution. My bedroom tax alone is £21 per week, but they only knocked down my contribution by £17 per week. They also wouldn’t allow any aspect of my transport needs in relation to the care package. I told the assessor that this was breaking the law because my transport had been an assessed need, but he just shrugged knowing that there was nothing that I could do.

    I do appreciate that the funding of treats in a time of austerity is not viable; I accepted that. But the cuts to care packages across North Staffordshire were removing needs, things that disabled people need doing in order to lead a normal dignified life, along with the ability to be able to afford to get out of the house for a few hours. I am lucky that I have friends and family who support me and do get me out of the house as well as doing necessary things for me, but what about those who do not have such support? I’m 50 and I’ve done my share of going out and having holidays, but what about young chronically disabled people, are they expected to stay in for the rest of their lives? What will they have to look forward to?

    So local authorities think that all we are worth amounts to feeding and keeping our bodies personally clean? We do more for our pets than that.

    Sasson Hann

  9. The original comment about Direct Payments being unclear is of no surprise because all LAs have different interpretations of the scheme, you have to be savvy about you record what you are using them for. As an example, the reference to a holiday that was mentioned. The LA will say they don’t fund holidays, however when my son goes away for a holiday that he is perfectly entitled to do the same as everybody else, he needs the support in the same way as he needs the support when he is at home, so he takes his PA with him and this is allowed. How else can he have a holiday (that I pay for) if he did not have any support, the PAs salary, accommodation costs and some expenses are paid for out of direct payments.
    It is all a matter of how you approach it, it is this kind of information we need to share with each other for disabled people to get better life chances.
    Les Scaife
    West Lancs Peer Support
    http://www.ukpar.org

  10. david permalink

    This paper gives an overview of IB/DP’s for the elderly:

    “Social Care Law Developments: A
    Sideways Look at Personalisation and
    Tightening Eligibility Criteria”

    LUKE CLEMENTS, Solicitor and Professor,
    Cardiff Law School, Cardiff University

    http://www.lukeclements.co.uk/downloads/ElderLawArticleJan2011.pdf

    It basically discusses the shortcomings of the scheme and how to balance ALL needs, which isn’t that easy to do. Some people in one area have to choose between lying for 12 hours in a wet and dirty inco pad (Elaine McDonald case) or going to bingo as the RAS system does not take things into account.

    The other thing it highlights is turning points into currency. Different authorities have different mechanisms. This results in people with the same needs in different authorities having radically different allocations, outcomes and support.

    It really is a minefield – Lucy Series (The Small Places) did a FOI request on local authorities for how (using RAS) people’s needs are quantified and turned into currency – without consideration for quality of live and qualitative needs which of course cannot be neatly quantified into a spreadsheet and a nice little box. Different authorities have different scorings, some authorities keep their data secret and some authorities do actually have IB/DPs that work!

    The paper is critical of DP/IBs, but personally I think that they are a good idea PROVIDED assessment is fair, flexible, transparent, it is what the person wants and it doesn’t affect their quality of life negatively (e.g. going to bingo or using the toilet!).

    What is needed is a standardised, transparent and holistic (qualitative and quantitative) assessment that is fair, honest and genuinely person-centred. Identified needs by humans, not a machine. Sadly corporate interests of software vendors, authority bean counters and government dictations prevent this from happening.

    • Hi Luke,
      What you have described in your final paragraph we have known since services have been delivered by LAs. What we need are some solutions to overcome those problems, this is what our minds should be concentrating on. We can spend another 40 years stating the obvious, but until we can get National and Local governments around a table with end users and their reps, if fear we will never make any progress in getting better services for the same money.

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