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Support Planning

January 22, 2014

Yesterday, I met the Support planner. A nice woman, who knew her stuff and was open to answering the many questions I had. It was a surprisingly pain free experience. Our task was to flesh out the new support plan. My proposal to pay the whole care package by direct payments and cut out the middle men trousering 54% of the money allocated to Steven’s care had been accepted, so we discussed how this is going to work in practice. The budget is made up of three elements: an amount to employ support staff for the normal day to day stuff; an amount to cover a respite allowance; and an amount to pay for Steven’s car travel in order for him to “access the community”.

The first big shock was to hear that my figures “were slightly out”. I’d been notified this in an email a couple of days ago and assumed that I had over calculated the figures in the proposal. It turned out that I had under calculated! The figure that I had submitted to cover the respite allocation was a good deal short. I guess this was a case of me being hoisted by my own petard. Two years ago, in a sort of dress rehearsal for this latest proposal, I costed a respite package myself. The council wanted Steven to return to the Unit where he had been unlawfully held for a year to “meet his respite needs”. Unsurprisingly, he doesn’t want to set foot in the place again, fearing that he’ll never be allowed out again. For a time, the council paid the agency that provides the normal day to day support to cover respite in our home but quickly pulled the plug on that as they felt the charges too expensive. So for the past two years, they pay me £65 twice a month, which I pay directly to a support worker to do the respite. The £65 was the figure I came up with having asked the support worker what he would accept. It turns out that the council rate for overnight respite is a lot higher than that but I was never told that at the time. If I had, I could have either had more respite nights or been able to afford to pay the worker more. But heigh ho – that was then and this is now. From now on, Steven’s budget will include the higher amount.

The council had already told me that all of the budget would be put onto a pre-paid card. I couldn’t work out how I would pay the workers and the cab firm from this card. The support planner explained that I will have to hire a payroll company to take charge of the wages for support and respite and the company will sort out all the wage slips, tax, national insurance etc. That is fine by me as I find the task currently very arduous and the budget also includes an amount for the payroll companies fees. So, the wages are all sorted. The money for the cab firm is more tricky as the whole point of the exercise was to move away from having an account with the cab firm and allowing them to charge way more than the standard fares. What will happen is that the council will allow me to keep open the old direct payment account and each month, I transfer money from the card into the account. Then I can draw money out each week and pay the cab drivers a cash fare each journey. Once again, a good deal because the money will go straight to the cab driver and not to the cab firm.

It did strike me as massively ironic that my proposal was built around trying to cut out the middle man but this new arrangement has as many middle men as before involved, albeit, getting less money for their part. The next step is to meet with one of the local disability organisations who help set up the plan and advise on issues like contracts etc. They have a contract with the council for providing this type of support. Then there is the payroll company that also has a contract with the council to administer service users’ payroll systems. And finally, there is the company who provide the pre-paid cards – another organisation contracted by the council. The more I’m involved in these systems, the more it seems that whenever you lift up any social care scheme, you’ll find several parasites underneath, eager for their cut of the spoils.

One thing that still confuses me about personal budgets is what they can be used for. I’m forever reading stories from the “inclusion” and “in control” groups about the the budgets being used to pay for memberships, season tickets, trips abroad, social trips out. These sort of things have never come up when I’ve discussed Steven’s care needs with Hillingdon. If I’m totally honest, and sorry to piss some of the inclusion people off, I’m not sure that personal budgets should be used for these sort of things. Steven pays for his gym membership and his entrance fees to the swimming pool out of his normal monthly income. Like me. I don’t have a problem with the personal budget going on support and expenses directly related to his learning disability but I can’t see how these other costs are justified. But whatever my personal feelings about the matter, I still don’t understand how people get these sort of activities into their personal budgets. I’m sure Hillingdon would laugh at me if I said I wanted Steven’s personal budget to cover his weekly charges at the Mencap Pool.

Anyways, this all starts on 1st April. Before then, I have to meet with the disability organisation to draw up the staff contracts and to be introduced to the payroll company. All the current support workers have agreed to the change over and we’ll have our first team meeting in a couple of weeks to iron out any potential problems. There is still the tricky job of notifying the support agency that our contract has come to an end – they won’t be happy.

I’m pleased. All of this time and energy feels like another important step in doing the right thing for Steven now and also securing his future. He now has his own home, and should something happen to me, it will be much harder for the council to move him away from his own home. The same applies with the new budget – once it is in place and working well, it will be tougher for the council to take it away from him. I just wish the social care world wasn’t so bloody complicated where even the smallest interaction needs military like planning. I think I’ve become pretty sharp at the tactical stuff but my goodness, it doesn’t half wear you out.

I’m not sure if all this is a success story for “personalisation”. I know a lot of readers of the blog feel that it is. The outcome may be good but it has always been about money first and foremost – Steven’s needs come way down the pecking order behind cash. I think we’ve reached the point in the social care world where we have to acknowledge that and for the authorities to be transparent about that and then just get on with the business of taking charge of the care we need.

From → Social Care

  1. Well done – and good luck!

  2. Jayne knight permalink

    The reason items can be included in a personal budget is that the local authority are making alternative arrangements for traditional day care and transport, meals etc. for which they have a mandatory duty to provide. Therefore if a goal is to get healthy and there is no free municipal provision then gym membership might be a more inclusive and reasonable way of getting health and fit than classes in a day centre. I do quality and cost comparisons to show this. I don’t believe in 10 things you can get and go or it approach, it has to have a means o an end. It’s an overall approach. If you want to be a citizen you have to contribute as a citizen too but some of these costs are above the cost a non disabled person would have to pay or maybe a non disable persom might get away with not doing much exercise whereas for a oerson with a disability its essential. i gave one lady who has skin cancer. a jacuzzi soa helps the incessant itching. we arrange that twice a month. Another chap gas very poor posture and difficulty with breathing. we arrange 1 to 1 motivational swimming lessons and singing. its made masses of difference. It’s about using the personal budget wisely to achieve the needs of individuals. Generally nowadays if they are not critical or substantial then they won’t be considered. Love it that things are going better

  3. Jayne knight permalink

    Sorry about typos. Doing on I pad

  4. Weary Mother permalink

    …and whether the rating is moderate, critical or substantial is a subjective lottery,in many peoples experience. The description of criteria for each rating is almost identical?

  5. Sally permalink

    Mark, well done, but Good God, how complicated, how fiddly and how stressful-as you said, this determines what Steven gets-and although ,if you miss something you could get it back, it would take further negotiating etc. Rather like checking a Statement, every comma counts,and every loophole left unclosed could be a problem in the future.
    I applaud what you are doing, and I too don’t want to cheese off any ardent inclusionists, but,my gripe with inclusion-or-death is that it is, I have found, often advocated by people who are verbally fluent. Good fighters. Not often on the breadline. (“Just hire a lawyer!” one cried to me.)

    Not every parent can cost up services, negotiate payments keep logs, oversee a payroll company, interview/hire/sack PA’s , and even if they can, when they are old and frail there’s nothing there to replace them. Our adult kids can then celebrate inclusion on their own.
    I am afraid that there will be nobody to replace parents to line up all the services etc as we are required to do. If its not down as anybody’s responsibility, the authorities will just look very sad when various stories of wretched adults with LD come to.light.I have been to lots of meetings about personal budgets. I have yet to hear any plans for what happens when I am too old or otherwise unable to do the admin . There isn’t going to be a service to call in, that’s the point of all this!
    Those fears aside, well done you. Almost there.

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