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A Personalisation Dawn

April 1, 2014

It’s D Day. Day one of our great Personalisation adventure. Today is the start of Steven receiving a personal budget to meet his care needs. I arranged for a lone piper to play Colonel Bogey outside my window this morning to herald this new dawn but he got held up on the Piccadilly Line.

It all started back in November when Steven had his Fairer Access to Care Services assessment and I was told that his budget would have to be cut as it was too expensive. After a bit of digging, I stumbled across the shocking fact that the agencies commissioned to provide the services were making a 54% profit out of Steven’s care. They were trousering over half the money the council were allocating for Steven. But under the Fairer scheme, it was seen as okay for Steven to have a huge cut in his budget whilst the providers continue to take their cut. Welcome to the world of adult social care 2014.

I put a proposal together where I managed the whole budget, cutting out both the support agency and the cab firm. I would pay the support workers direct, which was a real winner for them as I could pay them an extra £2 an hour more than the agency paid them. Same with the cab firm – I could pay the drivers a cash fare and do away with hefty account charges.

After much toing and froing, the council agreed. I saved them a third of what they had previously been paying out. And I saved Steven losing out of any of his activities or support workers. BUt almost immediately, another set of middle men came into the picture, wanting their cut of Steven’s money. The council load their personal budgets onto prepaid cards and everytime the card is used, the card company take a cut. The council also expected me to use a payroll company to administer the wages and surprise, surprise, they also take a slice of the budget as well. When councils made the decision to outsource practically all its functions, it left the door open for the vultures to see a rich feed from our disabled dudes.

I’m a stubborn bastard and having got rid of one lot of middle men, I couldn’t entertain a new lot moving in. I said that I would manage the payroll myself. And to stop the card company creaming, I’d make one transfer a month from the card into the old direct payment account and pay all the wages and cab fares from there. The card company make a profit out of that of …… 50p per month. I can live with 50p a month.

Over the past few weeks, I’ve written employment contracts, negotiated salaries, haggled over the cost of the cab fares (The old cab firm stuck rigidly to their figures, so it has meant we start with a new cab firm today), designed time sheets and payslips, set up tax accounts on the HMRC website, wrestled with the issue of employers national insurance contributions, planned supervision and training for the support workers, sat passively through a fairer charging policy assessment and had more meetings with interested parties than you can imagine.

I’ve been trumpeted by the personalisation Evangelists but it doesn’t feel like a success at all. It feels like bloody hard work – partly through my own obstinacy but mostly through the incredible bureaucratic systems that don’t feel the slightest bit helpful.

In one fell swoop. I’ve gone from being a Dad and a carer to an employer of five staff, and all that entails. I can see why personalisation fails – it is too complicated, too hard work, too time consuming.

And let’s remember what this is all about. I have become a major employer so that Steven can go to the gym and the swimming baths and have support for times when I’m at work.

So he can have a life basically.

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From → Social Care

7 Comments
  1. Kay permalink

    A friend of mine set up a personalised budget PA support system for her dude when he left school. She said it was a nightmare. If she hadn’t had fifteen years of being a partner in a business, writing employment contracts & supervising payroll, she could never have managed it.

    As for interested parties claiming your situation as a ‘personalisation triumph’, I’d like to land each one of the self-serving swine a damn good thump. Steven isn’t getting anything new, he is just getting to keep a few little things that make his life enjoyable. Steven’s care isn’t costing any less, it’s just that the overheads of providing it have been moved off the Council’s books and onto your life and ‘spare’ time. I admire your dedication, but think it’s outrageous the way it is being simultaneously attacked and taken advantage of.

    Fair access to services would mean budgets being worked out on the basis of, this is what it will cost to provide that care this person needs, and that sum is their ringfenced personal budget. Administration overheads would be dealt with separately and not affect the care budget. That would incentivise the Council to ensure maximal efficiency of its own administration.

  2. Liz. permalink

    The idea of Council’s operating at maximum efficiency brings a smile to my face. Direct Payments teams don’t appear to talk to the social workers, and the Finance Departments seem to be worse at sums than I am.

    I too employ five carers, and I am my daughter’s financial deputy. The phrase “hard working” is one I regard with a lot of suspicion these days – and compared with the hard, physical slog of providing care, it isn’t what I think of as “hard work” – just endless, and boring, and necessary shifting of paper, sorting of receipts.

    When I first came across the Personalisation agendas, I found them quite exciting. What a wonderful idea. I am beginning to find the enthusiasm and rhetoric something else, though. I would still support the abstract idea of it, but the hard reality is more than a bit of a joke. For the determined and the articulate with clear cut needs it may well be empowering – for the poor bloody infantry it is a con.

    Five carers! My life must now be so easy. In reality, I care for the carers now as well, I have less time and not much (any) support.

    How are you sorting out the training? I haven’t puzzled that one out yet.

    • Try talking to Skills for Care, they have made funding available to people using personal budgets for staff training.

  3. BiRo permalink

    Hi Mark,

    Your situation is very similar to ours. Our son, D is autistic and has a severe learning disability. He also loves Mr Bean and Abba! In 2000/1 we had direct payments for him, but it was a disaster for all sorts of reasons, but mainly because they didn’t give us enough money. I was as green as grass then because D was only 18/19 years old and he was just moving into adult services. I had to do all the management etc for nothing. The DP saga lasted less that a year! D lives in a rented house on his own with support. He currently gets a service from a Provider. They were ok at first but now they have been taken over by a big national company owned by a Canadian Pension Fund! The staff team are great – they have all been with D 6 – 8 years, but the management is very poor. They charge £17.58 an hour and £49.21 a sleep-in. As D needs 1:1 support all the time, 2:1 support when he goes out (he gets 28 hrs a week of 2:1) and sleep-in support it is very expensive! I recently took over the ILF component of his support myself and am now able to pay the staff a decent amount for their sleep-ins. The council need to reduce the cost of D’s package because of the ILF closing, a huge reduction in Supporting People Funding and other cuts they have to make. So, I am considering SDS for him. Like you this is mainly because I want him to keep a decent service – not due to any grand ideas of Personalisation! However, I am no longer “green”! I have costed in everything a Provider would cost in – including management! A friend has put it onto a spreadsheet and we reckon it will save the council over 20 %! I already have the Insurance (from Fish). I have the Payroll with a local accountant who is excellent and much cheaper than the one the council use. They can’t force you to use their payroll! I don’t think they can force you to use their silly card either! I will set up an Independent Living Trust (which is easy to do – you don’t need a solicitor) and the council will pay the money directly to the trust. But there is no way I am going to accept £10 an hour and whatever they pay for a sleep-in! If the council refuses to give us the right amount of money I will tell them they will just have to re-tender (it’s due for re-tendering) and we will go with another Provider who will, of course, cost them more!

    D has very obsessive behaviour and it is impossible to get him to walk from A – B without him getting “stuck” obsessively touch a lamp post etc. So he has to go to all his activities by car. He has a Motability car which takes up all his DLA Mobility but it is well worth it!

    Kind regards,

    BiRo (pen name!)

  4. Brigid Greaney permalink

    I am dreading the dawning of this era with my beloved daughter .I admire you all for your tenacity and never giving up attitude .Well done on cutting out the fat cats of the world Mark ! I hope Stephen and yourself find it a smooth transition to new taxi’s etc .I’m watching and reading every word( and making notes) -Thank you so much for sharing Good luck

  5. Kathryn permalink

    Well done Mark.

    I am in the process of doing the opposite – changing from being an employer, PAs, supervision etc etc and returning to using an agency.

    For four years I have done the PA bit for my brother and sister but I just can’t continue. Briefly I felt out of my depth as an employer, have struggled with staffing issues and added to this they live an hours drive away, in what was the family home, this distance (not being ‘at the coal face’) made the situation even more diffuclt.

    You are right they get better value for money with PAs however I was no longer their sister but an employer and carer (when staff were not available). I really hope it works for you and Steven and wish you all the best – and I’ll keep reading.

  6. basstubes permalink

    Excellent writing and I am singularly impressed by your tenacity. It is so unjust that this situation has arisen as a consequence of government ideology and their continued abrogation of all direct responsibility – no one in politics need ever resign again just keep the kudos. A totally appalling and stomach charmingly sickening creation – this Britain of Camerons.

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