The Confusing World of Personal Budgets – Part Two

The Confusing World of Personal Budgets – Part Two

This is the second part of my series on Personal Budgets.  Please start with part one here.personal budget care 2How does the assessment work?

When you eventually get assigned a social worker they will visit you to carry out an assessment. Don’t worry too much about this, it’s much more informal and relaxed than a benefits assessment, or something like that. They should be trying to meet your needs as best they can, and you have every right to have a say in this, and correct anything they get wrong.

The assessment isn’t usually a very specific question and answer session, but more of a chat that then gets converted to the information they need.  However, if you’ve already thought carefully beforehand about the areas you’d like help with, you could write it up and give it to them, or simply make notes of specific points to say.  It’s really up to you, and your social worker should find a way that makes you feel comfortable.

After this visit, the Social Worker will go and input all the information into their system. This is called the resource allocation system (RAS). A lot of people think you’d ask for you what you need first, and this information would get converted into an amount, but this isn’t how it’s done.  It’s based on your circumstances and the level of help you require.

In some ways it’s a bit like a hidden points system, as the higher you score, the larger your budget becomes.

The way the review is set up is quite onerous, as not everyone’s situation always fits into the exact questions that they ask, but the social worker has no choice but to try and mould you to fit this form.

What does the review form look at?

It will begin with your details, your disability and how it affects you, your current care situation and your carer, anyone you care for (i.e. children), and your views/aspirations.

It then breaks the assessment down into certain criteria that they look at, which includes:

assessment

The Social Work has to answer the questions relating to each of these areas, and assess how high your need is.

I will give you an example of one of these, just so you get an idea.  Under ‘Everyday Tasks’ one of the questions is on food and drink.

The options include:

  • I am able to feed myself
  • I need some help to feed myself (.e.g. cutting up food).
  • I need to be encouraged or helped to eat.
  • I am unable to feed myself without support and this needs to be done for me or with me.

The Social Worker has to select one, but if you don’t agree, you can ask for it to be changed and explain why.  If at the end your budget doesn’t quite meet your needs, this is a really good place to carefully review and make sure each of the options fits your situation.  Sometimes we make snap judgements about ourselves, such as, “Well of course I don’t need prompting to eat!” But sometimes if you think about it, sometimes this might apply when you’re in a lot of pain, or exhausted and don’t feel like eating even if you’re hungry.  So maybe sometimes encouragement or help does happen.

The second part of the review form is looking at banding your needs, based on certain activities you would like to do.  For example if you stated during your assessment that you cannot drive, the Social Worker will need to think about how this will impact you in each of the categories above. So taking the driving example, they may decide that not being able to drive could put you at risk of not accessing the community, and it would impact your relationships as you could become isolated.  Each of these areas of concern will be assessed using the fair access to care eligibility criteria, and put into one of four bands: critical, substantial, moderate and low. The council has a duty to address any needs that are either critical or substantial.  So carrying on with the driving example, they could say that they think you not being able to drive would very likely end up with you being isolated, so they may rate that as a substantial need that has to be addressed.

When you then get your budget, you must be able to ‘solve’ every issue that’s either critical or substantial.  So the driving issue could be solved by hiring a Personal Assistant that can drive for you.  However, this comes later in your Support Plan.

What you will need after the assessment has been carried out is a copy of your Review Notes, and the amount of your budget.  Make sure at this point you challenge anything that’s not right about your Review Notes.

Sometimes your Social Worker will tell you your notes are now locked, and they can’t change it.  If this is the case – tell them you need a review meeting.  (It sounds ridiculous to have a review meeting before anything has happened, but this is down to the old-fashioned RAS system).

Once you’re happy with your Review Notes, and your budget, this is the point where you really get involved, and can start carving out the solutions to your problems in your support plan.

What doesn’t the assessment include?

Something I found off when I was assessed is that cleaning time isn’t included in the budget, nor things like help with pets or gardening.

So they’ll help you get out of bed, get washed and dressed and expect you to sit in squalor. While your dog starves in the corner. Lovely!

The reality is that once you’ve employed a Personal Assistant, you can ask them to do anything (within reason) and you’ll notice most adverts do mention cleaning of some kind.  If Social Services give you time for something, you don’t have to use it for that task.  You can shift tasks and timings around so everything you need gets covered.

It’s worth taking to your PA about this during the interviews, and checking they’re happy to do the cleaning, walk your dog or pull up some weeds.  It’s all about being upfront to make sure you’re all on the same page.

The Means-Test

At some point after your assessment, you will go through a means-test, usually carried out by your local County Council.   There will be one of three outcomes after this test – you will have to pay everything, you’ll contribute towards the budget, or you’ll pay nothing.  Your first £6000 worth of savings aren’t counted.  There are also some other exceptions that also don’t count – such as a benefits back payment, or injury compensations.

Just because you receive income-related benefits, doesn’t mean you will pass the means-test.  However, out-goings are taken into account – particularly those related to your disability.

To prepare obtain receipts for anything disability related.   Do you have a cleaner, or gardener?  Other things that count are if you pay for any therapies such as massage, counselling, osteopathy, or chiropody for your feet (or anything similar, these are just some examples!)

There are other categories as well such as if you buy anything medical that’s not on prescription – cream, joint braces/tubi-grip, etc.  You also get an allowance if you need to wash clothes more than normal.

All of this information will be inputted into an income/out-goings sheet, and will calculate what you will have to contribute, if anything.

The next post will talk about creating your Support Plan, and how you may need to get past the ‘computer says no’ attitude from Social Services.

Carry on with part three.

The Confusing World of Personal Budgets – Part One

The Confusing World of Personal Budgets – Part One

personal budgets care
About a week ago I finally had my Personal Budget sent from my county council to my elected payroll service.  It was a long, stressful road – mostly because I had no idea what I was doing, and couldn’t wrap my head around the lack of transparency in the system.

I’m not an expert, but I wanted to share what I learned on the way, and to encourage more people to apply for a budget.  Once it’s in place, it could really make a difference to your life.

This will cover the basics of getting a budget.  Next week I will move onto how to find a Personal Assistant, and the basics of becoming an employer.

How do I get the help I need?

A few years ago the new buzzword became ‘Personalisation’ in social care.  The idea is that people with a disability should be put in control of any help they are assessed as needing by Social Services.  For example if someone is assessed as needing care, Social Services could link that person up to an agency.  They won’t know who is coming each day, and their visits may be fitted in around other clients – rather than when is right for them.  Instead a budget would allow the person to be given the ability to employ someone directly, therefore having chosen and vetted the person caring for them, and that person then working to their specific routine.  The budget then gives choice and control to the person needing care.

The idea behind it is very simple, although getting it all in place can be a little more complicated. However, it’s still a great improvement, and once you’re fully informed on how the system works, it can make a great difference to your life.

The one negative that I will say up front, is that the idea behind them is that once your budget has been assessed, you can spend it on whatever helps you to meet your assessed needs. But this ethos seems to have changed though (of course along with the many other welfare cuts) to “the smaller we can get your budget, the better!”  However there can be ways around this to try and stop that happening.

Eligibility for Personal Budgets

People with disabilities are the target for the budgets (although they do exist for carers and older people who may not see themselves as disabled), and they are usually for people who need some kind of care – although not always.  The Fair Access to Care Services (FACS) is the guide that councils have to follow when assessing your needs.  There are four defined eligibility bands – critical, substantial, moderate and low.  It’s a good idea to read the guide to see how they break this down.  All councils have to meet critical and substantial needs.  Some also meet moderate, and others meet all four – but this will depend on the size of the council’s overall budget, and the need in their area.  I will explain later on exactly what they’re assessing with these bands.

How do I get a Personal Budget?

 

In summary here are the steps that lead to a personal budget:

1) Call Social Services

You can self-refer.  Find your local office by searching ‘Adult Social Care Direct’ followed by the county you live.  Ask for an assessment for a Personal Budget.

2) Have a telephone assessment

They aren’t that in-depth, you most likely just need to answer a few questions about what you’d like to achieve with a budget.  You don’t need to go into detail here at all, I think it’s just to give them an idea.  However, it is important to mention any particular difficulties in your circumstances i.e. any issues with your current informal carer, if your health has taken a dramatic downturn, you’ve been injured, or any impending major life changes, such as a pregnancy, etc.  They then use this information to prioritise cases.

3) Wait a really long time

The next step is being assigned to a Social Worker, and this is usually where there is a long waiting list.  I think I waited about six months, but some areas will be shorter, others longer.

4) Have an assessment by a Social Worker

This is where things start to happen.  A social worker will visit you and find out all about you, and the help you’d like.  They use this information to generate your Personal Budget amount.

5) Have a means-test to see how much you will have to contribute to your budget

You may not have to pay anything, you may have to pay towards your budget, or you may have to pay for everything.

6) Create your Support Plan

Once you know how much your total budget is, you need to work out how you’d like to spend it.  This document then gets submitted back to your Social Worker for approval.

7) Argue back and forth if they won’t give you what you need

This is the part where you need to make your case about why you’re asking for what you are.

8) They agree it, and the funds get transferred

There are a few options of how the money is managed.  You can do it yourself, or another organisation can do it for you.

9) Go!

Spend it as you set out in your budget.

What kind of help can a personal budget provide?

If you have a look at the information online about personal budget it will tell you it can provide help with all kinds of interesting and helpful things. For example here is what the charity Mind say a personal budget can pay for:

  • getting help with cooking, shopping and cleaning
  • having short breaks or a holiday
  • leisure activities, e.g. an art class or a walking group
  • having driving lessons
  • buying specialist or computer equipment to make life easier
  • buying membership of a gym or sports club
  • finding a job or learning new skills
  • having an aromatherapy massage or other alternative therapy

That all sounds really great doesn’t it? You start thinking about respite breaks, being able to swim weekly when you haven’t been able to afford it before and so on. And it’s true when the budgets first started these are the kind of budgets people were getting.

However, as you can imagine budgets are now being squeezed. It’s not that you absolutely cannot get any of the these things provided, it’s just a lot harder.

You definitely need to be able to fight for it, and have the right support because it’s most likely your social worker will tell you it’s impossible to get this kind of help. They will have been told by their managers to keep budgets as low as possible, and often won’t give you the information you need to be able to apply for that kind of assistance.

Most of the support they will want to offer you will be around having a personal assistant if that’s something suitable for your disability and needs. They may still try to get the hours as low as possible in many cases, so you need to be on the ball and be able to justify your needs.

I just want to make it clear here I’m not necessarily blaming the social workers – I’m sure there are a lot of social workers out there who are still fighting for the best interests of the client, however when they’re getting edicts from above that budgets must be as small as possible and they’ll be queried as to why they’re not, it must be pretty tough on them. That’s why it’s really important that you know your rights so that you know how to get around the information that you’re being told.

What is a personal assistant?

A personal assistant is the new fancy way of saying carer – except carer can sometimes have a negative connotation of being “looked after”. It also takes into account that your PA will do a lot more than simply care for you. There is such a range of disabilities and needs out there, but not everyone needs a PA to get undressed and feed them for example, although of course some do. You may be perfectly capable of doing that yourself, that need someone to drive you to appointments, or support you with your paperwork because you get overwhelmed, or to come to activity classes with you because you need a little bit of extra help – there are so many things a personal assistant can do.

What if I already have a carer?

This is completely your decision, but sometimes I find in some situations a carer has become a carer out of necessity, rather than it being completely right for either your needs, or their lives. Over the last two years my mum has become my informal carer but she still works. This means that she has to take time off work because of my appointments, and that her availability to help me is quite limited.  I also feel she doesn’t really get a rest from work – as all her annual leave is spent on my appointments, and doing things I need to do, rather than on fun activities. So it doesn’t quite work as well as it could.

I think a lot of people have relatives that have become their carers, such as their parents, spouses or children. And they may feel this is their only choice, but it’s not. You are entitled to have a relationship with your parent, spouse or child that remains as it should be – without the added extra stress of them being a carer also, unless you are both perfectly happy with this arrangement.  In which case – carry on!  But the important thing is that Social Services cannot argue that as they are currently caring for you, this must continue.

Normally a Personal Budget will not allow you to pay a close relative – particularly one you’re living with to care for you.  There are some exceptions though, like where it would cause extreme distress for anyone else to do it.  It has to be a pretty big reason, but it’s possible.  So talk to your Social Worker if you think this may apply in your case.

Part Two is available here.  It will cover:  

How will the assessment work?

What areas of your life will the review look at?

How does the means-test work, and how should I prepare?

Stretching Disability Living Allowance to its Limit

Stretching Disability Living Allowance to its Limit

Yesterday I had an assessment by Social Services for Direct Payments.  I’d been waiting about seven months for it after being assessed as ‘Urgent’.  The Social Worker was fine – we talked through my condition, how it impacts me, the average day and what help I need.

What I did find interesting during the assessment is that after I was asked to give an overall idea of the help I’d ideally like – she then gave me a list of everything that my Disability Living Allowance was expected to cover, and so Social Services would not.  From my list this included all cleaning, gardening, treatments not covered by the NHS, help with pets, and any activities even if they related to quality of life/better health and more.

As an aside, while I was aware of the cleaning issue, I am appalled that Social Services won’t help people with disabilities with cleaning at all.  It’s not a cheap service to have, and I find it totally impossible to do such physical tasks as hovering, dusting, clothes washing, changing the bed sheets – and there’s people a lot worse than me out there.  So they’ll pay to get you out of bed, and showered – then leave you in squalor to fend for yourselves?

But, back to my main point, I thought it was interesting how far she expected DLA to stretch.  I currently use my DLA for an adapted car that has a hoist for my wheelchair.  Without this, I couldn’t leave the house – as my wheelchair won’t go on buses, and wheelchair-adapted taxis are a rare sight to behold in my town (and usually double the price).   Other people will often use this payment to hire a wheelchair from Mutability, or on taxis to get out and about.

Out of the rest of my DLA I and many others pay for things like extra heating, carers, mobility aids, therapeutic devices, special clothing/shoes, food that’s easier to cook (pre-prepared), the higher rents of accessible accommodation, medications, supplements, extra washing loads, specialist exercise programmes, special cushions, adapted items, insurance for wheelchair/scooter, petrol for additional car journeys (doctors/hospitals/travel to specialists often miles away, physiotherapists, other therapists, assessments as well as journeys most people would walk – but you have to drive instead) and so much more.

Of course people with disabilities are statistically more likely to be on a lower-income than the average person, even when able to work.  So DLA may also help towards rent, bills and normal day-to-day living costs.

When I was trying to obtain an electric wheelchair through the NHS, as I am physically unable to manually propel – I explained I was using my Mobility Payments on a car that I needed to get to work.  The assessors response was that I should be using it on a wheelchair.  I pointed out that if I used it on a wheelchair and gave up my car, the wheelchair would have to live in the garden – and I would have to live on the sofa, as the car was vital in transporting the wheelchair, so what would be the point of that?  She had no answer.  It seemed it was their policy to be telling people to spend the DLA on wheelchairs too.

But it doesn’t cover a fraction of the extra costs I have for being disabled, and while I totally understand there isn’t a limitless supply of funds – it doesn’t help when agencies are putting more and more strain onto the benefit.  Exactly how far do they expect DLA to go?

wheelchair push

Theatre Trip

Theatre Trip

Cover of "Ghost (Special Collector's Edit...

Cover of Ghost (Special Collector’s Edition)

I have a hospital appointment in London in September, so while we’re there my Mum and I decided we should do something nice and go and see Ghost the Musical which has just opened.

I phoned the accessibility line for the Picadilly Theatre as I need a space to put my wheelchair in, and they were very friendly and helpful.  They’ve booked me an end-row seat, someone to store my wheelchair during the show and my mum as my carer gets in free!  They also advised me of the best place to get in for level access, and the nearest parking.  Shockingly (or not so, if you’ve ever used an NCP car park!) they charge more for the parking than my ticket will cost!  So let’s hope we can find some parking elsewhere.

I am looking forward to it already!