The Confusing World of Personal Budgets – Part Three

The Confusing World of Personal Budgets – Part Three

This is a series on Personal Budgets, accessed through Social Services.  Please read parts one and two here first.

Personal Budgets Care

The creation of your support plan and who can help

This should be the first stage where another organisation will get involved. You are perfectly entitled to write your support plan by yourself, but in each area there is usually another organisation or charity that will help you. They should help you through every step of this process, but some are better than others.

Before I started this process I was warned that they will often want you to be an “easy” client i.e. write a Support Plan that goes along with what the Social Worker has agreed, submit it and they get paid.  Unfortunately I was not one of those easy clients, because I didn’t just want to go along with just the PA hours, but make a case for some massage treatment.  I’d been using my savings to pay for them, which were drying up, and they’re pretty much all that keeps me going.

As soon as I mentioned this, my ‘support’ dried up pretty quickly.  I was told a few times it wasn’t possible, then I didn’t hear from her again – even when I submitted my final Support Plan I wrote myself for her thoughts. So it took me weeks to put my plan together, when with some help it could have been much quicker.

However, this will be down to who you get, and I’m sure some organisations have the best interest of the client in mind.  if your Social Worker is backing you anyway, it should all be quite simple.

What will my Support Plan look like?

The Support Plan sets out all the help you need. I was told that this is the only document that the social worker sends through to have your budget approved, and so it is important that you explain who you are as a person.

Generally you’ll start off by talking about interests and hobbies, what your disability is and how it impacts you. You might talk about what’s important to you as a person, and then each of the problem areas highlighted in your Review.

Your eligible needs will be listed, for example: accessing the community, everyday living tasks, your physical health, your mental health, moving around, and relationships and under each of these headings you need to write what support you like to be given to help you meet each of those needs.

Under every day tasks, you may say a PA would enable you to have help to get up and dressed each day.  Or you may say under accessing the community that a PA could drive you to your friends, or to a class each week.  You don’t need to be specific and list every task they’ll do, just give a vague idea, and the time you’d like for it.  You can write more than one task under each of the categories.

How do the costings work?

You need to convert each of what you’ve asked for into a financial payment, that adds up to the amount you’ve been allocated.

In my area of PA our gets allocated £11.28. (This includes holidays and all the other things you need to think about as an employer, this is not the amount that they get paid to them directly.) Using this you can then work out how many hours that you could get each week, and then each day.

This can be broken down further i.e. I asked for a certain amount of hours my care needs, certain amount of hours for getting out community, a segment of hours for going to appointments, etc.  You don’t need to justify what you do within those hours, by giving specific tasks and timings.  However if something takes you a particularly long time, such as bathing or getting dressed, you could use this to justify additional time.

Don’t forget about contingencies as well – what happens if your informal carer becomes ill? What happens if you become severely ill and need further help? You need to build all of this into your budget, by allowing for additional hours for a certain amount of weeks for various scenarios.

You also get given in your first year £200 extra. This covers a DBS check (formerly known as a CRB check), and employer liability insurance.

What can happen when I ask for the help I need?          

Obviously everyone has different experiences, but something I’ve found is there isn’t much transparency in the system.  At all.  There don’t seem to be clear documents setting out what is and isn’t reasonable, and if you ask for one you get told everyone is different and they assess accordingly.

I kept being told certain kinds of therapies/activities I was asking for wouldn’t be covered in the budget, and they didn’t have that kind of money anymore.  However, that’s not how a budget works.  You’re given an amount before you can lay out how you want to spend it, so I wasn’t asking for any more than I’d already been told I could work up to.

And, if your budget doesn’t meet your needs – the budget isn’t right!  So this is where it gets a bit complex, as sometimes the Social Worker simply tells you “no” without explaining how to go about challenging their answers.

So, how do you get what you’ve asked for?

The most powerful thing you can do is provide evidence upfront.  I didn’t do it for everything I’d asked for, because I could clearly see where my Social Worker was supporting me (a PA, contingency plan), and where she wasn’t (massage therapy.)

You can go about this two ways.  Write and submit your support plan.  If they reject it, you can then submit evidence and it goes above your Social Worker to a panel, who will decide.

I could see quite clearly it was going to be rejected, so I gathered all my evidence upfront.

What does the evidence need to say, and who should write it?

I will continue using the example of the massage therapy, as that’s what my challenge was based on – but this could be on a gym membership, an art class, gardening equipment, additional PA hours, or anything.

Remember how I explained how they broke down everything into five categories?  Again, these are:

  • Access to the community
  • Everyday tasks
  • Relationships
  • Risk and safety
  • Support and advocacy

They also generally add on physical and mental health to these for the Support Plan.  These categories are what you should target when writing your evidence.

Take massage therapy – the condition I have causes horrendous muscle tightness and spasms. My evidence could have said it is quite clearly a health need to have this treatment, as massage is the only treatment that helps this part of my condition. However Social Services would have rejected this argument on the basis of it being a health need, and therefore the responsibility is with the NHS to fund it.  (It doesn’t matter if the NHS won’t fund it, the evidence would still have put it into that category.)

Social Services puts all the importance onto the five categories above, and so your evidence always has to work within them to explain how it will impact your life if you didn’t have whatever it is you are asking for.

My evidence focused on the fact that without massage my pain levels would be so high I’d be stuck in bed for weeks at a time, having to significantly increase my pain medications, etc and as a result I wouldn’t be able to access the community.   That’s the significant part.

I also argued that as my pain levels increased, my ability to function which decrease and as a result would need significantly more help to carry out everyday tasks.

You have to make similar arguments for every single category, (or at least as many as you can).  You can also make more than one point for each category – as long as they’re all true of course!

The more evidence you can provide, the better.  In my case my GP wrote a similar letter from their point of view, and my massage therapist also wrote a very detailed letter.

Think outside the box here, while obviously letters from consultants, GPs, physiotherapists and other medical professionals are great, letters from family members, close friends and, neighbours etc are just as important, if somebody has witnessed what a difference a specific activity or piece of equipment could make your life – just have them summarise that in their own words.

It’s also really important to write one from your own point of view. You can either talk about how vital it is to you to continue with an activity, or what a difference it would make to start doing something new.  Think about key aspects such as confidence, self-esteem, quality of life, well-being and respite.

I can’t guarantee that this approach will work for everyone, but the better quality your evidence is, the more chance you have to keep fighting and appealing.

Remember you can appeal your Social Workers decision.

What if I get really overwhelmed by the whole process?

If you’re finding yourself getting stressed and upset trying to get a Personal Budget, or your Social Work is being particularly obstructive – it might be a good idea to get an independent advocate.  Each area should have an organisation that receives funds to advocate for specific groups – such as people with disabilities.  You could also approach charities such as MIND, if that’s appropriate for you, your Care Advisor attached to your GP surgery, Welfare Rights linked to your council, Scope or DIAL.

Every area will have different organisations, and may not have all the ones listed above.  Google the name of your county followed by ‘advocacy’ or phone CAB and ask who provides advocacy if you’re getting stuck.

Try to do this is as soon as you can, as often there is a wait.  Often the Advocate won’t do it for you, but will come to meetings with you, suggest the next steps, or even talk to your Social Worker.

I had one, who was very good – and after a phone call to my Social Worker things suddenly became much easier.  So it’s worth having one if you can.

Part four will cover where the funds will go, writing your job description for your Personal Assistant and advertising the job.

Continue with part four here.

Back Nodger Review

Back Nodger Review

My mum saw the Back Nodger on This Morning a few days ago, and told me about it. The cheapest I found it for was £22.50 on Amazon compared to the £29.99 most places had it available for.  I thought it looked interesting, so purchased it.

The Nodger in its packaging.

The Nodger in its packaging.

It arrived today and looks… different to most other massagers!  It works by targeting trigger points and allows you to put focused pressure on it.  I suffer greatly from very painful trigger points, particularly in my neck, shoulders and lower back.

You push the curved side into your trigger point using the handle.  It has a 'Locator Spot' which digs into the muscle.

You push the curved side into your trigger point using the handle. It has a ‘Locator Spot’ which digs into the muscle.

I’ve spent some time trying it out in various tight knots.   It works best on my neck, where it’s easier to move around to get the right angle.  Similarly, it also does a very good job on my upper back/back of my shoulder blades, and it worked on my arms – but was much more painful than other areas.  I didn’t find it at all helpful on my lower back, so I’ll stick to using a tennis ball there!

The end would be quite nice in my lower back - if only I could reach!

The end would be quite nice in my lower back – if only I could reach!

All in all – I’m glad I bought it, as it works better than anything else I’ve tried for my neck – and it’s strangely addicting searching for the next painful spot to work on!  It will also work nicely in conjuction with my favourite deep tissue massager by Dr Graeme that I find too strong for my neck, and hard to reach the back of my shoulders.