Direct Payments and the Right to Choose Your Care

To Be Human Is to Choose

A very big part of what it is to be human is that you are able to make choices. And as a very wise person once wrote: even not choosing is a choice. Given that making choices is central to your humanity, is it any wonder that you are angry when you denied your right to choose. Joel Feinberg was an American philosopher. He stated that when you are subjected to paternalistic interference - interference that restricts your freedom to choose -  you feel “…violated, invaded, belittled”.

Your Right to Choose Your Care Provider

There are some decisions in life that you have to make that are just so important that your freedom to choose should not be interfered with. That is not to say that you should not seek advice; indeed, that would in many cases be a sensible thing to do. Choosing your care provider, for example, is one of those decisions. Quite rightly, you will feel violated, invaded and belittled if your right to choose is denied.

The good news is that you do have a right to choose who provides your care. This is a right that should not be interfered with. This right to choose exists whether you are funding your own care or you are wholly or partly funded by social services. 

Direct Payments

A direct payment is a payment of money from social services directly to you that you will use to meet your care needs. If you qualify for help with funding from social services you will be given a personal budget. The idea behind personal budgets is to give you greater control over how your care needs are met. 

If you qualify for support from social services and are allocated a personal budget and you do not fall into a small category of persons (people with certain court orders against them) who are not entitled to direct payments, then, under the Care Act 2014, social services have a duty to provide you with a direct payment where you have requested this. 

It Is your Responsibility to Request Direct Payments

Direct payments are all about choice and putting you in control. It is very important to realise that you must request a direct payment. Social services are required to have in place "clear and swift" processes to deal with such requests. Because it is all about choice, you do not have to have a direct payment. You are free to choose. Indeed, if you choose to have a direct payment and decide after a time that it is not for you, changing your mind is perfectly fine. You cannot be forced to have a direct payment. The idea behind direct payments is to enable and empower you. To force direct payments on you would do precisely the opposite.

Direct payments are good news. There is no-one who knows your needs better that you do. You go through life making your decisions, why should it be any different when it comes to choosing something so intimate and personal as care and support. 

To repeat the point, making choices is a big part of what it is to be a human being.

01843 235910 : 01304 892448

www.caremark.co.uk/thanet : www.caremark.co.uk/dover

thanet@caremark.co.uk : dover@caremark.co.uk

01843 235910 : 01304 892448

www.caremark.co.uk/thanet : www.caremark.co.uk/dover

thanet@caremark.co.uk : dover@caremark.co.uk

You Have a Choice: How to Choose the Care Provider You Want

 

Making Choices with Caremark

Are You Happy with The Care Provider That Was Chosen for You?

If you are receiving home care that is funded wholly or partially through social services you have a right to choose your home care provider. There is nothing wrong with allowing social services to set up everything for you. However, you may feel that you want the independence and autonomy that comes with choosing your own provider.

How to Choose Your Care Provider

It is very simple. If you want to choose your own provider the first thing to do is ask for a direct payment. If you have qualified for social services funding, you will have been allocated a personal budget. Having a direct payment means that your personal budget is paid directly to you. This allows you to deal directly with the home care provider of your choice. For more information about direct payments, go to this article.

With a small number of exceptions, you have a right to a direct payment. 

The law is very clear about this. With a small number of exceptions, you have a right to a direct payment. Section 31 of the Care Act 2014 says that if you request a direct payment, the Local Authority to which the request is made “must” make the payment to you. In an Act of Parliament, the word “must” used in this context means that a duty is imposed on a body or bodies, in this case Local Authorities. Where there is a duty imposed on a body there is usually a right granted to another allowing enforcement of that duty. In this case you have the right to a direct payment that is enforceable against the Local Authority.

Choosing Your Home Care Provider

Once you have a direct payment, you can go about choosing your home care provider. You cannot use you direct payment for just anything. It must be used to pay for goods and services that meet your care needs. You can, however, choose your home care provider. The people who carry out your care needs assessment and financial assessment  may wish to advise you about providers ans they may suggest that you go with one of the Local Authority providers: but the choice is yours. 

There is plenty of information available about home care providers in your area. A very useful website is www.homecare.co.uk. This site has a search facility that allows you to type in your postcode and it will return home care providers within a chosen distance of that post code.

The people who carry out your care needs assessment and financial assessment  may wish to advise you about providers, they may suggest that you go with one of the Local Authority providers: but the choice is yours. 

I have written quite extensively about choosing home care providers. You will find this article very helpful.  If you are looking for live-in care, take a look at this article.

To Summarise...

...very simply: you have a choice.

01843 235910 : 01304 892448

www.caremark.co.uk/thanet : www.caremark.co.uk/dover

thanet@caremark.co.uk : dover@caremark.co.uk

You Have a Choice: The Care Act 2014 and Your Right to Direct Payments

You Have a Choice

This article offers advice about choosing your domiciliary care provider. It is particularly aimed at people who are, or who are seeking to be, wholly or partly funded by social services. If you fund your own domiciliary care you can choose your provider. The same is also true if you are funded through social services: you have a choice. You may be very happy for someone to sort everything out for you: and there is nothing wrong with that. However, the fact that you are reading this suggests that you might be interested in exploring your options. Let’s look, then, at what having a choice means.

Social Services Assessments

I have written about these in previous articles so I’ll keep this quite brief. To qualify for social services funding there are two assessments required. The first is a needs assessment the second is a means test, an assessment of finances. You can read my articles on needs assessments and financial assessments by clicking the links.

If you qualify for social services support you will be given a personal budget. If you wish to choose your own care provider you can have your budget paid to you as a direct payment. As I said above, you do not have to do this. It is your choice. Whoever does your assessment should advise you that this choice is open to you.

Direct Payments

If you choose not to have a direct payment, social services will sort everything out for you. If you do choose a direct payment, you can look after it yourself or someone can look after it for you. Someone who looks after your direct payment for you is referred to as your nominated person.

You have a right to have a direct payment. It is enshrined in law. Section 31 of the Care Act 2014 says that if you request a direct payment, the Local Authority to which the request is made “must” make the payment to you. In an Act of Parliament, the word “must” used in this context means that a duty is imposed on a body or bodies, in this case Local Authorities. Where there is a duty imposed on a body there is usually a right granted to another allowing enforcement of that duty. In this case you have the right to a direct payment that is enforceable against the Local Authority.

There are certain circumstances where social services can refuse a direct payment request. However, under usual circumstances, so long as you are able to consent to having direct payments you will be entitled to them.

The Benefits of Direct Payments

As this is public money, quite rightly, you cannot spend a direct payment on just anything; and you will be audited by your Local Authority. Direct payments do, though, give you a large element of control over your care package. Direct payments allow you to choose your home care provider rather than having one chosen for you. But it is more than that. There are wider benefits that flow from exercising choice. 

Choice promotes dignity, and brings independence, and self-reliance, and enhances well-being, and satisfaction and peace of mind, and gives a sense of achievement: And these are benefits that should never be underestimated.

Nothing, though, is set in stone. You can change your mind. If you decide to allow Social Services to look after things for you, you can, at a later date, choose to have a direct payment. There is flexibility in the system to work for you. For more information about obtaining a direct payment and changing home care providers click on this link.

You have a choice.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Understanding Care Services: NHS Continuing Health Care

What Is NHS Continuing Health Care?

In England, NHS Continuing Health Care (NHSCHC) is care funded by the NHS. It is available for people aged 18 and above and is provided to meet physical or mental health care needs that have arisen through disability, accident or illness. NHSCHC is care that takes place away from a hospital. Care can be provided in your home or in residential accommodation.

Who Qualifies for NHS Continuing Health Care?

You will qualify for NHSCHC if you are assessed as having a primary health need. The NHS Choices website provides a very unhelpful circular definition of this. A primary health need, it is explained, is one that is on-going and substantial and is related to your health. An assessment will take into account the nature and complexity of your needs; the intensity and severity of your needs, and the unpredictability of your needs.

How Do You Get NHS Continuing Health Care?

In short, you need to be assessed. The assessment is carried out by a multidisciplinary NHS team. There is no right to an assessment, but if it seems that you might need NHSCHC then the Clinical Commissioning Group (CCG) for your area must carry out an assessment.

The fact that you have a long term medical condition is not, of itself, a qualification for NHSCHC. However, the following circumstances are likely to suggest that an assessment is appropriate. 1. Where  you are due to be discharged from hospital and you have long term needs, 2 Where a period of intermediate care has come to an end, 3. Where your health declines significantly, 4. Where you are approaching the end of your life, 5. Where you reside in a nursing home and your health care needs are under review and 6. Where your health and social care needs are being assessed as part of a community care assessment.

In most circumstances, there is a two stage assessment process. The first stage is an initial assessment. The purpose of this is to decide if you need a full assessment. The initial assessment may be completed by a doctor, social worker or other health care professional.

The full assessment is carried out by two or more health and/or care professionals. The assessment looks at the following criteria: behaviour, cognition (understanding), communication, psychological/emotional needs, mobility, nutrition (food and drink), continence, skin (including wounds and ulcers), breathing, symptom control through drug therapies and medication, altered states of consciousness, other significant needs.

Each of those criteria (or domains) is assessed on the following scale: no needs, low needs, moderate needs, high needs, severe needs or priority needs. The criteria in bold are assessed, on the full scale, from low through to priority. The criteria in italics are assessed from low to severe. The remainder are assessed from low through to high.

You will be eligible for NHSCHC if one or more criteria are assessed at the priority level or two or more criteria are assessed as severe. You may also be eligible if one criteria is assessed as severe and you have needs assessed in a number or other criteria or a number of criteria are assessed as high and/or moderate.

A two stage assessment is obviously a little time consuming. It can take 28 days from the initial assessment to determine you eligibility by way of a full assessment. Clearly in some cases this is far too slow. There is, therefore, a fast track procedure that can be used where your condition is worsening and/or you are terminally ill.

What Is the Cost of NHS Continuing Health Care?

There is no cost to you if you qualify for NHSCHC.

Who Provides NHS Continuing Health Care Services?

NHSCHC services can be provided by any number of health professionals including physiotherapists, occupational therapists, speech therapists and domiciliary carers. When you are assessed as being eligible for NHSCHC, you will be allocated a personal health budget. This is an amount of money that is used to support the needs that you have. It is similar to the personal budgets allocated by social services to support social care needs.

Just as with a social care personal budget, you can ask for your personal health budget to be paid to you in the form of a direct payment. A direct payment puts you in control of choosing who supplies your services. You don’t have to do this. You may, however, enjoy the freedom and choice that direct payments give you. You can find out more about personal health budgets and direct payments on this page.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Kent County Council Parts Company With One of Its Three Chosen Home Care Providers for Thanet

If you live in Thanet and receive domiciliary care through social services you could hardly fail to be aware of the controversial change that came into effect last year, 2014.  

Home care in Thanet, like home care throughout Kent, is provided by a number of private companies. Until last year, many of these companies would have provided home care under contract with Kent County Council (KCC). Prior to June 2, 2014, KCC worked with over 120 providers throughout Kent. From 2 June 2014, that number fell to 23. In Thanet, the number fell to just 3 home care providers. You can see the providers for each area in Kent here.

There can be little doubt that local authorities throughout the country were looking at the Kent experiment. If it was successful and saved money, you can bet that something similar would be adopted all over the place. It would appear, though, that things have not gone quite as well as might have been hoped.

When the experiment in Kent was being implemented there were many voices warning that this might not be an especially good move. One particularly prescient voice was Bridget Warr’s from the UKHCA. She is on record as saying that her concern was  “… that what we’ll end up with is vulnerable people not getting the support they need at the time they need it.”

Today, 28 May 2015, The Thanet Gazette has reported that KCC has decided to cease working with one of its three chosen providers in Thanet when the current contract comes to an end on 1 June 2015.  Amongst other things, it is said that a significant amount of negative feedback has been received about this particular provider. You can read the Thanet Gazette report here.

Many social services customers are under the impression that they have no choice but to have their care delivered to them by the company that KCC chooses for them. This is not the case. Anyone who receives social services funding is entitled to receive a direct payment. I have written about this extensively in previous articles that you can find here, here and here. What direct payments mean is that you are given a sum of money that allows you to buy your home care from a provider of your choice. And there is plenty of choice in Thanet.

Not everyone will want the responsibility of taking control of buying their home care: but many will. Under normal circumstances, if you receive financial support from KCC for your home care you have a right to have direct payments. All you have to do is ask. Direct payments put you in control. You choose your home care provider. If that provider does not deliver a quality service you go somewhere else. In most cases, that has to be a very good thing indeed.

If you want advice about direct payments or any aspects of domiciliary care, do not hesitate to contact me.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

How You Can Change Home Care Providers

Caremark Thanet: Excellence in domiciliary care

If you receive home care through Social Services, you probably had little involvement with how your home care provider was chosen. Everything would have been done for you, and there’s not too much wrong with that so long as you are happy with the service that you are being provided with.  You may, however, have decided that it is time to change your current home care provider, and you can do this very easily by getting direct payments from Social Services. 

Under normal circumstances, you have a right to receive direct payments. All you have to do is ask; indeed, you should be informed that you have the right to receive direct payments when you have a Social Services assessment. For more information; go to this page. 

If you are receiving care through Social Services, you will have been awarded a personal budget. (For more information on personal budgets, go to this article.) When you have a direct payment, your personal budget is paid to you. This allows you to choose the home care provider that you want to provide your care. If you do not want to take on the responsibility of the direct payments, you can allow someone else (a relative or friend) to do this for you. 

Direct payments work in a very straightforward way. Kent County Council pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. You then use this money to buy your care from a provider of your choice.

Direct payments put you in control. If you should like further advice about direct payments, or, indeed, any aspect of domiciliary care, please do not hesitate to contact me. My contact details appear below.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

You Are Free to Choose Your Home Care Provider

Freedom of choice is a bit like freedom of speech. Most people would agree that both are fundamental human freedoms and that they are not absolute – in most cases my freedom (to choose or speak) cannot extend so far that it affects you adversely. Another quality these freedoms share is that we don’t appreciate their importance until we are denied them. Let’s focus on the freedom to choose.

The Freedom to Choose

When I first went to secondary school aged 11 the only thing that I was interested in was sport and the sport above all that I was interested in was football. The academic side of school life held no interest for me. I’d known I was good at football from about the age of 8. I didn’t know that I was also a very good cross country runner; principally because I’d never done cross country until I went to secondary school.

We played football matches on Wednesday afternoons after school. The team for the match would be posted on a notice board on the Monday before the match. There was a football match on Wednesday 21 October 1970 (yes I remember the date). The team was posted on Monday 19 October. As usual my name was there on the team sheet. Unusually, this week, there was a second team sheet on the notice board. It wasn’t a football team sheet: it was a cross country team sheet; I was in the cross country team, and the race was to be on Wednesday 21 October 1970.

Thus it was that I was down to play two different sports, on the same day at two different venues. As far as I was concerned, I would choose to play football. I did nothing about it merely decided that I would turn up for the football team (with the hindsight of 45 years that was not a good move on my part). The football match was to be held at home; the cross country event away at another school. I went to the school changing room after lessons, got changed and waited for the team talk before we went out onto the pitch.

I never got to hear the team talk. The teacher who managed the football team (let’s call him Mr G) came into the changing room with a teacher (I’ll call him Mr A) I did not recognise and pointed to me. Mr A told me that the team bus (cross country team bus) was waiting for me. I explained that I was down to play football. Mr A was the senior of the two teachers. He pulled rank on Mr G and that was that.

Even with the passage of 45 years (that’s almost half a century!) I still recall how I felt at 3.45 pm on Wednesday 21 October 1970. I was angry that people in authority had made a mistake and they were angry with me for choosing what I wanted to do rather than what they wanted me to do.

I felt impotent. I explained my actions as well as I could. I wanted to play football. I couldn’t do both. They wouldn’t listen. A third teacher joined them and all three told me that I had to take part in the cross country event. I just could not get them to accept that they had presented me with the choices of two sports and I had chosen the sport I wanted to play.

There was also a feeling that I had no control over something which I should be in complete control of. The way I reasoned things at the time is exactly how I would reason things now. I accepted that there were things in life over which I had little or no control – I had little choice over the fact that I had to go to school, for example. However, there were parts of my life over which I should be sovereign – such voluntary activities as playing for school teams seemed to fall into the category of activities over which I was sovereign. But my freedom to choose had been wrested from me and, at the time, this felt pretty unfair.

The Freedom to Choose Your Home Care Provider

In the greater scheme of things, the event recounted above is pretty trivial. The experience I had was trivial: but having your freedom to choose taken from you is not trivial. What happened to me might have been a little unfair (no worse than that); however, when it comes to things that matter, having your freedom to choose denied is the most egregious injustice. Having your freedom to choose your home care provider is one of those aspects of your life over which it is of fundamental importance that your freedom is not interfered with.

Home care, or domiciliary care as it is sometimes referred to, is care provided in your home. There is no particular pattern that this care has to take. At one extreme, it could be just one visit a week for one or two hours for someone to help you around your home. At the other extreme care could be provided by a live-in carer. The tasks that carers carry out are wide-ranging. In short, most things short of nursing care can be covered by a home care provider.

Home care is usually provided by private companies. These companies may provide services under contract with social services or directly to individual private clients. The services provided by home care companies allow you to remain living in your home for as long as you are able. This is arguably one of the most important (if not the single most important) contributions that home care providers make to individual people’s lives – and by extension to society in general.

There is little doubt that the desire to remain living in their homes and maintaining as much independence as possible in their lives are two of the most powerful factors that motivate people to choose domiciliary care. There are choices, of course: friends and family may provide care and residential care is an option for some people.

It is important that people who need care have the option to choose care in their homes. But their choices have to go beyond that. It is fundamentally important that people can choose the company that they want to provide their home care. Put yourself in the shoes of someone choosing home care. The position is very simple. The care is being provided in your home. It is absolutely right that you can choose who comes into your home to provide your domiciliary care.

Personalisation

Everybody has a choice when it comes to choosing home care and this includes people who are funded wholly or in part by social services.

There was a time, and it was not so long ago, that the providers of domiciliary care took a paternalistic approach towards their customers. Paternalism means that somebody else knows what’s best for you. In the context of domiciliary care, it was usually social services who thought they knew what was best for you. But things have moved on. Domiciliary care is now guided by the idea of personalisation.

Personalisation is an approach to domiciliary care that is the exact opposite of paternalism. Personalisation recognises that you are the person who knows best what is suitable for you when it comes to choosing domiciliary care.

Therefore, personalisation places you at the centre of everything that happens with regard to your care. It’s all about your independence to choose. Control is handed over to you to be able to choose what type of care you want, who you want to provide that care for you and when you want it provided to you.

Personal Budgets

Of course, the obvious question is how you can have this independence, control and choice over your care if social services are paying partly or in full for your home care? And this is where personal budgets come in. A personal budget is a sum of money that is given to you to pay for the care that you need to meet your eligible needs

To get a personal budget there are two assessments that have to undergo. First, you need to have your care needs assessed. This is called a community care assessment. For more information on community care assessments (specifically in Kent) see Eight things to know about Community Care Assessments by Kent County Council.

Second, you need to have a means test, sometimes referred to as a financial assessment for more information about financial assessments (again, with specific reference to Kent) see How to get financial help for home care from Kent Social Services.

If you are found to have eligible needs following a community care assessment and qualify to have all or some of those needs met by social services you will be offered a personal budget.

Your personal budget can be held by you or by a friend or relative on your behalf. It is also possible for a care provider to administer the budget for you. In some cases, you may want the local authority to administer your personal budget.

Direct Payments

Once you have been awarded a personal budget, you should also be offered an opportunity to receive this in the form of a direct payment. Direct payments work in a very straightforward way. Kent County Council pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. You then use this money to buy your care from a provider of your choice.

For more information on direct payments see How to get direct payments to buy home care and How to get financial help for home care from Kent Social Services.

Direct payments put you in charge. You are able to choose the company who provides your home care. I said at the start that the freedom to choose is something that we do not realise how important it is until we do not have it. Personal budgets and direct payments have returned to many people a fundamental freedom that had been absent.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

It's a Fact: A Recent Survey Shows that Personal Budgets Improve the Lives of Their Recipients

Introduction

This article is aimed at people who are receiving domiciliary care or who are thinking about choosing domiciliary care for themselves or another.

A recent survey (published 28 October 2014) conducted by three bodies working together, In Control, Lancaster University and Think Local Act Personal, looked at the use of personal budgets in adult social services and health in England.

A striking finding of this survey is that 80%  of respondents (over 4000 people were included in the survey) said that personal budgets had made things better or a lot better for them in terms of dignity in their support and their quality of life. You can read more of the report for yourself here.

If you know all about personal budgets, you’ll understand just how significant that finding is. If you’re a little unsure about what personal budgets are, what follows is a brief introduction to them. Let’s start with a look at personalisation.

Personalisation

There was a time, and it was not so long ago, that the providers of domiciliary care took a paternalistic approach towards their customers. Paternalism means that somebody else knows what’s best for you. In the context of domiciliary care, it was usually social services who thought they knew what was best for you.

Personalisation is an approach to domiciliary care that is the exact opposite of paternalism. Personalisation recognises that you are the person who knows best what is suitable for you when it comes to choosing domiciliary care.

Therefore, personalisation places you at the centre of everything that happens with regard to your care. It’s all about your independence to choose. Control is handed over to you to be able to choose what type of care you want, who you want to provide that care for you and when you want it provided to you.

Personal Budgets

Of course, the obvious question is how you can have this independence, control and choice over your care if social services are paying partly or in full for your home care? And this is where personal budgets come in.

To get a personal budget there are two assessments that have to undergo. First, you need to have your care needs assessed. This is called a community care assessment. For more information on community care assessments see Eight things to know about Community Care Assessments by Kent County Council.

Second, you need to have a means test, sometimes referred to as a financial assessment for more information about financial assessments see How to get financial help for home care from Kent Social Services.

If you are found to have eligible needs following a community care assessment and qualify to have all or some of those needs met by social services you will be offered a personal budget. This is a sum of money that is given to you to pay for the care that you need to meet your eligible needs.

Your personal budget can be held by you or by a friend or relative on your behalf. It is also possible for a care provider to administer the budget for you. In some cases, you may want the local authority to administer your personal budget.

Direct Payments

Once you have been awarded a personal budget, you should also be offered an opportunity to receive this in the form of a direct payment. Direct payments work in a very straightforward way. Kent County Council pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. You then use this money to buy your care from a provider of your choice.

For more information on direct payments see How to get direct payments to buy home care and How to get financial help for home care from Kent Social Services.

What Is the Significance of the Survey Mentioned above?

Now you know about personalisation and personal budgets you’re in a position to appreciate just how important the findings in the survey are.

The whole idea of personalisation – and personal budgets - was (and perhaps remains) controversial. Many saw its introduction as a way of reducing costs for local authorities. There may well be some element of that. However, if personalisation is to be seen as a success, it has to improve the lives of those receiving home care.

Personal budgets are a central part of personalisation. If personal budgets are bringing about improvements in the lives of those in receipt of them then personalisation is bringing about the effect that was intended.

The Research Findings in Brief

1. Over 4000 people took part in the survey. 2679 were personal budget holders and 1328 were carers of people who hold personal budgets.

2. At least two thirds of respondents said their personal budget had made things better or a lot better in 11 of the 15 areas of life that were asked about: dignity in support (82%),  Independence (78.9%), arranging support (79.9%), relationships with people paid to support them (75.9%), quality of life (81.4%), mental health (66%), control over life (70.6%), feeling safe (72.8%), family relationships (74.6%),  paid relationships (67.8%), self-esteem (73.2%).

3. Less than 5% of people reported their personal budget having a negative impact on any of the 15 areas that were asked about

4. Over two thirds of the carers surveyed said that things had got better or a lot better in three out of eight aspects asked about: continuing care (78.6%), the quality of life of the person cared for (79.6%) and the carer’s quality of life (71.3%).

5. People were more positive about their personal budgets when they felt that their views were considered when their needs were being assessed.

6. Personal budgets were held by the individual budget holder in 34% of cases. In such cases the individuals received a direct payment. For more information on direct payments see How to get direct payments to buy home care and How to get financial help for home care from Kent Social Services.

7. In 21% of cases, direct payments were made to friends or family of the person receiving care. In 19% of cases the budget was administered by a care provider. In just 18% of cases did a local authority remain in control of the personal budget.

Personal budgets put you in control of your care. They promote your independence, give you choice and help enhance the quality of care you receive.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Eight Things You Should Know about Community Care Assessments from Kent County Council

Introduction

In order to get financial help from Kent social services for your home care needs there are two assessments that social services must undertake.  

To take these in reverse order; the second assessment that is carried out is a means test. This determines whether you are entitled to have your home care provision paid for in full by social services; partly paid for by social services or not paid for at all by social services –  in this last case, in other words you have to pay for it yourself. There is, though, an assessment that comes before this.

The first assessment is one of your care needs. This is known as a community care assessment. You may also hear it referred to as a care needs assessment. This article deals with the community care assessment only.  

The information that follows applies specifically to adults. It is also aimed at people looking for domiciliary care (home care) although much of what is said applies to people seeking residential care.

Here are eight things you should know about community care assessments from Kent social services. 

1. Kent County Council (KCC) has a statutory duty to carry out community care assessments. 

Local authorities, like Kent County Council, often have statutory duties placed upon them. What this means is that there exists a law that has been passed by Parliament – a law contained in an Act of Parliament, also known as a statute – that places the local authority under an obligation to do something. When such a duty exists, it is something that a local authority cannot fail to do. Such is the case with community care assessments. Local authorities, like KCC, therefore, are under a duty imposed by law to carry out community care assessments.  

2. The Duty to carry out community care assessments is interpreted in such a way that means that in practice it is highly improbable that KCC can refuse to carry out an assessment of your care needs.

The law imposing the duty says that if it appears that you may need community care services that your local authority may be able to provide then your local authority has a duty to carry out an assessment of your care needs.  

Even in circumstances where the KCC believes that you have little chance of qualifying for community care services: it must still conduct the assessment. Even in circumstances where KCC believes that you will not qualify financially for social services help: it must still conduct the assessment.

If you are disabled Kent County Council has an additional duty imposed upon it by law to carry out an assessment. 

3. If you are a carer who looks after someone (your wife, husband, relative or friend), you are also entitled to have a community care assessment. 

If you look after someone, you can request a community care assessment when the person you care for is being assessed. You are entitled to an assessment even if the person you care for decides not to have an assessment of his or her needs undertaken. 

4. To get a community care assessment your first step is to make a referral to Kent social services. 

You can do this yourself. Alternatively, a relative, friend or carer can do this on your behalf. You can also be referred by your GP or another health or social care worker. To contact Kent Social Services you can telephone: 03000 41 61 61 (text relay 18001 03000 41 61 61) or email social.services@kent.gov.uk.  You can also drop into a Gateway Plus Centre. There are several of these in Kent and you can find their locations by following this link. 

5. To get an assessment takes about 28 days from the day of referral.  

Although local authorities have a duty to conduct community care assessments, there is no duty placed on them that dictates how quickly they must deal with referrals. There are guidelines; however, and the guidelines state that referrals must be processed within 48 hours and the whole procedure completed within 28 days. Kent County Council says that in most cases it completes assessments within a month. In an emergency, a local authority can put in place temporary care services.

6. Assessments usually take place in your home.

If you are seeking home care this is the best location for an assessment to take place. It is possible for alternative locations, like a GPs’ surgery, to be used. If you are a little unsure about explaining your needs to someone, you might like to have someone with you at your assessment. This person will sometimes be referred to as your advocate, that is, someone who speaks on your behalf. 

It is also possible for assessments to be done by telephone. This may be fine for simple assessments but it is not advisable if you have more complex care needs. Telephone assessments are controversial because they can be used as a means of screening out people before the formal assessment is conducted.  

You may also be asked to carry out a self-assessment of your care needs. This may help you focus your mind on what your needs are but in no way should it be used as a substitute for a formal community care assessment.

7. Your care needs will be assessed as falling into one of four categories. 

The community care assessments measures the risk to your independence and well-being if nothing more is done – in other words what is the risk to your independence and well-being if no care is provided. 

The four categories are referred to as eligibility criteria and they are called: critical, substantial, moderate and low.These criteria are a measure of how serious your needs are. 

In the first, and most serious, category your needs are judged to be critical. If your needs fall into this category then your life may be at risk, and/or you have significant health problems, and/or you are at risk of serious abuse or neglect if nothing else is done. 

In the second category your needs are deemed to be substantial, which means that if nothing more is done you will havelimited choice and control over your living environment and/or you will be at risk of abuse or neglect. You will not be able to carry out most of your personal care or domestic tasks. 

The third, moderate category, without more being done you are not able to carry out several tasks relating to your personal care or domestic tasks. You are not able to maintain a lot of contact with society or take an active part in family life. 

In the final, low category, will not able to carry out one or two tasks relating to your personal care or domestic tasks without more being done. 

Many local authorities will provide funding for care only where your needs fall into one of the first two categories. Kent County Council provides funding for care falling into the first three categories. 

If you qualify for funding you are said to have an eligible need or eligible needs. However, even though you have an eligible need you will still need to qualify on a means test. 

8. If you are assessed as not having eligible needs, or you feel the assessment of your needs is inadequate, you can appeal. 

You must ask for the decision in writing. You need to know the reason why you have been assessed as you have. Make sure that you are aware of the local authority’s complaints procedure. Kent County council has a complaints team at: Brenchley House, 123-135 Week Street, Maidstone, Kent ME14 1RF.  Telephone:  03000 410 410 or:  Brook House, Reeves Way, John Wilson Business Park, Whitstable, Kent CT5 3SS.  Telephone : 03000 410 410. Alternatively you can email them at: complaintsteamadults@kent.gov.uk.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 23591001843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.