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Carers UK Forum • Direct Payments - Individual Budgets.
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Direct Payments - Individual Budgets.

Posted: Fri Mar 28, 2008 5:52 pm
by rosemary
Yesterday I attended a conference held locally about DP's so will share some of the comments made.

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The programme was set out as follows....

Welcome of the day...... our Mayor ( lovely woman )

Adult services - Our vision for the future

What we have learnt over the last four years - A Care Managers Perspective

Comfort break

Our experiences of Direct Payments - Service user and carer perspectives

Lunch

Introduction to workshop session

Feedback from workshops

Question and answer panel

Closing remarks.

In attendance -
DP's managers and staff team
majority was made up of those accessing the services and carers.
Adult services and childrens services.
Alzheimer groups and other local organisations
Inland revenue officers
Care agencies

Our borough in 2004 had 17 adults receiving DP's
March 2008 now 152

Children 2004 - 9
2008 - 32

What was discussed...............

Pilots of IB's
Resource allocation system
Borough signing up with voluntary sectors
Eligibility criteria
Transfer of care packages from childrens to adult services
Targets are set by government

Several people in receipt of DP's gave speeches about how much had transformed their lives and they answered many questions from carers who knew so little about them.

For me this was all building up to the main event after lunch....the workshops.However, after several voices were raised it was put to a vote,workshops round the tables or open debate.It was decided open debate but controlled in such a way anyone who wanted to speak was given a chance.

So to the question asked..............

At present Direct payments are made every four weeks.How would you feel about receiving a total years budget in one payment??

If we had discussed at tables the idea was to list 3 postive points and 3 negatives but as was open, way more than the 3 came about.Participating and taking notes was hard so the following in no particular order.

Positives

More flexibility
Less administration
Greater choice to do with money
More individual control
Easier to plan ahead
Looking at assistance on a National level

Negatives

Open to abuse,spent incorrectly
Once money given, what happens if needs change within the 12 months period.
DP criteria hard to achieve and so many cutbacks/tightening of budgets so why would IB's be any different.
How many audits a year as many would be needed to ensure money was spent correctly.
Far too much responsibilty for family members/carers to take on
Increased stress with large amounts of money in bank accounts.
Brokers would be needed at times and once again fees would be incurred.
More administration
If money spent too soon, is care continued
More people accessing DP's and IB's mean fewer attending day centres so in time more would close.

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The following only my own thoughts but would welcome comments from others.

I am actually in support of DP's when set up correctly BUT as long as there always remains a choice.It works great for the couple I am employed by and I know several other members here have benefited from them.Neither DP's or IB's would be suitable for Robert though.
Examples given tended to cover mostly young disabled adults or fairly mobile pensioners though.

Not sure if I can list all my concerns as so many but will try,feel free to add to them or disagree as we all have different circumstances so our outlook will differ.

Again for me the main category would be the 24/7 carer especially those where only a spouse or other family member cares.

Criteria - we still have a post code lottery so depending on where you live as to whether once again you can access a service.

Budgets - as more and more people access these services where is all this money coming from and what happens if it dries up.

Financial assessments - as IB's is money from various pots inc ILF how long before more benefits become means tested.

IB's will be same as DP's in that payment to family members living in same household will not be allowed unless really extreme circumstances and will be at discretion of the relevant LA

Who accepts responsibilty - I feel its so unfair to families.It seems both government and LA's involvement getting less and less.

And I have saved the best to last.....what about carers and CA.What affect will all this have.

I have more thoughts but you must be sick of my typing by now.I will leave it to the rest of you to add your own thoughts whether they be positive or negative.

I am posting the link to the site regarding the pilot scheme for IB's in case any members wish to read more.

http://individualbudgets.csip.org.uk/index.jsp

Rosemary
x x x x
















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Re: Direct Payments - Individual Budgets.

Posted: Fri Mar 28, 2008 6:42 pm
by gordie07487
Yesterday I attended a conference held locally about DP's so will share some of the comments made.

At present Direct payments are made every four weeks.How would you feel about receiving a total years budget in one payment??[/color]
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Hi Rosemary, this one jumped out at me, I think for the obvious reason,I agree that one could budget for the year. To play devils advocate would not the temptation be to say "one whole years money in one lump,can we buy that new fridge,carpet," etc. If that happens the obvious would then happen "please Mr can we have some more money?" so begins a vicious circle
Gordon

take it in one lump

Posted: Fri Mar 28, 2008 6:49 pm
by g.herschel
take it in one lump sum then off to FLORIDA to see Mickey

I think that in the

Posted: Fri Mar 28, 2008 9:30 pm
by kenm
I think that in the not too distant future IBs and DPs will be the only choice and carers of working age will be required to go out to work and employ a care worker. The end of CA !!

Two issues apply to IBs

Posted: Sat Mar 29, 2008 11:11 am
by cotula
Two issues apply to IBs as they do to DPs.

I get 'two hours' DP to let me get a little help, but the sum the Council give me is less than two hours at agency rates. There must be a defined relationship between actual costs and funds supplied, to prevent the whittling down of the money supplied.

I prefer to employ someone myself, but finding someone suitable is proving very difficult indeed. The help provided for recruiting begins and ends with providing sample documents (eg Job Description, Contract) and one advert in the local paper. For example, they recommend interviewing away from the house, for security - but cannot suggest anywhere, let alone provide it. It is essential more help is supplied with this - I have seen one or two websites supposed to help those looking for PA-type posts and those wishing to hire, but they have come and gone. Local understanding is needed for this sort of recruiting, anyway. I would like to see the social services working with Carers Centres and disability charities to build a 'pool' of pre-checked (skills and CRB) potential PAs. To improve the attractiveness of such employment, there needs to be access to training and routes to gaining qualifications, as there is in the better care homes.

Morning Cotula, One of the issues

Posted: Sat Mar 29, 2008 11:41 am
by rosemary
Morning Cotula,

One of the issues raised at that event was the different rates set by various agencies and like you said sometimes the money allocated for DPs from Soc Services falls short of this.
At last count I think in our area we have 6 agencies providing care services, yet the difference in their rates is tremendous.

What would you like to see happen?
Someone mentioned for the LA's to set the rate and let the agencies fight for your custom.

Handing all this over outside of the LAs authority,how long before agencies, once they have a foot in the door, start increasing their prices wherein people have to reduce on hours just to be able to afford a service.

How many young/old/disabled/ill health people/carers out there not even aware of what is coming.

I know what you mean about recruitment though.There is a massive drive in/on TV/radio/newspapers about jobs in Social care.My concern is they are painting too rosy a picture.They are not showing the reality of how it is for so many people.

Not sure if you are interested Cotula but here is a few links which give various opinions...

Poor Law care due for an upgrade
http://www.guardian.co.uk/society/2008/feb/06/3

Declaration of Independence
http://www.guardian.co.uk/society/2008/feb/06/8

Will care become a commodity
http://www.guardian.co.uk/society/2008/feb/06/8

A new breed of care worker
http://www.guardian.co.uk/society/2008/feb/06/17

This scheme is unfair to both sides
http://www.guardian.co.uk/society/2008/feb/06/18

We must be wary of cost-cutting
http://www.guardian.co.uk/society/2008/feb/06/19

All we seem to hear is the positive stories.For anyone to make a decision they need be aware of all the facts and so we need hear the stories of where DP's and IB's have not worked.






.

I have just found this.......postcode

Posted: Sat Mar 29, 2008 12:28 pm
by rosemary
I have just found this.......postcode lottery will kick in once again then.

0559_Teething_Troubles_Guardian_.doc

Regardless of the form the money takes,its about eligibility.Personal budgets are about the care you get once you have met the eligibility criteria.

I have sent an email

Posted: Sat Mar 29, 2008 12:41 pm
by rosemary
I have sent an email to the 'In Control' web site asking if any of their full reports about the pilot schemes are online that will show any negatives as well as the success stories.We need be aware of everything before informed decisions can be made.

http://www.prnewswire.co.uk/cgi/news/release?id=223196

Posted: Sun Mar 30, 2008 5:20 pm
by rosemary

The funding for patient care

Posted: Sun Mar 30, 2008 6:25 pm
by Guest
The funding for patient care used to be based on the money following the patient, you needed treatment, you got it, the NHS paid out of a pot allocated by government, the amount paid out of the pot for individual patients depended on the fluctuating needs of that patient, i.e. it was flexible. Individual healthcare budgets assume that the needs and therefore the cost of treatment of an individual patient can be predicted in advance. This is clearly nonsense, some patients will have money left in their budget at the end of the year, possibly spending it on nonessential treatment, others will find themselves with insufficient funding to meet their healthcare needs, do they do without, wait until the next financial year before embarking on treatment or pay for treatment out of their own pocket? And what happens when the money allocated for individual budgets has been allocated to these patients, do other patients, also with substantial healthcare needs find themselves refused treatment as already happens in the social care system? This has to be yet another ideologically-driven idea from this government, perhaps as part of the "responsibility" agenda as in taking responsibility for one's own health, that is ill-conceived and ill-thought out, there will be few winners and many losers.