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9 Jan 2012
Diane Lightfoot, United Response, director of communications and fundraising

From care recipients to consumers with a choice; supporting personalisation

Jane (not her real name) hadn’t heard of personal budgets until her council told her that her learning disabled son qualified for one worth an annual £40,000. A United Response finance manager met Jane at a “market place” event (where service users, families and carers can find out more about provision), just as she was planning the tailor-made support to help her son buy with his social care spending money.

Diane LightfootBut it was only when my colleague helped tot up the weekly care required – including transport and support costs - that Jane was shocked at how quickly the £40,000 got swallowed up. Had Jane not met my colleague, she might have purchased a care package without being adequately informed.

The potential pitfalls from a service user or family perspective when buying care is what has driven the latest piece of work from the VODG marketing group, Top Ten Tips When Choosing a Support Provider, a user-friendly guide to purchasing care. (PDF 72Kb)

The group was launched as a forum for sharing issues and disseminating good practice. The guide, published today, is aimed at anyone who needs to buy support for themselves, a friend or relative. It aims to help you learn what to look for when choosing a provider and the questions to ask in developing and paying for support.

While much of the focus in personalisation has been on local authorities and how they’re rolling out the person-centered agenda, there’s perhaps not enough on how to equip individuals with the best skills to make the most of this new approach.

United Response, along with our fellow VODG members, found that many of those we support and their families were confused and nervous when it came to things like personal budgets and the difference between budgets and direct payments.

Placing the person at the heart of the care can enable people to  follow their interestsWorking on this subject collectively, as part of the VODG, is efficient because by pooling our resources we’re avoiding duplication. Because member organisations are a diverse bunch – some are involved with carers and families or parents – we feel we’ve had a fairly comprehensive vision of the problem.

Our guide, however, is very much a starting point for debate. What we want is feedback from service users and their families. What’s missing? How helpful is this guide? Does it give you more confidence when making decisions about care?

The guide builds on very good existing work by care providers, VODG members among them, to help people find the right support. Crossroads Care, for example, has produced the Guide To Engaging a Homecare Agency (PDF on external site, size not known). Outside the VODG too there is good work including a project from Change to produce plain English documents to demystify the process.

We hope the guide will give people greater confidence in shaping their own care; people buying support services should be informed consumers with a choice, rather than passive recipients of care.

Here’s an edited version of the Top Ten Tips – Download the full, free PDF version (PDF 72Kb), or the easy-read PDF version (PDF 2.5Mb)

1. Learn some terminology as care and support can include lots of jargon

See our jargon buster box below for helpful social care words and phrases.

2. Think about how you want to be supported

Do you want a support worker or a personal assistant (PA)? Will you employ them through an agency or directly, in which case you need to ensure you are able to pay their wages regularly and pay their tax and National Insurance and maybe even sick pay or maternity pay. You are legally responsible for them, so you need to check that you have the right insurance. If buying support from a charity or a private company, they will usually be your support worker’s employer and should pay the wages, tax and other payments.

    Social care is full of jargon –
    here are a few key words and phrases that might be helpful:

  • Agency/provider/support provider – terms used for organisations that provide social care and support. They may be charities or private organisations and employ the staff who support you
  • Broker – this is a person or organisation who can help you find a care provider and to draw up a support contract. They may or may not provide support themselves, so do check this out
  • CRB – short for Criminal Records Bureau. All staff working with children and vulnerable adults must have a check of their criminal record before they are allowed to support them.
  • Direct payment – when you get the money directly paid to you so that you can then pay it out for your support
  • Domiciliary Care – where you get support provided to you in your own home that you either own or rent, including support to a child or adult who lives with their parents in the family home
  • Individual Service Fund (ISF) - this is where you use your personal budget to buy support from a provider who then holds the money for you on your behalf. You decide how to spend the money and the provider is accountable to you. The provider commits to only spend your Individual Service Fund on your support and on any management costs they incur in organising and delivering your (shared or individual) support service and not put your funding into a general pooled budget.
  • PA/Personal Assistant – a person who you employ directly to provide support to you
  • Personal budget – a a way of getting social care support. It means that you know exactly how much money you have to spend on your support and you should be able to choose how you spend it. You will need to agree this with your local council first and they may ask you agree outcomes with them. You can choose to have your personal budget as a direct payment or you ask the council to manage the money for you. If you would like a personal budget or do not have funding in place, contact your local social services department
  • Person-centred – support is developed around and tailored to each individual’s needs, rather than being an “off the peg” service. This should involve creating a detailed plan with each person being supported – and creating this with them
  • RAS –  short for “Resource Allocation System” – the method that councils use when deciding how much funding each person who is eligible for social care should receive
  • Safeguarding – ensuring that people being supported are safe and protected from potential abuse including physical or financial abuse. It should not be confused with health and safety and is not about preventing people from doing things
  • VODG – Voluntary Organisations Disability Group - a membership organisation supporting charities working with disabled people

3. Note your first impressions

Initial conversations with your support provider will be a good indication of future relationships. Does the provider do what they promised? Did they get back to you when they said, or can you get hold of them when they say you can? They should be interested and show an understanding of your needs and wishes and recognise that you are the expert in your (or your relative’s) support needs.

3. Check how they will develop your support package

Your support provider should spend time getting to know you, to find out about your needs and wishes. They should develop a person centred plan with you, which details what you want to achieve and you should receive a contract that sets out your support. Some of the things you might want to check include asking what happens about holiday arrangements both for the staff member and also the person supported?

4. Check how your support will be monitored – and changed

Your support provider should carry out a review of your support - sometimes called a “person-centred review” annually, and this should be led by you. Find out how your support will be reviewed; ask how people important to you will be involved. You should be able to easily contact your provider to make changes to your support any time – not just at your annual review.

5. Check the price

Your support provider should confirm a price that will not change after you and they have signed the contact, unless by mutual agreement. Check how the price is put together - if it is an hourly rate for support, is this for 1:1 support or shared support? Check what you will get for your money. Check what will happen if you or your relative needs more support during the contract – how will this be charged. Will there be an annual review of prices?

6. Check the staff who will be supporting you

Your support provider should arrange quality staff that will support you based on your individual needs. Have they made sure that all support workers have up to date CRB checks? You shouldn’t be charged for this. Check that legal training requirements are met and find out how staff will be trained to if they do not have the required skills. Check how the provider plans to involve you in the recruitment process. Check who pays for the staff training – and what will happen when your support worker is away being trained?

8. Check how they will make sure you are safe and supported properly

Your support provider should provide a service which meets certain standards. Check they are registered with the appropriate regulator, for example, the Care Quality Commission. Check what other quality tests they carry out including things like fire safety. Find out if they have a whistle-blowing policy and what safeguards are in place if there was an emergency.

9. Check your right to complain

If things go wrong you want to be certain that any problems can be solved quickly and efficiently. Check if there is a complaints procedure. Who do you contact if things go wrong? Is the complaints procedure written in an accessible way? The procedures should provide you with reassurance that complaints would be properly investigated and explain how they will feed back to you about what is happening as a result of your complaint.

10. Check how you can end your agreement

People’s circumstances change; there may come a time when you need to cancel your support agreement. Check the procedure for ending your agreement. Find out what notice period is required.

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