Choosing, Arranging and Managing Your Care and Support

Transcription

1 Adult Care and Health Services Choosing, Arranging and Managing Your Care and Support Your guide to Personal Budget Support

2 Welcome You have been given this booklet because we think you have ongoing support needs and that you may be eligible for help from Reading Borough Council s Adult Social Care Services. Our role is to support you to get the help you need to maintain or increase your independence and lead a fulfilling life. We also have a responsibility to ensure that the limited money available to pay for all adult social care in Reading is spent fairly and wisely to achieve best value for money. We believe that you are the best person to say what is right for you and that you should be able to decide how the budget allocated to you should be used to meet your support needs in the best way possible. 2

3 Your step-by-step guide to Personal Budget STEP 1: UNDERSTANDING YOUR SUPPORT NEEDS (p 4) We help you to complete an assessment form to identify your care/support needs and personal goals. We carry out a financial assessment of your circumstances to see how much (if anything) you may be asked to pay towards care and support. We may arrange for you to receive temporary support services to help keep you safe while we take you through the process. This is called INTERIM SUPPORT. If this is the case we will allocate a PERSONAL BUDGET to pay for your services. STEP 2: ESTIMATING YOUR PERSONAL BUDGET (p 5 ) We use the information from your assessment to estimate how much money it is likely to cost to buy support services to meet your eligible needs. This is your INDICATIVE PERSONAL BUDGET STEP 3: DECIDING HOW TO GET YOUR PERSONAL BUDGET (p 6-8) You can have a DIRECT PAYMENT (where you or a nominated person hold your Personal Budget and you arrange, manage and pay for the services you have chosen in your support plan) OR You can ask us to hold your Personal Budget and we will arrange, manage and pay for the services you have chosen (this is called a NOTIONAL BUDGET) OR You can have a combination of both. STEP 4: CHOOSING YOUR SUPPORT SERVICES (p 9-11) You decide how your Personal Budget should be spent to get the care and support that best meets your needs. This is called SUPPORT PLANNING. We can offer information and advice about services and activities available locally to help you choose your support if you would find this helpful. STEP 5: GETTING YOUR SUPPORT PLAN APPROVED (page 12) We will check your completed Support Plan to make sure you have chosen services and activities which meet your eligible needs and don't cost more than your Personal Budget. STEP 6: PUTTING YOUR SUPPORT PLAN INTO ACTION (page 13) The services you have chosen are put in place. We aim to review your care and support needs every 12 months to make sure your support service still meet your needs 3

4 STEP 1: UNDERSTANDING YOUR SUPPORT NEEDS To help us to understand your situation, we ask you to complete an assessment. You can ask someone to support you through this assessment, or we can help with this if you need it. The assessment is a form to tell us about yourself and your situation, including how much help you think you need to care of yourself and manage everyday tasks the things you would like to be able to do or achieve with support your financial situation, to understand if you likely to be eligible for help with paying for your care and support If you have family or friends who help to look after you, we like to include them in the assessment to make sure they are willing and able to continue providing the help they give you now. Caring for someone can be physically and mentally demanding so it is very important that your carer gets any support they need to ensure they don't put their own health and wellbeing at risk. Your carer is also entitled to a separate Carers Assessment to see if they are eligible for support in their own right. For more information, see our leaflet 'Looking after someone? How to get help with caring'. How do I get an assessment? You can visit to complete our online form or download/ print a paper copy. You can also call our Contact Team ( ) to complete your assessment over the phone, or to get support with the process (such as a social worker to visit you at home) if you need this. If you complete your assessment online or send us a paper form, we will contact you (usually within seven working days) to discuss the outcome. We aim to complete assessments within 28 days of you contacting us, but this may vary depending on the resources available. If you need support to keep you safe until you have completed your assessment and had the chance to choose the support you want, we will aim to put this in place within two weeks. * See our leaflet Am I Eligible for Ongoing Care and Support for more information. 4

5 STEP 2: ESTIMATING YOUR PERSONAL BUDGET Once we have agreed your assessment with you, we will input the needs and goals identified through your assessment into our Resource Allocation System to provide an estimate of the amount of money it should cost to pay for the support you need on an ongoing basis. We call this your INDICATIVE PERSONAL BUDGET. We use the Resource Allocation System to ensure that our limited resources are allocated fairly on the basis of need so we can help as many people as possible. We ask you to work with your Indicative Personal Budget. Once you submit your Support Plan for approval we will look at the support you have chosen and your estimated Personal Budget and make any reasonable adjustments at that time. Will I have to pay anything towards my Personal Budget? This depends on your income, savings and expenses. Our Financial Assessment and Benefits (FAB) Team will contact you within five working days of completing your assessment to carry out a Financial Assessment with you. We use rules set by the Council following the Government's National Guidance to work out the most you could afford to pay towards your Personal Budget - this is your MAXIMUM WEEKLY CHARGE. We won't ask you to pay more than your Maximum Weekly Charge towards your personal Budget. If you are on a low income you may not have to pay anything. For more information please see our leaflet How Much will I Pay for my Care and Support? If you have savings or investments above the Upper Capital Limit ( 23,250 in 2015/16) You will have to pay the full cost of your care. You can ask us to arrange, manage and monitor your care for you - in this case we will charge you the full cost of your care plus an amount towards our administration costs. If your care and support plan includes short stays in a care home (up to 28 nights a year) If you get a Personal Budget from the Council you will pay either your Maximum Weekly Charge (from your financial assessment) or the Council's Standard Minimal Charge, whichever is LOWER. If you have savings/investments above the upper capital limit we will charge the Council's Standard Minimal Charge for short period(s) of respite care in a care home identified as part of your support plan. If you choose respite care in a home which is more expensive than Council could arrange for you, you will be asked to pay the additional cost. Could my Personal Budget be reduced when my care and support needs are reviewed? It is possible, but ONLY IF your review shows you need less support than before or if the market has changed and the cost of the support you need has gone down. 5

6 STEP 3: DECIDING HOW TO MANAGE YOUR SUPPORT You decide how you want your support services to be managed. You can: take your Personal Budget as a DIRECT PAYMENT this means you hold the budget and arrange and pay for the services/activities in your support plan (if you can't manage this yourself you can nominate someone* to do this for you) ask us to hold your Personal Budget and arrange, manage and pay for your support services - this is called a NOTIONAL BUDGET Or have a combination of both. *a nominated person must always act in your best interests and may not profit from the Direct Payment If you have to pay the full cost of your care and support you can ask the Council to manage and pay for your support services on your behalf. We will charge you an administration fee for providing this service. How Direct Payments Work You or your nominated person sign a contract outlining your responsibilities - this is called a Personal Budget Agreement You or your nominated person set up a separate bank account for your Direct Payments (DP) (we will transfer our contribution towards your Personal Budget into your DP account every 28 days - if you are required to pay something towards your Personal Budget you do the same) You contact your chosen service provider(s) to arrange the support you need and/or You employ your own Personal Assistant(s) to provide the support you need. You are responsible for the day-to-day management of your employees and/or service providers and deal with any problems that arise. You pay your service provider(s)/employees from your DP Account. You send us quarterly financial reports to show you are spending your Personal Budget as agreed in your support plan. We visit you after six to eight weeks to ensure you are keeping the right financial records 6

7 Employing your own Personal Assistant If you choose to employ your own Personal Assistant you will have additional responsibilities including recruiting, training and paying your staff and meeting your legal and contractual responsibilities as an Employer. The Council has asked an organisation to provide support to help you to recruit and employ a Personal Assistant. Recruiting and Training PAs The organisation will: support people who wish to become Approved Personal Assistants by arranging relevant training to an agreed standard check personal references ensure PAs follow a Code of Conduct that promotes good standards in care. Supporting you to employ your own PA The organisation will: provide guidance and support to help you find and employ your own PA provide a matching service to link you with suitably qualified personal assistants put you in touch with other organisations providing employment support services (such as payroll). Disclosure and Barring Service (DBS) Checks Anyone you want to employ as a Personal Assistant must have a DBS check to make sure there is nothing in their past that would suggest they are unsafe to work with you. We can arrange these checks for you if you ask us to. You will need to see a copy of the DBS to confirm clearance for employment. 7

8 The difference between Direct Payments and a Notional Budget If you have Direct Payments arrange and manage your care) (you You have much more choice and flexibility about how your support needs are met You could choose to employ someone as a Personal Assistant to help meet your support needs. You will considered an employer for this person, but we will help you with this (see page 7 on Employing a Personal Assistant) You arrange your support services directly with your service providers If you need Personal Care, you can choose to buy this service from any care agency, as long as they are registered with the Care Quality Commission and offer a reasonable hourly rate You can use Direct Payments to buy Day Services run by any providers other than the Council You can use Direct Payments to buy respite (short stay) care in a residential home, as long as it s not run by the Council You can contact us for guidance if you have any problems with managing your Direct Payment or your support services We can help you to prepare a back up plan in case something goes wrong with your regular care You will must have a separate bank account for your Direct Payment and will need to transfer your Weekly Charge to this account every four weeks, if an assessment shows you need to pay this. You will pay for the support services you use from this account We will support you to keep records of how your spend your Direct Payment, and review these with you If you have a Notional Budget arrange and manage your care) (we You still have choice about how your support needs are met, but we arrange and manage this budget on your behalf You can t directly employ a Personal Assistant, but you can choose an Agency to support you We will arrange your support services with the providers on your behalf If you need Personal Care, you can choose an agency on the Council s preferred suppliers list (the Homecare Framework) You can use Day Services run by the Council or by any other providers as part of your support You can use respite (short stay) care in a residential home run by the Council or any other provider We will work with you to resolve any problems around your support services We will include back up care in your support plan in case something goes wrong with your regular care We will manage your notional budget and pay your services providers for the support you receive on your behalf. We will send you an invoice for your Weekly Charge every four weeks, if an assessment shows you need to pay this. We will send you regular statements to show how your Notional Budget is being spent 8

9 STEP 4: PLANNING YOUR SUPPORT Once you have completed your assessment and we have identified that you have eligible needs we can start to look at Offering advice about the different ways you could meet your needs giving you information about the services and activities available locally that will fit with your lifestyle and match your needs Encouraging you to be creative about how your support needs could be met. You are also welcome to ask other people (like family, friends or other professionals working with you) to help you with Support Planning - or you could do it alone. If you need help to make sure that your needs and wishes are properly represented in your support plan, the Council will find you an independent advocate. What sorts of things can I include in my Support Plan? You should include the help you need to stay safe at home and the support you need to do the things you want to be able to do - think about things like: Getting Around Lunch Clubs Short/respite Breaks Hobbies and Interests Social Activities Adaptations, Alarms and Equipment Staying Fit and Healthy Help with Everyday Tasks Learning Something New Help with Personal Care (washing & dressing) Volunteering Finding Work or Training We can suggest services, activities and groups. You can also find ideas on the Reading Services guide ( or call ReACT on ). 9

10 What should my Care and Support Plan include? 1. Information about you and things that are important to you It is important that the people who help and support you understand how you prefer things to be done and the things that are important to you. This could include: Things that influence the way you live your life (beliefs, values, traditions) What works well in your life now and what could work better Your goals - in addition to the needs and goals identified through your Supported Assessment/Review you should include information about the things you would like to do differently or new things you would like to be able to try - some of these may be possible with a little support. 2. A summary of the support you have chosen You must provide details of the support you have chosen. You can make your Care and Support Plan in any format you choose - we use a template similar to the table below to record details: Outcome Eligible Y/N Is outcome currently being met How will outcome be met Is this being provided via a DP, Notional Budget or other sources? How paid? One off payment or 4 weekly No. hours/ week Cost/ week To be supported to get clean and dressed to ensure I am ready for the day and ready for bed Yes Partly 6 x 30 mins call in the morning (mon to sat) to be provided by a home care agency 1 x 45 min call in the morning (sun) to be provided by my wife as a carer to help me have a bath Notional Budget and support from my wife as a carer Four weekly Total hours: 7hrs 15 min 3 hrs from home care agency x 30 mins call in the evening to help me to bed to be provided by my wife 10

11 Are there any restrictions on how I spend my Personal Budget? Yes - the support you choose MUST be: effective in meeting the eligible needs and goals identified through your assessment (including meeting the Council s legal duty of care) affordable within your agreed budget - we also expect you to choose support which offers good value for money legal (within the law) and appropriate (for example, you can t use your budget for gambling). Can I buy residential or nursing care with my Personal Budget? Not on a permanent basis - we only provide Personal Budgets to help you to stay living in your own home and keep you involved in your community. However, you could use some of your Personal Budget to buy short/respite breaks in a care home. The Council will only normally fund a permanent move to a care home if you are eligible and your assessment shows that your care needs cannot be met effectively in the community. If you are helping make decisions for someone else The MENTAL CAPACITY ACT 2005 empowers and protects people who do not have the ability to make their own decisions because of a learning disability, dementia, mental health problem, brain injury or stroke. The law aims to ensure that people who lack capacity get the support they need to be as involved as possible in decisions about their lives. It also outlines how an assessment of mental capacity should be made, in which situations other people can make decisions for someone who cannot act on their own and how people can plan ahead in case they become unable to make decisions in the future. If someone is not able to make their own decisions and we have to take action on their behalf we will do this in their best interests. We will discuss their needs with anyone who is legally allowed to make decisions for them because they have been given Lasting Power of Attorney or they have been appointed by the Court of Protection. 11

12 STEP 5: GETTING YOUR CARE AND SUPPORT PLAN APPROVED To be approved: (For Direct Payments and Council-arranged support) your plan MUST be specific to you and be what you want - we won t approve your plan if it looks like other people have made decisions that you could reasonably have made yourself (see Mental Capacity Act 2005 on page 11) the services and activities included in your plan MUST meet the needs and goals and manage risks identified in your assessment - we won't approve your plan if the support you have chosen is not suitable or is likely to make your situation worse your plan MUST be clear about who is responsible for different aspects of your support your Support Plan should be within your Indicative Personal Budget allocation. We will write to you to confirm approval of your Support Plan. This letter will include confirmation of your final Personal Budget, your start date and a copy of your Support Plan plus details of who you should contact if you have problems at any time. What happens if my Support Plan is not approved? We will explain which parts need to be changed and help you to change them. For example you might need to provide more evidence about how you will manage risks or you may need to consider less expensive support options. What if the support I choose costs more or less than my Indicative Personal Budget allocation? Your final Personal Budget could be more or less than your Indicative Personal Budget but our decision will be based on the evidence in your Support Plan. If your Support Plan shows we can meet your needs and goals for less than the Indicative Personal Budget allocation we will reduce your Personal Budget. If, after you have developed your Support Plan, you believe your Indicative Personal Budget Allocation is not enough please talk to your Personal Budget Coordinator. They will look at your situation again to make sure your Personal Budget is appropriate for the needs identified in your assessment and look at the options you considered in your Support Plan to decide if we should increase your allocation. If you still think your Personal Budget allocation is unfair you can make a formal appeal please write to the Customer Relations Team, Reading Borough Council, PO Box 2624, Reading, RG1 7WB giving your reasons. 12

13 STEP 6: PUTTING YOUR SUPPORT PLAN INTO ACTION If you choose Direct Payments: Once your Support Plan has been approved you can start to make arrangements. Once we receive your signed Personal Budget Agreement we will authorise your payment and confirm to you the final amount and date of payment. We will transfer your Personal Budget (less any contribution you are required to make) to your Direct Payments Bank Account at the Council s next payment run. If you choose a Notional Budget We will write to you to confirm your Support Plan has been approved and make arrangements for your support to start. We will send you an invoice for your contribution (if required) every four weeks. What if I don t like my support or it doesn t meet my needs? We will carry out a review within six weeks of your support plan being put into action to check that your plan is working and you are happy with it. You can make small adjustments at any time as long as your support continues to meet your eligible needs and goals and is within your allocated Personal Budget. What if my needs change or I want to make big changes to my support? Please contact the Adult Social Care Team on who will review your situation. We will ask you to complete a review every year anyway to see if your situation has changed or improved. This may affect your allocated Personal Budget and will give you the chance to make changes to your Support Plan. What if I need extra help for a short time? If you suddenly need extra help for a short time because: You have an illness or injury which means you can t manage your personal care or other essential tasks OR A relative/friend you depend on for care falls ill/ or gets injured and can't provide the support you need. Please contact your Personal Budget Coordinator or the Adult Social Care Team - they can authorise an additional payment to cover the costs of the extra help you need. If this change becomes more permanent we will ask you to complete a new assessment for us to review your circumstances. What happens to my support services and Personal Budget if I go into 13

14 hospital? You MUST let your service provider(s) know that you don't need their help while you are in hospital. If you are in hospital for LONGER THAN FOUR WEEKS: You MUST let us know as this will affect your Personal Budget. If you don t tell us we will continue to charge you for your weekly contribution. A longer stay is likely to trigger a review of your needs and a revised Support Plan. If you are in hospital for LESS THAN FOUR WEEKS: We won t make any changes to your Personal Budget and you MUST continue to pay your weekly contribution, even though you are not receiving your regular care services. The money you save can be used to fund any extra support you may need when you first come back home. What happens to my assessed weekly financial contribution if my care and support varies from week to week? Once we have assessed your weekly contribution towards your personal budget we will ask you to pay this amount every week throughout your Personal Budget year - even if your support varies from week-to-week. At the end of the year, before we finalise your budget for the next financial year, we will compare the payments you made over the year with the actual cost of your care and support services. If you have overpaid we will refund the overpayment to you We won't normally change your weekly contribution during your Personal Budget year. 14

15 Complaints If you are unhappy with the way you have been treated by a member of the Council s staff or we have not done something we have promised then please let us know as soon as possible. The easiest and quickest way to complain is to tell the people working with you that you are unhappy. If you feel uncomfortable with this please contact our Customer Relations Manager (contact details on page 16). Once we know something is wrong we can take steps to put things right, or at least explain why we can't do things differently. Please see our leaflet 'Listening, Responding and Improving' for more information. Data Protection We have a duty to keep full and accurate records of the information you provide, the discussions we have with you and details of any care and support services agreed with you. This is your Social Care Record. Under the Data Protection Act 1998 we are required to keep your Social Care Records confidential and to process your information fairly. This means being clear about: The information we hold about you How we use your information How we keep your records secure and maintain your confidentiality Who we may share your information with and why For more information please see our leaflet "Your Social Care Records and How to Access Them". 15

16 Contact Us Reading Adult Contact Team (ReACT) Tel: Customer Relations Manager (Adult Social Care) Tel: Write to: Freepost RTLS CKGX RKLL, Reading Borough Council, Customer Relations Team, Civic Offices, Bridge Street, Reading RG1 2LU This information can be made in alternative formats (such as Braille or audio) or languages on request. 16 April 2015