Action Disability Kensington and Chelsea's Personal Budget Team Blog.
The ADKC Personal Budget Project is an independent project, funded by the City Bridge Trust. The PB Team provides all types of support to PB users and Self funders including advocacy, campaigning, training and specialist information and advice.
The Royal Borough of Kensington and Chelsea, part fund some parts of the low level Personal Budget Service (e.g. basic PB info provision, admin costs for the PB User group.)
The ‘Work Capability Assessment’ (WCA) is the testing system used to decide what support and out of work benefits disabled people can access. It is also used to move disabled people off incapacity benefits and onto either ‘Employment and Support Allowance’ (ESA, if found only partly fit for work or unable to work at all) or ‘Jobseeker’s Allowance’ (JSA, if found fully fit for work).
There are about 11,000 WCA tests every week and Disability Rights UK is very concerned that the system:
is unfit for purpose (40% of the people tested appeal the initial DWP decision and 40% win their appeal costing £27 million in the last financial year)
is not delivering the central aim of reform (ensuring disabled people are supported into work where possible); and
causes significant distress and anxiety for disabled people.
Recently, Channel 4 ‘Dispatches’ and BBC ‘Panorama’ investigations have also suggested significant problems with the WCA system. These programmes can currently be viewed online at: http://www.disabilityrightsuk.org/wcaontv.htm
Professor Malcolm Harrington is undertaking his third and final independent Review of the WCA and we would like your help to shape our response.
We have drafted a short survey and your answers and input could help improve the WCA.
The questions from the Harrington Review form part of our survey. We also provide some extra questions to ensure we provide a response based on disabled people’s experiences.
We hope you will complete our survey and thank you for your involvement in advance – but please don’t forget to provide us with your email address if you’d like to receive a copy of our final submission to the Review.
The High Court accepted West Berkshire Council's argument that the 2003 Fair Access to Care Services guidance, which was updated in 2010 permits a critical only threshold.
However, Irwin Mitchell will argue that the FACS guidance does not of itself establish the legality of the critical threshold - merely that councils should prioritise critical needs over substantial needs, over moderate, over low.
In its appeal to the Court of Appeal, the firm will restate its argument that a critical only threshold is in breach of section 2 of the Chronically Sick and Disabled Persons Act 1970, which establishes councils' statutory duty to provide community care services where necessary to meet their needs.
Drawing on the defining 1997 judgement in R v Gloucestershire County Council, ex parte Barry, which stated that councils could take their resources into account in applying section 2 so long as they treated disabled people reasonably, it will argue that a critical only threshold is unreasonable.
Interestingly, the government looks set to use statute to outlaw the 'critical' threshold - or its equivalent if it does away with FACS - in setting a national minimum threshold for social care through the draft Care and Support Bill issued last week.
Irwin Mitchell has welcomed the proposal though will fight on in the knowledge that it will not become law before 2015. It will submit its argument to the Court of Appeal next week and await a response on when any hearing will be held.
Draft Care and Support Bill open for online comments
The Department of Health is inviting online comments on the draft Care and Support Bill. You can comment on each clause of the Bill and answer questions. Your views will feed directly into the process of parliamentary scrutiny and will be used to assist and challenge the government in considering how to improve the proposals in the draft Bill. You can post comments until 19 October 2012.
Sector slams lack of funding solution in care White Paper
Social care leaders warn of pressures on providers, NHS and carers and ongoing unmet need for vulnerable due to lack of funding in White Paper.
Councils can maintain services at existing levels through efficiency savings, claim ministers
Mithran Samuel
Wednesday 11 July 2012 14:02
Social care leaders have slammed the government's failure to commit additional resources to the sector through today's White Paper.
Today's package of measures, also including a draft Care and Support Bill and progress report on reforming the funding system, came under fire from charities, providers and council leaders alike for the lack of action to tackle social care's funding shortfalls.
Ministers have provided councils with an additional £300m from 2013-15, much of which will be used to implement measures in the White Paper, leaving little to address existing funding shortfalls and compensate for cuts already made to adult care budgets from 2011-13. Also, the government made no commitment to implement a cap on lifetime care costs for older people - as proposed by the Dilnot commission - despite accepting the measure in principle, saying this would be considered as part of the next government spending review due in late 2013 or 2014.
'Massive failure' Alzheimer's Society described the proposals as a "massive failure" while Carers UK said carers would "despair at yet more delay in tackling the fundamental challenge of social care funding".
While accepting many of the White Paper's other proposals on promoting prevention, personalisation and integration with the NHS, Association of Directors of Adult Social Services president Sarah Pickup warned: "The proposals brought forward today, however measured and helpful, cannot compensate for the absence of a fundamental resourcing solution which will need to sit alongside new ways of working with the NHS through joint commissioning and service reform." Government funding for councils is being cut by 28% in real terms from 2011-15, partially compensated by the transfer of £2.7bn in funding for social care from the NHS. Adass surveys have shown that almost £2bn have been taken out of adult care budgets since 2011 and, though most of this has come through service efficiencies, about a quarter has come from cutting services or increasing charges on service users.
Pickup pointed out that there were also hidden costs in service efficiencies through councils not funding providers' cost pressures. "We cannot sustain a position where inflationary pressures faced by providers go unfunded," she added." Our concern is the potential impact on the availability of services for individuals before a longer term solution is found.” 'Chronically underfunded'
Among providers, Bupa said the government had "ducked the fundamental question about how to sustainably fund a social care system that has been chronically underfunded for over a decade". Think-tanks the Joseph Rowntree Foundation and the King's Fund, which have researched the funding of social care over many years, also slammed the lack of a funding solution.
"The consequence of indecision will see a widening gap between the care people need and what is available and mounting pressures on reducing local authority budgets will in turn compromise providers’ ability to maintain quality care," said Richard Humphries, senior fellow at the fund. "An increasingly crisis driven service will in turn place greater pressures on the NHS and on carers." Government defiant
In the White Paper, the government maintained its long-held review that the 2011-15 spending review provided enough resources for councils to maintain services at 2011 levels, so long as they adopted a "rigorous approach to efficiency". It has not taken a view on whether services were under-funded prior to 2011.
On the government's failure to commit to Dilnot's recommendations, health secretary Andrew Lansley said: "I think the Dilnot commission sets out a funding model that we support and we want to implement. We will look for ways to do that, but it may involve public expenditure consequences, and these will have to be weighed agianst other priorities." Mithran Samuel is Community Care's adults editor.More White Paper coverage Care assessments to be outsourced under White Paper plans Powers of entry to stop abuse mooted for social workers What people are saying about the care White Paper Social care White Paper: Early responses
The Papworth Trust have put together
this useful timeline on the Personal Independence Payment (PIP) which
will be replacing the Disability Living Allowance (DLA). (Click on
the ‘play’ symbol, then if you click on each box it zooms in to give you
a clearer view.)
For more information visit the Papworth
Trust’s website
Citizens Advice buckling under volume of
calls over new benefits 4 Jul 2012:
Already overstretched service pushed
to breaking point by requests for assistance with incapacity benefit,
says CAB
New figures show that ESA advice shot
up by an unprecedented 71 per cent - to more than 97,000 problems - in
the three months January to March 2012 compared with the same quarter
last year.
More social care assessments done through
call centres
Quarter of social care professionals
say initial assessments are carried out through call centres, while there
has been an apparent fall in face-to-face assessments, finds Community
Care's annual personalisation survey.
In April 2013 the Personal
Independence Payment (PIP) will replace the Disability Living Allowance
(DLA). The new PIP is ‘based on an assessment of individual need. The new
assessment will focus on an individual’s ability to carry out a range of
key activities necessary to everyday life. Information will be gathered
from the individual, as well as healthcare and other professionals who
work with and support them.’
Membership is exclusive to PAs and those who employ them
and we have just welcomed our 600th member. It does not seem that
long ago when we were celebrating our 100th member. The growth of
our membership is really exciting. The more members we have, the
more we can support each other via the e-Forums and have influence with
major policy makers.
Skills for Care have asked if we could nominate 2
members of PA Net who employ PAs and who would like to sit on Skill for
Care's sector advisory group. The group will consult via telephone
conference (all calls set up and paid for by Skills for Care).
The group will be asked to feedback on draft materials and will be
involved with directing and advising how the work should go
forward. Please
contact us if you are interested.
We still need members who employ PAs to complete a
Skills for Care questionnaire (NMDS). Please, if you can spare
the time, would you contact
us. You can complete it online or we can send you
paper copies or we can talk through it over the telephone.
Skills for Care - support for people who employ
their own PAs
Over 160,000 people across England are now employing
Personal Assistants (PAs) to provide care and support for themselves or
a loved one. With the benefits and flexibility of employing one’s own
staff comes the responsibility of being an employer. This is often a
new role for people and it can be a daunting prospect. Skills for Care
have developed a range of products to help inform and guide through the
responsibilities of an employer to help make the process easier to
understand. These are all listed in the 'We help
people who employ their own Personal Assistants' booklet
and outlines the following guides and information.
To help an employer get started, recruit and keep staff,
the PA
Toolkitoffers
guidance through the recruitment and interview process. The
Quick Guide to Manager Induction Standards identifies
the knowledge and skills that an employer should aim to have in the
role as a manager.
Skills for Care has also produced a guide on
Inducting a PA. Staff Induction is the first piece
of learning a worker should undertake; it is the first step in
developing staff to ensure that they provide the high quality care
and support needed. The
Personalisation and Partnership report explores
relationship building.
Further training needs for a PA may be funded by Skills
for Care through it's partnership with PA Net. For details of the
training for which funding is available and to see a case study which
shows how qualifications can be tailored to a specific job role visit
the Skills for Care website.
"Passport" your funding - wherever you
want to live
Many disabled and older people cannot consider moving to
another postcode because they cannot be sure that they will get
equivalent levels of care and support in a new area.
Last year, Baroness Campbell introduced the Social Care
(Portability) Bill which makes it possible for people who get
state-funded care to move from one area to another without fear of
losing support or having to battle their way through bureaucracy.
Unfortunately she was not able to take it through to Second reading
because of parliamentary and health reasons. However The VODG is
delighted to say that Baroness Jane Campbell is back in the House of
Lords and last week the Bill received its First reading. We need
to show MPs and the Government that there’s a real need to support
portability. If you have any stories to share (good or bad), please
email
Disability Rights
NEWS FLASH
Minimum standard to be introduced
Further information about the forthcoming white paper has been leaking
out. According to this article the white paper will ‘introduce a national
eligibility threshold setting out the minimum care each elderly person
is entitled to wherever they are in the UK.’ This should make the
issues surrounding portability easier.
In April 2013 the Personal Independence Payment (PIP)
will replace the Disability Living Allowance (DLA). The new PIP is ‘based
on an assessment of individual need. The new assessment will focus on
an individual’s ability to carry out a range of key activities
necessary to everyday life. Information will be gathered from the
individual, as well as healthcare and other professionals who work with
and support them.’
Disability Horizons was founded by its co-editors, Srin
Madipalli and Martyn Sibley who both have a physical impairment called
Spinal Muscular Atrophy. Their aim is to create a positive, interesting
and useful disability related magazine with articles and resources to
help disabled people achieve whatever they wish.
You can sign up to receive the magazine free of charge
on their website.
Our last briefing congratulated one of PA Net’s members,
Katy Etherington on winning the Association of colleges Gold Award.
Katy was among eight former students whose careers have been positively
influenced by their former Colleges. Katy was presented with her
award by Lord Willlis at the House of Commons. Previous Gold award
winners include Stephen Fry, Baroness Betty Boothroyd and actor John
Hurt.
The Department of Work and Pensions have now launched a consultation about the closure of the Independent Living fund- which supports many disabled people with very high support needs.
if you want to have your say you can log on to the DWP website at http://www.dwp.gov.uk/consultations/2012/future-of-ilf.shtml - there will also be consultation events held by the Independent Living Fund and by local user led organisations. If you are interested in attending a consultation event at Action Disability Kensington and Chelsea, please contact Jenny at pbsupport@adkc.org.uk.
The easyread version of the questionnaire are as follows -
The Future of the Independent Living Fund – easy read questions - comment online
How to respond online
Register and log in.
Select Leave your response and add your response to the box that appears.
Select Submit Response to save your response to each question.
You can return to add to or edit your response later, or if you move away from this page.
You will lose your response if you do not save it before moving away from the page.
Please make sure that we get your reply by 10 October 2012.
Question 1
From 2015, the government wants disabled people’s care and support needs to be paid for by local councils and will give councils extra money to meet the needs of Independent Living Fund users. This would mean the end of the Independent Living Fund in 2015. Do you agree with this?
At the moment, people get some help from the Independent Living Fund and some help from local councils.
What big challenges would people have to deal with if only local councils are meeting their care and support needs?
How can we make this easier for people?
If we closed the Independent Living Fund, how would this affect local councils and how will it affect care and support services?
How could we make this easier for local councils and care and support services?
Some people, who have been getting help from the Independent Living Fund since before 1993, do not get any help from their local council.
What will we find hard when trying to make sure that these people can use all the local council’s services and get help with their care and support needs?
How can we make sure this happens?
What is the best way for the Department for Work and Pensions, the Independent Living Fund and the local councils to work with and talk to the Independent Living Fund users between now and 2015?
How can the Independent Living Fund work with each local council if the government decides to close down the Independent Living Fund?
You can also email your reply to the consultation to – ilf.consultation@dwp.gsi.gov.uk
Or you can post replies to this address –
ILF Consultation Team
Ground floor
Caxton House
Tothill Street
London SW1A 9NA
Please make sure that we get your reply by 10 October 2012.
HM Revenue & Customs (HMRC) offer a series of free online presentations or ‘webinars’ to give tax help to employers and the self-employed.
There are two types of presentation each lasting 30 minutes:
Live presentation or ‘webinars’ - available on set dates and include a further 30 minutes for a live questions and answer session. They'll also be available to view from these pages after the event.
Pre-recorded webinars - available to view at a time to suit you 24 hours a day, seven days a week.
Please note: the webinar platform used by HMRC is supplied by a company called CITRIX. Neither HMRC nor CITRIX will ask for or retain any information about you or your business.
For employers who want to find out what happens when an employee is absent from work due to illness, how to decide if Statutory Sick Pay is appropriate and what help is available to calculate what is due.
Available dates and times
For employers who have an employee who is either having a baby, adopting a baby or looking after a mother who has had or is adopting a baby. How to decide what payments are appropriate and what help is available to calculate what is due.
Available dates and times
For employers or directors who may be paying, or thinking about paying expenses and/or providing or thinking about providing benefits to their employees.
Available dates and times 31 July 2012 from 15:00 to 16:00 (Opens new window)
How can I take part?
Before you start you need to check you have the right computer software and then register in advance. PC users need: Windows® 7, Vista, XP, 2003 Server or 2000. Macintosh users need: Mac OS® X 10.4.11 (Tiger®) or newer.
Registering is simple - you only need your name and email address to register.
Research raises questions over state of social care and personalisation for blind people
By Andy McNicoll on July 4, 2012 2:39 PM|No Comments
I've been reading a report by the Royal National Institute of Blind People on local authority support for people with sight loss, and it raises a few issues around social care provision for the client group.
Blind and partially sighted people interviewed for the RNIB's 'Quick wins and missed opportunities' research reported a lack of contact with social care professionals. After initial contact with a social worker, "participants were usually left to 'get on with things' themselves", the report found.
So what's the answer? With caseloads spiralling, extra contact time with social workers could be hard to secure.
But the RNIB report contains an interesting case study from Plymouth where a low vision community liason worker post has been created. The role offers support to stop people "slipping through the net" between health and social care.
Could that be an example of the kind of (and sorry to use this phrase) "joined up" support that's needed to ensure that someone's initial contact with a social worker is the start, not end, of their support? The report also found that blind people are missing out on personalisation's benefits, either due to them being deemed ineligible for personal budgets or simply not being aware of them.
The frustration that personalisation's potential for clients is not being realised is shared by many social workers. Just take a look at the findings from our State of Personalisation 2012 survey published today.
The RNIB report, which I should mention was produced in conjunction with the Office for Public Management, is targeted at commissioners. But it's worth a read for some of the social care focused case studies.
Plus it provides a good insight into issues affecting blind people beyond social care - such as transport, training and employment. Check the report and summary out here.
Personalisation must deliver for those who have least
By Mithran Samuel, adults' editor, on July 4, 2012 12:01 AM|No Comments
Councils have delivered complexity, rather than choice and control, for users in the way they have implemented personalisation, to the particular detriment of those with the greatest needs and the least family support, says one older people's mental health social worker.
[Read full coverage of our coverage of the 2012 personalisation survey with daily updates on our special report page]
The personalisation agenda, launched in 2007, was about changing the mould of adult social care delivery in England. We had seen direct payments increasing both options and delivery methods for care and the idea was that these benefits could be extended to all users of adult social care services.
So has it 'gone wrong'? Some of the more worrying elements of Community Care's latest personalisation survey revolve around the discrepancy between the way the policy was envisaged and the reality. While I remember being fed stories about the positive impact that external agencies could have in support planning, 68% of survey respondents said planning was mainly led by council employees, with 3% saying it was led by users and family members and a worrying 0% saying it was led by user-led organisations.
There was a lack of appropriate structures to support personal budgets and support planning across adult social care when the ambitious policy was rolled out. The targets given to local authorities were about take-up rates for personal budgets. These could be met by ticking boxes to make a 'care plan' a 'managed personal budget' overnight without evidencing any differing outcomes in terms of service delivery or choice, so an opportunity was missed. Few lessons were learnt from the implementation of direct payments because the process seemed to be 'more of the same' with a few tweaks. However, what was needed was a more wholesale systemic change in structures - not just of assessment and review but of commissioning and management.
As the survey makes clear, local authority managed budgets remain the most prevalent delivery method for personal budgets. Managed budgets have allowed local authorities to meet the targets by providing personal budgets on paper while using the same block contract agencies, with the same time-limited visits by the same people. I hope that policy makers heed this and pay much more attention to the need for flexibility and choice in managed budgets, and move some of the focus away from direct payments, which are often working better, in my experience anyway.
It's important to remember the positive objectives of personalisation - although it's easy to forget sometimes in the face of increasingly complex paperwork that is tailored more to the organisation than the end user, ironically. As social workers we owe it to those who rely on us to advocate for them and push out the message that personalisation is about better outcomes, not processes.
Social workers need to push for greater transparency in the operation of resource allocation systems that currently seem to be loaded or just plain over-complicated. Improving support planning by using advocates, particularly for those who may lack the capacity to make decisions about support needs or lack family who are able to support them in this way, is crucial too, and if this cost needs to be built into the RAS so be it. Currently there is no additional provision for this group of people and the time and consideration needed isn't built into the funding systems, making it 'easier' for the social worker to default to less ambitious and less meticulous support planning as there is no additional time.
The difficulty is that much of the implementation of personalisation has come during a period of cuts. The irony is that good service delivery doesn't have to be more expensive but it definitely has to be less complicated and more transparent. We need to focus on co-producing support plans with people, especially those who rely on managed budgets, rather than embedding bureaucratic systems that alienate everyone, including social workers, who would prefer to be delivering a better system for all, rather than one which discriminates in favour of those who have more family support and louder voices.
Personalisation is working but we must remove obstacles
By Mithran Samuel, adults' editor, on July 4, 2012 12:00 AM|No Comments
Community Care's annual survey hows personalisation is delivering benefits for users despite problems of implementation; now it is time to remove those obstacles, says Martin Routledge, programme manager for Think Local Act Personal, the sector coalition set up to aid the implementation of personalisation.
[Read full coverage of the 2012 personalisation survey with daily updates on our special report page]
The annual Community Care survey offers a helpful temperature check on what readers - mostly professionals and managers - see as the current state of play with personalisation. The findings can be read alongside other pieces of intelligence and research to add to our understanding of the position and where the priorities for action lie.
For Think Local Act Personal, the survey will help us with our plans for the National Self-Directed Support (SDS) Forum, which is now moving forward with projects. The forum brings together many organisations and people, national and local, with good knowledge about what is working and not working with self-directed support, and includes The College of Social Work. One major piece of work to be undertaken, with the Association of Directors of Adult Social Services, Department of Health, Social Care Institute for Excellence and older people's and carers' organisations, is to review personal budgets for older people, including older people with dementia.
Perhaps the key finding of the survey is that twice as many believe personal budgets will be of benefit to local people using them as those who believe they will not. This positive figure has increased since last year - quite remarkable in the circumstances and despite the many challenges and concerns identified in the survey. This is a strongly hopeful sign that if we can make better progress in clearing away some of the challenges and obstacles to good delivery, major benefits are possible for people.
Even in these really difficult times, significantly more respondents said that personalisation is having a positive rather than negative impact on their jobs - though we should be concerned about the substantial minority that say otherwise or that the status of social workers has been negatively affected. Social work has key roles to play in personalisation but these need to be more strongly articulated both nationally and locally - an issue the SDS Forum has identified for action.
The core challenges noted remain unhelpful bureaucracy and process, lack of co-production with people using social care and continuing cultural barriers. There is a picture of more needing to change about the way business is done - one example being that 72% reported no delegation of budget sign-off, another the reporting of low levels of support planning not being undertaken directly by council staff.
In the light of the frequently expressed concerns, it was perhaps surprising though encouraging to see a majority saw council-managed personal budgets offering greater choice and control than traditional packages though the numbers seeing direct payments offering this were much higher (76%). Given recent Adass findings that managed personal budgets are increasing rapidly as a proportion of the total, this suggests that proposed SDS forum work on direct payment uptake strategies and demonstrating how to achieve choice and control via managed personal budgets is important.
The pattern of recent years seems to be largely continued in these survey findings: they demonstrate both belief in the possibilities of personalisation and continuing frustration with persistent obstacles, many of which seem to represent more of a cultural than technical challenge but also in a really hard financial context. There remains much to be done by both practitioners and leaders. Think Local Act Personal will continue to play its part in this. We will be pleased also to work with Community Care in identifying positive practice and bring those to readers' attention.
Posts
How to respond online
Question 1
From 2015, the government wants disabled people’s care and support needs to be paid for by local councils and will give councils extra money to meet the needs of Independent Living Fund users. This would mean the end of the Independent Living Fund in 2015. Do you agree with this?