It may be helpful to read our Guide to Accessing Free Personal Care before reading this article.
1. The council has only offered me 6 hours a week so is that all I can get?
Firstly, the council will assess your needs based on how many ‘hours’ of care they think you need. It is from this number of hours that they calculate how much money they will contribute to your care based on their current preset hourly rate. For example, if you have been assessed as needing care twice daily for 30 minutes and the hourly rate is £15, the council will contribute with 7 hours a week or £105. They key word here is contribute! In the majority of cases, you will need to top up to access that actual care package you want.
Once you know how many ‘hours’ you are entitled to it becomes very unhelpful to view the payment in terms of hours of care. Instead, go with the weekly contribution in actual £s. Once you know the weekly amount they will contribute, you can then decide how much care you actually want. Further, you will understand what you can afford with both the council’s money and with your own money to top it up.
It is misleading to think the council will be able to provide enough money to pay for your perfect care package. View the councils’ money as a contribution only from which you can build your own care package on your terms. A helpful rule of thumb is that usually, in the context of a holistic care package put together by a family, the contribution from the council may cover 20-25% of the total cost. You can have as many or as few hours of care as you want, provided you can afford to top up as required with your own money.
2. Can I only use a care provider whose pricing structure is the same as what the council will give me per hour for care services?
No. Despite what you might be told occasionally, you can use any provider you like. You just need to remember that if you choose a provider whose hourly rate is higher than the council rates, (which will likely be the majority of providers these days), you will need to be able to self fund the difference. The principle behind the ‘personalisation’ agenda is all about putting control back to the users of care services. Therefore, you are in control and no one can tell you who to use your direct payments with. The only caveat is that the money is from the public purse and as such you must be able to justify where and how it’s been spent. You should evidence that it has been used for care and support services and not spent on a luxury holiday to the Caribbean!
3. The payments can only be used for personal care.
This is not true. But, you may get differing opinions! In order to answer this question, one must first understand what personal care is and is not. Personal care is helping you to get in and out of bed. It will assist with washing, dressing, and toileting, medication prompts, and very basic meal preparation. It is not for companionship, shopping and errands, housekeeping and extended support, and other matters of general well-being.
The council will often assess a person’s requirements for personal care in blocks to determine their need: ie, bath = 30 minutes, breakfast = 15 minutes, toileting 15 minutes etc. We know life does not work like this. Especially as we age, we like to take our time and if someone is rushing us through personal care tasks, it can become unsettling. It would also do little to help us maintain our sense of independence and control.
Within the context of quality care and quality time, it is not always so easy to break down care arrangements into what is a personal care and what is not. Therefore, it is unhelpful to be prescriptive about whether or not it can only be spent on personal care. We tend to subscribe to the notion that if the support provided is helping to contribute to someone’s well-being and independence at home, then the direct payment is justifiably spent on it.
4. If I want to access direct payments, do I need to become an employer?
No, not at all. In fact, we would generally recommend against it unless you are in a position and are prepared to take on all the legal and employer responsibilities on yourself. If you use a professional established provider of care services like Bright Care, they carry all the legal responsibilities for the safe and proper management of its staff which in turn serve you.
Some people may choose to use a direct payment to hire someone directly. Setting yourself up as an employer is fraught with difficulties and challenges which often cancel out any potential savings of hiring directly as opposed to using a provider, however, there is free assistance with this process from charities like Lothian Centre for Inclusive Living.
It has been our observation that setting yourself up as an employer may provide a greater sense of control for a younger adult with full capacity who requires a lot of day to day care and assistance in their life. We would take the general view that in terms of care for older people, setting one’s self up as an employer is rarely going to be the best solution with all the added challenges of recruiting and managing staff, staff absences, holiday pay, sick pay and employer liability, the list goes on!
5. Can I nominate the provider but the council will pay them on my behalf?
Yes. Under what is defined as Option 2, they will, but there are caveats! Option 2 is defined by the government as “the selection of support by the supported person, the making of arrangements for the provision of it by the local authority on behalf of the supported person and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of that provision“.
This statement could be somewhat misleading. Firstly, if you choose a provider whose hourly rates are higher than the amount set by the direct payment, which is increasingly common, the local authority will not pay the full bill. This would leave a top up to be paid. Further, it can get very messy and confusing in terms of knowing what you owe.
Secondly, if you have chosen Option 2, it’s probably because you do not want the hassle associated with paying a private provider. So, if you find yourself being involved in paying a top up, you may as well have opted for ‘Option 1’, in which you are responsible for paying the full bill from the care provider. ‘Option 1’ is defined as ‘the making of a direct payment by the local authority to the supported person for the provision of support’. When pursuing direct payment, generally speaking, we would strongly recommend ‘Option 1’ in connection to getting extra financial support for caring for an elderly loved one.