Care Plans and Cuts FAQs If travel costs associated with meeting someone’s assessed needs are in excess of the mobility element of PIP- should the costs be covered by the personal budget? Is it lawful for a Council to say they won’t pay for gym membership to meet need? Do service users have any right to access records and admin concerning their accounts if they have a managed account? A Local Authority has stated they do not fund holidays or pa travel expenses- is this lawful? Who really has the right to decide on how and when a DP’s use can be changed? How do assessments remain ‘carer blind’ in situations where family members are involved and provide paid care via Direct Payments? Can social workers cancel Direct Payments if the service user or carer requests a remote review in place of a home visit? How much flexibility is there with Direct Payments? Do you always need to be reassessed if you wish to use a pre-exisiting care package/budget differently, just to better meet needs, not because there’s been a change in them? Should CHC funding cover therapies/activities needed to prevent deterioration in challenging behaviour and meet psychological/emotional needs? For example, things such as sensory activity, swimming, sensory integration therapy, physio. Should the CHC care and support plan be built on the type of care and any other support needed to meet health and social needs, rather than work backwards from an indicative budget that is just a sum of money? For example, we have been told that if we need staff paid at a higher rate, this will mean fewer hours of care will be able to be funded. Is this correct? When it comes to employing family members through CHC funding for a personal health budget by way of a cash payment, are there any hard and fast rules on how that gets approved by the ICB? Or is it like the “exceptional circumstances” rule with direct payments, or worse, just a postcode lottery? What is the avenue for challenge for CHC care planning and support plan disputes? Could ‘a preference’ to be in a more expensive setting be argued for on the basis of the quality of care, being a need, and not perhaps likely to be assured through a cheaper facility? Or is a reference to quality always going to be seen as just a want or a preference? Should unpaid family carers be included as part of a Continuing NHS Healthcare training budget ie receive training along with paid staff, as they also provide care and are an essential part of the team? Can a local authority rule out a particular care home, for respite or long term care, on the basis that it does not have a commissioning relationship with it? When someone has an existing care package in place and their needs increase to such a point that they require two to one care, does the council have a duty to provide more money to fund a second carer, or can they force a reduction in the over all care hours to split the budget between two carers instead, leaving the service user with fewer hours support overall? Does a local council’s policy (for either commissioned care or personal budgets) trump the Care Act? For example, can a council refuse to fund night sits because it’s their own policy to do so, even if the Guidance states they can’t have blanket policies? My son receives s.117 Aftercare funding. He is due a small legacy of £40K. He is currently in supported living and both his housing and care are paid for by the ICB. However, if my son were to move into his own home, i.e a rented flat would his legacy money have to pay for his housing and care or as he is s.117 funded would the ICB be responsible for paying for both? Can the LA refuse to pay costs incurred by a PA (that they are funding to meet eligible need) such as mileage, expenses while out supporting the individual such as meals/entrance fees etc?If they cannot refuse, how does the LA work out how much to provide to allow for variable allowances? How should a person’s personal or social care needs be identified if they change after the person has become CHC eligible – that is, the last Care Act assessment is now out of date? Regarding CHC decision-making for CHC eligible people – is there a right to have a Social Worker involved in care planning if you are CHC eligible, or is this up to the individual ICB? Should establishing and/or agreeing on how the care is best provided come before a budgeting decision? Which way is lawful please? I care for a disabled adult and I’ve heard social workers claim it would be more cost effective to put him in residential care. I understand the council can’t force this but are they able to stop paying or limit/reduce his care funding to indirectly leave him with no choice? Are the council allowed to say they will only pay the same for care at home as they would in a care home? How does anyone find out how much residential care would cost the council without going through an assessment that they oversee? Is the amount of care a person receives dependent on how much charge for care/contribution a person is assessed to make? Is a council under any obligation to place someone (young or old) with a specific physical disability in a specialist care home that caters to it, or can they just offer the bog standard one? After years of fighting for an adequate care package at home, my elder sister’s council/social worker offered her a care home and refused to provide a slight increase in care that would have meet her needs in the community. Since she’s been in the care home she has rapidly declined in her physical and mental health as well as her mobility and cognitive/language abilities. She still maintains her own GP, who is shocked by how rapidly she’s declined despite the home providing decent care. She is a thousand times worse in the residential home than she was in her own place with the meager amount of support she was given. Is there anything at all we can do about this to hold the council responsible for failing her in this way? What considerations does a social worker need to have when an adult with eligible needs has NRPF and what additional steps are required in the assessment process? Does someone’s wealth, or ability to pay charges, impact HOW MUCH care a person will receive from a council under the Care Act? Accepting that it’s been demonstrated to be lawful for an LA to take account of its resources in making an offer of care – what if for example the ‘maximum offer’ for an individual is lower than the cost of support the LA is providing to My sister is severely disabled requiring 24 hour care. My parents are her main carers with me and my brother paid PAs for respite. Due to a family emergency whilst my parents were on holiday the siblings/PAs had provide care for a full week including nights. The social worker said this care would not be funded as family should step up in a crisis. She said we should have contacted them to provide short term residential care. Is this correct? When a local authority is made aware of the forthcoming closure (and planned subsequent demolition) of a registered care home, because of a commercial decision made by the provider rather than its business failure, which has a resident whose accommodation in that care home is part-funded by that local authority, does this event automatically trigger a requirement for that local authority to carry out a new needs assessment as per Section 9 et seq of the Care Act 2014 since that resident will have no choice but to change accommodation? If so, what are the relevant Care Act and case law references please. How would you recommend establishing a strong evidence base for claiming DRE for holidays, and which are the most relevant legal precedents to refer to? After years of fighting for an adequate care package at home, my elder sister’s council/social worker offered her a care home and refused to provide a slight increase in care that would have meet her needs in the community. Since she’s been in the care home she has rapidly declined in her physical and mental health as well as her mobility and cognitive/language abilities. She still maintains her own GP, who is shocked by how rapidly she’s declined despite the home providing decent care. She is a thousand times worse in the residential home than she was in her own place with the meager amount of support she was given. Is there anything at all we can do about this to hold the council responsible for failing her in this way? How do you go about ensuring the care budget from a Local Authority will be sufficient to pay for Supported Living housing needs and all care/access to the community activities that our young person will need when he leaves residential college? In what circumstances would it be lawful for a local authority to say that a particular response that someone is requesting/requires in order to meet needs that have been determined as eligible under the Care Act are “outside of the remit of adult social care”? Are there any examples of good practice you can point us towards in initially drafting a Care Plan – something we can customise to be relevant to our son?
