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Direct Payments are a Burden on Carers

The Government’s Vision for Adult Social Care (England) requires  local authorities to provide personal budgets for a carer with her daughtereveryone eligible for on-going social care, preferably as a direct payment. The aim is to give choice and control to the people needing support rather than social workers deciding the package of support they would get.

People should be able to choose and control the services they receive and personal budget is a method for doing this. More choice and control can give them a sense of independence and help transform lives.

There is a genuine fear that councils are deliberately withholding the offer of personal budgets to retain control, or that the council says a personal budget has been allocated but in reality the council and not the person controls what it is spent on.

This is why the Government are promoting Direct Payments over personal budgets. With Direct Payments, the money is actually given to the person to spent and manage in contrast to a personal budget where the council administers the budget, despite the person being in control.

However, using a Direct Payment brings extra burdens for people. Unlike with personal budgets where the Council remains the employer, in Direct Payments the holder becomes the employer and all that entails. Tax issues, redundancy if you dispense with a personal assistant, holiday pay and sick cover and dreaded paperwork.

Research  showed that the burden of managing a Direct Payment or personal budget often falls on the carer, adding to their responsibilities. By promoting Direct Payments, the Government is effectively increasing the burden on carers.

I worry that people who don’t want a personal budget will be pushed into receiving one because of the Government target, and that there may be some people who would prefer a personal budget but are pushed into a Direct Payment because of the Government guidance.

If so, I want to hear from you.

Take care

Gordon

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February 9, 2011 Posted by | Benefits, Social Care | , , , | 15 Comments

New Government’s programme: what’s in store for carers?

Thirteen days and twelve hours after the polls closed, now we know. The new Government’s programme – an amalgamation of manifestos – has been published. You’ve got to hope that those who stayed up during election night didn’t wait this long before catching some sleep.

In relation to health and social care, what’s in store for us?

Paul Burstow, Carers Minister

Paul Burstow (now Carers Minister) & Tom Brake MP with local carers earlier this year

The big worry was that there would be no reform of social care in England. But the good-as-could-hope-for news is that a(nother) commission will report within one year on ideas including a voluntary insurance scheme to protect assets of those in residential care (Tory policy) and a partnership scheme proposed in the Wanless Review (Lib Dem policy).

People receiving support and carers must be a part of this commission.

For carers specifically, the new Government has said they will use direct payments to carers and better community based provision to improve access to respite care. We’ve heard on the grapevine that the new Health team (Andrew Lansley MP is Secretary of State and Paul Burstow MP is Minister for Care Services) are keen to address PCTs not using the Carers’ Strategy money for carers. We hope to work with them on this.

And the Government are proposing elections for part of the Primary Care Trust boards. Carers – get in there!!

Other announcements include:

  • Help elderly people live at home using community support programmes and adaptations
  • Retain winter fuel allowance, free TV licence, free bus travel, eye tests and prescriptions for older people
  • Restoration of earnings link for the basic state pension from April 2011 and will rise by the higher of average earnings, prices or 2.5%.

So this is the good news. The bad news, that we must all expect, will be the £6bn savings to be announced in a new budget promised within 50 days of taking office. But that’s only for this financial year. April 1st 2011 is the date that many local authorities dread, which I’ll explain about more in a later blog.

Take care

Gordon

May 20, 2010 Posted by | Carers Strategy, Conservatives, Health, Liberal Democrats, Social Care | , , , , , | Leave a comment

Does focus on services for the carer detract from a whole-family approach?

Margaret Thatcher and Gordon Brown outside Downing Street

I've been thinking about what's changed

I’m coming to the end of 10 years in the carer’s movement so I’ve been thinking about what’s changed.

Every campaign and movement for change starts by carving out its identity. It has to be clear about who it’s for and who it’s not, so that, in our case, the government and the public understand who carers are and why their needs matter.

I think the carer’s movement has done that pretty well. People still say “carer” when they mean “paid care-worker”, but you only had to look at the three party leaders competing to sing the praises of unpaid family carers to realise that understanding of carers has hit the mainstream. I can’t imagine Thatcher, Kinnock and Steel/Owen having that conversation.

That necessary focus on carving out a space in public policy for carers has had some downsides, though. In fighting against being lumped together with services for people with long term conditions, we haven’t always had enough of a focus on whole-family solutions. Nine times out of ten, carers come to Carers’ Centres with a crisis in the life of the person they are caring for, which has in turn become a crisis for them. It is usually some time before the Centre can help that person to begin to reconnect with themselves as an individual, rather than seeing themselves solely as their relative or friend’s carer. In the messages we give to government, I think we are still finding the right balance between promoting the need for independent services which are first and foremost for the carer, and helping policy makers to understand that decisions made about people’s health and social care support are decisions that affect whole families.

Getting this right will become ever more important, because councils and the NHS are about to come under huge pressure to cut and amalgamate services and because we have seen the personalisation reforms (personal budgets, direct payments etc) have both good and bad effects on the people who continue to provide the bulk of many support packages: the unpaid carers.

We are all inter-connected and interdependent. Both those who give and those who receive care and support can be excluded from ordinary life chances such as employment, community life and full participation in family relationships.. The state can barely afford health and social care as it is. Without a whole-family approach that feels joined up and supportive to unpaid carers, as well as to the people they support, that funding gap will widen and we will again see the NHS and social services teeter on the brink of collapse.

But if over the next ten years, the carer’s movement can help to make it self-evident to every council and local NHS trust that carers are both fundamental to delivering services, and also individuals in their own right, the rewards unlocked for families and for the state will be huge.

While I’m moving on to a new job, I have been thinking about the many carers for whom caring is life-long. Working with carers has, I hope, left an indelible mark upon my life. I’m grateful for that and for the thousands of contributions of time, expertise and experiences The Trust receives from carers: there would be no change without you.

Alex

Alex Fox, guest blogger this week, is Director of Policy and Communications at The Princess Royal Trust for Carers

May 11, 2010 Posted by | Carers movement, Health, Social Care | , , , , , , | 3 Comments