ALL QUESTIONS BELOW ARE BASED UPON A SEVERELY DISABLED ADULT WHO HAS A DIRECT PAYMENT BUDGET TO PROVIDE FOR THEIR CARE AND SUPPORT NEEDS.
1. Please advise what rate per hour is your specialist PA rate.
Our (2018-2019) rate for a Direct Payment taken to employ a personal assistant is £12.00 per hour (gross). However, a different rate may be negotiated if additional specialist knowledge or skills are required.
2. Does the PA rate increase for unsociable hours i.e. evenings/weekends
The rate for a PA is a standard rate but when the DP is set up, care managers will also consider any of the following factors, which may impact upon the price:
• Whether the PA is to be employed or self-employed
• The ‘sufficiency’ of the care package i.e. whether it meets the needs /outcomes as described in the support plan
• Any specialist knowledge or skills required of the PA
• Considerations in respect of the Employer’s responsibilities regarding National Minimum Wage/National Living Wage.
3. An enhanced DBS is required every year do you pay for this to be done for all PA’s
Where the DP recipient is an employer, if a DBS check is required for a PA, the DP recipient can contact their Independent Living Advisor who can help them to organise this. DCC will cover the cost of the DBS in this situation.
4. If a PA is unavailable and there is a need to meet the shortfall using agency staff how is the higher hourly rate for this service met by the DP Budget.
If there is a change in need or circumstances, the DP recipient should contact their social care team to discuss the change. It may be that, in the scenario above, additional funds can be made available to fund the use of an agency during this period. Alternatively, we can commission a service as an interim measure to ensure the person receives the support they need.
5. Please confirm all the on costs that are associated with the employment of PA’s and explain how these costs are included in the DP Budget.
The Direct Payment hourly rate, for people who are employing a PA includes the following elements (where appropriate):
• Employee pay rate
• Allocation for holiday pay (compliant with HMRC guidance)
• Employer NI
• Employment Allowance
6. In exceptional circumstances you are able to consider the use of direct payments for the employment of family members living together to provide support above and beyond what family carers would be reasonably expected to provide please confirm how many families has this been agreed for since 2014.
Devon has agreed that, in exceptional circumstances, this may be permitted. We do not have any information relating to the number of cases where this is the arrangement. To extract this from our data would require an individual review of every single case where direct payments have been made. This would take significantly longer than 18 hours and this information is therefore exempt from disclosure pursuant to s.12 of the Freedom of Information Act 2000.
7. Do you make an allowance in the DP Budget to cover PA expenses.
The expectation is that the gross hourly rate covers all costs such as travel. However, in some exceptional circumstances, we may cover some additional travel costs if the DP recipient lives in a known ‘hard to reach’ area. We would need to have evidence that the expenses were required in response to a direct need for the cared for person, in line with our Fair and Affordable care policy.
8. What payments are included in the DP Budget for retainer payments to a regular PA.
If the DP recipient were to be admitted into hospital for a significant stay, a retainer can be paid to the PA for up to 4 weeks. After that period, this arrangement would be reviewed on weekly basis.
If a DP recipient was aware they would be having regular and planned periods away e.g. in hospital, then this should be factored into the contract the DP recipient has with a PA.
9. What payments are included in the DP Budget for holiday pay.
There is a notional amount within the budget, which is allocated for annual leave, and included within the gross hourly rate. The expectation is that this amount is retained used as and when required.
10. What payments are included in the DP Budget for care whilst on holiday when a client needs 2 to 1 support at all times.
It is our expectation that the Direct Payment amount would remain the same throughout the year unless there is a significant change in need or circumstances.
11. Do you allow relatives to take respite breaks together if it meets specified needs/outcomes.
An individual’s personal budget will include a component “Weekly allocation for sustaining unpaid carer’s role (respite)”. The amount required for the year will be part of the support planning process and should be determined based on the individual needs of the carer and the person themselves.
When receiving a Direct Payment, it is the responsibility of the people themselves, or their nominated persons, to agree how the budget is spent to meet the needs/outcomes.
12. How are respite monies included in the DP Budget and how much is it per week. how is the amount of weeks respite a year decided upon for each client.
Any budget for Replacement care (respite) is individually assessed and not paid at a standard rate.
13. If the clients needs are very complex and demands skilled micro management are you able to provide a higher hourly rate (perhaps in line with agency fees) to attract suitable PA’s.
We do, on occasion, pay a higher hourly rate, for example, if the needs of the individual are complex. However, this decision would be made following an assessment, with a view to finding the best possible outcomes for the person within their agreed personal budget.
14. What proportion of the DP Budget do you pay to the person who is providing the administration/management of the budget.
Where it has been assessed that the person requires additional support to be provided in relation to the administration of the budget, an admin fee may be added to the Direct Payment at a standard rate of £4 per week. This amount reflects the level of payment made to an independent management company that Devon County Council contracts with to offer administrative support to DP recipients. If the budget needs to be administered, we can also arrange this through an organisation called Disability Focus.
15. Do you detail in the care and support plan how emergencies and contingencies will be met when a PA is absent. How do you ensure needs continue to be met when the client is unable to use/access respite care and agency staff ie do you provide enough hours for a floater.
To cover this eventuality, there is a section in the Your Care and Support plan called ‘Your emergency back-up plan if your care and support is disrupted’.
This requires the development of a plan which is agreed between the person and the assessor, based on any presenting or potential emergencies or disruptions to the care and support.
There is a contingency amount of money allocated within a Direct Payment to support sudden changes or emergencies, i.e. sudden increase in care and support needs because of health changes.
16. Friends, family and neighbours can offer many kinds of support for free. Do you allow the DP Budget to pay a small amount of money to say thank you for help received (known as a legal reward). If yes what is the maximum allowed per person and per budget.
Currently, we don’t cover this scenario in our policy or practice guidance, so we would need to consider each case based on its own circumstances.
The guiding principle should be that an individual’s personal budget, within the Direct Payment, is provided based on the person’s assessed eligible needs. Devon adopts an ‘asset-based’ or ‘strengths- based’ approach to assessment which means we look at how a person’s friends and informal networks may meet some of their needs, without the need for formal care or support. So long as the Direct Payment is being used in line with this approach, meets the individual’s needs and outcomes appropriately, is not spent on ineligible items, how a person chooses to deploy their fund is, within reason, their decision.
17. How do you ensure that any review/reassessment of an autistic adult is carried out by someone with specialist training in autism in line with the care act.
For any review or re-assessment of a person’s needs, the case is allocated by a team manager (or team) who will need to assure themselves that the person who is doing the work has the appropriate skills and experience to do it appropriately and effectively.