There are more and more people looking at recieving direct payments for their care services.
Below are some testimonials from current users of direct payments (some testimonials from people will remain anomyous, as they requested).
Adults Social Care Direct Payment case studies
Children and Family Services Direct Payment case studies
Background
Mr Z is 79 years old and he moved to the UK about 12 years ago. He has no local family. In his own country he was a successful businessman and won recognition for services to his country. Upon arriving in Scunthorpe he became well established and well known.
Five years ago Mr Z sadly suffered a stroke and was unable to mobilise without equipment nor could he use his left arm and hand due to weaknesses. He was required to move from his home due to access difficulties. Obviously this also meant he was moving away from his established area where he used to visit his local club, shop and visit his bank to manage his affairs. He regularly ate only heated microwave meals that often contained foods, which he did not eat.
Mr Z had an assessment undertaken by Social Services, Older People’s team, which highlighted his needs as assistance with personal care, shopping, meal and drink preparation, general domestic duties, assistance with managing his post and help with collecting pensions. He received a total of seven hours assistance per week. Mr Z declined day-care due to him wanting a 'normal life', he was unfamiliar with large groups and felt he would not have anything in common with the other people that attended. However, Mr Z was isolated, he was unable to access his previous venues, meet his friends and said he felt like a prisoner in his own home. He felt that nobody cared and was frustrated and lonely.
The journey
Explaining the Direct Payments process to Mr Z and building up trust has been a long haul. It took three months of fortnightly visits and regular telephone calls to reassure him that I had his best interest at heart. He was reluctant to believe that I was there to support and assist him to regain independence and control over his life.
Penderels Trust (Direct Payments Support Service) have continued to support Mr Z through complex issues such as tax, employee insurance, plus signing of cheques to pay his staff which Mr Z has found difficult to grasp. Sometimes contact has been weekly or daily as Mr Z needs dictated.
Finding the right Personal Assistants (PAs) has been a battle for Mr Z – due to his specific needs. Staff illness has at times affected his care, and responsibility has fallen back onto Social Services to provide care at times. A hole in the bath meant no bath, a broken tripod meant a trip to equipment stores and a plea for a new frame meant no mobility. No contribution towards his care has sometimes meant no money for staff – explaining this to Mr Z has sometimes been very difficult. The difficulties have arisen due to the fact Mr Z has no family or other support networks – only us.
Current
Mr Z now has two personal assistants who work a total of twenty hours per week, over seven days between them. In addition he receives support from Housing Support Officers who assist him weekly for two and a half hours per week with budgeting and finances. He goes shopping, visits his club and bank, collects his own pension, has lunch out and enjoys conversation with his PAs – they have time! When shopping he chooses his favourite fresh foods and his assistants cook for him.
The journey has been one of exploration for me and I have learnt a lot, and I have had the opportunity of working closely with the Support Service to ensure a joint approach to the complexities of this case.
From a care management view the paperwork is the easy part. From all our points of view it has been worth all the effort when Mr Z says he feels like a human being again.
Hello, my name is Lilly. 25 years ago, at the age of 21 I injured my cervical spine. Five years later I underwent major surgery which unfortunately did not have a successful outcome. Up to 10 years ago, despite the limitations my injury has placed upon me I've managed to lead a fairly active / independent lifestyle and have always worked. In 2004 I was diagnosed with breast cancer.
Prior to using Direct Payments I had services arranged through the council. The first six weeks were extremely successful as it involved the Community Support Team who are employed directly through Social Services, assisting me to meet my care needs. They were excellent.
Once this six-week period ended Direct Payments were mentioned to me for the first time as a option to meet my assessed care needs, but I did not feel well enough at that time to manage the paperwork and responsibility of a Direct Payment – so I declined the offer. It was a bit of 'Catch-22' for me as I knew I needed a better standard of care which I could organise via Direct Payments, but just did not have the energy to do so.
At this point Social Services arranged my care needs to be met through a private contracted agency. This did not work from the beginning. I found the timings when they could get to me were restrictive, I was confounded by the number of different carers that were sent to my home and rarely had anybody regular.
I felt out of control and suffered a distinct lack of dignity as people were turning up to clean whilst I was in the bathroom having a shower. I also felt there was a negative attitude towards me as I was not private paying client, and staff left early without completing care tasks to move onto the next client. I feel many agencies are geared towards caring for elderly people – I was only in my forties and needed a different form of care and probably had higher expectations about what I wanted to do with my life.
I felt that I didn’t have a voice, and that I was not listened to. I complained regularly about the services I was receiving, but nothing was ever resolved. I felt extremely vulnerable.
Back then I also used a local day centre run by the council – however this centre was also used for people with learning disabilities which I did not find appropriate for my needs. I took up this option as it was the only escape out of the house, but eventually gave up as it was not for me and didn’t honestly get anything out of it.
My life on Direct Payments
Using Direct Payments has revolutionised my life – I have been lucky enough to find an agency that sends me a few dedicated staff. I have control over what happens in my house, and when it happens. I have flexibility in that I decide what care routine works best for me, and can bank hours if required to do other things that cannot be arranged through traditional services. The member of staff at times accompanies me on trips out, so I can shop and try on clothes rather than ordering everything from catalogues. I can go to the garden centre to buy things for my garden, go swimming or she will accompany me to the gym if I want. I can also use my hours to have accompanied hospital/GP visits if required.
I would like to take up a course but feel there are still barriers in the way, in that I am unsure as what other people's perception of me would be as I don’t 'look' disabled, so undertaking something like that would be a major life changing experience for me.
I feel I have regained my dignity and respect, through the way staff treat me and also being able to have some hours for socialisation. My staff also help me with meal preparation at times if required, so I can cook nice meals for me and my husband which may be more complex or take longer to prepare than normal.
This scheme just fits in so well with my chosen lifestyle and my family’s needs. I pay invoices direct to the agency out of my Direct Payment account – therefore have no employer responsibilities at the present time. I feel I have more negotiating power now – if these services do not work to my benefit I will go elsewhere.
To be honest if I could not get services like these though an agency I would have no hesitation now in employing a Personal Assistant direct and becoming an employer as I feel much more confident now with the system and how it works. However, I think I would still worry about contingency cover such as staff holidays and sickness. As it stands though – this way works for me, and for the staff that work for the agency.
Usually all my care is done in the morning and therefore there are no further intrusions into my private home life after that – my husband's day off used to be a Wednesday, so I did not have any carers on that day, but he has had to finish work through ill health so have kept up this routine which suits both parties. Agencies have been willing to let the same member of staff increase their hours as the Direct Payments has increased to meet my increasing care needs, which ensures continuity.
I feel very fortunate to be on this scheme and I would recommend Direct Payments to anybody who was interested. I have recently agreed to join the Support Service’s networking group so I can talk to people who are considering Direct Payments, to let them know of how it has enabled me to be independent.
Child X testimonial
Child Y testimonial
A direct payment has meant that the care is flexible and there when we need it, it also means that I choose who cares for child Y.