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Help! Direct Payments or internal services?

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
Hi all :)

Mum has up to now been having care on a private basis via a local agency with whom we have built up an excellent working relationship.

Now that mum's capital has fallen below threshold, we have had a social services assessment, and as I wanted to carry on using the same agency, I asked for direct payments. I got a costing from the agency and submitted it, and what I was dreading, has now happened.......

The local authority has a contract rate with the agency, which is much less than the private rate, so SS are wanting us to accept what they call 'internal services', ie care through the same agency, for, at present £129 per week less than the private rate.
Social Services call this a 'saving', but of course it's only a saving to them.... For the agency, it means that they will be asked to provide the same care at a vastly reduced rate. I have no guarantee that they will accept this. Furthermore, IF we go with this, Social Services will be at liberty to source mum's care in future from anyone who is cheaper :( We lose any say over things, and even if we keep the current agency, they may well give us less convenient times etc.

There is also the issue of care workers being paid a living wage. I really don't want to be involved with such exploitation of care staff, in the interests of the local authority keeping costs down...

So my dilemma is, do I go ahead with direct payments, meeting a shortfall of £129 a week from mum's / our savings ?? It would place a considerable burden on us, but we'd do it if we decide it's worthwhile. And fairer all round.

So, what do you think? Is it worth topping up direct payments in order to stay in control of mum's care, and being able to hold our heads up morally??

Lindy xx
 
Last edited:

Beate

Registered User
May 21, 2014
11,891
London
Have you asked the agency yet whether they would do this? You can't be the only one getting direct payments. It's a bit like with care homes - some people pay the LA rate some the private rate, and it balances itself out. Homes and agencies accept LA rates because of certain advantages like having the money guaranteed. It shouldn't affect the standard of care they deliver. With regards to a living wage, they either get it already or they don't - I doubt very much it would depend on what one end user is paying them.
So I would say talk to the care agency and get their take on this. Don't offer to pay any top ups (can you even do this?) before you've gathered all the facts.
 

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
Have you asked the agency yet whether they would do this? You can't be the only one getting direct payments. It's a bit like with care homes - some people pay the LA rate some the private rate, and it balances itself out. Homes and agencies accept LA rates because of certain advantages like having the money guaranteed. It shouldn't affect the standard of care they deliver. With regards to a living wage, they either get it already or they don't - I doubt very much it would depend on what one end user is paying them.
So I would say talk to the care agency and get their take on this. Don't offer to pay any top ups (can you even do this?) before you've gathered all the facts.
Thanks Beate, you speak a lot of sense :) I am just finding the whole thing really upsetting.

I did ask the agency a couple of weeks ago whether they could take on mum's care through social services. At that time they said no, as they had no slots for SS clients....However now that we are are a bit further along the line, you're right, I'll ring them tomorrow and see what's possible.

Thanks again :)

Lindy xx
 

bemused1

Registered User
Mar 4, 2012
3,402
It definitely won't make any difference to the care workers. This is one of my gripes about self funding, the carers get nothing like what I pay and they are all on zero hours contracts.
For all my recent problems with agencies I don't feel the carers get a fair deal . How can you support yourself if you don't know what your income is.

Incidentally Lindy I would not hand supervision over to the council, but this is my husband and I feel that if and when I have to hand his care over to someone else, it will be someone I have chosen.
 

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
It definitely won't make any difference to the care workers. This is one of my gripes about self funding, the carers get nothing like what I pay and they are all on zero hours contracts.
For all my recent problems with agencies I don't feel the carers get a fair deal . How can you support yourself if you don't know what your income is.

Incidentally Lindy I would not hand supervision over to the council, but this is my husband and I feel that if and when I have to hand his care over to someone else, it will be someone I have chosen.
Thanks bemused1 :)

I agree, the pay carers receive and their working conditions are a disgrace :mad:

I am finding it truly hard to come to terms with, in effect, handing over the supervision of mum's care to SS. Like you with your husband, I feel that she is my mum and it should be possible to have more input into her care. However, it seems you're either self-funding, or you're stuck with 'the system'. It makes me feel literally sick to know that a faceless bureaucrat will be able to cut mum's care, or transfer it to a cheaper agency. And yes, I did used to be one of those people....:(

All the best

Lindy xx
 

Pete R

Registered User
Jul 26, 2014
2,038
Staffs
It makes me feel literally sick to know that a faceless bureaucrat will be able to cut mum's care, or transfer it to a cheaper agency.
I certainly hope everything will work out OK but if they do not and your Mum's needs are not being met by this new arrangement then surely you can ask for a review and ask for Directs Payments instead?
 

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
I certainly hope everything will work out OK but if they do not and your Mum's needs are not being met by this new arrangement then surely you can ask for a review and ask for Directs Payments instead?
Thanks Pete, you're right :) However, as ever, the devil is in the detail. I can ask for a review, but whether and when I get it is up to SS. Whereas, when self-funding, you simply review when you feel the need......

Sorry, maybe I'll feel better tomorrow.....especially if the same agency will simply transfer the billing arrangements......
 

Louby65

Registered User
Mar 26, 2014
619
Scotland
Hi Lindy 50. I have employed a personal assistant to look after my mum since last may , using mine and my mums' money . I applied for personalisation / self directed support and I am waiting on a final decision though my mums' social worker says it will be successful . I have informed her that I will be continuing to employ the personal assistant and she has said I can do that . If there is any shortfall I will make up the shortage as i do not want to change her , she is absolutely wonderful and I believe that she is assisting me greatly in my wish to continue looking after my mum at home . Good luck and please post again to let us know how you get on .


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Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
Hi Lindy 50. I have employed a personal assistant to look after my mum since last may , using mine and my mums' money . I applied for personalisation / self directed support and I am waiting on a final decision though my mums' social worker says it will be successful . I have informed her that I will be continuing to employ the personal assistant and she has said I can do that . If there is any shortfall I will make up the shortage as i do not want to change her , she is absolutely wonderful and I believe that she is assisting me greatly in my wish to continue looking after my mum at home . Good luck and please post again to let us know how you get on .


Sent from my iPhone using Talking Point
Hi Louby :)

I really like the idea of employing a personal assistant. However, I don't think it would suit our situation as mum doesn't live with us (she's in sheltered housing) and actually having a team of care staff provides a lot of stimulation for her. They currently do four visits a day and I pick up the difference, for example I am there most afternoons and do any care that's needed.

I hope your plans work out well :) It's such an emotional thing, isn't it, allowing someone else to take responsibility for periods of time....

Can I ask where you found your personal assistant? Did you already know her, or did you advertise or whatever?

Good luck :)

Lindy xx
 

Louby65

Registered User
Mar 26, 2014
619
Scotland
Hi Lindy50 . I went on a carers website and registered( I don't think I can say the name in case it is seen as an advert - but you could message me and I will let you know) I then placed an advert saying what I would like and the times I needed my mum looked after . You put your post code in and ask for people who live within a certain distance. I received many replies from people who all sounded very good . I interviewed a few , checked disclosure and references and got the perfect one . I really can't do without her . She is so kind to both my mum and I . I hope things work out for you.


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Izzy

Volunteer Moderator
Aug 31, 2003
60,903
68
Dundee
Hi Lindy. I've employed personal assistants for over 5 years now. It works really well for us but I can understand how might not work in your situation. I poached ours from the agency!


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Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
Hi Lindy. I've employed personal assistants for over 5 years now. It works really well for us but I can understand how might not work in your situation. I poached ours from the agency!


Sent from my iPhone using Talking Point mobile app
Thanks Izzy :) In most ways, it would be my ideal to employ personal assistants (the admin wouldn't be a worry). However, looking forward I have to ensure a safety net for mum, not least because I am on the waiting list for a knee replacement, which will put me out of action for who knows how long. I have been putting it off for years, hoping it wouldn't affect mum, but the consultant is insisting that I am doing myself harm by waiting.

So....no option really. We have to use an agency to ensure regular cover, since I won't always be able to step in. I just wish we could do it using Direct Payments....but really the top up cost is not feasible in the long term ( and who knows how long term it will be?)

Thanks for posting :)

Lindy xx
 

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
Okay, I've bitten the bullet :eek:

Have contacted SS and agreed to take mum's four visits a day through internal services. The package will be provided at the moment by the same agency as at present. Have to say I felt horrible letting them know they will be £129 a week worse off - sentimental though that may sound to some.

The good bit is that as mum won't accept respite care, we will have a direct payment of £50 a week in lieu of this, to allow me to add extra visits or other care that that may be needed eg when I have my op. That at least gives some flexibility.....:)

Feel better now the decision is made, and am now just waiting for all the relevant paperwork ;)

Many thanks for your support :)

Lindy xx
 

Pete R

Registered User
Jul 26, 2014
2,038
Staffs
Okay, I've bitten the bullet :eek:

Have contacted SS and agreed to take mum's four visits a day through internal services. The package will be provided at the moment by the same agency as at present. Have to say I felt horrible letting them know they will be £129 a week worse off - sentimental though that may sound to some.

The good bit is that as mum won't accept respite care, we will have a direct payment of £50 a week in lieu of this, to allow me to add extra visits or other care that that may be needed eg when I have my op. That at least gives some flexibility.....:)

Feel better now the decision is made, and am now just waiting for all the relevant paperwork ;)

Many thanks for your support :)


Lindy xx
I hope it all works out OK.
 

Grey Lad

Registered User
Sep 12, 2014
5,736
North East Lincs
I am facing the same decision about Direct Payment and need to bite the bullet. It seems like more work but the Agency often seem stretched to the limit and unable to provide the same carers.
 

Lindy50

Registered User
Dec 11, 2013
5,239
Cotswolds
I am facing the same decision about Direct Payment and need to bite the bullet. It seems like more work but the Agency often seem stretched to the limit and unable to provide the same carers.
Hi GL :)

I think the decision must depend partly on how regularly you need the carers, what you need them to do, and whether you could manage if / when individual personal assistants were on holiday, off sick etc. And whether you could manage any potential top up payment, of course....

In our case, I really need reliable personal care for mum, both because of my own health, and because she doesn't live with us. We've thought of moving her here, but I think that would no longer help her, for a whole variety of reasons....

So I hope that for us, we've struck the right balance between SS organised care, and a smallish direct payment to allow flexibility.

I hope you can come to a decision soon, it's such a worry, I know

Lindy xx