FAQ for people receiving a personal budget or personal health budget | QCS

FAQ for people receiving a personal budget or personal health budget

Dementia Care
April 24, 2020

What are the current expectations of the flexible use of direct payments?

It is expected that during the pandemic local authorities, CCGs and direct payment holders will adopt a more flexible approach to the use of direct payments, as it is vital individuals are supported to keep healthy, well and out of the hospital.

Direct payments should continue to be used as agreed within the care plan, as far as possible. In some cases, there may be staff absences which affect the use of the direct payment and in these circumstances, individuals should raise and discuss this with their health or social care team, including their local authority or CCG. They should be willing to give more flexibility in how the direct payment is used with the guiding principles being that you safely receive the care and support you require.

When taking any decisions on using the direct payment differently during the pandemic, individuals must retain any receipts or evidence of use as they would do for purchases normally made, and a log of how their direct payment was used that they can then discuss with their local authority or CCG following the pandemic

Emergency funding – Can unspent direct payment allocations (contingency funds) be used or is there access to emergency funding?

In exceptional circumstances, the unspent allocation can be used and must be recorded within a log with the relevant receipts or evidence also kept to justify the spend once the pandemic is over.

Emergency funds should be requested in the normal way and any need as a result of COVID-19 will be prioritised by the local authority or CCG.

Will my personal budget or personal health budget direct payment be stopped during the pandemic?

No, except in extreme circumstances. In these cases, the local authority or CCG will explain to you why this has happened and discuss alternative arrangements to ensure you receive the care and support you require.

Will personal health budgets and personal budgets be delivered differently?

In some cases, due to the current guidance and rules around isolation, some care and support that was in place may need amending. Local authorities and CCGs have also been encouraged to consider providing longer-term payments to reduce the administrative burden at this time, so the amount you receive in your direct payment may be different to normal.

Will my direct payment continue if I am admitted to the hospital?

As per normal practice, this will be dependent upon your condition and circumstances, length of stay and any extenuating circumstances that mean your needs have changed and are no longer as set out in your care plan. A temporary stay in the hospital, should not necessarily mean the direct payment will cease.

Will my budget continue to be reviewed?

Yes, although it may not be reviewed as frequently during the pandemic

Do I need to continue to evidence my spend?

As per normal practice, you must keep hold of receipts and evidence that shows how the direct payment has been used.

What support do I have if I pay for my own care?

If you are using your own money to employ a PA you should follow the general guidance given here and in the direct payment guidance around contingency planning, and health and safety.

Should you find yourself in a position where these arrangements are unable to support you due to the wider impact of COVID-19 and you have no alternative arrangements available to you, you should contact your local authority to discuss alternative care and support arrangements.

Can my carer or PA support me while I am in the hospital?

During the current pandemic access to the hospital for anybody who is not a patient or member of staff is limited, it, therefore, may not be possible for your carer or PA to support you. Rules and guidance issued by the hospital will be able to further support you on what is possible.

Should I develop a contingency plan?

This is not a requirement but is strongly recommended that everyone with a direct payment develops a contingency plan or updates an existing plan.

The plan should be discussed and agreed with your local authority or CCG, where possible and elements to consider include:

  • Staffing – longer shift patterns, less frequent handovers
  • Alternative provision – use of other avenues when care and support elements cannot be delivered i.e. indoor exercise classes, technology)
  • Alternative networks of support
  • Upskilling of existing staff

Is my PA eligible to receive PPE?

As an essential worker, your PA will be eligible to receive PPE and if they normally receive PPE to support you this will continue.

Can my direct payment be used to buy PPE for the PAs I employ?

If your existing direct payment contains funding to purchase PPE for you PA, then this will continue. If this is not the case, you should seek assistance from the local authority or CCG that provides your direct payment.

What PPE should my PA be using?

Please refer to the relevant guidance here

What safety procedures are in place when using PPE?

There are a number of resources available to support the safe use of PPE, please refer here.

Will family members receive PPE if they are providing care and support?

Where people are taking on care work in a voluntary capacity then they should also be able to access and use PPE.

What happens if my PA becomes sick? How do we both keep safe?

In this situation, you or someone on your behalf should try to organise alternative arrangements. If arrangements cannot be put in place it will be necessary to put your contingency plan into action. This could mean family members stepping in and supporting you. Local authorities and CCGs should adopt a flexible approach to ensure the appropriate care and support is delivered.

Where no arrangements can be put in place you should contact your local authority or CCG immediately, who will support with developing a temporary plan.

Can family carers or close friends be paid out of the agreed direct payment if PAs are not available?

Consideration will be given to paying family members from the direct payment on a case by case basis by the local authority or CCG.

What is the government’s expectation on the furloughing of PAs?

In general, the government expects that the Coronavirus Job Retention Scheme will not be used by many public sector organisations or individuals who employ people through funding provided to them as a direct payment. This is because the majority of public sector employees are continuing to provide essential public services or contribute to the response to the coronavirus outbreak. The government considers PAs to be an essential worker, and as such, furloughing of this cohort should be minimal.

Where employers receive public funding for staff costs, and that funding is continuing, we, therefore, expect employers to use that money to continue to pay staff in the usual fashion – and correspondingly not furlough them. This also applies to non-public sector employers who receive public funding for staff costs.

In a small number of cases, for example where it is not possible for your PA to deliver the care and support you require, and where they cannot be redeployed to assist with the coronavirus response, the Coronavirus Job Retention Scheme may be appropriate. You will need to explain why this is the case when processing your claim for furlough.

Can my direct payment be used to cover additional expenses incurred by my PA during the pandemic?

In some circumstances, this will be appropriate and necessary in order that you receive the care and support you require. You will need to judge the appropriateness and cost-effectiveness of incurring reasonable additional expenses. You can discuss this with your local authority or CCG.

Can I re-employ previous PAs in emergency situations, if they have the training to support me?

Yes, if required to provide temporary cover. This will be part of your emergency contingency plan.

Will PAs have official documentation to show they are doing essential work?

No documentation is required to prove travel to and from work. A letter can be provided by the PAs employer if they feel they require one.

If my PA self-isolates will they get Statutory Sick Pay (SSP)?

Yes, if they are eligible, they will receive this from day one rather than day four.

Do I need evidence from my PA that they are self-isolating?

No, you do not need evidence from your PA to be able to claim SSP.

If I need to pay SSP, will I get it refunded?

Yes, SSP will be paid out through payroll and claimed back via HMRC.

What if my PA refuses to self-isolate?

If your PA is showing symptoms of COVID-19, they should immediately self-isolate as per the guidance issued by the government. Under no circumstances should anybody showing symptoms continue to provide face-to-face care.

If they (or anybody else you meet) refuse to isolate, you should immediately speak to your local authority or CCG, who should support you to enforce this.