Continuing healthcare, personal health budget: help finding out all the costing/financial informatio

Rer24

Cyclamen said:

There should be an employers support organsiation used by your CHC but they (at least in this area) were not well set up for PHB/ DP.

 I would start by asking the LA who supports the LA DP users and then see if they would take your on as well.. this is often a CIL Centre for independnet living. 

 There are also groups that  are specific to CHC and can do all the admin and help your recruit or just do part of it. Have a look at 'Health your way' and 'ask jules',  on google. 

I had a close friend with a  terrible experience wih a CHC team that didnt understand direct payments/ phb at all.. 

its also worth checking fb out for various direct payment and CHC per support groups, there may be someone from your county and national ones such as peoplehub

Just saw your reply and this is very helpful. Thank you very much.

Albermarle

Could someone who manages their own direct payments, or on behalf of a loved one, shed some lights on demanding/work is involved to manage direct payments?

It is probably not the answer you want, but we just use a care agency.

They send us one invoice a month, and we pay that from the direct payments ( LA not NHS but do not think it makes any difference) Apart from the initial set up and occasional review, no more admin than that.

I know you want to have continuity, but even if you employ someone direct they could well move on at some point. In fact we do get some continuity as the care needed is a bit complicated, so each carer needs some experience of what to do. 

Savvy_Sue

I think I would second what Albermarle says: changing agency isn't without its issues, but if you're struggling with the admin for direct employment then that's going to be an ongoing issue. And if you employ directly, you're going to have issues every time someone moves on, so may end up needing an agency for those times anyway. 

It is going to depend on what agencies there are locally for you: there are a couple near me who have an excellent reputation and one of my friends works for one of them. There is as far as possible continuity of care: sometimes my friend has to cover and go to someone they've not met before, but the note keeping is very good. They seem to be good to their staff too: no 15 minute visits and good backup if the carer finds a problem. 

Agencies are inspected by the CQC, it could be worth looking to see who is well rated where you live. 

https://www.cqc.org.uk/help-advice/help-choosing-care-services/services-in-your-area

Cyclamen

Sory ive been away from my laptop due to my own health and social care battles.

You can have various options
1) the council or nhs (depending on who is funding) organise, manage and send carers.. this is commisioned care

2) direct payment managed account - a company acts as an 'in between' and does the paperwork on your behalf, you can still choose who to employ an dhave some control . this can be for contracting an agency or employing PAs directly. 

3) Direct payment with support and advice.. here they sign us all up to insurance with legal advice, payroll and the local CIL to sort budgets and contracts, recruitment support etc.  But the bank account is in my name, the payslips are sent to me and I pay my team.  

It is getting harder and harder to recruit PAs the wages and often shift lengths just aren't great unless you can offer full days / live in. 

For me I found agencies started off Ok then swapped out the initial staff to those that were not quite so good.  I much prefer PAs but if i use an agency I prefer to go via Direct Payment rather than giving the choice to the council.

It really is worth looking to see if there is a county support group as others will hopefully be able to suggest agencies etc.  Be careful asking on open social media pages as often the people recommending an agency so enthusiastically are the carers themselves.. which isnt always the best way. 

If you are on fb there are pages for direct payment users

Albermarle

Cyclamen said:

Sory ive been away from my laptop due to my own health and social care battles.

You can have various options
1) the council or nhs (depending on who is funding) organise, manage and send carers.. this is commisioned care

2) direct payment managed account - a company acts as an 'in between' and does the paperwork on your behalf, you can still choose who to employ an dhave some control . this can be for contracting an agency or employing PAs directly. 

3) Direct payment with support and advice.. here they sign us all up to insurance with legal advice, payroll and the local CIL to sort budgets and contracts, recruitment support etc.  But the bank account is in my name, the payslips are sent to me and I pay my team.  

4) Direct payment- you pay the agency direct, no need for any third parties inbetween. You just have to reconcile the payments in and out .

It is getting harder and harder to recruit PAs the wages and often shift lengths just aren't great unless you can offer full days / live in. 

For me I found agencies started off Ok then swapped out the initial staff to those that were not quite so good. Sometimes the opposite problem - you get the same carers but there is inadequate back up in case of illness/holidays. I much prefer PAs but if i use an agency I prefer to go via Direct Payment rather than giving the choice to the council. In our case when needing a new agency, the council have a system of putting the work out to tender, and will then suggest an approved agency to use that are interested. In theory you still have the final say.

It really is worth looking to see if there is a county support group as others will hopefully be able to suggest agencies etc.  Be careful asking on open social media pages as often the people recommending an agency so enthusiastically are the carers themselves.. which isnt always the best way. 

If you are on fb there are pages for direct payment users

Just added a few comments.