New Types of Worker - Individual Budget Co-ordinator
Individual Budget Co-ordinator & Team within Domiciliary Care C & S Care Services Limited
Background
Sue Fisher Manager of C and S Care
Government policy states that there will be major changes to the way Domiciliary Care Services will be commissioned, assessed, planned, delivered and monitored as the focus will be a more flexible person centred approach. Government aims are that all service users should receive direct payments or individual budgets over the next three years. As a Director of C and S Care Services - a Domiciliary Care Company - I too can see such benefits of this vision, however in order to be part of this transformation I needed to identify the implications from a range of perspectives, but particularly the perspective of a domiciliary care company. Currently the majority of work of my organisation is commissioned by the local authority. We deliver packages of care to service users, following an assessment by social service departments. The implications for us as a business are potentially very great.
Objectives
The main aim of the project was to research the implications of the direct payments / individualised budgets from a variety of perspectives.
The objectives were to find out:
- what the current involvement of several domiciliary care agencies is with individualised budgets / direct payments
- whether Care Providers had started to think about how their service may need to change to fit in with the vision
- whether an influx of direct payment flexible packages would cause problems for current working systems
- whether individuals who are in control of their budgets would continue to use a Care Provider
- whether a new type of worker would need to be identified to co-ordinate support to recipients of direct payments
- whether policies / procedures / training may need to be changed to meet the Government's vision
The Plan
I planned to identify groups of people to interview in order to answer some of my questions.
The project was split into 3 phases:
- phase 1 to identify relevant stakeholders. Prepare to consult and meet with these stakeholders.
- phase 2 to meet with relevant stakeholders. Conduct interviews / consultations activities.
- phase 3 to consider and reflect on outcomes of consultation / research.
What happened
Interviews took place with:
- people who are in receipt of direct payments / individualised budgets – both those who use a domiciliary care agency and those who arrange their own care, or a mixture
- local authority commissioners / contract managers
- organisations that support recipients of direct payments
- commissioning and contract managers from two local authorities
- meetings with domiciliary care providers
- people within C and S care services
- interviews with Personal Assistants (both self employed and one working for an agency.
A report has been produced of the findings, which will be available on the web site in the autumn. Some of the key findings are:
- the majority of care provided to recipients of direct payments is "static" that is to say there are few changes to the overall care package each week, with the odd exception of service users who save the hours and may have a longer time once a month
- the Personal Assistants recognised that their work was structured, however more flexible on a day to day and week to week basis depending on the condition or activities required by each Service User
- one care agency felt that increasing the number of direct payment recipients would not pose problems, as they are already providing person centred care packages. The remaining professionals (excluding personal assistants) could foresee problems – the main one being rostering flexible care packages with Direct Payments into their current systems with current levels of staff.
- the Personal Assistants recognised that the more full their working week the more difficult it becomes to manage the flexible changing needs of their Service Users whether via Direct Payments or privately funded.
- one Company had already got revised policies in place and had identified that a different system had been put in place with staff in other areas of the country within her organisation. Other stakeholders were concerned about a range of issues, including terms and conditions of employment for personal assistants and health and safety and other policy issues
- service users wanted more flexibility and personalised care
- some Personal Assistants expressed concern about there terms and conditions of employment
What was achieved
A lot of interesting issues were raised and the debate with stakeholders has been very valuable.
It is evident from this small project that a change in systems and ways of working for care providers is required, what is unclear is in what form and at what cost this change will need to take place. Local authorities are aware of what the Government is proposing but it is very clear that they remain unsure how they will go about changing contracts for providers to reflect the outcome.
My Local Authority welcomes ideas from Home Care Providers which is encouraging and sees this change as something that should be discussed together in partnership and is ongoing.
The final stage of this project is not complete as my findings have now posed new questions which will require answering before new roles / training and systems can be identified.
For more information please contact
Sue Fisher C & S Care Services Limited
Wolverhampton
Tel: 01902 810074(Staffordshire)
E mail s.fisher@candscare.co.uk
