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It wasn't about what the key-worker thought my needs were; it was what I thought my needs were.
What is a Personal Budget?
What can't you use your Personal Budget for?
How do I get a Personal Budget?
How do I get my needs assessed?
How is my care/support plan drawn up?
Why does the local authority have to agree my care/support plan?
How much money will I get in my Personal Budget?
Will a Personal Budget affect my benefits?
Do I have to pay anything towards my social care?
How do I receive and spend my Personal Budget?
How will the local authority know how I spend my Personal Budget?
Who can I get help from?
What if my circumstances change?
Who can I complain to if I have a problem with getting a Personal Budget?
References
Useful websites
Useful organisations
Further reading
'I'd like someone to go shopping with me, my life would be so much better to have that kind of assistance – to go shopping, to be there.'
A Personal Budget is an amount of money that comes from your local social services department and is allocated to you to meet your social care needs. You will receive a Personal Budget if you have been assessed as having social care needs that your local authority will fund. In some areas the money may be offered as part of the mental health services you receive.
Examples of what some people use their Personal Budget for:
Remember, these are examples only. You can use your Personal Budget to meet your social care needs in many different ways according to what you think is best for you, as long as it is approved by your local authority and is safe, legal and healthy.
I was given a grant to go and see my grandma before she died.
Personal Budgets are a way for you to be in control of the support you get from social services: you will know how much money you have available, and you can have choice and control over how it is spent.
Personal Budgets were introduced in 2008 in England (only), and all local authorities are expected to be offering them from April 2010. They are part of a new system called Personalisation: the government is expecting local authorities to take a personalised approach, which means that each person's care and support will be designed and delivered around their individual needs.
There are some things that you definitely cannot spend your Personal Budget on. These include gambling, debt repayment, alcohol and tobacco. Nor can you use a social care Personal Budget to pay for specific health services (although it can sometimes be difficult to differentiate between 'health' and 'social' services in mental health). Note: Personal Health Budgets are being piloted in some areas of England from 2009 to 2012 to test whether health services might be delivered in a similar way to Personal Budgets in the future.
There are four main steps to receiving a Personal Budget:
There are two ways in which people with mental health support needs can request and receive a needs assessment. This will depend on whether you are already using secondary mental health services or not. Secondary mental health services are those provided by specialist mental health teams in hospital or community settings.
For people already receiving secondary mental health services
If you are in contact with secondary mental health services, there will be someone who works closely with you to assess your needs, works out a care or support plan with you to meet those needs, regularly checks that your needs are being met and reviews your progress with you. The person who you work closely with could be a nurse, social worker or occupational therapist from a mental health team, or it might be another worker who is based at the service you use and who knows you well, such as your 'key worker'.
If you are using a number of different services, the person who oversees your care will be called a 'care co-ordinator'.
If you have one, you should ask your care co-ordinator for a review of your current support. If you do not have a care co-ordinator, you should ask your key worker or the person who works with you most closely to do the review.
For people not receiving secondary mental health care
You can have your needs assessed even if you are not receiving secondary mental health care. In England, each local authority social services department is responsible for assessing people to find out what help and support they need. The law says that the local authority must carry out a needs assessment if:
If you feel that one (or more) of these applies to you, you should request an assessment of your needs from your local authority social services team. You can find their contact details in your local phone directory, at the directgov website or via the National Centre for Independent Living website (see 'Useful organisations' and 'Useful websites'.)
The needs assessment
Each local authority has their own way of doing needs assessments. An initial assessment might be conducted over the phone using standard questions, or you might be asked to fill in a self-assessment form about what needs you have. A full needs assessment usually involves someone coming to visit you to discuss your needs with you. This might be someone from social services, or someone from your local mental health services.
Whichever way the assessment takes place, it should always place you at the centre and focus on what you think your needs are. This is what is meant by a 'person-centred assessment'. You could ask a friend or an advocate to be with you at the assessment meeting if you would find that helpful. (See The Mind guide to advocacy.)
Your assessment is likely to include a discussion about your personal history, your social circumstances, the symptoms of your ill health and how this impacts on your daily living, and what you think your needs may be.
It would be helpful for you to give some thought in advance to what you think your needs may be, as it can sometimes be difficult to think of everything on the day of the assessment. You could, for example, keep notes or a diary of:
You should think of all aspects of your life, as the assessment should cover:
Finding out approximately how much money you will receive to meet your needs
Because the demand for services is greater than the money available to provide them, not everyone can have all their needs met.
You will only be able to have your 'eligible' needs met by the local authority. To decide if your needs are eligible or not, most local authorities use eligibility criteria. These are based on the Department of Health 'Guidance on Eligibility Criteria for Adult Social Care' which replaced the 'Fair Access to Care Services' (FACS) framework in April 2010. This grades your needs into one of four bands, based on the risk to your 'independence and wellbeing or other consequences if needs are not addressed'. The four bands are 'critical', 'substantial', 'moderate' and 'low'. Some local authorities can only fund those needs of yours which are assessed as being 'critical'; other local authorities also fund needs which are graded as 'substantial' or 'moderate' and there is no-one else who is willing or able to meet these needs for you.
In some local authorities, people who are receiving secondary mental health services may be automatically eligible to have some or all of their social care needs met.
Once your eligible needs have been identified, you will be given an estimate of how much money will be allocated to you in your Personal Budget. This is called an 'indicative' amount, because it is an indicator only. Your indicative amount is calculated according to your local authority Resource Allocation System (RAS). This is the system that is used to decide how much money you get. The final amount is only decided after you have drawn up a care plan explaining how you would like to use the money to meet your needs. Note: A few local authorities use their own systems, which are based on what they would usually expect to pay in similar circumstances.
Once you know approximately how much money you will have in your Personal Budget, you can start to draw up a care/support plan to explain how you would like to use the money to meet your needs.
Once you have had your needs assessed and you know which of your needs the local authority can fund, you will need to create a care/support plan. (See 'Who can I get help from?') A care or support plan is essentially the same thing. The word 'care plan' is used in some areas, and the word 'support plan' is used in others.
Your care/support plan should state:
Your eligible needs
It is important to think about what your needs are and how you want them to be met, rather than thinking about what services are available. For example, if one of your eligible needs is for support in getting out of the house and mixing with other people, there are lots of different ways of meeting this need according to your own interests and preferences:
Your plan should state what you think would best meet your needs and improve your quality of life, and how this could happen.
It's about recovery and self-management because you have to devise a plan that'll help you reach your goals.
Your goals
Your plan should also state what you want to achieve or what your goals are. These are sometimes called 'outcomes'. It is important to write down what you want to achieve so that you will know if you are making progress towards that goal. In the above example, your goal might be to have met two people who become your friends, or to go to a social event such as a birthday party on your own.
Potential risks
It is also important to state what you think any risks are that might affect how your support is delivered. For example, when you are unwell, you might be tempted to isolate yourself and not let a support worker visit you. You should think in advance about how you could manage this risk.
Fluctuating needs
Your plan should include how you want your support to be managed at times when you may be unwell and unable to direct or manage your support yourself. If your needs fluctuate, so that sometimes you require more support than at other times, your local authority might build into your Personal Budget an amount of 'contingency funding'. This would give you additional money to help you cope when you need it most.
Informal support and unmet needs
Your plan should take into account any informal support that you receive from family and friends, or your local community. The local authority will fund the needs that you have that are not being met by them, but they will also want to check whether the people who support you are eligible for an assessment of their own support needs.
The local authority has a duty of care and a responsibility towards you. They should only agree a plan if they feel it will meet your needs. They should not approve it if it places you in a dangerous situation, if it does not meet your needs, or if any risks that have been identified cannot be adequately managed.
You should be encouraged to identify what is important to you. That is what is meant by 'person-centred care planning'. However, someone from social services or your local mental health services will go through your plan with you to think about any risks involved in meeting your needs. Your final, agreed care/ support plan should enable you to manage any risks that are identified, so that you can live your life in the way that best suits you, as long as that doesn't stop other people from doing the same.
Your local authority will also need to agree your care plan so it can be sure that you will be using your Personal Budget to meet your needs in a cost-effective way. This doesn't mean that the local authority will only approve the cheapest way of meeting your needs. It will consider how much your proposed plan will cost, but it will also want to meet your needs in ways that are effective and that support you with good quality arrangements.
Once your plan is agreed and costed, the local authority will decide the final amount of money that you will receive in your Personal Budget. Because everyone is different and may have different personal circumstances and needs there is no 'standard' amount of money that you will receive – it is personal to you.
No, a personal budget is money for social care or support. It is different from the money you may get in your benefits.
The local authority will always ask people to pay towards their social care or support, if they can afford it. So they may do a financial assessment, to see how much, if anything, you should contribute. This works differently in each area. However, the amount must be 'reasonable' for you to pay, and if it does not seem reasonable or you are unable to pay, you have the right to ask the local authority to reduce your contribution.
Generally, people on very low incomes would not be expected to make a financial contribution for their support. If you have been discharged from hospital under Section 117 of the Mental Health Act you cannot be charged for your support.
Once the amount in your Personal Budget has been agreed, it will not be classed as income when assessing social security benefits, and it will not be liable to income tax.
Personal Budgets place you in control of the support you need to live your life as you choose. This is called 'self-directed support'.
You can choose to receive and spend your Personal Budget in a number of ways. (Note: This might depend on where you live.):
Generally, your local authority will be concerned with making sure that you achieve what you want to achieve – the goals or 'outcomes' that you have identified in your care/support plan. Your care/support plan will be reviewed regularly to ensure that it is meeting your needs and that you are achieving what you want. If you receive a Direct Payment, you will also be asked to account for how you have spent it. Each local authority will have its own requirements for how you account for your Direct Payment spending. Some local authorities ask for copies of bank statements and for all receipts and invoices to be sent to them at regular intervals. Others ask for a self-declaration form to be completed, but for copies of bank statements, receipts, invoices and cheque book stubs to be available for auditing if necessary. Your own local authority will let you know what monitoring arrangements it has.
The government suggests that local authorities should take a 'light touch' approach to monitoring, and that they should try to achieve a balance between choice and control and an appropriate level of accountability.
You are not on your own. Most people who get a social care service need some help in working things out. Some people need support in thinking about what their needs are; others need help in designing their own care/support plan. You can do all this on your own, but there should be lots of help to draw on:
Your social worker, care co-ordinator or key worker should review your needs with you on a regular basis. You will be told how frequently your reviews will be when your Personal Budget is agreed. If your needs are likely to change or fluctuate, the reviews may be more frequent. If your circumstances change such as if you need to go into hospital, or if you think that you need more, or less, support, or that the costs to meet your needs have increased, you should contact your social worker, care co-ordinator or key worker to discuss this with them. They could discuss with you whether a Personal Budget is still required, or could arrange for a reassessment of the amount of Personal Budget that you receive.
If you have a concern or a suggestion about any service, you should first try to write or speak to a member of staff about it. So if you have a problem with getting a Personal Budget you will need to speak to your care co-ordinator, your key worker or the person who works with you most closely.
If you are not happy with their response, you could contact your social service's complaints officer. The complaints officer will investigate your complaint and send you a written reply within a set number of days. You can find the contact number of your local social services department in your local phone directory, at the directgov website or via the National Centre for Independent Living website (see Useful organisations).
Carr, S. (2009) SCIE research briefing 20: The implementation of individual budget schemes in adult social care. London: Social Care Institute for Excellence.
Carr S. (2008) Personalisation: a rough guide (Report 20). London: Social Care Institute for Excellence
Department of Health (2009) LAC (DH) (2009)1: Transforming Adult Social Care. London: Department of Health.
Department of Health (2009) Personal Health Budgets: first steps. London: Department of Health.
Department of Health (2010) Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care - guidance on eligibility criteria for adult social care, England 2010. London: Department of Health
Heslop, P. and Williams, V. (2009) Personalisation in mental health. Breaking down the barriers: a guide for care coordinators. London: Mind.
HM Government (2007) Putting People First: A shared vision and commitment to the transformation of Adult Social Care. London: HM Government.
www.citizensadvice.org.uk
Advice on healthcare and money
www.direct.gov.uk
Find your local social services department
In Control
tel. 0156 482 1650 (support line), web: www.in-control.org.uk
Supports local authorities to deliver self-directed support, and individuals to get more choice and control
The Personalisation Network
tel. 020 7972 1337
web: www.dhcarenetworks.org.uk/Personalisation
A Department of Health network where people involved in changing the adult social care system can get guidance and examples from across the country
National Centre for Independent Living (NCIL)
tel. 020 7587 1663 (general) or 0845 026 4748 (advice line)
web: www.ncil.org.uk
Provides support, advice and consultancy about independent living, direct payments and personal budgets
Social Care Institute for Excellence
tel. 020 7089 6840, web: www.scie.org.uk
Identifies and spreads knowledge about good practice in social care and supports the delivery of transformed, personalised social care services
How to assert yourself (Mind 2010)
How to cope as a carer (Mind 2008)
How to cope with hospital admission (Mind 2004)
How to improve your mental wellbeing (Mind 2007)
How to look after yourself (Mind 2006)
How to recognise the early signs of mental distress (Mind 2008)
The Mind guide to advocacy (Mind 2010)
The Mind guide to food and mood (Mind 2008)
The Mind guide to managing stress (Mind 2009)
The Mind guide to massage (Mind 2004)
The Mind guide to relaxation (Mind 2009)
The Mind guide to physical activity (Mind 2008)
With us in mind: service user recommendations for advocacy standards in England (Mind 2006)
For a catalogue of publications that can be purchased from Mind, send a request with your address details to: publications@mind.org.uk or call 0844 448 4448.
Visit the online shop to see details of all the publications stocked.
This booklet was written by Pauline Heslop for the Mind 'Putting us First' project
First published by Mind 2010
ISBN 978-1-906759-04-9
No reproduction without permission