Personal budgets and direct payments & personal health budgets.
Firstly what is a personal budget? It is a sum of money that is awarded by the Local Authority for that person to spend on their care to meet their assessed needs. It can be spent however that person considers appropriate, however it should be spent on assessed needs and is not for what is considered a luxury of life to the detriment of paying for essential care.
The person in need of care and support can request a direct payment also known as a personal health budge of their personal budget, which means that the money is paid to the person or to the carer to be spent on behalf of that person as they see fit.
The care can also be commissioned by the Local Authority. They will have undertaken an assessment of needs and in order to meet those assessed needs a sum of money will be allocated to that person, subject to means testing their ability to fund their own care. Assuming that they do not have sufficient funds to meet the cost of their care, the Local Authority has a statutory duty to meet the cost of those assessed needs. In doing so, it can take account of various factors, including their own budget, so they can choose a cheap option, as long as the cheap option does meet the needs of the person.
The personal budget should be sufficient to meet the cost of the assessed need and there should be transparency as to how that sum of money is calculated. It should also reflect the cost to the Local Authority of meeting that need, so if the person wants to purchase care more expensive than the Local Authority can provide, then the cost will need to be topped up by a family member or from an unassessed asset. The Local Authority must show that the care can be met for a lower cost than the enhanced rate, so as to pay a lower rate. It is not sufficient to suggest that a particular provider can do a task at a certain rate, they have to show that the provider has capacity to meet the needs of that person and is willing to do so for a particular fee.
If the budget is to be taken as a personal health budget and the person in need of care is for example going to employ their carers directly rather than through an agency, then the Local Authority doesn’t need to pay the agency fee and can show that as they would commission care through an agency, that they can pay less as a personal health budget doesn’t need to meet the agency fee. However they still need to pay sufficient to meet the needs, so it is not a reason to cut budget. When directly employing a carer, the person may also need to make holiday payment and pension contributions, depending on the terms of the employment and these costs need to be taken into account in the budget.
If there is an issue about the budget, then a meeting with the social worker and finance team is appropriate, to go over the assessment of needs and then to use that assessment to calculate the cost of care and to devise a budget and then discuss what, if any, part of the budget can be made as a personal health budget. The person can choose to have a mixed budget, with some care directly commissioned and others parts of their needs met by a personal health budget directly paid to them.
It is a tricky area of contention, if the person needing care believes that they have not been paid a sufficient amount to meet those assessed needs and with Local Authority budgets stretched, they closely scrutinize the money they pay to meet the cost of social care.