Pilots for Direct Payments in Residential Care

Anne Reeves

Hertfordshire County Council

Introduction

August 2012 - Hertfordshire asked to identify the issues for the new pilots and write report for DoH

5 October 2012 - Deadline for authorities ‘Expression of Interest’ to be a pilot

January 2013 – I submitted my report & I will summarise today into 5 categories

February 2013 – the 20 pilot sites announced & receive £14k start up payment

March 2013 – 1st meeting of pilots

Costs and Staffing

A breakdown of care and accommodation costs is needed

Paying Providers Impact on home staffing ratios Our Challenges Our Aspirations

Processes

New processes in the LA's; I looked at: Referral / Care assessment / Capacity /

Commissioning / Looking for a Home / Full financial assessment where direct payment and client contribution confirmed / Budget holder agreement / Use of the DP / DP made to service user / Paying the Home / Property cases & Deferred Payments Agreements / Placement in the Home & reviews / Any changes to the DP amount / Checking the DP bank statements

The resources issues for local authorities Our Challenges Our Aspirations

Capacity & Safeguarding

Be satisfied the person is capable of making decisions, or has others willing and able to do so on their behalf.

Best Interests decisions where the authority is responsible for making arrangements (e.g. social worker). Authority may act formally as Deputy.

Potential for financial abuse as with non res but higher amounts involved

Safeguarding is already an issue - need to be increased consideration of risk of misuse of the DP

Our Challenges Our Aspirations

Commissioning

Commissioning/Contracting/ Placement Agreements NHS elements (if joint funded

placement then NHS element normally paid to the Home by PCT or equivalent)

Our Challenges Our Aspirations

Policy context

How fit with authorities moving away from CQC Resi to supported living and & group homes.

How we can make sure we include different client groups

How the pilot ends Our Challenges Our Aspirations

Who are the pilot authorities?

20 pilots Bristol – Cornwall – Dorset –

Enfield – Essex – Gateshead – Havering – Hull – Lincs – Manchester - Milton Keynes – Norfolk - North Lincs – Notts – Redbridge – Staffs – Stockport - LB Barking & Dagenham - Surrey

What happens now?

Knowledge Hub for pilot sites SCIE support role Sites decide how to pilot – client

groups and partners Evaluation National meetings to report