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England - Understanding the Funding

Traditionally, local authorities have funded residential care and other traditional placements, often through "block booking" agreements. Recent government policy has moved towards enabling disabled people and their families to have more control over the funding that provides their care and support, and there are a number of opportunities available, such as direct payments and indirect payments.

Direct Payments

When the Local Authority assess that a person's needs are eligible for a service and funding is agreed to meet those needs, the person can choose to take the funding from the Local Authority directly rather than have them organise the service. The person takes on the responsibility of organising and managing the way their needs will be met. This may involve directly employing helpers (usually known as 'personal assistants') or directly contracting with an agency. The person will also be expected to keep records for monitoring and auditing by the Local Authority to show that the direct funding (that is 'Direct Payments') is spent appropriately.

The advantage of such a scheme is that a person can tailor the support needed to suit his or her own preferences and choose who delivers that support. This places the person in control. Whilst it is necessary for the person to consent to this option, they do not need to manage or run the scheme themselves but can nominate another or others to look after the day-to-day 'business'. Once this is in place, the Local Authority has a duty to make Direct Payments.

Support services are available to help individuals and their families along the path of exploring this option (contact your local authority). Help is also available with recruitment, budgeting, payroll and monitoring.

Indirect Payments

When a person does not have the capacity to consent to Direct Payments, it may be possible for the Local Authority to agree to make the agreed funding available to a third party. The third party is usually set up as a Trust, with the Trustees taking responsibility for the organising, managing and monitoring of the provision.

Capacity to consent

Consent is when someone accepts or agrees to something that somebody else proposes. For consent to be legal and proper, the person consenting needs to have sufficient mental capacity to understand the implications and possible consequences of his or her actions. In cases where an individual is judged not to have capacity to consent, a group of involved people from a range of backgrounds (e.g. health, education, social services, family, advocate) can come together and discuss the issue and what course of action would be in the best interests of the person, and then make a decision on their behalf.

Trust and Trustees

A trust is an arrangement whereby money or property is owned and managed by one person (or persons, or organisations) for the benefit of another. Trustee is a legal term that refers to the holder of property on behalf of some other beneficiary therefore a person who knowingly takes possession of trust funds is a Trustee. Trustees can only act jointly and unanimously in decisions regarding those trust funds.

Whilst the Local Authority does not have a duty to make Indirect Payments, it will consider the option if circumstances make the Direct Payments option a non-starter.

For more information:

Direct Payments: 'A parents guide to Direct payments' (Department of Health) - telephone 08701 555 455, email dh@prolog.co.uk or visit www.dh.gov.uk/publications

The Social Care Institute for Excellence (SCIE) has a booklet entitled "Direct payments: frequently asked questions" which is available free. Phone 020 7089 6840

Individualised Budgets

The Department of Health is piloting a scheme whereby all the funds available to an individual, from various sources, are pooled into one budget (an Individual Budget) which the individual (or people appointed on his/her behalf) manages to arrange the care and support that he/she requires. This means that there is one 'pot' - all the money the person is entitled to goes in it, and it is used to meet the person's needs. Everyone involved knows how much is in the 'pot':

"The idea behind individual budgets is to enable people needing social care and associated services to design that support and to give them the power to decide the nature of the services they need. Key features are:

A transparent allocation of resources, giving individuals a clear cash or notional sum for them to use on their care or support package
A streamlined assessment process across agencies, meaning less time spent giving information
Bringing together a variety of streams of support and/or funding, from more than one agency.
Giving individuals the ability to use the budget in a way that best suits their own particular requirements
Support from a broker or advocate, family or friends, as the individual desires. "

(Department of Health)

Funds which go into the individual budget include those from local authority social care, Independent Living Fund, Access to Work, Supporting People, Disabled Facilities Grant and Integrated Community Equipment services. Some of these are explained below.

A DVD entitled "Getting in Control: People with learning disabilities and their families, Individualised Budgets and Self-Directed Support" (price £12 inc p&p) is available from HFT. Tel: 0117 9302608 or familycarersupport@hft.org.uk

Independent Living Fund (ILF)

The Independent Living Fund was set up as a national resource dedicated to the financial support of disabled people to enable them to choose to live in the community rather than in residential care. Awards are in the form of regular four-weekly payments to individuals, which are used to buy personal care in the community. Recipients may use care agencies or employ personal assistants, but may not employ relatives who live in the same house. An ILF award can form part of an individualised budget. For more information, telephone 0845 601 8815 or visit www.ilf.org.uk

Supporting People

The Supporting People programme was introduced by the Government in 2003, and aims to achieve a better a quality of life for vulnerable people (including people with learning disabilities) by enabling them to live more independently and maintain tenancies. The Supporting People programme is administered via your local authority, and only funds housing related support (personal care is not funded via this programme). Contact your local authority for details of Supporting People in your local area. The Supporting People funding can form part of an individualised budget.

Disabled Facilities Grant

A person with a disability who owns the property they live in, or is a tenant, may qualify for a disabled facilities grant towards the cost of providing adaptations and facilities to enable the disabled person to continue to live there. Such grants are given by local councils under Part I of the Housing Grants, Construction and Regeneration Act 1996. Contact your local Housing or Environmental Health department of your local council for more information, or request a booklet "Disabled Facilities Grant" from 0870 122 236, or email communities@twoten.com