How Calderdale residents who need care can live at home with Personal Budgets

Personal Budgets are made either as direct cash payments to the individual, in the form of a managed budget where the person requests the local authority to arrange commissioned services on their behalf, a mixed budget where the person uses a mixture of the first two methods, or an individual service fund where an independent sector provider holds money on behalf of the person.

Of 1,980 adults receiving a personal budget when the report was compiled, 582 received their personal budget in the form of a direct payment, 242 in the form of an individual service fund and 110 were getting a direct payment for respite support, said the report by the council’s Interim Assistant Director for Adults Health and Social Care, Ged Taylor.

In terms of expenditure annually £9.6 million was spent on care in the form of direct payments with another £450,000 on direct payments for respite care and £4 million on individual service funds (ISFs).

This works out per service user at £16,550 in direct payments, £4,127 in direct payments for respite care and £17,534 in ISFs.

According to the latest available data for 2017-18, around 30 per cent of adults in Calderdale who were receiving support had a direct payment, one of the four methods by which they can receive their funding, members of the council’s Adults Health and Social Care Board heard.

This puts the authority in the top third of council’s nationally for using direct payments to fund care.

The board also heard that at the time of the report 48 people were receiving Personal Health Budgets (PHB) – planned and agreed between the person and their local NHS team or with a partner organisation of the NHS such as the local authority – at a cost of £1.6 million.

The benefit to people receiving care through personal budgets and PHBs is that it is a method of personalising people’s care, supporting their health and wellbeing needs and in a way in which they have a say.

It is based around principles of recognising each person is unique, that their needs may be met in different ways and that service users are best placed to understand their own needs.

National evidence is still developing but showing it is cost effective for those eligible and locally cases presented to the board demonstrated how the payments were able to increase people’s quality of life.

Councillors heard of a 40-year-old man who had physical disabilities and was diagnosed with epilepsy being able to employ a personal assistant who encouraged him to take up activities, increasing his confidence, taking courses including money management and eventually moving into supported living accommodation.

A second case presented to them showed how a man in his 20s with learning disabilities, sensory impairment and challenging behaviour whose family were finding it difficult to cope was able to use his personal budget for his family to transform a room in the house into a multi-sensory room.

This room provided a space to relax and listen to music and following this his anxiety levels and medications prescribed were reduced, sleep improved and his appetite increased – he was far happier, enjoying life more and was presenting a less challenging behaviour, councillors heard.

In the case of Personal Health Budgets, these are one way in which the council and health partners can deliver a more personalised approach to care – a key components of the council’s Calderdale Cares policy.

Councillors asked and received answers on issues including what happened to the payments if a person moved out of the area or passed away, how long it took to develop a plan, what happened if budgets were exceeded and what happened if a person’s health situation changed.

Reviews were taken including how checks were placed on how each individual was spending the money.

Service users need to evidence how they had spent monies, and the council’s Direct Payments Team checked this as part of an audit process.

In very rare circumstances the payments could be withdrawn, members heard.