Top Tips for Personal Budgets

Many of our clients rely on support from the Government to pay for care. The system of Personal Budgets allows parents or carers to apply for financial help from their local council. The procedures and criteria for each council are not the same which makes the whole process confusing and inconsistent.

Alison Brooks recently attended a talk, given by Nottingham City Council  (“NCC”). They gave helpful advice about how to apply for a personal budget (“PB”) and what is covered. Here are some tips you might find useful but please note that every case is decided individually and another council may be different.

What are PBs

  1. Personal budgets cover education, health or social care. They are used to meet the additional needs of a disabled child. They do not cover the usual costs of bringing up a child. This means they do not include costs for childcare so a carer or parent can go to work, even though we know some families struggle to find suitable care for a disabled child.
  2. There is no minimum age limit but councils are reluctant to pay a PB for babies and young children as they would need more help than an older child. Direct payments will stop at age 18 unless the child is in a special school when payments continue to the end of the next school year at age 19.
  3. Payments are usually made direct to the parent who can use the funds to provide respite care or extra help for their child.
  4. Some payments are made to the provider, for example education payments to a school or social and health payments to a care agency.

What Can You Claim?

  1. NCC will pay up to £1,600 if your child has a diagnosed disability, without needing another assessment.
  2. You can also claim up to £6,000 without an assessment but your child will need evidence from a multi agency assessment to show more help is needed.
  3. Your needs will usually be assessed by a social worker if you need a higher budget, for example, overnight short breaks for respite. NCC will fund up to £9,000 per annum.
  4. For those families with very complex needs, a budget over £9,000 can be paid. This is available to children with exceptional health care needs and usually also involves a specialist nurse assessing your child.
  5. Please note this criteria is only applied by NCC. Find out from your own council about their pathways for claiming.

Applying for a Personal Budget

It can be time consuming applying for help. Consider if a close relative or friend can assist; they may have noticed when help is needed that you have not thought about.

Here are some items to think about including in your application

  • Keep a note of extra time you spend in the day and at night for your disabled child compared to one of their siblings.
  • Keep a diary or take photos of times when you have needed someone to help your child access social events.
  • Are you a single parent? Councils are more likely to increase help if you are coping alone.
  • Are there other circumstances at home which might affect your child’s needs, for example, looking after an elderly relative or another child with special needs.
  • What about your own health? It is vital that parents and carers remain healthy and often we see families struggling to look after their own health needs.
  • Keep details of payments and a record of activities which were not covered by the PB plan. You may want to consider adding these to the PB when you apply the next year.
  • If your child’s needs increase, let the council know. The council is able to review PB plans before the annual review takes place.
  • If you need to employ a carer, include the cost of an agency to set up payroll.
  • If your carer may need training, for example, how to move a disabled child safely, then include the costs for manual handling training courses.

If you are not getting enough to help your child, the more evidence you have, the more likely the council will be able to help.

Using Personal Budget Payments

You will need to set up a separate bank account to keep a record of payments. Most councils, including NCC, will monitor paments to make sure you use the money for the needs identified in the support plan. The PB must be used for specific care needs but can include help for your child to mix with their peer group and to achieve as much independance as possible. Accessing social and leisure activities can be included in your plan so make a note of the cost for a carer coming with you.

NCC require 3 monthly monitoring of bank statements and documents. Check what your council needs so you can make sure you have the right information for them. NCC make it easier by setting up an account which they can monitor. This is a good option for busy families and saves you time

If you need to employ carers, make use of the help councils provide to put you in touch with an agency to set up payment. They will include DBS checks as well as making sure pension and payroll and properly set up. YOu will need to keep a record of time spent emplying the carer. Whilst the cost of using an agency will come out of your PB, if you include it in your plan, the money will be there for you to use.

Carers may also want to attend courses on safeguarding (which is usally free to attend) and you may want to ask for money in your PB to cover manual handling courses.

Summary

Working your way through direct payments for Personal Budgets is hard when you are coping with a child with special needs. Do contact your local council to get as much help as possible. It is regrettable that PBs are still a postcode lottery and what one council will pay may vary from each area. We can only suggest you get as much informaton as possible to support your application and ask the council for advice before you send it in.

The council can also tell you about any other services yo might use. We know that NCC has a “Max Card” which families can use for free or discounted access to an event or venue; see www.mymaxcard.co.uk

Get advice from your local doctors and therapists. If you have a social worker, ask them what you can claim and ask other families about their experience – knowledge is power!

 

 

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We ended 2016 with another clinical negligence win at Court against the NHS but this comes at a cost to us all. We therefore welcome the decision to review why clinical negligence cases cost so much and how they can be resolved more quickly. This review will be carried out by Parliament’s spending watchdog, the National Audit Office.
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Lessons From Patient Deaths Missed By The NHS

This was the stark warning from a report issued today by the Care Quality Commission (CQC). The year long review found that not even one NHS Trust around the country was getting it completely right.

The CQC have urged the NHS to use their findings to ensure that patient’s deaths are properly investigated with families being involved and heard. The CQC looked into this issue after several high profile cases involving the deaths of patients with mental health or special needs. Here are just some recommendations which the CQC set out:

  • Families should be engaged with the investigation and their voices heard.
  • Families should be informed of their rights and how the death of a family member will be investigated.
  • Families should be kept up to date about investigations.
  • Clinicians need to record when a patient is vulnerable so that other organisations can be informed of the death to decide if an inquiry is needed.
  • Clinicians and staff should have proper training and time to carry out investigations when a patient has died.
  • Medical staff continue to be worried about blame attaching to them and this needs to stop so that there is more openness about the events leading up to a patient’s death.
  • A national framework is needed to give a consistent approach to investigate patient deaths and how to communicate with the patient’s family.

The report was commented upon by the Chair of the Academy of Medical Royal Colleges who said ” we have consistently failed and continue to fail too many of the families of those who die whilst in our care.

The Director of INQUEST was also quoted as saying there was ” a defensive wall surrounding NHS investigations, an unwillingness to allow meaningful family involvement in the process and a refusal to accept accountability for NHS failings in the care of it’s most vulnerable patients”

Our own experience mirrors these sentiments. We know that many of our clients turn to us to find the answers to questions which should have been resolved by the NHS. The determination to stop future deaths is also at the top of our client’s reasons for seeking legal advice.

We are saddened to read that many families are still not told about the circumstances of the death of a loved one; the statistcs showed that the NHS could demonstrate in only 3 out of 27 reports that they had considered the family’s perspective.

The changes recommended by the CQC have been presented to the Secretary of State for Health to consider. We hope this will be the wake up call needed to ensure the NHS do not continue repeating mistakes which can lead to the avoidable deaths of patients.

If you need advice about the death of a family member please contact our Clinical Negligence or Personal Injury Departments who can talk to you in confidence.

Clinical Negligence Reforms Proposed

Birth Injury Cases

The DoH have just announced plans to create a “rapid resolution and redress scheme” for maternity claims. It is suggested that claims take on average 11 years and families often face lengthy fights to secure compensation.
We welcome any proposals which help secure quicker admissions of liability and earlier payments for our clients. However, we would be very concerned if this proposal is intended to limit involvement of proper legal advice for the most severely injured clients with cerebral palsy and reduce their entitlement to proper compensation.
In the last 10 years birth injury claims have not reduced in the NHS. This would suggest that lessons are not being learned to prevent children suffering brain damage. Not every child with cerebral palsy has a medical negligence claim but those who do face a lifetime of financial and emotional cost. We continue to see clients with cerebral palsy whose child should have been born without injury.This should be the priority for the NHS.
The NHS quote an average of 11 years for cerebral palsy claims. We think this is inaccurate; many families only contact a lawyer many years after the birth of their child. Once judgement on liability is entered for a client with cerebral palsy or other serious conditions, it is common to wait until the child is older to finalise the claim, when final medical prognosis is possible. Substantial payments are still awarded during the claim so that clients can move to adapted accommodation and get the help they need until the Court can approve a final award. Arguments by the NHS that families struggle financially for 11 years is certainly not our clients’experience.

Small Claims Limit

The DoH are also considering a fast track for cases under £25,000.The costs are high in clinical negeligence claims because of the complex medical investigations and expert evidence needed. Cases under £25,000 can often involve fatal cases if the Claimant was under 18 years old or clients have a limited life expectancy.
We will be looking carefully at these initiatives to ensure patients are still able to seek specialist advice.

A Duty of Candour

There already exists a duty on hospitals to tell patients when a mistake has occurred. If doctors and nurses continue to work in a blame culture, they can be reluctant to come forward. However, the latest plan is to prevent patients seeing documents around the investigation of a medical incident. We do not see how this will encourage more openness by doctors and medical staff or help to prevent future medical accidents.
At the moment we ask for all investigation documents but under the new plans they would only be disclosed with a court order. In our view this is contrary to the duty of candour. In particular:
– how will patients know if the investigation has produced relevant information for a clinical negligence claim and why should they not be told exactly what has happened, whether or not there is negligence?
– Costs will increase for clients and court time will be wasted if applications to court need to be made before a medical claim can be investigated.
– justice will not be seen to be done
– It creates an unfair system if only defendants have sight of investigation documents which contain a fuller recollection of events by medical staff
– patients will not have the information needed to know if future medical mistakes can be prevented.

We can see no benefit for any patient if this plan is introduced. Indeed, we think it will be a backward step for patient safety and openness by the medical profession. Honesty and avoidable medical accidents should be at the forefront of medical care.

If you would like more information about a clinical negligence claim, or are unhappy with your current solicitor, please contact Julie, Emma or Alison in our Clinical Negligence Department.

Martin’s Case- Getting The Right Advice

” Hi David,

I just want to take the time to thank you for all you have done. I know this case has been anything but simple but you’ve stuck with me through the process.

I thank you for yours and Lee’s continued understanding and co-operation. I can now start my life and try to build a brighter and better future.

Kind regards”

If you have instructed solicitors who do not have experience in complex claims please contact us for advice. All enquiries are considered by qualified lawyers so you can have the best possible advice. Martin had no regrets because David Tomlinson personally ran the claim and, with over 25 years expertise handling complex injury claims, he was better able to secure compensation for Martin.