A Personal Budget is a sum of money that may be available for eligible children and young people who need extra help above that available to most children and young people through universal and targeted services. A Personal Budget is an amount of money that can be used flexibly to support the extra needs of the child/young person or their parent/carer following an assessment. The Personal Budget is not all of the resources that are available to support a child or young person, just the amount that can be used flexibly by the family or young person to support the additional needs of the child /young person/carer. This money may come from Social Care, Education, or in some cases from your NHS clinical commissioning group (CCG). If you receive funding from the NHS this is known as a personal health budget.
Within Warrington Personal Budgets are available to families, following an assessment of need which results in:
- Education, Health and Care (EHC) Plan
- Continuing Care Package of Support
- Short break Package of Support
In relation to EHC Plans, young people and parents of children have a right to request a Personal Budget, once the authority has confirmed that it will prepare a draft EHC Plan. They may also request a Personal Budget during a statutory review of an existing EHC Plan. They may be considered at other times for particular aspects, such as care during a separate review.
Local Authorities must consider each request for a Personal Budget on its individual merits and prepare a Personal Budget in each case unless the sum is part of a larger amount and:
- disaggregation of the funds for a Personal Budget would have an adverse impact on services provided or arranged by the local authority for other EHC plan holders, or
- where it should not be an efficient use of the local authorities resources.
An example of the above is services such as Physiotherapy or Speech and Language Therapy, which are currently part of ongoing contractual arrangements and the full budget is committed to the existing agreements.
There are four ways in which the child’s family and/or the young person can be involved in securing provision:
- Direct Payments – a mechanism to receive a Personal Budget to contract, purchase and manage services themselves. This is paid via a prepayment card.
- An arrangement – whereby the local authority, school or college holds the funds and commissions the support specified in the plan (these are sometimes called notional budgets)
- Third party arrangements – where funds (Direct Payments) are paid to and managed by an individual or organisation on behalf of the child’s parent or the young person
- A combination of the above
Elements included within a Personal Budget
Depending on the needs of the individual and local eligibility criteria, the scope of the budget will vary. At present, a Personal Budget may consist of elements of funding from education, health and social care. In the main this will be:-
Mainstream schools and colleges receive funding to support children and young people as follows:
- Element 1 (Universal offer for all children and young people) - standard placement funding. A Personal Budget cannot be used to purchase the cost of standard placement funding
- Element 2 (Targeted) – an amount of money to provide up to £6,000 of extra individual help for lower level needs.
- Element 3 (Targeted) – the amount of money provided by the Local Authority to meet higher level individual needs above Element 2.
Note: Personal Budgets do not apply to Element 1 above. All of the above elements are included in the costs of the placement (commonly Special Schools, Designated Provision and Specialist Colleges).
Element 3 funding may be made available for use as a Personal Budget. This can only be included with the agreement of the school or college and the Local Authority. It is not always possible for a school or college to release element 3 funding into a Personal Budget because it may be part of the existing overall provision. At the discretion of the head teacher/college principal a Personal Budget could also include all/parts of element 2 funding.
If a parent / young person wishes to employ staff to work and support their child within a school or college environment they would have to have the school or college permission (usually the Head Teacher or Principal). Furthermore, a Personal Budget and in particular a Direct Payment cannot be made in respect of provision which will take place in a school, post 16 institution or early years setting without the written consent of the head teacher, principal or the person occupying an equivalent position. Therefore this would need to be carefully planned.
Currently within Warrington the primary area for inclusion within the social care element of provision supported through a Personal Budget is that of Short Breaks. However this area continues to be developed to ensure that the needs of individuals can be met as best possible. Other services, such as equipment/adaptations to meet the identified needs, following an assessment by an occupational therapist, could be included in a Personal Budget, however the amount paid will be consistent with the value of the product offered by the Local Authority. Parents will be able to ‘top-up’ the value from their own resources if this is their preference.
A Personal Health Budget (PHB) is an allocation of resources made to a person with an established health need. The purpose of the budget is to ensure the person is able to call upon a predefined level of resources and use these flexibly to meet their identified health needs and outcomes. For full details regarding eligibility and relevant processes please refer to Warrington Clinical Commissioning Group (WCCG) ‘Personal Health Budgets Policy and Process’
There are three ways that a personal health budget can be managed:
a) A notional budget: Notional budgets could be an option for individuals who want more choice and control over their healthcare but who do not feel able or willing to manage a budget. The individual is aware of the amount of funding that is available to them and co-develops their agreed health outcomes and the solutions for achieving them. However it is the NHS that still commissions services and manages contracts on their behalf. Where someone chooses a notional budget it is important to note that they will not be able to employ Personal Assistants directly.
b) A third-party arrangement: an organisation legally independent of the individual and the NHS (for example, an independent user trust or a voluntary organisation) holds the money on the individuals Behalf, and buys or provides the goods and services chosen.
c) A Direct Payment for health care: the money is transferred directly to the individual, and they buy the goods and services agreed in their support plan. Direct Payment support organisations exist to act as an agent and help them manage the Direct Payment.
From April 2014 people receiving continuing healthcare support from the NHS have the right to ask for a Personal Health Budget and from October 2014 there will be a right to have a Personal Health Budget (subject to exclusions under Regulations as described under paragraph 1.5).
In order to be eligible to receive a Personal Health Budget, the individual must reside and be GP registered in Warrington and must be assessed as eligible for NHS Continuing Care for Children and Young People.
Whilst individuals can request or may be offered a Personal Health Budget, there is no obligation for an individual to accept the offer.
Declining involvement should not disadvantage the individual as in those cases normal routes to provision of a care package will apply. Should the individual wish to accept a Personal Health Budget they are free to choose to resume a traditional care packages at any time.
Where a child or young person is eligible for a Personal Budget, support will be offered via a Children and Families Practitioner / Social Worker in relation to care needs. This person will have been involved in the assessment of needs and will support the family and child/young person in considering how their needs can best be met, taking account of the services available and the needs/preferences of the child/young person.
Where possible, a referral to a brokerage service can be undertaken, unless the family express a preference to take on this role themselves. Brokerage is currently only available in reference to a Personal Health Budget; however this is an area for further development in relation to Personal Budgets within Warrington.
The Children and Families Practitioner / Social Worker or Brokerage service will work with the family to develop a personalised and creative Personal Budget Support Plan that specifically describes how they will use their indicative budget to meet the agreed outcomes as identified in the EHC Plan. All allocated money within a Personal Budget must be utilised to meet the agreed outcomes within the relevant plan and be consistent with the Personal Budget Support Plan. In addition, a formal Personal Budget Agreement will be completed prior to any allocation of funds. This agreement represents a formal contract between the Local Authority and the recipient regarding the use of the Personal Budget and how the Direct Payment will be processed and managed.
Cheshire Centre for Independent Living (CCIL) has been identified by WCCG to support individuals in obtaining and managing their Personal Health Budget. To receive a Personal Health Budget, the child or young person needs to be eligible for NHS Continuing Care. This is established through an assessment and multi-agency panel agreement. If the individual feels that their needs may be better met with the use of a Personal Health Budget, CCIL will offer information, advice and support around how to access and utilise it. They will complete a support plan with the individual and agree how the Personal Health Budget will be managed (see previous section). Personal Health Budgets are agreed at the Continuing Care Panel and reviewed each year by CCIL. Audits of any bank accounts will take place on an annual basis.
Once a decision has been made to progress with a Personal Budget the relevant professionals will use their judgement to determine the resources required to meet the needs identified. The decision making processes will vary depending upon the pathway being followed.
A potential budget, also known as an indicative budget, is shared with the family so that detailed discussions can take place to plan the provision required to meet the individual outcomes identified
An ‘indicative budget’ is established for all Personal Budgets relating to Short Break care. This will be calculated primarily using the standard Direct Payment hourly rate, currently £10.
In some circumstances the actual budget will need to be higher than these rates, for example if agency support is needed or group based activity. In these cases an additional allowance can be added to the indicative budget in order to accommodate specific needs; an ‘agreed budget’ is then approved and finalised. If subsequently, the additional support from the provider and/or the reason for the additional allowance is no longer valid, reference would be made to the indicative budget and a new agreed budget established if appropriate.
An example is provided below. For cases where families opt to employ personal assistants and the standard rate is appropriate, the indicative budget and the agreed budget will be consistent at the agreed hourly rate. Indicative budgets must be reverted to if the need for an additional budget is removed, as in the example above.The care element of Personal Health Budgets will be calculated on the same basis, (along with additional allowances where this is required to secure the right provision).
Direct Payments are a mechanism through which families receive their Personal Budget.
Direct Payments for special educational provision, health care and social care provision are subject to separate regulations. These are:
The regulations have many common requirements including those covering consent, use of nominees, conditions for receipt, monitoring and review of Direct Payments and persons to whom Direct Payments must not be made (such as those subject to certain rehabilitation orders).
Administration and support
When a Personal Budget has been agreed and where the family opts to utilise their Budget to directly employee carers/personal assistants, a member of staff from Warrington Disability Partnership will visit the family to explain how the Direct Payments work and what support is available. If the family decide to proceed, various forms are completed and the payments are administered by the Direct Payments Officer in Neighbourhood and Community Services.
If families require help to find a Personal Assistant, support can be provided by Warrington Disability Partnership.
A payroll service is also provided by Warrington Disability Partnership and most families opt into this support. Advice on employment issues is also provided.
The Children and Families Practitioner /Social Worker will monitor the support package in place to ensure it is meeting the needs of the child, young person and their family. The use of the Personal Budgets will be directly linked to the outcomes identified in the Personal Budget Support Plan. This Plan should be made available for review by the Children and Families Practitioner /Social Worker at any time. If families experience any difficulties in arranging the services to meet the needs identified, they must refer to their worker for further advice and support.
In relation to Direct Payments expenditure will be monitored through access to the on-line records and also periodic audits of the family’s account to ensure the Direct Payments are being used in accordance with the agreement. Any issues arising from the monitoring arrangements are referred to the relevant Manager for review and if necessary, liaison with the family will be undertaken.
Management reserve the right to suspend or stop a Direct Payment if the agreement is not followed. Whenever a Personal Budget is reduced or stopped, Warrington Council will ensure that the person receiving the Direct Payment is given four weeks’ notice, and an explanation regarding the reasons for the decision, in writing.
The Personal Budget will be reviewed formally within three months of the person receiving a Direct Payment; and when conducting a review or a re-assessment of an EHC Plan. If Warrington Council and or WCCG become aware, or are notified, that the person’s circumstances or needs have changed, they will consider whether it is appropriate to carry out a review of the Personal Budget Support Plan to ensure the individual’s needs are still being met. If necessary, new or updated assessments will be undertaken. Similarly, if they become aware, or are notified that the Direct Payment has been insufficient to purchase the services agreed in the Personal Budget Support Plan, a review will be carried out as soon as possible.
Purpose of a Review
The review will be a mechanism to consider whether:
· the agreed provision should continue to be secured by means of a Direct Payment
· the Personal Budget Support Plan adequately addresses the needs of the person and the agreed outcomes are being met
· the Direct Payments have been used effectively and appropriately
· the amount continues to be sufficient to secure the agreed provision
· the conditions set out are being met
· progress is being made against the agreed outcomes
The review is also an opportunity to consider whether their needs have changed, and if so, whether a new assessment is required and also whether the Personal Budget Support Plan is still appropriate.
Transition from Children’s Services into the Adult Services occurs when a young person reaches their 18th birthday. As part of the transition planning arrangements, a transition referral will have been made to the Transition Social Worker who will arrange for assessments in order to determine eligibility for Adult’s Social Care.
If the young person meets the criteria for continuing healthcare, a referral will also be made prior to the young person turning 18 in order to establish eligibility for Adult’s Continuing Care. As these assessments are undertaken and updated, the EHC Plan, including the Personal Budgets section will be updated accordingly.
Wherever possible Warrington Borough Council and/or Health Commissioners will try and resolve issues or areas of disagreement by meeting and talking with those involved in supporting children and young people with special educational needs and/or disabilities. This includes not only the parents and carers but also the children and young people themselves.
In line with the Code of Practice and Children’s and Families Act 2014, Warrington Council will consider each request for a Personal Budget on its individual merits. A Personal Budget will be prepared in each case, unless the sum is part of a larger amount and:
· disaggregation of the funds for the Personal Budget would have an adverse impact on services provided or arranged by the local authority for other EHC plan holders, or
· where it should not be an efficient use of the local authority’s resources.
In these circumstances, Warrington Council will inform the child’s parent or the young person of the reasons it is unable to identify a sum of money and work with them to ensure that services are personalised through other means.
Before proceeding it should be clear if it is a complaint or an appeal. Where it is a complaint the Warrington Council Complaints Procedure must be followed or the Warrington Clinical Commissioning Group Complaints Procedure. If you are unsure as to whether you need to follow the ‘Complaint’ or an ‘Appeal’ process then we would advise you speak, in the first instance, with:
· Your relevant team officer or manager
· Warrington SEND Information Advice and Support Service (SENDIASS) (http://www.warringtonsendiass.co.uk/)
· Independent Supporters Service (http://www.psspeople.com/)
Parents, carers, and Young People will have the right of appeal against the decision in regards to the decisions of where:
· A Personal Budget has not been offered.
· The amount of money in the Budget is not felt sufficient to cover the needs of the child/young person.
· Limitation of choice in how a Personal Budget can be spent
· Decision to refuse, stop or reduce a Direct Payment - If the Local Authority refuses stops or reduces a Direct Payment, the explanation of this decision will have been sent in writing. This decision can be challenged through this appeal procedure. (If the refusal concerns the Personal Health part of the plan, then the explanation concerning the refusal must be sent out by the Clinical Commissioning Group (who are the health organisation responsible for the decision.) or a combination of both Local Authority and WCCG.
However it would be best to avoid an appeal process if the issue can be easily resolved and the relevant team officers/Keyworkers will be required to apply their existing knowledge and experience to resolve any issues as they arise.
Warrington Borough Council is committed to dealing with all complaints fairly and impartially and to providing a high quality service to those who make them. Complaints are important to us so that we can put things right where they have gone wrong, learn from complaints to improve our services and stop the same thing happening again. If you feel we have let you down then please tell us about it.
How to complain
The council encourages any customer who is unhappy with any aspect of a service provided by the council to raise their concerns with a member of staff in the service area first, to see if it can be resolved another way before escalating concerns to a complaint. If you then wish to make a complaint then please contact us using one of the methods below:
- Use the online complaints form
- Email us at firstname.lastname@example.org
- Phone us on: 01925 443322
- Write to us at: Contact Warrington, PO Box 5, New Town House, Warrington WA1 2NH
- Fax us on: 01925 443211
- Visit us at: Contact Warrington, 26-30, Horsemarket Street, Warrington WA1 1XL