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Moving from care agency to PAs….

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  • Graham
    replied
    This is very helpful James.

    It is very similar to what I have, only I totally manage my care and run the payroll, I don't use Penderels.

    The app holds the rotas and is able to calculate wages. I use the self-employment model which fits well, as I have a team of part timers for flexibility.

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  • Lcfcno1fan
    replied
    Originally posted by Graham View Post
    Hi James,

    Can you please briefly explain what you have done so far to set up with your PAs?

    I want to make sure that the comprehensive care covers your setup.

    I want to be in a position, hopefully later this year where you can test it out.
    Hey Graham,

    I would be really pleased to help you with any feedback or testing of your app. Just drop me a line when you need it 👍

    Here’s some bullet points on what I have done to get to this point, I hope this is what you’re looking for….?
    • I had a care agency hours in place to help me at key times during the day but I was not very happy with the care agency and the lack of flexibility. I was also unhappy with the way carers were treated and the lack of continuity with my care.
    • I spoke to my social worker who suggested that we explore the possibility of using PAs instead of agency. I was sent an information pack and introduced to the direct payment team at my local council who sent me some more information
    • I was referred to the Penderels trust for further support and information
    • A review was carried out of my current care provision and what we would require from PAs
    • We agreed to go ahead and we started the recruitment process with the trust, they placed adverts on their website and on the indeed website. Meanwhile the council put funding in place in light of the new budget and put things like the prepaid card account in place. This account was ready and funded before we recruited any PAs.
    • I interviewed some PAs at my home and we recruited the daytime hours first of all. We left the agency doing the morning shift as this is more difficult to cover at short notice if you have a problem. The council and Penderels between them also took care of DBS checks and employers liability insurance, The cost of this was taken up in my direct payment budget. There has been no cost to me other than adding my PAs to my vehicle insurance (the reasoning here is that your PIP mobility element is there to cater for this).
    • I also had a couple of my regular carers who are happy to go onto a casual contract to support me if one of my PAs is on holiday or off sick
    • we organised a start date for the PAs and coincided that with giving notice for the daytime hours to my care agency (I had to give two weeks)
    • The PAs have very good hourly rates and also proper contracts for the hours they do rather than zero hour contracts
    • in terms of managing the PAs I agree with them the hours they are doing and we have a diary to record hours worked and to communicate messages between them. We also have a WhatsApp group. Once a month I need to tell the payroll company who has worked what hours so they get paid correctly.
    • once the PAs had settled in we then set about recruiting additional PAs for the morning shift
    • we are just in the process of waiting for the care agency notice period to expire and take on our fifth PA
    I hope this helps? James

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  • Lcfcno1fan
    replied
    Originally posted by Jo jo View Post
    Hi James,
    Thanks for your reply. I will be getting in touch with them and the social care and find out how I would go about doing this. Where would you look for a PA ? we have two carers come in the morning and get him up, showered and dressed. I care for him for the rest of the day. I know I will have to return to work very soon and that’s a scary thought but needs must and bills still to pay. Unfortunately he cannot move his arms or legs anymore so needs everything doing for him. Do your carers stay all day?
    Hi Jo,

    You should talk to them, after all you have nothing to lose by having the discussion. 👍☺️

    In terms of looking for a PA it depends as to whether you are on direct payment or as in your case CHC. When I was on a direct payment my local council put me in touch with an organisation called the Penderels Trust https://www.penderelstrust.org.uk/ they help with recruitment and also employment contracts and the suchlike. As well as advertising PA vacancies they also have a board for PAs to post their availability. My funding in August also moves to a CHC but unfortunately the NHS do not deal with the Penderels Trust, instead my new payroll provider (Smartpaye) also provide recruitment services for PAs. I would have a good look at the Penderels trust website even if you won’t be able to use them as there is some really good information there about recruiting PAs.

    In our case the care hours have been provided to take my wife out of care equation so that she can carry on working full time. I have two PAs between 7 am and 9 am to get me showered, shaved, dressed, toileted, breakfasted, etc. I then have a single PA who works between 10 am and 2 pm to help me around the house, feed me at lunchtime, take me out and then finally set me up for the afternoon. I also have no use of my arms and legs but am quite competent in my power chair with head controls, I also have access to drinks and Voice controlled home automation for lighting and heating, etc. I also have a catheter so given all of this I can still be left on my own quite happily for a few hours. In an emergency I can get somebody around to help me if I need help. My wife then feeds me at teatime and puts me to bed later on.

    I hope this all makes sense it’s not easy to put it down in writing 😂😂😂

    James x

    Leave a comment:


  • Graham
    replied
    Hi James,

    Can you please briefly explain what you have done so far to set up with your PAs?

    I want to make sure that the comprehensive care covers your setup.

    I want to be in a position, hopefully later this year where you can test it out.

    Leave a comment:


  • Jo jo
    replied
    Hi James,
    Thanks for your reply. I will be getting in touch with them and the social care and find out how I would go about doing this. Where would you look for a PA ? we have two carers come in the morning and get him up, showered and dressed. I care for him for the rest of the day. I know I will have to return to work very soon and that’s a scary thought but needs must and bills still to pay. Unfortunately he cannot move his arms or legs anymore so needs everything doing for him. Do your carers stay all day?

    Leave a comment:


  • LindaB
    replied
    Originally posted by matthew55 View Post
    Sounds too expensive for my pocket. Society is going backwards 😄x
    Adult Social care is financially assessed however a lot of people are assessed as nil contributors. Free.
    If people are awarded full Continuing NHS care then again it's free to the person.

    Ps like the new avatar

    Leave a comment:


  • Lcfcno1fan
    replied
    Originally posted by shrew View Post
    Matthew I think you would get direct payments to cover the cost of your Personal Assistant. They would be responsible for paying tax and having insurance etc. You would be given so many hours per day. I think that this is whats being discussed?
    Hi Shrew,

    Pretty much except you are the employer and you are responsible (through your payroll provider) for paying tax and having insurance. There are some self-employed PAs out there but in my case the local council didn’t really want to use self-employed PAs and preferred me to employ my own.
    Last edited by Lcfcno1fan; 30 July 2021, 12:09.

    Leave a comment:


  • Lcfcno1fan
    replied
    Originally posted by matthew55 View Post
    Sounds too expensive for my pocket. Society is going backwards 😄x
    The cost of a personal assistant hour is significantly less than that of a care agency hour. If you already get funding for care agency hours then these can be moved to a direct payment via your social worker team. If you are on a CHC than you already have care funding in place.

    Leave a comment:


  • shrew
    replied
    Matthew I think you would get direct payments to cover the cost of your Personal Assistant. They would be responsible for paying tax and having insurance etc. You would be given so many hours per day. I think that this is whats being discussed?

    Leave a comment:


  • matthew55
    replied
    Sounds too expensive for my pocket. Society is going backwards 😄x

    Leave a comment:


  • Lcfcno1fan
    replied
    Originally posted by Jo jo View Post
    Hi James, my partner has just been awarded CHC and we were wondering how all this works. We currently have a care agency that was put in place by the local council but they have sent out 20 different carers over the past 29 days. I’ve made a complaint but not holding out much hope. We only have carers come in in the mornings at the moment.
    Hi Jo,
    I am sorry to hear that you are struggling with your local care agency. It seems to be a big theme with them changing carers frequently and this is one of the reasons I moved away. I would raise a complaint back to your CHC Practitioner as having too many carers is counter-productive to the needs of the client. You need stability and trust with the people looking after your partner and this can only be established over a period of time. It’s also not fair on the carers as they can work much more easily with people that they know.

    So how this works…….. have a meeting with your nurse practitioner (or whoever it is managing your CHC at the NHS, if you were not on a CHC this would be your social worker) to discuss the feasibility of you moving across to using personal assistants. This is not for everybody as you effectively are the employer of your own people, although you will receive support from an external agency to help you with tax, payroll, recruitment and contracts, you also will have somebody to help you manage the cash account. Your practitioner will want to hear some good reasoning as to why you would move away and also have some confidence that the continuity of care would still be in place….. what I mean by this is that although care agencies have many faults they will however turn up to every scheduled visit (in theory at least).

    The major upside (and this is huge) is that you can decide who you employ and agree what hours they work (within the scope of the budget you are given). Because MND is progressive the budget is always up for review as your partners care needs will change. You can also decide what the PA does to help, in our case we are a fairly young family (I am 51 and we have a 15-year-old daughter at home), My wife works full time so as well as attending to all my personal needs my PAs also help me out with tasks around the home such as cleaning, cooking, shopping and laundry. They are also insured to drive my wheelchair vehicle so we can get out and about to the shops or go for lunch or something like that. I now have 4 PAs covering 50 hours a week with 2 in reserve on casual contracts to help with holidays or sickness.

    I hope this helps?

    James x

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  • denise
    replied
    And me

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  • matthew55
    replied
    I too would like an explanation of how this works in reality please

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  • Lcfcno1fan
    replied
    Originally posted by Graham View Post
    Yes James, I too am on DP... much better than agencies at the expense of complexity.

    But I am developing a comprehensive care app to deal with complexity.

    hi Graham, I did see this in another thread and I’m looking forward to seeing the results. The complexity is definitely an issue but, as you say, if you are prepared to deal with this then the rewards are well worth it 😀

    Leave a comment:


  • Jo jo
    replied
    Hi James, my partner has just been awarded CHC and we were wondering how all this works. We currently have a care agency that was put in place by the local council but they have sent out 20 different carers over the past 29 days. I’ve made a complaint but not holding out much hope. We only have carers come in in the mornings at the moment.

    Leave a comment:

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