Money management - Respite care provided through vouchers
Paying for respite care
Overview
Some Councils issue vouchers or pre-payment cards for respite care which is usually temporary residential care. This system is based on pre-authorised spend from Council budgets with approved providers, but it could be used with any kind of provider in principle.
Features
Outcomes
What are the outcomes we want to achieve?
- People and their family or carers have a range of options to arrange respite care independently
- Carers understand the entitlement for respite care of the person who uses services; what the local process is to access the scheme and that the entitlement will reduce the carers' need
- The process for accessing and arranging respite care is straightforward enabling people to get the respite they need at the right time
Inputs
What tools and resources do we need to do a good job? What are the steps we have to go through?
- Carers assessment
- Awareness that respite is usually a service for the person needing care
- Carers can receive respite care in exceptional circumstances
- Agreement with a range of local providers to offer respite care at an agreed price via a voucher scheme
- Clear respite policy outlining:
- Agreed approach for discretionary allocation of hours and charging related to whether the person who uses services/carer are formally eligible and owed a duty, or merely coping with access to a preventive service
- Clear process for making 'top up' payments manageable
- Flexible respite scheme and payment mechanisms:
- DP
- Clear expiry dates
- Providers
Outputs
What are the products we will have at the end of this process?
- Respite care - in whatever form achieves the desired outcome
- Information and advice on the local respite offer
- Feedback from people who use services and carers
Timescales
When does this process start and end and within what timescales should this process be completed?
- Begins with assessment of the person who uses services
- Reviews should be held annually unless circumstances, or needs, change
Workforce
Who needs to be involved and what is their role? Who is taking the lead?
- Person
- Family or carer
- Independent applicable chosen representative
- Interpreter
- Brokerage team
- Care navigator
Problem
Under the Care Act the Council cannot give people with care needs a flat rate of respite. The council has to work out, with them, what service would meet their eligible assessed unmet needs. This depends upon how much an informal carer can help, the type of support that they need, and the carer's willingness and ability to care. The Council also needs to consider how respite care is provided i.e. funded from the carer's personal budget (PB) or from the personal budget of the person with care needs either way, respite is something provided directly to the person with care needs, so the carer should not be charged.
Solutions
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Case Study: Doncaster Council - Respite care provided through vouchers (pdf - 161Kb)
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Doncaster Metropolitan Borough Council (DMBC) offers people a personal budget as a direct payment to purchase their respite care. This provides them with greater choice and control over how they meet their respite care needs. The Council's previous offer for respite care had been a voucher scheme where tokens were exchanged for short break provision in residential, elderly mentally ill (EMI) or nursing settings. Only a quarter of vouchers issued in 2013/14 were exchanged for respite indicating that this offer did not appear to meet service user or carer need. An added bonus for the Council has been a streamlining of their administrative role by using a proportionate approach to the social care journey. (See case study: Proportional approaches).
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