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Disabled people have challenged the meaning of ‘independent’. ‘Independent living’ does not mean doing things for yourself, or living on your own. Instead, it means:

 

  • Having choice and control over the assistance and/or equipment needed to go about your daily life
  • Having equal access to housing, transport and mobility, health, employment and education and training opportunities.

All of the chapters in our Guide for People with Disabilities focus on different aspects of independent living ranging from aids and adaptations to finance and knowing your rights.

In this chapter we look at the Governments proposals for strategy to improve independent living, the Independent Living Fund, Direct Payments and new Individual Budgets.

Care Services

The Role of Peterborough Community Services Health and Social Care is to work with adults over 18 years of age.

All referrals are taken through Peterborough Direct Tel: 01733 747474

If you become disabled and you experience difficulties with personal care needs, or your circumstances change so that you need some extra help, you should contact Peterborough Community Services Health and Social Care as soon as possible. They have a statutory duty to carry out an assessment of your care needs. Once a referral has been made you will be directed to the team responsible for services to you, who will conduct an assessment of your needs.

As part of the Community Care Act 1990 everyone is entitled to an assessment of personal care needs and this is carried out by a Peterborough Community Services Health and Social Care Assessor.Please say if your request is urgent.
The Assessor will contact you and make an appointment to visit you. During the visit the assessor will look at your specific individual needs. Your carer is also entitled to an assessment.
The assessor will put together a care-plan to identify your individual needs, and arrange a care package if your needs meet the qualifying criteria. A copy of your assessment will be sent for you to approve and sign. Arrangements for the provision of the necessary services will then be made. For example it might be agreed that you need alterations to your property, an Occupational Therapist will work out exactly what is required and arrange for the adaptations to be carried out.

The advice given by Peterborough Community Services Health and Social Care is free, but you might be asked to pay for some of the services they provide. A financial assessment will be carried out by the local authority before any social care package is implemented. This will determine if you have any financial contribution to make.
Some people have ongoing health and social care needs which require detailed assessment. Staff from Health and Peterborough Community Services Health and Social Care will usually work together to plan and deliver services to support such people after discharge.
The assessment will involve discussion with the ward staff, with you and your family/ carers. This process of information gathering and clarification of the situation will enable the care manager to:

  • Identify your needs
  • Decide on the extent of the assessment required
  • Establish your eligibility for services
  • Give you information about the services that may be available and any charges involved.
  • If you are unclear ask the ward staff or Patient Advise Liaison Service

Tel: 01733 75858

Fair Access to Care Services is a government policy. It provides a guide to Social Services departments. This helps them decide who can get a service from adult social services through an assessment. Fair Access to Care Services Guidance covers all adult users of social care, including older people.
Having a good support package in place can be essential for independent living. It says that authorities should assess ‘presenting’ needs and decide whether these are ‘eligible’ needs. If there are eligible needs, the authority must arrange appropriate and cost effective help.
To decide which needs are eligible, the authority must assess needs against an eligibility framework, grading needs as either:

  • Critical
  • Substantial
  • Moderate
  • Low

They should assess the risk to the independence of the person being assessed, in each of four areas below equally not just risk in relation to Health & Safety:

  • Autonomy and freedom to make choices
  • Health and safety including freedom from harm, abuse and neglect
  • The ability to manage personal and other daily routines
  • Involvement in family and wider community life, including leisure hobbies, unpaid and paid work, learning, and volunteering.

The assessment should also take into account:

  • Life and health including risk of abuse or neglect
  • Choice and control over day to day environment
  • Ability to carry out personal routines
  • Ability to take part in work, education or learning
  • Sustaining social support and relationships sustaining family roles and other social responsibilities

The assessment should be rounded, person centered, transparent and non-discriminatory. If it is agreed you need assistance then a ‘care plan’ should be developed.

The written record of the ”care plan” a copy of which should be given to the user, should include as a minimum:

  • A note of the eligible needs and associated risks to independence.
  • The individuals preferred way of getting the support
  • Options to manage emergency situations.
  • Details of services to be provided, and any charges the individual is assessed to pay, or if direct payments have been agreed.
  • Agreed support which “carers” and others are willing and able to make.
  • A review date.
  • Councils should not have blanket policies to not provide certain services. Councils can have cost limits on packages as a guide, but should not apply these rigidly. In particular, the range of services available to older people should not be substantially different from those available to younger people.

Individual budgets

The commitment to pilot individual budgets comes from the Government reportsImproving the Life Chances of Disabled People (Prime Minister’s Strategy Unit January, 2005),Opportunity Age (Department of Work and Pensions March, 2005), and Independence, Well Being and Choice (Department of Health March, 2005) followed by Our Health, Our Care, Our Say (Department of Health January, 2006).

An individual budget is a sum of money allocated to an individual. Both individual budgets and direct payments are methods of self-directed support that is it is the individual who decides how their support needs will be met.

An individual budget can cover more than personal social care, for example access to work, and can be a cash payment, or arranged services, or a combination of both. Therefore all, or part of an individual budget, can be received as a direct payment.

Registering as a disabled person

Peterborough Community Services Health and Social Care maintain three registers of people who are physically disabled, hearing impaired and visually impaired. You have to be registered or ‘registerable’ to be able to claim some services e.g. Disabled Facilities Grant. Once you have completed the application form and your eligibility has been confirmed, Peterborough Community Services Health and Social Care will send you a letter with your registration number.

Under the Community Care Act, Peterborough Community Services Health and Social Care are committed to helping you to remain in your own home for as long as possible.

Government Proposals The Prime Minister’s Strategy Unit report “Improving the Life Chances of Disabled People” identified several key areas where action was needed in order to deliver the vision for equality for disabled people by 2025.These included early years and family support, transition to adulthood, employment, and independent living.

The strategy sets out a five-year plan that seeks to realise the Government’s aim that all disabled people (including older disabled people) should be able to live autonomous lives, and to have the same choice, freedom, dignity and control over their lives as non-disabled people.

The aim of the five year Independent Living Strategy is that:

  • Disabled people who need support to go about their daily lives will have greater choice and control over how support is provided
  • Disabled people will have greater access to housing, transport, health, employment, education and leisure opportunities.
  • The Independent Living Strategy

The Independent Living Strategy includes the following Government commitments:

1. Promoting independent living: To promote a shared understanding of the principles and practice of independent living

2. Action and Learning Sites and Regional Initiatives: We will strengthen the evidence-basis to inform future policy development and investment, and demonstrate how to use resources to better promote choice and control.

3. Housing: We will take action to maximise disabled people’s housing opportunities

4. Transport and mobility : We will consolidate progress made in the areas of training, information, and accessibility in public transport and consider action required to enhance the mobility opportunities of people whose needs cannot be met by public transport.

5. Health: Our Strategy aims to enhance the understanding of health services’ contribution to independent living, to enable disabled people to have choice and control over their non-acute healthcare needs, and to enable them to manage their own long-term conditions.

6. Employment and economic wellbeing: We want to enable individuals to remain in employment when they acquire an impairment or when an existing impairment or condition deteriorates. We will also ensure that benefit and charging systems, and recent reforms, do not create unnecessary barriers to independent living.

7. Personalisation, choice and control: We will support the transformation of social care to deliver a system which will focus on timely, preventative and high quality personally tailored services. We want everyone – whether they receive state-funded support or fund support themselves – to have maximum control and power over the support services they receive and we will work with local authorities and key partners to help them deliver this. The long-term aim will be to ensure that every disabled person in receipt of social care, and/or related funding, has the opportunity to have choice and control over the state funding they receive.

8. Support, information, advocacy and brokerage: Effective support, information, advocacy and brokerage services are a key aspect of enabling disabled people to make choices for themselves that might otherwise be made for them by other people. Our policy of transforming social care includes a commitment to a universal information, advice and advocacy service for people who need support in their lives.

9. Older people: We will promote a co-ordinated, strategic approach to investing in independent living for older disabled people, and will also seek to ensure that older disabled people’s voices are heard and that they are enabled to participate in the development and delivery of services.

10. Young disabled people in transition to adulthood: We will seek to ensure a seamless transition into adulthood for young disabled people, including those with complex health needs, in all aspects of their life, including between children’s and adults’ services, as well as housing, transport, employment, education and training.

11. Disabled parents: We will promote more joined-up working between health, education and social care to provide timely and flexible support where this is needed by families affected by parental disability. We will also encourage policies and services aimed at parents in general to include families affected by parental disability.

12. Measuring progress: We are committed to monitoring progress on the aims of the Strategy and the vision it represents. We shall use the new performance framework, in particular the Equalities Public Services Agreement (PSA)

Direct Payments is an amount of money that you may be able to get instead of traditional services from your local Health & Social Services Trust. It will enable you to arrange your support in a way that suits you best. You must already have an assessed need You can get Direct Payments if

  • You are over 16.
  • You are assessed by a Social Worker or Care Manager as personal care needs
  • You are willing and able to manage Direct Payments (with as much help as necessary).
  • You need help with daily living tasks.
  • You can use Direct Payments to arrange your own support at home, as well as daytime activities and respite. Direct Payments are available to disabled people with any impairment, including learning disability, mental health service users etc.

Direct Payments are available to:

Disabled people.
Older people who get services from the Trust.
Disabled parents.
Parents of disabled children.
Carers for services to meet their own needs.
If you think you would benefit from having more control over the assistance you get, then Direct Payments may be worth considering. To find out more about Direct Payments and how to get started:

Contact Peterborough Council for Voluntary Services who run a direct payment support scheme Tel: 01733 342683
Ask your Social Worker or Care Manager
What is the difference between Individual Budgets and Direct Payments?

Both individual budgets and direct payments are methods of self-directed support that is it is the individual who decides how their support needs will be met.

A direct payment is a cash payment for social care from the local authority instead of services.

An individual budget can cover more than personal social care, for example access to work, and can be a cash payment, or arranged services, or a combination of both. Therefore all, or part of an individual budget, can be received as a direct payment.

Independent Living Funds (ILF)

The ILF may make payments to disabled people to be used towards the cost of them employing Personal Assistants (PAs) or using a care agency to give them personal care and domestic assistance. The money comes from the Government and it enables people to live at home with choice and control over the assistance they receive. The ILF is a discretionary organisation, which means they can decide not to pay someone even if they meet all the conditions to get ILF payments. The ILF is managed by a board of 9 Trustees and has recently become an Executive Non Departmental Public Body.

To get help from the ILF you must meet all the following conditions:

You must get at least:

  • £320 worth of support a week
  • or
  • £16,640 a year from Adult Social Care
  • This support could be something like going to a day-centre or getting money from a direct payment scheme.
  • You must get the higher rate care component of Disability Living Allowance (DLA).
  • You must be at least 16 and under 65. If you apply before you are 65, the funding can continue after your 65th birthday as long as you still meet all the other conditions.
  • You must be living in the UK and expect to live in your home for 6 months after you have applied.
  • You must have less than £22,250 in savings/capital (this includes any money your partner has).
  • Applications are subject to prioritisation .

From 1 April 2008 the ILF has introduced budgetary measures, if you live in England, Scotland or Wales, ILF will give priority to users already receiving payments from the Fund and then, new applications will be given priority as follows:

The first priority group is: People who are paid to work 16 hours or more each week

The second priority group is: People who are getting Income Support, Income based Job Seekers

Allowance, Pension Credit Guarantee Credit or similar income and whose total care package costs £500 per week or more.

Your contribution ILF then work out how much money they may be able to offer you, they take into account the following benefits if you get them.

Disability Living Allowance (DLA) To apply for payments you must already be receiving the higher rate care component of DLA. They take half of this benefit into account when working out how much the ILF may be able to offer you.

Severe Disability Premium (SDP) If you get Income Support, Income Based, Job Seekers Allowance or Pension Credit Guarantee Credit, ILF take the SDP part into account.

How can I apply?

There are 3 forms you and your social care worker from Peterborough Primary Care Trust have to fill in.

The forms are:

  • Application Form
  • Financial Information Form
  • SSD 1000

Once ILF have received all of the 3 forms back they will check you meet all the conditions. If you meet all the criteria and fall into one of the priority categories one of the ILF assessors will come out and visit you with a social care worker from Peterborough PCT.

Forms you need to apply for ILF are available from:

Tel 0845 601 8815

Occupational therapists work with people who have a physical impairment, a medical condition, a mental health problem or a learning disability. They help people who have difficulties with practical everyday tasks. The aim of occupational therapy is to enable you to live as independently as possible – at home, in employment or in education.

An occupational therapist can help you adapt to changes in your everyday life and to overcome practical problems. They do this by:

  • Providing advice
  • Looking at ways an everyday task can be done differently
  • Recommending alterations or changes to your home
  • Referring you on to other services that can help – for example, speech and language therapy
  • Helping you to address work-related issues
  • Occupational therapists have specialist knowledge and can advise you on disability equipment, housing adaptations and adaptations to the workplace.

You may qualify for a Disabled Facilities Grant towards the cost of adapting your home. An occupational therapist will be involved in the process of assessing your needs.

Receiving services Health and social services departments differ but normally have guidelines to decide the level of services people receive and how quickly they get them. If you need vital equipment, adaptations or personal support, arrangements will be made for you to work with an occupational therapist as soon as possible. If your disability has a moderate or minor effect on your day-to-day life, you may have to wait several weeks.

Shopping In Peterborough all of the major supermarkets will provide assistance to disabled customers and have special trolleys and designated wider check-outs. Most have toilets for disabled people. Many stores have given their staff common sense guidance and information on ways in which they can assist disabled people. Under the Disability Discrimination Act all have a duty to make reasonable adjustment to be accessible. Many of the larger shops have online shopping facilities who offer home delivery at a small extra charge.

Below are a few of the major internet grocery service providers:

Iceland supermarket web site features a store finder and information on meal ideas and in-store deals. However, you can only buy household appliances online and not your groceries. Iceland used to offer internet grocery shopping, but now they’ll only deliver your groceries to your home (for free) when you shop and order in your local Iceland store.

Ocado say they want you to be able to shop for quality food without compromising on price. That’s why they now match Tesco prices on all household brands, while continuing to offer lower delivery charges than most competitors.

Ring to find out if they deliver to your postcode in Peterborough Tel: 0845 399 1122 http://www.ocado.com/

Sainsbury’s supermarket chain offers a wide range of food products and wine online. The Sainsbury’s supermarket site also features a store locator and food & Health information. Tel 0845 301 2020

http://www.sainsburys.co.uk

Waitrose supermarket chain offers secure ordering and delivery of groceries and party food in selected areas of the UK through their deliver and entertaining service. Their wine, gifts and flowers are actually offered through John Lewis .

Tel: 0800 188884 http://www.waitrose.com

Marks & Spencer website lets you shop for clothes, furniture, flowers, wines and gifts online. You’ll also find information about M&Ss food range, recipes and the latest in-store food offers. A store locator and store opening times are presented too.

Tel: 0845 609 0200 http://www.marksandspencer.com

Tesco grocery shopping online offers a choice of all the usual brands and discounts are available as well as some exclusive online offers and you can still earn Club Card points. You can pre book delivery times

Tel 0845 7225533 http://www.tesco.com