Individual budgets have been touted as a revolution in how care is paid for and accessed. But what are they and how can you get the most out of them? Robert Mair reports.

In this section you will find:

  1. How are individual budgets different to direct payments?
  2. Who is eligible?
  3. What can individual budgets pay for?
  4. Who looks after your finances?
  5. What are the legal implications of an individual budget?
  6. What are you entitled to claim?
  7. How can you plan your support?
  8. Can you make changes to your plan?
  9. What if your individual budget isn’t enough for your needs?
  10. How are individual budgets linked to NHS money?

How are individual budgets different to direct payments?

Individual budgets have been compared to direct payments, and while they are similar there are crucial differences between the two. Direct payments are cash payments made by the local authority instead of providing services, while individual budgets draw together several grants and benefits to provide one payment, including:

  • Social care services
  • Independent Living Fund (although this has been closed to new applicants)
  • Disabled Facilities Grant
  • Access to Work
  • Supporting People Funding
  • Integrated Community Equipment Services (ICES)

You can choose to have your individual budget as a direct payment – the money is paid directly to you - or you can have it as an indirect payment paid to a nominated individual.

Who is eligible?

Everyone with access to social care services is entitled to an individual budget.

However, the criteria for who can access services differs between local authorities so someone eligible in one part of the country may not be eligible in another.

What can individual budgets pay for?

Individual budgets can be spent on a variety of different things, provided the local authority - and the person in control of the budget - is satisfied it does what it is intended to do.

For example, one multiple sclerosis sufferer used £375 of his individual budget to buy a season ticket for a friend to enable him to watch Rochdale FC and the local authority agreed this would improve his quality of life.

It may also be spent on holidays or days out if it meets the local authority’s eligibility criteria – as well as more traditional forms of care.

Who looks after your finances?

If you are unable to look after your finances, several other people and agencies can help you manage your individual budget, including:

  • Brokers
  • Advocates
  • Family members or friends
  • The local authority

What are the legal implications of an individual budget?

Anybody receiving their individual budget as a direct payment will need to have all of the legal paperwork that applies to direct payments.

This means they would need insurance to employ someone in their home and be classed as an employer, for example.

What are you entitled to claim?

Your claim will be dependant upon your level of need and the local authority’s criteria for providing care.

How can you plan your support?

Effective planning ensures that you have access to the right sort of care for your needs, and can be done with the help of your local authority. An effective care plan should include:

  • Clear expectations of what the individual budget will achieve
  • A list of the different types of support available
  • A review process so the support can be evaluated

A care manager will assist you in putting together your plan and to find any help you may require to manage your budget, such as an agent.

Once the manager is happy and the plan has been signed off, you will receive your individual budget. A date will then be set for a review.

Can you make changes to your plan?

Once your plan has been decided, if you feel it isn’t working for you, you may be entitled to make changes to it. Individual budgets are designed to be flexible but it depends to an extent on the terms agreed in the contract.

However, if you plan to make any changes, you should notify the local authority before you do so.

What if your individual budget isn’t enough for your needs?

If your individual budget does not meet the needs set out in your plan, it should be looked at again. Each local authority has a resource allocation system (RAS), which assesses whether your individual budget is reasonable for your needs.

Local authorities also need to ensure their RAS complies with the guidance on Fair Access to Care Services.

How are individual budgets linked to NHS money?

At present, NHS funding is more rigid than social care money, meaning funding for long-term health conditions is separate to funding for social care needs.

However, if you have health problems after you receive your individual budget, you can ask for your support plan to be reviewed.