Everybody, it seems, agrees that it is essential to put the people with long term health and care needs at the centre of their own care planning, making the service personal to the individual, not a one size fits all.
Over the last few years, and in anticipation of legislative changes in the form of the Care Bill, we have seen the emergence of a number of organisations whose role is to provide information and advice to those in need of care and their carers. These organisations have included Local Authority/Government and charitable services such as those run by Carers Trust Network Partners (carers centres and Crossroads Care schemes), as well as the private sector. The services they offer vary widely from the provision of information and advice, (often in the form of factsheets or face to face), through to direct services, comparison tools and websites, to bespoke independent advice and support. Whilst choice and control is key to personalised care planning, this can sometimes feel like a minefield of information for people to grasp and make best use of.
The Care Bill, which is currently going through the parliamentary process and due to come into force in April 2016, aims to empower those in need of care, help them understand their options, give them choice, ensure the quality of care they receive, and allow people to stay active, independent and connected to their communities. The Care Bill will require local authorities to provide information and advice and services that prevent, reduce or delay needs for care and support. It will also introduce an entitlement to independent advocacy.
Councils in England have been providing personal budgets for some time and From April 2014, people eligible for NHS continuing healthcare will have the 'right to ask' their clinical commissioning group (CCG) for a personal health budget (PHB) and from October 2014, they will have the 'right to have' one.
One of the ways of delivering this is to have a ‘broker’ service; a person in receipt of council or health funded care, or those that are ‘self funders’ and private paying clients can work with brokers or an Independent Care Adviser (ICA) to work alongside people with long term health conditions themselves and their carer, by planning care and support that help them have their “best day”.
Free information resources, such as factsheets and comparison websites, are useful for making the wealth of information available to all. At the other end of the spectrum, Independent Care Advisers and support brokers provide specific options and choices relevant to the individual based on an assessment of needs. In other words, they take the available information, analyse it and extract what is relevant to the individuals concerned.
The difference between an Independent Care Adviser (ICA) and a broker is that ICA's provide a holistic service to their clients and their carers. This includes bespoke independent care advice and support to help clients and their carers find the right care at the right time to meet their specific needs and wishes. It typically begins with a face-to-face consultation to help understand the needs and wishes of all parties and to agree a support plan. This is followed by a detailed analysis of all local care options which offer the right service of the right quality to meet a clients needs and wishes. ICAs and independent brokers then help clients and their carers choose and arrange the right providers for them. After care services have begun, ICAs / brokers continue to monitor them to make sure that their clients are receiving the care and support they need and any matters arising are attended to. In addition, some ICAs and brokers will advise on or refer clients to experts who can help them manage related matters, e.g. health issues, support for the carer, their means of funding their care, legal matters and wealth management.
A broker's role can be slightly different. Brokers tend to work on behalf of local authority funded service users to help them get the most out of their personal budget. A Local Authority social worker typically carries out a needs and means assessment in order to identify eligible needs (those of an urgent or particular level of severity, which the Local Authority must provide care for) and set a personal budget for the amount the Local Authority will contribute towards that care (if any). At this point a broker might be engaged, either by the Local Authority or by the service user directly, to help a service user find suitable care providers to fulfil their care plans. An independent broker or ICA will make a charge for the provision of the services they deliver.
Clearly there is some crossover between the roles. In short both an Independent Care Adviser and broker should be able to offer a holistic and integrated approach to care. They work on behalf of their clients and can also be a private alternative to social services for clients who are either not eligible for social services support or Local Authority funding.
Independent Care Advisers and brokers are there to help clients and their carers navigate the emotionally challenging waters of care, whether that's healthcare, social care or general well-being. By helping clients find and arrange the right care at the right time to meet their specific needs and wishes, Independent Care Advisers and brokers should be able to improve quality of life and reduce the overall cost for all concerned. In the wake of the Care Bill it is anticipated that they may become a lynchpin to integrating care.
Nick is an example of someone who received a service of this nature. A double amputee whose wife had been his carer. Nick’s long term health conditions required health and care support, ranging from help at home to regular visits to hospital.
When Nick’s wife sadly passed away, he found a broker, somebody with their own lived experiences of health and care services who would understand his needs. Working with him, the broker was able to help him manage his money and personal budgets and provide care support staff who met his needs. But Nick wanted a life defined by his interests, not by his needs and he and his broker found an amateur dramatics society and were able to work with the group to make the adjustments that he wanted to enable him to participate.
As health and care services become more integrated and people demand greater control over their own service planning, brokers and ICA’s are likely to play an increasing role in enabling people like Nick to plan for themselves and for them to have their “best day”.
This article is a copy of one posted by the Carer's Trust, which Westcott contributed to. http://www.carers.org/getting-most-your-independent-care-adviserbroker