“It is important to me that I continue to have the same carers as they are my community.”; “Familiarity of my team who knows me well” and “My family”
“Luke needs care 24 hours a day owing to physical and visual impairments. He prefers not to have any care for 2 hours on Tuesday afternoons, as he likes to spend some time on his own. He has declined to consider doing this every day (though he has done so before) which would reduce the costs of his PAs. Luke and his mother feel that Assistive Technology would not assist him. Luke has said that he does not wish to have a live-in carer although this would be a more affordable option.”
“When alone for 2 hours Luke has access to a large button telephone which he can use to summon help. He has needed to do this once only, according to his mother”: “Care is required to be available 24 hours a day. This is currently being provided by a team of PAs. A live-in carer would be able to meet all of Luke's needs but he feels very settled with his PAs and there are significant risks attached to making such a major change to his care provision, especially in respect of his mental health and emotional wellbeing.”
“Luke, Jasmine and Sue state they are happy with the current level of support, which they have been providing for the last 20 years, approximately and do not wish there to be any change to the current routine”
“A reduction in Luke's current care package will enable regular visiting support rather than 24 hour support. Luke currently spends Tuesday afternoons alone at home, but has a carer present at all other times. This is Luke's choice to enjoy a period of privacy away from his carer support………. Currently, a carer is present at all times, apart from Tuesday afternoon, when Luke requests that he enjoys some time away from his carer to watch videos in privacy”
“Support considered: Live in Care Cost:£750 -900 approx Comments: Luke and his family have declined live in care at this time, preferring to retain a team of PAs”
“Life is full of risks. Risk is often thought of in terms of danger, loss, threat, damage or injury. But as well as potentially negative characteristics, risk-taking can have positive benefits. As well as considering what could go wrong, it is worth thinking about potential benefits ('nothing ventured, nothing gained') This section of your support plan is to help you agree a level of risk that is acceptable.”
“Luke risks loss of independence and autonomy as although he lives in his own home he has become dependent on carers and family to meet his needs”
“Managed by carers encouraging Luke to do as much as possible for himself, within safe limits. ...”
“… Introduced in the plan are increased times when Mr Davey may be alone and it has been assessed that he can safely be left alone and these include when he would normally be resting in bed e.g two hours at the start of the day. Mr Davey had already elected to spend time alone on Tuesday afternoons. Discussions had been held on how the time he chooses to spend alone can be extended so that there are increased intervals when no carers are present. Built in to the plan are also times when he would be without a carer and options to manage those times had been discussed (such as use of a large button phone if assistance is required); his time alone has not been driven or constricted by funding.”
“Assessment of an adult's needs for care and support (1) Where it appears to a local authority that an adult may have needs for care and support, the authority must assess – (a) whether the adult does have needs for care and support, and (b) if the adult does, what those needs are. (2) An assessment under subsection (1) is referred to in this Part as a “needs assessment”……. (4) A needs assessment must include an assessment of – (a) the impact of the adult's needs for care and support on the matters specified in section 1(2), (b) the outcomes that the adult wishes to achieve in day-to-day life, and (c) whether, and if so to what extent, the provision of care and support could contribute to the achievement of those outcomes.”
“(1) A personal budget for an adult is a statement which specifies – (a) the cost to the local authority of meeting those of the adult's needs which it is required or decides to meet as mentioned in section 24(1) (b) the amount which, on the basis of the financial assessment, the adult must pay towards that cost, and (c) if on that basis the local authority must itself pay towards the cost, the amount which it must pay”
“11.25 The Act states that the personal budget must be an amount that is the cost to the local authority of meeting the person's needs. In establishing the 'cost to the local authority', consideration should therefore be given to local market intelligence and costs of local quality provision to ensure that the personal budget reflects local market conditions and that appropriate care that meets needs can be obtained for the amount specified in the budget. To further aid the transparency principle, these cost assumptions should be shared with the person so they are aware of how their personal budget was established.”
“You must pay them at least the national minimum wage. On average, the typical hourly rate for a Personal Assistant is around£8.50 during the week and£11.05 at the weekend. …”
“…The importance of the wishes of the service user is fully addressed in the provisions of the Act itself. The relative balance between those wishes and the assessment of the local authority is struck in the provisions of the Act themselves. In my judgment, and in the light of the principles set out above, there is no warrant for a conclusion that, by dint of the application or consideration of Article 19 itself and the concept of independent living therein, that balance is weighted more in favour of the service user, than it would otherwise be under the Act, to the extent that the service user can have the final say on his own needs and personal budget or dislodge the principle that, under the Act, the decisions are ultimately to be taken by the local authority. The wishes of the disabled person may be a primary influence, but they do not amount to an overriding consideration.”
“……A live-in carer would be able to meet all of Luke's needs but he feels very settled with his PAs and there are significant risks attached to making such a major change to his care provision, especially in respect of his mental health and emotional wellbeing”
“171. As to whether the Defendant did have regard to the Claimant's individual circumstances, first, I do not accept that the October 2015 Support Plan was based exclusively on the existing team of PAs. It was based on ateam of PAs. Secondly, the Defendant was plainly aware of the Claimant's own view of the importance of his existing team of PAs and to that extent took account of it as a consideration. [Thirdly], and importantly, there is no sufficient evidence that, at the time of the impugned decisions, or indeed since, the changes in the pay and conditions of the PAs had resulted or will result in the break up of the existing team of PAs, or indeed any one or more members of the team of PAs leaving. I accept the Defendant's submission that, in making its assessments, the Defendant was not required to make judgments about the future: see [R(M) v Slough LBC]and paragraph 57 above. 172. Finally, and in any event, the Defendant did not consider that a change in the team, even if it did occur, would have an adverse impact upon the Claimant's mental health and wellbeing. In her witness evidence, Ms Lovelock explains that in her view changes in the Claimant's current care team would be positive for the Claimant and his emotional wellbeing, enabling him to reduce dependence upon specific carers. This would be unsettling in the short term, but bring important benefits in the longer term. In this way, the Defendant, did, in general terms, take account of the importance of the existing team of carers.”
“As a matter of ordinary language, while reformulation of a statutory expression can be dangerous, "are in need of" means much the same as "currently require"……… As for the word "are", it seems to me that, unless the contextual imperative to the contrary is very powerful indeed, the use of the present tense excludes the future, let alone the future conditional. It would seem wrong to extend a duty owed to a person who satisfies a statutory requirement to a person who currently does not satisfy the requirement simply because he will or may do so in the future. I should add that, as a matter of practicality, humanity and common sense, this cannot mean that a local authority is required to wait to act under section 21 until a person becomes seriously in need, however close and inevitable that serious need may be, and however much the authority reasonably wants to assist at once…….”