Supporting Service Users Through the use of Direct Payments - Paul's Story

In our first episode we talk to Paul, who gives us a service user's experience of using self-directed support and how it enables him to keep his independence. Paul has a spinal cord injury and from his experience is able to give practical information about how he employs his Personal Assistants using Direct Payments alongside his privately funded arrangement. 

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What is Self Directed Support with the Northern Trust?

Self Directed Support is part of the Transforming Your Care strategic approach to developing Person Centred Services. It is a pathway where individuals are enabled and encouraged to have more choice and control in how their care and support is provided. Self Directed Support is available as a way to meet the needs of individuals who access social care in both children and adult services.

This series tells the service users story on how self-directed support can improve health, wellbeing and maintain independence at home and gives listeners a unique insight into how the process could benefit those currently in Northern Trust arranged support.

Direct Payments - Paul's Story
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Hello and welcome to the Northern Health and Social Care Trust podcast. My name is Sarah Butler and I'm a social worker within the Community Care Directorate. In the following series of podcasts we are going to introduce Self Directed Support, more commonly known as SDS. Each podcast provides a different perspective on how self directed support can be used to improve health, well being and maintain independence at home.

Self directed support allows service users to design their own personalised bespoke supports to assist them with their assessed care needs. It can also help to alleviate care stress by providing flexibility for short breaks as and when they're required. One of the options available is direct payments.

Here, rather than the trust paying for and organizing your care on your behalf, You are given the money directly to arrange this yourself. This means that you privately employ someone to help you with your care needs, pay them their wages and complete any other employer related paperwork and responsibilities, including holiday and sick pay, tax and national insurance contributions. I am now delighted to pass you over to Paul. Paul is 35 years old. He has a spinal cord injury and is a full time wheelchair user. Paul has been availing of direct payments for over two years and you can now listen to his experience of using direct payments to maximize his independence and help with his care needs at home and at work.

And I suppose, starting off, how did you find out about it? Was it something you always knew about? Well, I kind of knew about it in the background, but It's going to sound bad, but Mum and Dad are getting older And as usual, as we all are, but And so I decided that I would need To get my own support or trying to get support and not lean on them or use them as much as I have been over for my life really.

So that's when we got the ball rolling really. And contacted Sarah's team which was Margaret social worker. So um. Um, and it just started from there, really. So, yeah. Didn't you have some awareness though? Because when you were at uni, did you have something similar? Well, I had some, yeah, I had, I got, so, yeah, going back then, that was, that was back, possibly 15, 15 years ago now, that I had, when I was, when I went to Queen's.

Okay. I had some, um, direct payments and then the education board at Queen's covered some as well, so it was between, you want to say the education board and health board, kind of. Okay. Um, um, came together. Then I moved home and started working here, so then. And then there was that gap of, what, 10, 15, 15 years, whatever, and then a year and a half or whatever started, started the ball rolling again.

Okay. Yeah. So when you started the ball rolling and contacted the social worker, what did the assessment entail? What did that look like for you? Um, it was done over Zoom and whatever, and uh, it was during COVID. Margaret just went through, like, my needs, more or less. And it was just, it was just backwards and forwards, that time.

But then I did meet up with Caroline? Caroline? Um, up in the health centre, up in the hospital. So yeah, so it just, we just, like, just backwards and forwards. And I think pre getting the direct payment, Paul had been funding PAs. Anyway, and I think on paper, Paul's been funding 96 hours for direct payment and it's just really been the assessment and that back and forth to see how much of that the trust can fund.

Yeah. And it is like. In my head, like, direct payments is a good idea or system or, you know, it's, it's very needed. Um, because I, I, like, I, over the years, I just played wheelchair basketball and wheelchair rugby and then boccia. And I know quite a lot of disabled people, not just in this area, all over, even, like, even England, Scotland, you know, different places all over the UK and down south.

And like, some people don't know about it, you know, that's been really the downside of it is that nobody knows about it or it needs to be talked about. Speaking with your mum the last time I was here, she said there'd be a lot of people that just seem to be unaware that it's a service that's out there, it's under advertised. It should be, like, it's, in my head it keeps me out of hospital, which would cost a lot more.

So no, it's definitely needed. That's it, and I suppose the aim of the podcast is so that the information is more accessible to people. Yeah. Yeah. So to alleviate some of those fears of, of what are we doing, you know, it's, it's too much hassle. What does it look like? How does it work? Yeah. Yeah. So do you want to maybe tell us a wee bit about how you hired your PAs or how you find them?

Like I've, we've had PAs for years and years and years, um, even before I went to uni. Well, it's more to start off as. And then, as I got older and stuff, it turned into more of a PA job, um, and like, I probably couldn't go to bed if, if I didn't have them. Um, and then of course that leads to more problems if i was in bed all day.

So then, well, I've had, I've said, I've like, loads, I don't know, I've lost quite a many PAs over the years. We've looked for them in a different way, so we like advertised them, just putting that on the paper. Went through the job market as well, and so it's just different avenues of advertising and some were word of mouth really as well, like, and then we just went down the, the kind of, the proper way of employing people, of like going through interviews and of course interviews are good, but sometimes people say stuff in interviews, like say a little do whatever.

When it comes down to reality, when you employ them, it's slightly different, um, like you kind of have to have it, like you can't really. It makes the boundaries of like being a friend and an employer and employee, you know, it needs to be that set up or else it just falls apart. Yeah, no, you just, over the years, you just get used to it and you just have to, you get more.

Stronger, more confident or whatever to get to employ them. And when you moved over to the direct payment, then it was three existing PAs that you already had? Three existing, yeah. They, yeah. Yeah. They're all three. The three existing, the last, Steven was the last one on the books, you can say. Um, but you know, they were still, they're all here before, before direct payment.

Then three, three I have now have been good and there's no problem with them, but you never know what's going to happen. And so for the purposes of the direct payment, then they had to come in and do an access NI check. They went through access NI, um, through yourselves, Margaret organized that. Yeah. So like we have like with the access NI check, um, lawyers liability, you know, with all of it, it's done through payroll, like SAGE payroll.

So the pay's done that way and they pay all like the. National insurance, tax, pension, and it's all through the same bank account. So it's all seeing what's going on. So you had to set up a brand new account. I'd set up a brand new bank account and that's where they're paid out of and that's where the direct payments go into.

So you mentioned Sage there. Is that like a website or an app or something? Yeah, it's just, it's a, it's a payroll website where you literally put in their month, They're paid monthly, so they put in their monthly figure, and then before expenses, so that before their tax, insurance, pension, um, and that Sage works that out.

Um, and the reason why we know is because we've got the shop. So we've, like, the mom and dad's been employing people outside of this, um, situation for years and years. So they have business experience. We have a business experience behind it. So other people may not have that business experience or whatever to run, like, It's not a business as such, but, you know, it has to be run kind of like a business.

Do you pay for that, Paul? Yeah, you do. It's like, it's like £8 a month It's not a big expense, but Um, and there is companies out there, there is people out there that will do Training. Like, um, on like Sage, again, there's other companies out there, but Sage would do training for, to show you how to use their, their system.

It's quite, it's quite simple. It's not, I say simple 'cause I, I could do it now, but, uh, it definitely would scare people like, um, put people off. A lot of our population would be older. Yeah. And it would scare them, so then we would have the centre of independent living. Yeah. In Belfast. And they can help out with that side of things.

Aye. So there is, there is ways around it, but that's hopefully one part that shouldn't, but like that should be the least of their, their problems is like, um, and you can like, you know, I know like accountants may, may do it as well and stuff, you know, for a small fee or you might be able to get someone to do it for you, but.

Let's say it can be daunting because it is, in effect, you are becoming an employer. This is your business now and you know, in terms of how to work that, people automatically switch down and they're like, no, no, that's not for me. That's too complicated. And. I suppose knowing that there are pieces of software out there that can Yeah, you know, there's loads of like, we use Sage, but I know there's loads of different software out there Um, and training will need to be, well you said there's an independent, everyone may do it for them, but It's just literally putting a few figures and hit a few buttons and it stuns or anything like, but uh, It is one part of it to get people, in my opinion, yeah.

So we've talked about employing someone and how we pay them In terms of the tasks that they complete for you, Paul, do you want to tell us a wee bit about that? So I've literally broken it right down to like, get out of bed, shower, change, you know, just everything like broken down to every, as much as we can.

Like, um, if the cleaning wasn't done and stuff. Then, like, I'll get infections, whatever, and then that may, may lead into, like, hospital appointment, you know, like, being in the hospital. So, it is, like, in our eyes, they are important, but That's it, that's it. There's, it's hard to draw the line, because they can't cover everything, like, but Because it's not black and white, it's quite grey.

Yeah. Yeah. And what's critical for you wouldn't necessarily be critical for somebody else. I suppose the ongoing assessment and the ongoing review that this area is doing, I suppose from the nursing and OT perspective, there are critical tasks that help you to, as you say, get out of bed in the morning, those kind of things.

What would your PA do for you specifically, I suppose, throughout the day? Just any tasks, really, I ask them to, you know, like, cleaning the house, or washing, or preparing food, or, and then they come with me to, like, they assist me, like, to work, and, when I'm in work, I work in the office, so, like, when I'm in work, the way we put it is, they're my hands.

So if anyone needs lifted or moved or whatever they're willing, they'll do it, you know. And then, like, if I go to any hospital appointments or, um, social events or sporting events, they would come with me as well because I need, like, catheterised or toilet and, like, all the time. So, um, I need someone I really, like, my shadow, you could say, um, there all the time.

So, they'll literally do anything for me. And that's the beauty of it because Paul is funding 96 hours. The trust are giving 46 and a half hours of that. So you're paying a lot of money still privately. So you do have that flexibility where they can do the things that would be outside of the critical criteria.

Yeah, and it also doesn't curtail me to like time slots. So if I was waiting, say a nurse come in or um, for toilet and whatever, like the way it is, it just wouldn't work for me. Mm-Hmm. , um. Because I get up in the morning and go out, and you know, there's always something on. So, in my head I can't really wait for a nurse or somebody to come and do something, you know.

But again, other people are different, you know, they may, that may be okay for them or whatever, but, uh. Yeah, for some people a domiciliary care package with specific time slots throughout the day would work. I work for them. For you, direct payment works better. Yeah, it works. Because you have that flexibility.

Flexibility. And like, you can, like, they'll come anywhere, so it's not like, I have to be back at home for the nurse, or I have to be back for certain things, which wouldn't. So, if I were to walk in here today and said, are you right, Paul, do you know what, sorry, direct payments are stopped and trust have said no, no more direct payments, what would be your biggest worry?

What, what is it that works best for you from a direct payment perspective that you wouldn't get from a trust arranged service? Well, it's the flexibility would be the biggest, the biggest thing because I could probably trust one, but you would have to, again, it goes back to trust. Time slots probably.

Mm-Hmm. . Um, and that would curtail me to like the house or this, or even Ballycastle, probably in general. Um, because it said like, you know, going to sporting events or social events or whatever, or even hospital appointments or whatever, they have to be able to come with me so I can't be, and so by having the direct payment, it's enabling you to have paid employment that's enabling you to engage in all these social activities and sport events that a domiciliary care package.

Wouldn't really be able to support. And like, if it was, if direct payments was pulled away, then like, I would have to lean on back, lean back on the family more. They all have their own lives and you can't be like, pausing their life because, look after me, whatever. And I wouldn't, I wouldn't want that. Like, and then probably end up, what, nursing home or something there.

Probably if it was pulled, um, which would be, no offense to nursing homes, but it would be rubbish. It would be. It would take away your independence in effect and, and I suppose the direct payments are Yeah. Yeah. Yeah. That's definitely for me, it's the best setup. That's it. Everybody is entitled to a social work assessment and it's the outcome of that assessment that's going to determine what pathway is most appropriate for them.

So, is it direct payments? Is trust range more appropriate? You know, what is going to work for people? And it's the fear. That direct payment, even the words can instill in people, you wouldn't think. Yeah. From setting up the bank account, so how did you find that process, Paul? It wasn't, wasn't too bad. Again, I just can't say it again because I'm in like work in the business, so it's kind of, I do them things.

We're not setting up bank accounts every day, but you know, I'd be involved with stuff like that. So, for me, it was simple enough, um, just contact the bank and they open their accounts or anything. It does take, there's paperwork and stuff, you have to sign and whatever, but, um. Did you have to let the bank know that it was free?

Yeah, I would have told them it's for like, employing PA's and then the direct payments. So I, I already had that account kind of set up. I suppose sometimes people have bank accounts that are already open that they don't use and there's maybe a small amount of money in that they can use, and we're, I suppose the social worker's not very good at doing that.

Asking that question because you're like, right, new bank, can't do this, do this, do this. Yeah. But they can use an old bank account. There's, there's no money in it. Um, and nowadays with like online banking as well makes it easier. And then I just put the returns in to the, the board or to finance team or whatever.

It's, um, so is that every. Quarterly, quarterly, that's what I think so. I am sent out a reminder every three months to do it, but uh, I do do it, um, I haven't slipped up yet. Do you annotate them Paul, or do you just send them off, or what way does that work? Yeah, no, so I do I, no, I, it's quite clear, like I have it clear enough, like I write down, you know, statement's wage or, you know, the PA's name and then wage so they can see that.

And then also they'll see, like, the money going to the government for national insurance and tax and they'll see the pension. It's a company called Ness. There's a government thing, um, that we use for it, for the pension, so it's, it's very clear on the bank accounts what the money's going to. Yeah. It literally just downloads the PDF, whatever, and just send it back off to, send it off to the finance department.

Um, but it's daunting from the start. That's how I describe it to people, is it is daunting at the start and there seems to be quite a lot of wee nitty gritty things that need to be done. Yeah. But once it's set up and in place It works really well. But it does have to be made for a job, like you can't, you can't really expect someone like, it might be a, I'll say it anyway, but it might be a down time.

So I could be in here, like, say, build Lego or something. I don't need to, so we have another room for them. So, technically, they're getting paid for doing nothing. But, there's no other way around it. Like, there's no, like, to make a, I'm not saying we're making a job for them, but to make it more worthwhile.

For every sec you have to pay them, you know, the, the set amount, you know. Yeah, like, if it had been a domiciliary care package, you would have carers coming in for, like, 15 minutes. Yeah. Lots to get everything done and then go again. Yeah. And that's sometimes how the funding is still viewed in the direct payments.

It's those critical elements and can they all be done in a time frame. But as Paul said, he needs to employ the people throughout the day. So there is going to be periods where there isn't things needs to be done. And he's kind of funding in between the critical tasks privately. And that's, that's the only way, like, it can be, in our eyes, that's the only way it can be done.

Like, and again, I sound a bit selfish, but I don't want to be to time slots. Yeah. They're going to tell you the time slots. So like, even if, even if I was getting direct payments, I still would, I wouldn't like people coming in and saying nine and ten, you know, like different times. And then you're also relying on them to turn up, you know, like if it's kind of a domino effect, like if they don't turn up at nine o'clock then, or even say eight o'clock, then I don't be in work for nine and, you know, it's just really just silly things like that.

So you just have it in a shift pattern then? So we have it for, yeah, well. So the way it is, like, 7am to 11pm, well that's Monday to Saturday, but, and the family would step in Sunday, but, um, again, if I'm away, somewhere, like, um, they would, they would do it Sunday. So there has been times, like, Mum and Dad's been away, and the PAs would, like, stay overnight.

So that PA won't leave until the next one comes in. Okay. You know, and like, these three PAs I have now, like, probably count in one hand the amount of times someone's not turned up for a shift, like, so it's not, it's not very often. And again, if it was often. You would have to go down the route of, you don't want to do it, but like dismissing somebody, you know, like, which we've had to do over the years, we've had to get rid of a few people over the years.

Um, it has to be made as a job, like, kind of, as well, um, to make it fair for everybody. Absolutely. Yeah. So you mentioned travel, um, in terms of a personal assistant, how do they support you to engage in your sport activities and, and go places? Yeah. So they, for sporting, like they would, they would get all like, if I need any equipment or whatever, they'd get it prepared and stuff and assist me, you know, I would, I would either drive or they would drive me to wherever we're going.

Yeah. So I, I play, I play a sport called boccia, which is similar to like bowls, but it's inside. And, uh, so like. Boccia balls and then like a ball holder and stuff and everything. They different equipment I need to bring with me. So that would be better and stuff. And then when we're at the venue, like a some like a sports hall or whatever, they would assist me like on the watcher court with like just different drills and different things and work with like my coach and stuff.

And then of course assist me with Toilet and as well and stuff as well and if there's any food needs prepared or whatever they would do that as well. So we have like a contract and job description all laid out for that. So when they're applying for the job and going for the interviews that that's all in black and white in front of them.

So we try and we've learned a lot, learned a lot over the years. So like we've, we've changed it probably every time we employ somebody or interview somebody and some people turn up the interviews and we're like. No, I can't do that. And then we're like, that's okay. You know, it's, it's not for you. You know, like, so it's, it's not, it's definitely not for everybody.

Um, and it also like, okay, we have three PAs, but they haven't really overlapped or seen each other that much. Okay. They're in a team of three. But there's still a one that, like, there's only one at a time, so it's still individual than in a, in a team as such. It's just the way it works, and they're happy enough with it, like, they're not, they're not too worried, which, like, they're very happy to work on their own stuff, and they only, I only need one.

at a time, so it's not that I need, I know other people may need two or three people, you know, to assist them with different things, but. Sometimes it's just good to have options because you do have to accommodate for annual leave and yeah, so they, yeah, so again, they, it's in the contracts and stuff and they would have to work up.

If someone's off for holiday, for sickness or whatever, or bereavement or whatever, so like, are on maternity with younger ones and they've, like, they've been off for the guts of a year, but, so we've had to, like, bring people in temporary, to cover that again. So that all has to be put into the contract and they're paying and stuff.

They get their 5. 6 weeks a year holiday or whatever it is. I can't remember the entitlement, official entitlement and stuff so, and I would keep track of that as well, so like I, well How do you find out all that information, you know, like if someone had no clue about business and you've just employed somebody, how do you find out?

Yeah, that's the thing, like again, there must be, you must be able to do training, there must be companies that will guide you through that. Also, the government website has quite a lot of info on it. And you just have to change from what the government, like, the different guidelines the government give you as well and stuff.

Keeping up to date. Keeping up to date. And like, so you get, like, you get, like, it's emails and different stuff. But, you know, I remember years ago getting letters from the government saying, The minimum wage is this, and you have to do this, and different, you know, different like And do you find the direct payment, whenever there's a change to the minimum wage, with the government, does the direct payment fall through quite quickly with an uplift, or?

Well, I think so. Do you notice a big difference with that recent change? Yeah, yeah, no, it's good, yeah, no, it's definitely good. So it seemed to go £12. 91, £12.19 to £12.91, £13.18 to £14.75. Oh, so like, yeah, yeah, yeah. Literally within a few months. Yeah, it's weird. And it was back paid as well. It was. Because I've had a few people ring and think they've been paid double.

They're like, oh, is this Christmas? Is this paid early? Kind of thing. And it's like, no, it's been back paid, so. We got, we got letters saying it's going to be back paid. Yeah. So we're sitting at the minute on about 46 hours is it? Yeah, or is it 45 and a half? 45 and a half. And then two nights sits? What, two nights is included in that?

That's included in that. I suppose in terms of like home based short break or anything like that, Paul, have you ever considered that? Like respite and everything? Uh huh. No, I haven't, I haven't been down that route at all. It's because I have a good family network that we're set up. You know, like, so say your mum and dad and sister were all going off on holiday at the same time and it was, you needed to have someone here 24/7.

For some people we would arrange respite where they would go into a care home. Yeah. But we can also do home based respite through direct payments and that's just like a temporary uplift. To your direct payment, you know, but no, I, I normally go on the holidays with them. So they're not going to escape from me.

It might be, but no, it's good to know it's there. But, um, yeah, no, I've never used respite. No, but I've heard different people like. Um, using it, or like, I mean not that one, you've described it, definitely using respite, for their parents, whatever you're going to buy, um, you might be able to get more financial help, but the PAs would just step in, and they wouldn't work between the three of them, they'd just work round the clock, you know, um, I would have to change the, the rota, the way it's done, but that's simple enough, but um.

There are, we just have to up their hours to cover it, but yeah. Yeah, I suppose it would be fair to say that the PAs are, are flexible to you, you know, and completely depend on what family support there is to enable them in that gap. Do you find by employing them yourself, Paul, that you kind of get a sense of what's gonna work for you and what's not, how adaptable people are gonna be or? Well, like I said, like interviews, like we've, I've done millions of interviews, interviewed loads of people. In my opinion, the first minute of the interview, I know if that person's right or not. And that's the nice thing too about direct payments is that you have that control whereas with the domiciliary care package you have no control of what cares are employed by either the trust or a private domiciliary care provider.

There could be one that you just don't gel with and they're having to come into your space in your home. Yeah. Seven days a week and there's not really much that can be done about it. Well, going back to my Queen's time, the guy, we employed, agency, um, up in Belfast, and they just kinda threw people in. And I'm like, Oh, what are you doing here?

So, you know, like, um, which I didn't really like. So then I got onto like the, the, um, the company and was like, so I'm being picky, but I need to, I've set people that I need to know who they are, kind of. Um, but no, I, I just like the way that. Like, I have my three set ones at the moment, and we've come up with three because, probably could get away with two, but to cover holiday and sick leave and different things, it's three because if there's only two and somebody was off for a week or two weeks, then that puts a lot of strain and pressure on the other person.

Yeah. So they have three people. Would the three do an even kind of amount of shifts in a week, or would you have two that do more and one that kind of just does a They do, they do two days a week, minimum, each. Two, two, two. So, it's like, one that you see once a You know, and then they would work up. So then if someone was on holidays, they would, the other two would do three days a week, you know, on that, when the other person's off, or sick, whatever.

So again, that's all laid out at interview and contract stages. Um, we've, again, we've talked about it at Black and White, saying like, ask the PAs, like, they can't just turn around to me and say, Paul I'm going on holidays next week. Like I, I, in the contract it says like, I need a minimum of like a month, like four weeks notice that I would need.

Because I need people to get the rota sorted for the other ones. You know, so they can't. And of course there's certain circumstances like, you know, someone suddenly dies or something like that, that's different. Yeah. Um, completely different scenario, whatever. But um, and then of course if I am going away and anywhere our holidays, whatever family, I would give them noticeably and they would, you know, the way we've set up it works.

Yeah. I'm not saying it's perfect and I'm not saying it would fit everybody's box, but for me it works. If somebody said to you, Paul, I'm thinking about direct payments but it seems really stressful, what do you think? Do you think you could have managed it? What would you say to them? Yeah, no, definitely, like, I'd encourage people to do it.

I would tell them to go back to their social worker and tell the social worker to get more information for them, or more training for them. But again, that shouldn't, like, the system shouldn't scare them. Like, the system should be nearly as easy as possible, like, you know, um, I think it's the best, it is the best way, but no, definitely, like, it shouldn't, like, the whole administration behind it shouldn't, like, the, the reward, kind of, out.

outweighs the administration, like it definitely does, like for me anyway. Um, there definitely needs to be more people shouting about it and talking about it. Yeah. Um, because I know there's people out there that's Definitely need it. And tell me this, do you think you would have been able to manage, set it up and manage a direct payment if you didn't have such a supportive family?

Um. Do you think it would have been doable without the support of your family? Possibly, I could probably set it up without the support of the family, yes, but maybe not from the knowledge of what I've had, like if you've had no business background. I suppose from my perspective, there's some clients out there who would be interested in doing it, but it's, that's kind of why you need to always have a backup PA or you need to have options because I suppose there can be crisis situations and if you've just employed one person and you don't have family to take care of.

step in. That sometimes scares people is what if this person doesn't turn up and I don't have any, you know, that's what the benefit of a domiciliary care package is that the care should always be coming and it's not your responsibility to think for it. So I think it's always really making sure people have a pool of PAs.

Yeah, that's why I said like why we're three. Um, because when we started off, we thought we'd get away with one or two and we, we did start with two and then we quickly realised like. If the second person, the first person is off on holidays and the second person has to do work around the clock and that's just not, it's not fair on them because they have their own lives as well, like they have their own children and partners and whatever but, but no it's definitely, um, and it has to be done in , uh, a kind of professional level, again, when you start, I know other people like where they've like had PA started living in with them and staying in the house when they're not working and getting paid.

You know, it's just, then it gets very messy and it gets like that boundary is broken. So I, i'm afraid if that boundary is ever broken then it's time to, for them to move on or it's time for you. Well, sacks not the word. You know, it's not going to be. No, it is Paul.

That part, that employing, some people might be scared of actually taking on responsibility of even employing somebody because they might be scared like if I slip up I'll be sued or again you, you, you get the employer's liability and there's a, there's like a company behind that like we, I use Fish Insurance and again if I have any employment problems you just lift the phone to them and they talk you through like what to do and um.

And also if there's someone I suppose if they didn't want, the responsibilities associated with employing someone yourself, you can go to an agency so you can employ someone through an agency and they're kind of taking that responsibility, but then's, but you still get that wee bit of a flexibility.

You know, but then it is more money your paying out. Yeah. Yeah. There's, it takes an amount of confidence and, and certainly experience in terms of, 'cause yes, there's the shop and your day to day job, but something that's so private and so personal to you Yeah. You know, is very different. Yeah. And you know, that has to be right.

There's no. So it's not a miscalculation, it's, it's something that could ultimately cause you to become unwell or, or, you know, risk of injury, so. And like, we have, I have, over the years, um, we've employed some people and in a few stages they'll say, yeah, we'll do like bowel care, catheterisation or whatever, you know, and then we employ, we bring them in and show them and train them and stuff, and they're like.

No, can't do that, and they just leave. So like, there has been situations where it's on paper it looks alright, but in reality, it's not for them. You know, I mean which is grand. There's loads of people out there. That's what makes the world go round. And I suppose you have to find PAs that want that kind of part time, they want that balance of only working two days a week and, you know, because it doesn't really work if you have one person full time because then it's.

How do you have your back up options? Yeah, well it is, it is, it is only two days a week, but it's 32 hours, it's like still 32 hours a week. Yeah, yeah, yeah. So it is, okay, they're only working for two days, but they're doing a week's work in two days. So, like, they enjoy, they, they like that, so like they're off for what, six other days?

Yeah. Or, no, five other days. Um, um, so like they're off for, So, I suppose just to wrap up, we've talked about the flexibility that Direct Payments gives, how you use it for your day to day functional and physical needs, and then also how the PAs can help you with your sporting events and things. What advice would you give to someone?

Definitely go for it. Go for it, like, and, like, yeah, could be scary at the start and But there is the support out there to, like, there is, well, yourselves, hopefully, but, um, there is different companies and different people that can, again, for the employer's liability, I use Fish, there's other insurance companies out there to do it, but, um, it was through the Spinal Injury Association that I found out about Fish, um, insurance, and They do talk you through, like, you could say the legal part of employing people.

Even if I go away on holidays, but I bring, you know, I bring PA with us. So I like, it, that's, that's like paying for like two holidays at once. Mm hmm. Because like you've got double flights, you've got double accommodations. Of course I wouldn't share the same room with them, so like I have to get them another room.

So it's different, you know, it's, for me to go away, it's double the price. You know, so it's, my trip is say 200 quid, it's 400 quid for me to go. Mm hmm. You know, and that's just the way it is, you know. But then if I don't do that, it's I'm, I can't go on holidays or I can't live, you know, so it's, it's kind of the price you have to pay.

And I suppose in terms of the short break, you know, that can be to get like required rest or that can be to facilitate going away. So, you know, it's something to consider. I'll definitely keep that in mind. Um, yeah, no, it's definitely, definitely overall the system's good. Um, I didn't realise the insurance companies would give that much help with the, yeah, with the writing of contracts and the whole legalities thing.

Yeah, so like, yes. They do help you, like, they, they would help you for, they would help you set up contracts and then they give you, there's like a, they call it like a handbook, so it's kind of like, The legal side of it, like, of like, if your employer, employee steps out of line, how do you, like, deal with that?

You know? Because I had one situation before COVID, um, before yous got involved, was like, didn't ring in this morning, like, didn't turn up for shift. So I got somebody else to step in, and I phoned, like, phoned round to see where she was, but she wasn't answering. And then, so, I phoned a few times that day, no, like, completely, radio silence.

And then, so the other PAs, they stepped in and stuff, and they just kept on going. There was no communication back to me at all. So I contacted Fish Insurance, probably after a couple of days, three days or whatever, and said, like, she hasn't turned in, what do I do, blah, blah, blah. So I did, like, she, he, they sent me, like, a letter, a template of saying I have to send a letter to, to the employee, employer, employee, sorry, employee, and ask in writing.

I'm not as blunt as this, but what's going on, like, you know, I need to know, you know, like, you've, you've, you've got a job and you've got responsibilities and stuff. Again, I had nothing back from her at all. And then, so then, like, I had to invite them in, invite them in for an interview, an interview, like a disciplinary interview.

Um, again, like, the insurance company gives you all them. Um, questions and guidelines and templates. Yeah. And, um, well, she didn't turn up, but then we had like, I was sending her another letter saying that she's being dismissed. And also like they have a key for my front door, you know, so we had to get the key back, you know, it, you know, so there's, there's that, there's that responsibility as well.

And like, so our whole house, they have access to our whole house, you know, so like, do we go to a point of changing the locks, you know, like that, but then she, she posted the key back and this day I haven't heard, I haven't heard anything back from her, but she just posted the key back. I'm like, yeah. Yeah.

So again, that's like, and like, that's you opening up your house to, not to anybody, but like, it's, it's, it's a trust. You have to trust the PAs not to abuse that and then the second, in my opinion, the second anything's abused, that's it over, you know, and like, you just have to get rid of them. Sounds bad and blunt, but No, you have to, you have to protect yourself and your own property.

Ultimately, the people that you're employing are to add value to your life, not to put you at potential risk. Yeah, yeah, no, no, yeah, definitely, like, and So, no, it's definitely, like, there is, like, the insurance company does help you a lot. And we, the last couple of PAs, we use Rutledge, um, Agency for Employment, or, so again, you pay them a small fee and they put the ad out for you and they would, you could, they VET, they kind of check everything out.

The initial checks. The initial checks, and then, I wasn't, we were involved with the interview, but they would do the interview as well for you, but in my opinion, we had to be involved because It's no offence to, to them but they didn't know what, who really was involved with the job. Even though I sent over, um, like, um, ads and contract stuff, they didn't actually know.

So again, you pay them a small fee to do, to help you through that. So there is people out there that's just trying to group all that together for you, for you, or whatever, you know, like, you know, like, what they choose there. There's probably other companies. There's lots of stuff here that I think should be included in that booklet that we give out to people about the insurance companies and the things that they can do.

But there's definitely more. Like, probably to sum it up is like, it's definitely good, people should go for it. But there needs to be more support. I don't mean like, of course, the financial support, but it's the, it's the Support and guidance around setting it up. Yeah. And making sure people know that there are resources out there to help them every step of it's trying to point them in the right direction to get their resources, like uh, Yeah.

Um, but no, it's definitely I feel like we've covered how direct payment's really flexible and how they work for you, but maybe one side of it that's not overly flexible is the funding. And I think that needs to be quite clear whenever people are Yeah. Because I think sometimes people might think oh I could get a direct payment because then they could come on holidays with me and I suppose in reality for funding purposes for the direct payment, the funding from the trust is only going to be for those critical care tasks and then people are having to use benefits and stuff for the likes of cleaning tasks and Private monies then for anything that maybe falls outside the, yeah.

So in effect, you would be paying your PA on holidays the exact same amount as you would be paying them if they were in your own home. Yeah. But also in theory. Oh yeah. Well, technically that's like, in my opinion, it doesn't matter if I'm in this house or I'm in Australia, you know, like they're still doing the same task.

So in my eyes, I should still be getting the direct payment. Yeah. Okay, it may not be within like the Northern Trust, um, but. But that's what the flexibility is there. That's, in my opinion, that's the system should still go on, you know. Yeah. But I mean when the PAs. Continue to pay for what they would have paid for.

Yeah, because when the PAs, in my opinion, doesn't matter where the, where, where the work is. Yeah. It's still the same. Yeah. Stuff getting out of bed, the shower, you know, it's all the same. But it's just a different location. Yeah. Um, but no, definitely like, I don't really agree with like paying, you know, of course paying flights or transport or whatever combination, of course that, like, like, you don't get paid to go in your, like, you're only, you know, mainly you just have to take that out of your, your own personal fund and your own personal money.

So like, I agree, I kind of agree with that. Like, we're. And the other expenses that you pay for yourself, but definitely in the direct payment, you should still go on. Absolutely. It doesn't matter where you are. That's it. And that's where looking at options for the rights of short breaks and things. For example, if you were going for one week and at the minute you're only getting two nights support, you know, that's where a temporary uplift or a one off uplift could be considered as situations and circumstances change.

So that's it. Even for a service user or a client to hear you say on today, you know what? There is. It's quite a bit to set up a lot of administration in terms of set up, but it is. The benefits outweigh the the initial trouble. So you know that's ultimately a starting point for someone who's considering direct payments.

In this episode, we have discussed the flexibility of direct payments to support service users. In the podcast summary, you will find a short survey link, which we would really appreciate you taking a few minutes to complete. This will help us to receive feedback on the podcast you have been listening to today.

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