Receiving a direct payment from your local Council or the NHS allows you to purchase support to meet your health and/or social care needs in a variety of different ways. Many people choose to recruit and manage their own Personal Assistants (PAs) however, you may prefer to use the services of a care agency to provide your care instead or a combination of both.
Even if you employ your own PAs, and if your direct payment budget will allow, you may wish to use an agency service to supply temporary staff to cover at times of holiday or absence, or in an emergency where your regular PAs are unavailable. If you do this, please ensure it is agreed by the Council or the NHS.
This factsheet is intended to give some advice about what you need to think about when choosing and engaging agency services.
Finding the right agency for you
You will need to find out which agencies are providing a service in your local area. Independent Lives can supply you with a list of agencies operating in your area but cannot recommend a particular service.
Depending on your area, the best place to start is a Care Guide which is jointly produced by a local council and usually a user forum to provide information and advice about care and support services for adults. These can be found on the Council website.
Making the right decision
You will need to decide which agencies to talk to and then discuss with each agency how they can help you achieve the agreed outcomes in your support/personal plan. This will mean negotiating when and how you want their service delivered and how much you will pay depending on what is affordable within your budget and represents good value for money.
There are many registered agencies to choose from, as the customer, you are free to clearly express your preferences for certain staff. Continuity of care in terms of having the same agency staff is very important to some customers and you may find it difficult to establish a good relationship with a changing staff team.
If you think this is likely to be the case you should explain this to the agency before you engage them to provide your care, to establish if you will have the choice over which members of staff will work with you on a regular basis.
Checking quality standards
It is important to ensure that the care agency you choose can meet your needs. This means not only checking out what they can provide, but also ensuring that the care they provide is of a sufficiently high and consistent quality.
The Care Quality Commission
As part of the Government’s initiative to improve care standards, all care agencies and providers of residential respite care must be registered with the Care Quality Commission (CQC) who are the independent regulators of health and adult social care in England.
CQC register, and therefore license, providers of care services once they can show that they meet essential standards of quality and safety. CQC then monitor agencies to make sure they continue to meet these standards. You should only use agencies who are registered with CQC and who produce a Certificate of Registration upon request.
The Care directory search tool on the Care Quality Commission’s website www.cqc.org.uk lets you search by postcode, town and geographical area for social and health care services.
Every health and adult social care service in England is legally responsible for making sure it meets new fundamental standards of quality and safety. Some of the 13 fundamental standards are:
- Person-centred care – care that meets your specific needs.
- Dignity and respect – being treated with care, compassion and consideration etc.
- Safeguarding from abuse – protecting your health and wellbeing from harm or neglect.
- Fit and proper staff – well trained and able to undertake role effectively.
The full list and details of each of the standard can be viewed here: http://www.cqc.org.uk/content/fundamental-standards.
Introduction agencies and self-employed staff
Care agencies that employ their own staff are responsible for all aspects of their staff’s pay and employment. However, some agencies act simply as ‘Introduction Agencies’ and will charge you a fee for introducing you to new carers. You will need to check with your funder to see if you can use your DP funds to cover this cost.
The workers they provide may class themselves as self-employed, in which case you will have to pay the carer directly rather than paying the agency. You should always ask the agency what the employment status of their workers is and you should always insist on a written contract for services from the agency.
Checking self-employment status
If you do take on a self-employed PA, it’s important that you read our factsheet on self-employment, please see factsheet 7.2: Self-Employment and use employer template 7.2(b) Summary of important steps to take when using self-employed carers.
Paying the agency
The agency you use will invoice you on a regular basis (weekly or monthly) for the services you receive from them.
You will need to pay the agency invoices by direct transfer from your Direct Payments bank account or prepaid card (some areas use virtual accounts and assist with paying invoices). Please note that registered care agencies are not allowed to charge VAT on their invoices to you.