Author: nld01

Direct Payments and NHS Continuing Health Care #SaveWILG

The following article was taken from the Luke Clements site and was written by Ann James. 

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The Deputy Minister’s update statement on the Welsh Independent Living Grant[1] (WILG) is particularly welcome because it acknowledges the risk to the independence,choice and control of disabled people in Wales unless the Welsh Government enables people in receipt of either a Joint Package of care funded by the Local Authority and Local Health Board or NHS Continuing Health Care to receive a Direct Payment.

This risk to independence has been known to Welsh Government for some considerable time,[2] has been identified in a ‘direct payment note’ on Rhydian Social Welfare Law in Wales and highlighted as a risk in a paper on the Closure of the Welsh Living Grant that was offered as evidence to the Petitions Committee dealing with the Save WILG.

While it is heartening that the Deputy Minister ‘has instructed her officials to undertake a review of the Direct Payments and CHC interface’ one could argue that this is very late in the day. It would be hard to convince disabled people and their carers that setting up a system that enables them to have meaningful and personal control over key elements of their care package will compromise the principles of a public service NHS. The time is ripe to redress this lacuna which has this potential to derail Welsh Government commitments and aspirations for disabled people in Wales.

Recipients of the WILG require immediately the confidence that they can continue to retain the right to have personal assistants of their choosing irrespective of whether the funding from the LHB is a proportion of the cost of the care and support package or whether it is a NHS CHC funding arrangement.

There are those people who are not previous recipients of the WILG but who are fearful that their future is in the hands of local government and local health board officers who erroneously believe that Direct Payments cannnot be facilitated.They require an unambiguous statement from Wesh Government that all Local Authorities in Wales and all Local Health Boards are required to facilitate a joint package of care through a Direct Payment as set out in Continuing NHS Healthcare: The National Framework for Implementation in Wales[3].

In the absence of legislative change Independent User Trusts (IUTs) should be offered to disabled people and facilitated by the Local Health Board, to enable a person who has become eligible for NHS CHC to consider this option and its suitability for his/ her circumstances.

While we await a successful conclusion of the review set up by the Minister, there needs to be measures in place to enable disabled people in Wales to achieve their personal outcomes and maintain their independence. Welsh Government commitments and aspirations to Social Model of Disability is currently being shown to be hollow when the level of physical impairment and health related needs determine whether a disabled person in Wales can have control of their care and support arrangements through a Direct Payment.

Local Authorities and Local Health Boards need practice directions from Government and training in this matter if we are to avoid further human rights infringements in Wales.

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[1] Julie Morgan AM, Deputy Minister for Health and Social Services Written Statement: Welsh Independent Living Grant (WILG) – Update on Independent Care Assessments (Welsh Government 13 February 2020)
[2] See for example letter Welsh Government Director of Social Services and Integration dated 10 February 2016.
[3] Welsh Government Continuing NHS Healthcare: The National Framework for Implementation in Wales (2014).

PeterRabbitmeme

The Human Right To Dignity

The following article dates from Friday, 15 April 2011 and is taken from The Broken Of Britain blog. This was a blog written by the late Dr Rhydian Fon James and his words are as relevant today as they were nine years ago.

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To read a biography about Rhydian, please click the following link. I would recommend reading all about this prolific inspirational who achieved so much before tragically passing in January 2016 at the age of just 31. Like me, Rhydian lived with Friedreich’s Ataxia. 

It is encouraging that the social care landscape has changed for the better in Wales since this article was published, as disabled people are now protected by the Social Services and Wellbeing (Wales) Act of 2014. In addition, the Welsh Government have made a commitment to the Codes of Practice to Article 19 of the UN Convention on the Rights of Disabled People.

I have now received my ‘independent reassessment’ from ICS and WCBC and am working behind the scenes to sort out an appropriate care package. I do not want to say too much at this stage as I need to concentrate and stay focused on the negotiations ahead.

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The Human Right To Dignity

This week was meant to be a quiet one, with Parliament in recess; no pressing issues on the news agenda; no MPs to brief. Meant to be. It hasn’t quite worked out this way, and we’ve all been busy preparing the continued campaign. This has meant that I haven’t had a chance to write about an interesting court case that’s been on my mind for the last couple of weeks.

Last week the Supreme Court heard an appeal case with huge implications for disabled people who receive packages of support. The court heard the appeal of Elaine McDonald, whose care package was cut by Kensington and Chelsea council even though it had assessed her as needing that support. McDonald became disabled following a stroke in 1999 and later broke a hip in a night-time fall. She had been provided with a weekly package of 22.5 hours of daytime support and another 10 hours of care seven nights a week.

A needs assessment by the council found night-time care was essential to provide supervision to prevent her falling while using the commode at night, due to a bladder condition. But in 2008 the council said it planned to cut her care package, and said she could be given incontinence pads instead of an overnight care worker, even though she is not incontinent. In November, the Court of Appeal ruled that the council had not breached care laws, McDonald’s human rights or the Disability Discrimination Act (DDA) by cutting her support.

The Supreme Court confirmed three weeks ago that it had granted her leave to appeal. McDonald’s case is being funded by the Equality and Human Rights Commission, which said in November that it feared other councils would use the judgment to “reduce community care and services for disabled people”. The Supreme Court’s decision will not be handed down for a few weeks yet, but it will be massively important for anyone who gets a care package from their local council.

This is because the Court of Appeal had found that a council could simply review a service-user’s care needs and then reduce their support, without needing to conduct a new assessment. The precedent set by this case would affect all service users. At the moment, if the council want to cut a person’s care package, they must show that their needs have changed and that they are thus entitled to fewer hours.

As service users will know, councils have been anxious to cut costs in recent years. This has led to a great deal of pressure to cut care packages, and the near-impossibility of new care packages being offered, but the need to re-assess has slowed the austerity zeal. This is because, regardless of whether they wish to cut, councils must show that the service user’s needs have lessened prior to cutting, and a council cannot be considered to have conducted a lawful assessment simply by reviewing a disabled person’s care package.

If the Supreme Court were to uphold the Court of Appeal’s decision, it would give councils free reign over decisions to cut care packages. It would also mean that it would be more difficult to argue that the refusal to provide care was a breach of her human rights to dignity and to a private and family life.

You might think that forcing a disabled person to, effectively, wet themselves at night when they are not incontinent is humiliating and degrading. But when councils are hunting for possible cuts, it may not be illegal for councils to cut care packages and force just that outcome.

WRITTEN STATEMENT BY THE WELSH GOVERNMENT #SaveWILG

TITLE: Welsh Independent Living Grant (WILG) – Update on Independent Care Assessments

DATE: 13 February 2020

BY: Julie Morgan AM, Deputy Minister for Health and Social Services

It is paramount that people’s ability to live independently is not compromised by changes to the way their care and support is arranged and provided. Last July, and following close working with the #SaveTheWILG campaign, I updated Members on the new arrangements I had introduced to provide independent care assessments for people who used to receive payments from the Welsh Independent Living Grant (WILG). These new arrangements were to aid any former WILG recipient who was unhappy with the outcome of their local authority care assessment. This statement is an update on those independent assessments.

Following my last update, ICS Assessment Services were appointed, through a competitive process, to organise and undertake the independent assessments for those who requested these, and 46 former recipients of payments from the WILG took up this opportunity. ICS has now undertaken all of these assessments.

All of the independent assessments completed have now been quality assured by ICS and passed to the respective local authority to consider. This was prior to a discussion between a social worker from ICS and a social worker from the respective local authority about the outcome of the independent assessment, and any effect its findings may have on the person’s current care package. Subsequent to this, a joint meeting is held with the person to discuss the outcome of that discussion, talk through the implications for their care package and agree the future care and support they will receive as a result.

In around half of the independent assessments completed, the discussion between the ICS and local authority social workers has now taken place, with the remaining discussions taking place over the next few weeks. Following these, meetings with care recipients have begun, with outcomes for those people being agreed and starting to be put in place. While it is too soon to comment on the overall outcomes from these independent assessments, some important issues are coming to light.

In a number of cases ICS has found that individuals are currently receiving larger care packages than expected, potentially because those individuals are at the transition point for NHS Continuing Healthcare (CHC). This interface between CHC and direct payments, and the challenges this can cause for care recipients, are issues that have also been highlighted to me at the National Social Care Partnership Board

Having reflected on this, I have instructed my officials to undertake a review of the direct payments and CHC interface. This is with a view to determining whether there are other mechanisms, for example independent users’ trusts, that could be used to ensure people that need more support from the NHS are not put in a position of losing the team of personal assistants they have funded through direct payments and built up over a number of years. If a better more equitable way can be found, this would remove the apparent fear that some people feel about the prospect of CHC.

It is a complex area and I will not compromise the principle of an NHS that is in the public sector rather than in the hands of private individuals, but I want us to see if there is a better way and to do that work quickly.

The United Nations Convention on the Rights of Persons with Disabilities, Article 19, is clear that States must ensure disabled people have access to a range of home / residential and other community support services, including the personal assistance necessary to support living independently and inclusively within their community. The key principle regarding this human right is the ability to choose how you are supported in your everyday personal care.

As the outcomes across the span of independent assessments are confirmed, I would remind Members that the cost of the independent care assessments, and any additional social care that might be identified from them, will be met by the Welsh Government. This is so that there can be no question of changes being made to people’s care and support as a cost cutting measure. The under-pinning principle of my approach is to ensure that outcomes reached are fair and consistent with supporting people’s agreed wellbeing outcomes.

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Birthday Musings… #SaveWILG

Many thanks to everyone for all the birthday wishes – it means a lot and is much appreciated.

I can’t believe twelve months have passed so quickly. I am proud to have published Dancing on Thin Ice – a selection of Tanka and Haiku poems in the last year. It was a year that began with a visit from Julie Morgan AM, who works as the Deputy Minister for Health and Social Services in the Welsh Government. She attended my house to inform #SaveWILG campaigners that she had decided to give those who were unhappy with local authority assessments, the chance to have an independent assessment with extra funds provided by the Welsh Government to pay for any extra support needed.

This seemed like a victory for #SaveWILG campaigners. Indeed, the support given by the Welsh Government has been encouraging and comforting. They appointed ICS to undertake the independent assessments and the vast majority of these were completed by the end of October 2019.

However, WILG recipients are still stuck in limbo almost six months later. This is not due to any failing by the Welsh Government or ICS, but local authorities are still keeping us waiting, as they rubber-stamp the independent assessments.

I am really not knowing which way to turn at the moment. Life remains very insecure until I find out what the reassessment says about what support I can expect in the future. I am subsequently unable to decide where to put my energies. Do I write a new book, create some new poems or take a well deserved holiday before deciding on my next venture? I can’t make a decision on this until I know how much my independent assessment has been coloured by their meetings with WCBC.

I was told last week, that I could expect to hear back from Adult Social Care at the beginning of this week. At close of play today (Wednesday), I have still not heard anything. I believe a verdict is imminent, as I know a decision has already been made, but being kept in the dark about this is seriously damaging my physical and mental health.

The anxiety all this has caused me and other WILG recipients, is appalling. We should all be claiming compensation for the way we have had to wait, but I am sure we all agree that we just want it over and done with – as long as we end up with the support we need, to live on a level playing field with the rest of society.

Once again, many thanks for my birthday wishes and I hope that by this time next year, I am looking forward to the future with some degree of certainty.

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Taking Wales to the World

I have received the following email concerning the future of Wales beyond Brexit, from First Minister Mark Drakeford. It is really encouraging to know that we have a Welsh Labour Government working for those of us in Wales to make the most of the opportunities that we have to take to protect the future of our proud nation.

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Last week, the UK left the European Union but this doesn’t mean that we have left Europe. Wales remains a European nation, open for business and eager to trade internationally.

As we move beyond Brexit – as international relationships are reshaped and trade deals are negotiated – it will become even more important that Wales remains open and outward facing.

Our future success will be rooted in our engagement with both Europe and the wider world. We are strengthening international relationships and economic partnerships – attracting inward investment, and helping Welsh businesses stand out across the globe.

This is why the Welsh Government has – for the first time – appointed a Minister with portfolio responsibility for International Relations, Eluned Morgan, and why we’ve published our first International Strategy, setting out how we’ll be promoting Wales around the world, strengthening existing relationships with international partners and making new ones and supporting businesses in Wales to grow their businesses overseas.

We have a series of high-profile trade and overseas visits arranged for the coming weeks ahead, which are an important part of this work and will build on the success of our trade mission to Japan last autumn during the Rugby World Cup.

We’ll be in Ireland to promote Wales and in a number of other European countries, with an event in Berlin at the beginning of March. Our first mission of 2020 to Arab Health recently returned from Dubai. Wales Week in London will be part of our St David’s Day celebrations and Eluned will be visiting Canada and the west coast of the United States.

We do all this while continuing with the work of making a real difference to the lives of people in Wales – investing in our town centres and local communities; building more affordable homes; improving health services; speeding up access to new medicines and bringing new job opportunities to Wales.

We are embarking on a new phase of our history, which doesn’t include EU membership. As the world changes, Wales will change with it, but Welsh Labour and your Welsh Labour Government will always stand up for Wales.

Yours in solidarity,
Mark Drakeford AM
Welsh Labour Leader and First Minister

DWP accused of altering disability assessment reports to cut or end successful claims

Politics and Insights

gailPictured: Gail Ward, who was told that she did not qualify for Personal Independence Payment, despite living with a rare and potentially life-threatening heart condition – Prinzmetal’s angina – attacks can occur even when she is resting. She also had other health problems. Remarkably, Gail was told by the DWP that she doesn’t qualify for PIP. She won her appeal after waiting 15 months for her case to be heard at a social security tribunal.

It has been claimed that officials within the Department for Work and Pensions (DWP) have edited or removed thousands of work capability assessment reports submitted by privately contracted healthcare professionals.

It’s alleged that officials reduced qualifying points awarded during face-to-face assessments, delivered by ‘independent’ private firms, and in some cases disposed of the reports entirely.  

The Daily Recordreports that during the last year paperwork was altered or amended in around 1,840 cases, while…

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#SaveWILG Campaign Relaunched

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As many of my regular readers will know, I have spent the last 5 years campaigning to protect independent living for disabled with high support needs across Wales. In February 2019, we made a break through and the Welsh Government agreed to offer independent assessments to all recipients of the Welsh Independent Living Grant who did not agree with the decisions made by their Local Authority.

Since February, the Welsh Government have pulled out all the stops to make sure that WILG recipients have been assessed properly. They recruited the assessment company, ICS, to carry out the much needed reassessments and the majority of these were completed by the end of October 2019. WILG recipients were looking forward to resolving this issue before Xmas 2019, so that they could look forward to the future some degree of certainty.

However, WILG recipients are still stuck in limbo land and are unable to make plans for the long term future due to the fact that Local Authorities are dragging their feet and refusing to sign off the assessments made by ICS.

The fact that LAs are involved in this process is a contentious one as these are supposed to be independent assessments.The context is that these are being undertaken by ICS without its social worker having sight of any previous care assessments undertaken. This is as ICS did not want its social workers unduly influenced by what a local authority had undertaken or produced previously. Consequently, at the point ICS has concluded and quality assured its assessment on a person it does not know how the outcome of this compares to that which the person’s local authority has undertaken previously. In addition, a local authority may have some key information about a person or their care which may be relevant if ICS had known this.

This seems fair enough and WILG recipients have nothing to hide so would welcome LA involvement. If only it were that easy. I have had no reply to countless emails sent to WCBC this calendar year even though it is in the best interest of WCBC and myself to get this situation sorted once and for all. I must make it clear that I am very thankful to WCBC for agreeing to fund 24/7 support for myself while we await the outcome of the assessment. I appreciate this, but would still like to secure a long term plan that I know will see me through what is left of my life. Surely, a bit of security is not too much to ask while I continue to fight a progressive, genetic disease of the nervous system…

The stress and anxiety that all this indecision and uncertainty is causing, recently forced me to spend a period of time in hospital with a nasty chest infection. I am slowly getting back on my feet, but this whole episode has just renewed my determination to get this this whole sorry mess sorted out once and for all.

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