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Direct Payments and Non-Commissioned Services

Direct payments are intended offer greater choice to people who have a personal budget allocated following a social care assessment. Direct payments can be used to pay for eligible social care needs and recipients may choose from a wider range of options than people who choose to have the council arrange their care and support.

Direct payments can and should be used flexibly and creatively to meet need.

2022/232 18-64 65+ Total
DP recipients 369 72 441
Cost £5,538,190 £630,312 £6,168,502
Paid direct 350 64 414
Cost paid direct £5,751,212 £784,800 £6,536 012
855
£12,704,514

Direct Payments account for 14% of the total Adult Social Care market spend.

Dudley Council spend on Direct payments is £ per year:

  • 33% of DP spend is for directly employed PA support
  • 9% is for direct payment for agency support

 Spend per Primary Support Reason

Learning Disability £9,825,153
Physical - Access and Mobility £2,944,953
Physical - Personal Care £985,903
Mental Health £405,044
Mental Health - Memory and Cognition £174,198
Sensory Dual Impairment £57,128
Sensory - VI £52,690
Social - Isolation £14,149
Sensory - HI £8,964
Social - Carer Support £1,449

The Black Country ICB actively encourage the use of Personal Health Budgets, which in most cases take the form of Direct Payments.

These are mainly for adults assessed as having NHS Continuing Healthcare needs and children and young people assessed as having NHS Continuing Care needs, in accordance with the relevant National Frameworks.

Often Direct Payments are used to fund traditional services such as independent day services or home care where there may restrictions for example times for when and how care and support is delivered. Over the next 3-5 years Dudley intends to focus on Personal Assistant development and creative use of personal budgets, direct payments and exploring the introduction of Individual Service Funds that will enable people to direct their care and support in ways that are far more personalised and enabling.

Message for the Market / Commissioning Intentions

  • We intend to increase the number of people accessing direct payments to manage their care and support needs
  • Expand and develop the PA market to provide a wider range of choice for Direct Payment recipients and person budget holders
  • Increase access to Personal Health Budgets for those with eligible health needs
  • Explore the development of Individual Service Funds

Carers

Dudley Council is committed to supporting citizens who provide unpaid care, through its local Carers Strategy, the council’s vision is that carers of all ages are recognised, valued and able to benefit from personalised support to meet their personal outcomes and aspirations by:

  • alleviating stress and and anxiety
  • providing a sense of belonging and reduce feelings of loneliness and isolation
  • providing skills and appropriate support to enable them
    • to sustain the caring role safely and enhance their capacity to care (if they wish)
    • to identify personal and social goals outside of the caring role and make them a reality
  • placing children who are young carers first and at the heart of all that we do so they receive the support that they need to achieve their full potential

Census 2021, published 19th of January 2023, identified 31,515 carers aged 5 years or over living in the borough, 10.3% of the population. Although, this was a 15.4% decrease from the 2011, however, the number of carers providing substantial levels of care i.e. 20hours or more per week has increased.

Carer Population by Gender

There are a more female carers (58.8%) compared to male carers (41.2%)

Carer Population by Age

Age Number
90+ 170
85-90 560
80-84 1,095
75-79 1,605
70-74 1,965
65-69 2,260
60-64 3,295
55-59 4,235
50-54 4,020
45-49 2,910
40-44 2,280
35-39 1,970
30-34 1,830
25-29 1,315
18-24 1,350
5-17 655

Dudley's carer population by age shows that:

  • 2% are aged 17 years or younger
  • 4.3% are aged 18-24
  • 69% are aged 25-64
  • 24.3% are aged 65 or over

The largest group by age is 55-59 years.

170 carers are aged 90 years or over.

Carer Population by Number of Care Hours Provided

Hours % Population
19 hours or less 48%
20-49 hours 21%
50 hours or more 31%

Of the local carer population the highest percentage of care hours provided was 19 hours or less per week at 48%, while 21% of carers are providing 50 hours or more of care a week.

The Dudley Adult Social Care Carer Survey 2021/22, identified that:

  • Carers Reported quality of life was 7.4%, the third highest for the region
  • Overall satisfaction with social care services was 33.7%
  • Fewer carers felt they had as much social contact as they would like compared to 2018/19
  • 64.3% of carers felt involved in discussions about the person they care for
  • 60% of carers felt that they were able to find information in Dudley about support for carers and/or accessing adult social care

Working in partnership with the Dudley Carers Alliance and Young Carers Forum Dudley Carers Strategy 2019 – 2022 sets out the council’s vision and priorities for supporting carers. Although, the strategy is currently being reviewed and refreshed, as a working document identifies.

Note: This strategy is currently under review and will be updated shortly to reflect local priorities for carers for the next three years.

The council delivers support for local carers through the Dudley Carers Hub and Wellbeing Service, which first opened in June 2018.

The current service delivery is achieved using a mixed commissioning approach through the in-house council’s Carers Network Team, externally commissioned provider and partnership working with the voluntary and community sector. The service includes two hubs within the borough, managed and operated by the council’s Carers Network Team:

  • Brett Young Carers Hub, Old Hawne Lane, Halesowen, B63 3TB
  • Queens Cross Network Carers Hub, Wellington Road, Dudley, DY1 1RB

Working across social and health care services, commissioned providers, voluntary and community partners the service aims to ensure local carers are, able to access information and advice when they need it; understand the type(s) of support available to them and the person they care for, able to maintain their own health and wellbeing.

The council’s Carers Network team and commissioned provider work collaboratively to deliver the service to all carers.

Carers Hub and Wellbeing service Proposed Service Delivery Model

Flow chart of proposed service delivery model for the Carers Hub and Wellbeing Service. It begins with Dudley Carers Hub and Wellbeing Service. This has two branches. The first is Carers Network (DMBC) and the second in Commissioned Providers. Carers Network (DMBC) has three branches. 1, Single Point of Access – Triage. 2, Carers Hubs (Brett Young and Queens Cross). 3, Statutory Assessment and Support. Commissioned Providers has four branches. 1, Digital Carer Support. 2, Adult Carers Wellbeing Service (18-25 years and 25 or above). 3, Carers Short Break Service. 4, Young Carers Service (5-17 years)

In 2022/23, the Carers Hub and Wellbeing Service engaged with and/or supported approximately 3,594 carers, providing a range of preventative and statutory support based on individual needs of carers.

Level and Type of Support Access by Carers in 2022/23

Carers Hub and Wellbeing Service 2022/23 (as of 31 March 2023)
Adult carers engaged: new carers registered with the council's Carer's Hub 3,594
No. of carers referred to the Adult Wellbeing Service 401
Value of supporting in newly claimed welfare benefits and financial support £1,129,317
No. of hours preventative sitting service to support carers, providing a short break to carers 800 hours
No. of carers received statutory services/support via Council's Carers Network Team Carers assessment 244, Carers direct payments 95
No. of young carers registered with Young Carers Service 278 (as of 31 Dec 2022)

In addition, the council has piloted a web-based digital carers service to identify and engage the wider carer community and those who may not wish to access direct services. During the course of the pilot, it has achieved:

  • 19,751 hits to the website with 67% of these outside of normal working hours
  • 2,306 carers engaging directly with the digital service
  • 641 carers directly supported

The success of the pilot has informed the council’s future commissioning strategy for unpaid carers, to include a 'digital offer' to ensure carers who may not access services directly are able to access support.

The current 3-year Carers Wellbeing Service contract has been extended until a tendering process will take place during the summer with the new 3 year contract targeted to commence 1st December, 2023.

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