Carers Personal Budget Sign Off Process

When you are satisfied that the Support Plan meets all requirements, it should be submitted for sign off in line with local processes and agreed levels of budgetary sign off.

See: Adult Care and Community Wellbeing Scheme of Authorisation

The personal budget and how the carer intends to spend it must be acceptable in accordance with the following seven criteria:

1. The plan is person-centred;
2. The plan has clear outcomes;
3. The planned support is fully described;
4. The plan shows how the carer will stay healthy and safe, including contingency considerations;
5. The plan shows how the carer will stay in control of their life;
6. The plan shows how support will be managed;
7. The plan should show the cost of the support.

These are the three principles in the Care Act that apply to any process that will decide a personal budget.

See: Deciding the personal budget amount to read more about these principles and the Care Act requirements when signing off a Support Plan.

You must make sure that the process you use to sign off Support Plans and agree final personal budgets is robust and consistent. The process should not allow for a variance in how budgets are decided or situations where carers with similar needs receive different outcomes from the process.

tri.x has developed a tool that can be used as required to support consistent decision making when signing off plans and agreeing final personal budgets.

See: Care and Support Plan sign off tool

The final plan must:

1. be appropriate and proportionate to meet the eligible needs of the carer;
2. contain clear outcomes for review purposes; and
3. represent the best use of available resources (both local services and Local Authority financial resources).

When considering each of the above, you must have regard for the carer's wellbeing and outcomes at all times and be able to demonstrate that you have taken into account their reasonable preferences about how to meet needs, when signing off the plan and agreeing the final personal budget.

Managers should consider all of the evidence and information provided by the Carers Assessor during the sign off process. If they require further information from the assessor, they should request it before signing off the plan.

Helpful questions to ask during the sign off process include:

1. has the carer's involvement in the plan been maximised (is there evidence that they have been involved or supported by an appropriate person)?
2. will the plan promote individual wellbeing?
3. is it clear from the plan what the carer's outcomes are (and are they realistic)?
4. is it clear how the plan will support the carer to achieve their outcomes (including how any support services will contribute to this)?
5. will the plan promote the carer's independence, choice and control over how their needs are met and outcomes achieved?
6. does the plan maximise opportunities to prevent, reduce or delay needs?
7. does the plan demonstrate that a strengths-based approach to meeting needs has been used (rather than a traditional service-led approach)?
8. do the services/support options explored make best use of available resources (both local services and Local Authority financial resources)?
9. is the level/intensity of service/support in the plan proportionate to meet the carer's needs and manage risk?
10. is the type of service/support in the plan appropriate and proportionate to meet the carer's needs (for example, if the service/support is specialist is this level of specialism required)? and
11. is any contingency plan proportionate to the level of need and risk?

The method of managing the carers personal budget will be via a Direct Payment.

The appropriateness of a Direct Payment

Before signing off the plan, managers must be satisfied:

1. that the Direct Payment is not going to be used to provide services directly to the cared for person (if this is the case, the services should be paid for as part of the cared for person's personal budget and not the carer's personal budget);
2. from the information available to you, that the carer is not subject to a requirement, license or order that requires them to undertake drug or alcohol rehabilitation, behaviour therapy or testing.

If the manager has any concerns about the appropriateness of a Direct Payment, they should discuss this with the assessor before signing off the plan. Unless it is clear that the criteria for a Direct Payment has not been met then they should still agree the Direct Payment, but it may be necessary to impose some conditions on the provision and use of a Direct Payment, such as:

1. increasing the frequency of Direct Payment reviews; or
2. requiring certain information is provided at specific times to ensure effective monitoring of the Direct Payment.

See the Direct Payment procedure for further guidance.

Considerations of a Direct Payment

Consideration needs to be given to other resources available to help the carer achieve their outcomes, and then in addition how the need will be met through the use of a personal budget if there are no other options. Consideration also needs to be given to the value for money for the use of the budget and the reasonableness of the request for the use of a personal budget, and there is a clear narrative on how the outcome will be met through the use of the personal budget.

A manager must agree a personal budget when the plan:

1. is appropriate and proportionate to meet needs; and
2. makes the best use of available resources.

This should be done in line with local processes and requirements.

The manager should not agree the plan or proposed budget if this is not the case. Instead, it should be returned to the assessor who submitted it.

When returning a plan, the manager must:

1. be clear about the reasons that the plan has not been signed off at that time;
2. suggest steps that the practitioner may take to resolve the issues identified.

When the assessor re-submits the plan, it should be considered again.

You should contact the carer whose plan it is to let them know that it has been signed off as soon as possible after being notified.

Following the sign off process, the carer must be given a written record of the Support Plan. This should be sent to them with a Personal Budget letter confirming their final personal budget amount and a copy of their assessment (if not already provided).

It is important that the carer understands:

1. the Support Plan; and
2. how their personal budget has been decided.

If you are of the view that the carer will experience substantial difficulty understanding the plan, then you must make sure that appropriate support is in place, including consideration of the duty to provide an independent advocate.

If an independent advocate is already in place, they should be informed when the plan has been provided so they can support the carer to understand it.

In all other cases, a copy of the Care and Support Plan can only be shared with the carer's consent.

A copy must be shared with anyone that the carer requests you share a copy with, even if they were not involved in the planning process itself.

Concerns about a request

You must provide a copy of the plan to anyone that the carer requests you to unless you are concerned that doing so could put the carer, the person they care for, or another vulnerable adult or child, at risk of abuse or neglect.

If this situation arises, you should seek advice from your line manager and decide whether:

1. to share the record in full as requested;
2. to share the record partially, omitting sections where information could put the a vulnerable adult or child at risk; or
3. to decline to provide a copy of the record (although the carer can of course still choose to make a copy available from their own record).

Sometimes the carer (or another person involved in the planning process) may ask for amendments to be made to the Support Plan. You should:

1. consider the request;
2. if the carer whose Support Plan it is has not made the request, consult with them; and
3. review any evidence or information you have which may support or refute the request.

If you reach an agreement with the carer about the need to amend the plan, you should do so.

The amended plan will need to be signed off but this should be done in a proportionate way to reflect the level of the changes made to the plan. This may or may not involve a full sign off process.

The amended plan should be circulated to the same people as the original plan, unless the person requests otherwise.

If you are unable to reach an agreement with the carer and you feel that an amendment is not required, you should not make the amendment. You should be clear about your reasons for not making the amendment and you must make the carer aware of their right to complain about your decision.

The plan will not have been signed off for one of two reasons:

1. It is not appropriate or proportionate; or
2. It does not make effective use of available resources.

The authoriser who has returned the plan to you should have explained the reasons that the plan has not been signed off.

They should have also suggested the steps that you need to take to resolve the issues with the plan before resubmitting it for sign off.

If it is not clear to you what the issue with the plan is, then you should:

1. discuss this with your line manager; or
2. discuss this with the authoriser (if this was not your line manager).

When you understand why the plan has not been signed off, you should think about the steps that you now need to take.

A request for information

Where a plan has not been signed off because you did not provide sufficient information or evidence to enable a decision to be made, you should consider whether this information is available. If it is available, you should provide it and resubmit the plan for sign off.

If the information is not available, you should consider how it can be gathered and make arrangements to do so, having full regard for the Caldicott Principles, Data Protection Legislation and local information sharing policies.

A need to revise the plan

Where a plan has not been signed off because there is a particular element that has raised a query, you should:

1. establish whether you have information or evidence that can be submitted to resolve the query;
2. make arrangements to undertake (or revisit) steps of the Support Planning process as required.

When you have taken the necessary steps and made any amendments to the draft plan, it should be resubmitted.

You should notify the carer that the plan has not been signed off and the reasons for this at the earliest opportunity.

Where you have been able to provide additional information and resubmit the plan, you should confirm to the carer the new timeframe for sign off.

Where you are required to undertake (or revisit) steps of the Support Planning process, you should agree how best to do so with the carer.

The right to complain

If the carer is unhappy with the decision not to sign off the plan, you must make them aware of their right to complain about the decision.

If there are urgent needs, you may need to arrange interim services to ensure that these are met during any extended support planning sign off process. If this is the case, see: Urgent or interim support.