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Direct payment and Personal Assistant employment - Coronavirus update

For more information about employing a Personal Assistant, please see our full frequently asked questions.

We know people who employ their own Personal Assistant (PA) for their care and support may be concerned about Coronavirus COVID-19.

We have put together information to help answer some of the most common questions we are receiving.

This is based on the information as of today and we may update this information several times in the coming days and weeks. For up-to-date government information, please check the Gov.UK website.

Coronavirus (COVID-19): guidance for people receiving direct payments - GOV.UK

 


 

Clarity of self-isolation periods

The government advice relating to self-isolation is:

  • if you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 7 days from when your symptoms started
  • if you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, but all other household members who remain well must stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the house became ill
  • for anyone else in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14-day isolation period

 


 

Frequently asked questions

The following are the most common questions we are receiving from people on a direct payment and who may also employ staff.

What are the expectations around the flexible use of direct payments?

Covid-19 is an exceptional circumstance, and it is vital that we make sure if you take your budget as a direct payment, you continue to receive the support required to keep you healthy, well and out of the hospital.

As far as possible, direct payments should continue to be used as agreed to within the care and support plan. However, there may be circumstances during the pandemic where this is not possible, for example, through staff absence.

In these circumstances, you should raise and discuss this with your Social Care Practitioner who will be able to advise what options are available.

Can I use unspent direct payment allocation (sometimes known as contingency funds) or access emergency funding from the council?

Yes. In exceptional circumstances, unspent allocation can be used to ensure that the appropriate care and support is provided. Use of this funding should be recorded within a log, with the relevant receipts or evidence also kept in order to justify the spend once the pandemic is over. You should always obtain authorisation from your Social Care Practitioner.

If you have a change in needs or require access to emergency funds please contact your Social Care Practitioner.

Given the pandemic, will my direct payment be stopped?

The council has no plans to stop direct payments. Except in extreme circumstances, your existing direct payment should continue.

If your direct payment is stopped due to an extreme circumstance, this would be explained to you, and alternative arrangements discussed with you in order to ensure you receive the care and support you require.

If I am admitted to hospital, will my direct payment continue?

In line with normal practice, this will be dependent on your condition and circumstances, length of stay, and any extenuating circumstances that mean your needs have changed and are no longer as set out in the care and support plan.

However, a temporary stay in hospital should not necessarily mean that the direct payment should cease – and direct payments are often part of the support arrangements which can help you to return home safely, as soon as possible – you should check with your Social Care Practitioner if you are unsure.

Can my carer or PA support me in hospital, if I am admitted?

We understand that you may prefer some personal care tasks to be undertaken by your carer or Personal Assistant (PA) rather than hospital staff, which the direct payment can usually allow.

While your preferences will be taken into account, the measures taken to combat the current pandemic means that access to hospitals for anybody who is not a patient or member of staff, is limited. It therefore may not be possible for your carer or PA to support you in hospital, during this period. Rules and guidance issued by the hospital will provide further information on what is possible.

If your carer or PA is able to support you in hospital, they will be subject to infection control measures as is normal practice. In no circumstance should the personal care interfere with the medical treatment. Carers, PAs or anybody supporting you must adhere to the guidance set by government and the hospital around supporting people when in acute care.

Carers and PAs will have a vital role to play upon discharge. Separate guidance has been published on the discharge process in place during the pandemic.

Should I develop a contingency plan? 

While not a formal requirement, we strongly recommend that if you have a direct payment that you develop a contingency plan, or update your existing plan, to ensure your needs can continue to be met.

This plan can be discussed and agreed with your Social Care Practitioner if possible, and then exercised when necessary. Elements to consider within this plan include:

  • staffing – identify options for alternative arrangements where those who are employed via a direct payment cannot work in their usual way. Longer shift patterns and less frequent handovers could also be considered, taking into account any additional pressures being placed on the individual
  • alternative provision – when elements of the care and support are unable to be delivered (such as accessing exercise classes in the community), use of other avenues should be explored (for example, the use of indoor exercise classes and the use of technology)
  • alternative networks of support – the identification and contact with extended family and/or friends and/or volunteers may need to be considered as part of any emergency contingency plan to keep safe and avoid acute admission, so that people can stay at home. Be mindful that information, advice and training may be needed
  • upskilling of existing staff – identify what possible additional training or support there is for existing staff members. This does not necessarily have to be through face-to-face training – it could be through peer learning or e-learning

A template contingency plan can be found in Annex A on the gov.uk website. 


 

Personal Protective Equipment (PPE)

The use of homemade face coverings are not suitable for use in any care setting.  Homemade face coverings are only recommended for use in public settings by the public when in confined spaces such as some shops or on public transport. 

All care settings including in your own home,  your Personal Assistant or care provider must have access to sufficient and suitable fluid Resistant Surgical Masks to IIR standard as outlined in the guidance.

See more information about personal protective equipment (PPE)

Is my PA or home care agency eligible to receive Personal Protective Equipment (PPE)?

Yes. Your personal assistant is entitled, as an essential worker to personal protective equipment. There is a small stock in several locations (101 KB) these are listed on our website. Furthermore, if your PA normally receives PPE to support you, this should continue.

If you procure home care support, your home care company will provide PPE for your home care assistant. 

What Personal Protective Equipment should my personal assistant or home care assistant wear?

The following answers presume that care is taking place in a household setting. If you are receiving PA support in another setting, please find the relevant guidance from Public Health England (PHE).

Guidance from PHE should be consulted when determining what PPE is appropriate for PAs to wear. See the guidance for home care during a time of sustained COVID-19 transmission (as we’re currently experiencing).

This guidance applies whether the individual receiving care has symptoms of COVID-19 or not and includes all individuals, including those in the shielded group.

In short, the guidance sets out that:

When providing personal care that requires a PA to be in direct contact with you (for example, touching), or when within 2 metres of anyone in the household who is coughing, the PA should use:

  •  disposable gloves,
  •  a disposable plastic apron and
  •  a fluid-repellent face mask.
  • Eye protection may be needed if there is a risk of droplets or secretions reaching the PA’s eyes (for example, caring for someone who is repeatedly coughing) 

When the PA’s visit does not require them to touch you but they need to be within 2 metres of you, gloves and an apron are not needed but a surgical mask is recommended. This might cover activities such as removing medicines from their packaging, preparing food for those who can feed themselves without assistance or cleaning. 

If you or any members of your household are in the ‘extremely vulnerable’ category undergoing shielding, any visit from a PA requires, as a minimum, a single-use, disposable plastic apron, a surgical mask and gloves. If direct contact is required, a fluid-repellent face mask is needed instead of a surgical mask. Further details on who this category includes can be found in the shielding and protecting extremely vulnerable people guidance

New disposable gloves and plastic apron must be used for each episode of care. It’s essential that PPE that has come into contact with someone with COVID-19 symptoms is stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin. Waste that has not come into contact with anyone that has COVID-19 symptoms can be disposed of as normal. 

Surgical and fluid-repellent face masks can be re-used for different episodes of care and potentially while caring for multiple individuals, providing the PA does not have to touch or remove the face mask in between episodes of care. Eye protection can also be used continuously, subject to risk assessment. The current domiciliary care PPE guidance provides details on the conditions when this should be carried out.

Can I use my direct payment to buy PPE for PAs I employ?

If your existing direct payment contains funding to purchase PPE for your PA, you should continue to use that funding to purchase PPE.

If you, or your PA, cannot obtain PPE in this way, or your direct payment is not set up to fund PPE, then please ask them to visit our website

What are the safety procedures when using PPE?

PPE is only effective if it used correctly. PHE has produced a number of resources that explain how PPE can be safely used to minimise the spread of infection. See the guidance on how to use PPE effectively 

It is important to take off PPE safely in the recommended order to prevent self-contamination.

PPE is also only effective when combined with good hand hygiene (cleaning hands regularly and appropriately), good respiratory hygiene, avoiding touching your face with your hands and following standard infection prevention and control precautions.

What about family members, will they receive PPE if they are providing care and support?

We would encourage all unpaid carers and family members looking after loved ones to continue to follow the general hygiene guidance provided by the government, including washing their hands and cleaning frequently used surfaces.

Where people are taking on care work in a voluntary capacity, and the care requires PPE according to the PHE guidance, then they should also be able to access, and use, PPE. 

Details of where supplies are located (101 KB) are available to view.

Guidance on what PPE is appropriate to use

Should my PA wear shoe covers to reduce the risk of COVID-19 on their footwear?

Footwear covers have not been included as part of PPE guidance for personal assistants or home care organisations. General interventions to reduce potential transmission may include increased cleaning of floors and surfaces and keeping the property properly ventilated by opening windows whenever safe and appropriate.

Should my PA be using paper towels to dry their hands rather than individual hand towels?

PHE guidance does not state a requirement for paper towels. Clean cloth towels, specific for each personal assistant, can be used and should be replaced frequently. Good hand hygiene and the correct use of PPE will reduce the potential for contamination.

When people are using paper towels after coming in contact with someone with COVID-19 symptoms, they can be disposed of in regular household waste but should be double bagged. There should be a 72-hour wait period before being removed from the home and placed ready for collection.

Responsibility for paying for PPE

As we are responsible for funding your care, we are also responsible for making sure that your staff have correct PPE to provide care for you. PAs are regarded as key workers by the government, and, as such, they must be able to access PPE in line with guidance from PHE.

If you have an allocation of funding for PPE in your direct payment, you may be asked to continue purchasing this from your usual supplier, and funding for any additional PPE required above your usual order may be added to your budget. 

Location of Emergency Supplies and Contact details (101 KB)

What are the procedures for infection control in the house? 

If those employed through a budget undertake cleaning duties, then they should use the usual household products, such as detergents and bleach. These products are very effective at getting rid of viruses on surfaces. Frequently touched surfaces should be cleaned regularly.

Personal waste (for example used tissues, continence pads and other items soiled with bodily fluids) and disposable cleaning cloths should be stored securely within disposable rubbish bags. These bags should then be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin for disposal as normal.

Dirty laundry should not be shaken before washing. This minimises the possibility of dispersing the virus through the air. Items should then be washed as appropriate, in accordance with the manufacturer’s instructions. All dirty laundry can be washed in the same load. If you do not have a washing machine, wait a further 72 hours after the 7-day isolation period (for individual isolation) or a 14-day isolation period (for households) has ended. The laundry can then be taken to a public launderette. Items heavily soiled with body fluids, for example vomit or diarrhoea, or items that cannot be washed, should be disposed of, with your consent.

See further guidance on laundry and waste disposal


 

Self isolation

How will my PA get paid if I am self isolating?

If you are in receipt of assistance and wish to self-isolate and your Personal Assistant is available for work, then Personal Assistants are entitled to full pay. 

If your Personal Assistant self-isolates, then they can claim sick pay subject to them qualifying.

What happens to my contribution during this time?

If you are in receipt of assistance and wish to self-isolate and your Personal Assistant is available for work, then Personal Assistants are entitled to full pay. The contribution should still be paid.

Will the PA qualify for the 80% that the government is willing to pay?

Personal assistants do not qualify for the 80% funding from the government at this time.

In general, the government expects that the Coronavirus Job Retention Scheme will not be used by many public sector organisations, or people who employ personal assistants through funding provided to them as a direct payment. This is because the majority of public sector employees are continuing to provide essential public services or contribute to the response to the coronavirus outbreak. The government considers Personal Assistants to be an essential worker, and as such, furloughing of this cohort should be minimal.

If I employ a PA through a payroll provider and can’t find the contract, should I carry on paying even though I can’t have a Personal Assistant at home?

If you wish to self-isolate and your Personal Assistant is available for work, then your Personal Assistant is entitled to full pay. 

If your Personal Assistant self-isolates, then they can claim sick pay subject to them qualifying.

If my PA has to self-isolate, will they get paid Statutory Sick Pay (SSP)?

Yes, if they are eligible (earn over £118 per week). They will be paid from day one rather than the fourth day of their illness. This will be applied retrospectively from 13 March 2020.

My PA says they are self-isolating. Do I need them to provide me with a fit note from the doctor or NHS 111?

If your PA says they are self-isolating, they will not be able to go to their doctor and are being asked not to call NHS111 unless they really need to. You do not need evidence from your PA to be able to claim SSP for them. If they are self-isolating and then become sick, they should let you know (by telephone not in person).

My PA is self-isolating and I need to pay SSP, will I get it refunded?

Yes. SSP will be paid out through payroll and claimed back via HMRC. Your payroll provider will deal with this for you. This refund will be for up to two weeks per employee.

If my PA has to self-isolate or is off sick due to Coronavirus and is not eligible for SSP, what do they do?

Those affected by the Coronavirus will be able to apply for Universal Credit and can receive an advance without physically attending a job centre. For further information on applying for Universal Credit, please see the Department for Work and Pensions website.

My PA is showing symptoms but does not want to self-isolate and says she/he is fit for work. What do I do?

They should be sent home. If they are sick or self-isolating because they are showing symptoms, and you should put in place SSP f they are eligible.

If not, they will need to apply for Universal Credit. You need to put your contingency plan into action.

My PA(s) can’t work. I still need care and support. What do I do?

You need to refer to your contingency plan. If that is not possible e.g. the care agency isn’t able to provide care, consider asking your friends and family for help. If you are unable to do this, please refer to your social care practitioner for support. There are lots of community and volunteer groups who may be able to help. 


 

Personal Assistants

My PA has young children. She wants to bring them to work as their school has closed. Neither the PA nor the children are displaying symptoms. Is this ok?

The short answer in normal times is no you cannot bring children into the workplace as your employer’s liability insurance will be invalid if there is an accident. However, this is a crisis situation and you should use your discretion and be flexible on the rules e.g. it would be better for a PA to provide you with essential care even if they have a child with them.

The government has confirmed that PAs are classed as ‘key workers’ (someone who is employed to deliver an essential service and must be supported to continue to work). This means that if they are a single parent or the other parent is also a key worker, they can send their child to school or other childcare provision.

I am in the ‘high risk’ category and have received a letter from the NHS saying I need to stay at home for 12 weeks. Can my PA still work for me?

Yes, your PA can still work for you as your care and support needs will continue. It is really important that everyone you come into contact with (your PA and anyone else who lives in your house) follows strict NHS guidelines on hygiene to reduce risk. If you have personal protective equipment (PPE) such as gloves, aprons or masks, you should use them but we know they are in short supply. 

Can family carers or close friends be paid out of the agreed direct payment if PAs are not available?

We recognise that during this pandemic, short term emergency changes may be necessary. Families and close friends may need to be called on for support beyond any unpaid care and support they may already be providing. They may be able to provide this support on a voluntary basis for a short period of time, where there is a gap in care and support provision- for example, through staff sickness.

We also recognise that this may not be viable or sustainable in the longer-term, if the situation is ongoing. In these circumstances therefore, consideration could be given to paying the family member or close friend from the direct payment.

If you feel it is necessary for family members to become your care and support workers, this should be raised and agreed with your social care practitioner who will consider this on a case by case basis. 

If you think this may be necessary during the pandemic, you should include this when developing your contingency plan. Please contact your social care practitioner in advance of use. In deciding whether funding from your existing direct payment should be used for family members and close friends who may need to be called on for support beyond any unpaid care and support they may already be providing, it is important to consider the following:

  • routine employment and payroll processes will need to be followed, including adherence to agreed hours and pay rates in the personalised care and support plan
  • consider whether there is any additional training and assessment of competence required
  • any employment law issues related to the rights of existing paid care workers or PAs
  • any additional costs involved if existing employees are entitled to ongoing pay
  • if family members take on paid care and support work this could impact on any benefits they receive
  • family members are often already providing significant levels of care and support. Consideration should be taken of the impact on family members’ health and wellbeing and whether any unreasonable strain is being put on them
  • if the family member is also the direct payment recipient and the employer there can be a conflict of interest. In these instances, employment of the family member through an agency or third party may be a solution
  • any impact it may have on relationships if the family member is also an employee

Can my direct payment be used to cover additional expenses incurred by my PA during the pandemic, for example, car park charges if they are unable to travel by public transport?

In some circumstances, this will be appropriate, and necessary in order for you to receive the care and support you require during the pandemic (if your PA could not reach your home without using their own car, as public transport is reduced). It’s vital that you continue to receive the care and support you need to remain at home, avoiding admission to hospital – and we recognise that much of the support is delivered by essential workers like PAs. You would need to provide receipts, evidence and justification and agree this with your Social Care Practitioner.

Can I re-employ previous PAs who already have the training to support me, in these emergency situations

Yes, if required (for example through PA illness) then you could contact a previous PA, who may be able to provide temporary cover, and will be familiar with your needs. This should make up part of your emergency contingency plan. You should consider whether there’s any additional training and assessment of competence or upskilling necessary (such as peer learning or e-learning) to get them up to speed as quickly as possible.

Given the social distancing measures, will all PAs have official documentation to show they’re doing essential work?

No. Government guidance is clear that anybody is permitted to travel to and from work if it is not possible to work from home. There is not special status for key workers in this respect. This is reiterated in guidance to police officers issued by the National Police Chief’s Council and the College of Policing. No documentation is required to prove travel to and from work is necessary.


 

Respite / day care / home care advice

My Day care provider is no longer operating, but they want paying, do I have to pay them?

There are different arrangements in place for different day care providers, some are providing alternative support to day care and therefore should continue to be paid. Please contact your Social care practitioner for confirmation about the arrangements for your day care provider.

My home care provider isn’t wearing PPE what do I do?

Advice and guidance on appropriate PPE has been made available to all Care providers. If your homecare provider is not wearing PPE then you should contact their manager to advise of this.

My respite provider is no longer operating, can I carry forward my allowance to use in the future? 

We cannot confirm future arrangements at this time, we will contact you with further advice regarding respite arrangements when providers are able to operate again.

What is an emergency or crisis situation?

Emergency Respite could include:

  • Carer Breakdown short term – unable to provide care due to ill health i.e. Hospital Admission due to fracture and all alternative types of care and I Care / community-based support have been exhausted i.e. Homecare.
  • Carer Breakdown long term – the carer has informed the social care practitioner / social care team they will no longer provide care and support to you, all alternative offers of support have been declined, and you are required to leave the family home.
  • Provider Placement Failure – current care and support has irrevocably broken down and you are served notice and will require alternative care and support

How is emergency respite requested?

If you require access to respite, you should contact your allocated social care practitioner or duty team to discuss your circumstances. 

Social Care Practitioners will work with you to explore a range of options to meet critical care needs. 

If it is not possible / suitable to meet your critical care and support needs within your home, building based respite may be explored.

When will I be able to book any further non-emergency planned respite?

We will take into consideration all national guidance.  We will keep the situation under review and keep you updated. 

The current proposal is to cancel all planned stays until 31 May 2020. We will provide further updates and guidance, as appropriate. 

Will I still have to a pay a contribution to this service?

You will be required to make a financial contribution for the care and support you receive.

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