In my blog below, I outlined some pernicious myths about personalisation. One of them is that personalisation is all about giving people Direct Payments, usually to employ a Personal Assistant (PA). This myth is important: if we don’t address it, it has the potential to do real damage to the goals of personalisation, which are that people will have a real choice of how they are supported and by whom and that they will be able to build a life where they feel in control and like they belong.
We are seeing an increasing number of cases where an individual is supported by a Personal Assistant (PA), but does not want the responsibilities of being an employer. Sometimes individuals and PAs are encouraged to treat the relationship as one in which the PA is self-employed, in order to avoid the budget holder having to take on the tax and employment liabilities of being an employer.
This is dangerous. The Revenue have pursued disabled people for thousands in unpaid National Insurance contributions and tribunals have found that people who were treated as self-employed were nevertheless employees, entitled to sick pay, holiday pay and so on. Cases like these add the perception of personalisation as risky and badly thought out. There are three things we need to do to address this situation, and some of them are part of the work we have taken on as part of the commitment in the Chancellor’s Growth Review, which is that NAAPS will produce a single ‘map’ for micro-enterprise, outlining newly clarified areas of law and regulation which will, we hope, make life simpler and clearer for people.
The first solution is to ensure that people understand that PAs are nearly always employees, however they have been encouraged to describe themselves. Unison have just produced a useful guide to employment law for PAs and it’s also the subject of one our factsheets for micro-enterprise members.
The second is to let people know that there are alternative ways to spend Direct Payments than on PAs. Councils should stop allocating resources using pounds-per-hour formulae, as if employing someone is the only thing people would ever want to do. You’ll find lots of examples of more imaginative spending of Direct Payments in this blog. Where people do want personal assistance, workers can come together in partnerships or tiny organisations in which they are clearly not employed by the budget holder. We produce guidance on forming micro-enterprises of this kind and we are working with the government to increase the clarity (so please tell us your issues!).
Thirdly, Shared Lives is one effective example of how a service can provide very personal, very tailored assistance, but without you having to be the employer of the person who assists you, because the support is purchased from the Shared Lives scheme, not directly from the Shared Lives carer. This, like some of the micro-enterprise models, also ensures that there is a plan B if things don’t work out between you and your Shared Lives carer, or if they need to go off sick. A good Shared Lives scheme ensures that Shared Lives carers receive training and can meet up to provide each other with peer support, in contrast to the isolation of many PAs.
There will always be a significant number of people (and family carers) who do not want to become employers. If the government is serious about rolling out Direct Payments universally, and really wants that to translate into better lives, we need to sort the confusion and pitfalls around PAs out sooner, rather than later.
Escaping the invisible asylum 
Useful set of observations, thank you.
I’m interested to see how Personalisation will support (or perhaps even drive) self-assessment and greater ‘client’ involvement in care management. I think there are significant improvements to be made in the understanding of both how to access personal budgets/direct payments and what they can be used for.
Shared Lives and similar schemes, where a ‘contract’ for ‘services’ can be provided is a highly effective way to manage that budget without having to employ a PA.