Hertfordshire PASS in the Top 100 Apprentice employers in the UK - reported in the Trustees report for 2011-2012

Hertfordshire PASS Trustees Report

1^st April 2011 – 31^st March 2012
(The following report was written by Nigel Fenner and approved by the PASS Trustees following a number of additions and changes. The report was contained in PASS's Annual Report - available on request.)

Hertfordshire PASS in Top 100 apprentice employers in the UK.

In 2010 when PASS was celebrating its 10th birthday it set itself the ambitious target of appointing 10 further apprentices (to add to the 6 PASS had already appointed to its staff team). By March 2012 it had achieved 9 of the 10, and for this, and other achievements, Hertfordshire PASS was only 1 of 2 charities placed in the Top 100 apprentice employers in the UK for 2011 by City & Guilds, and the National Apprenticeship Service (NAS).

Being innovative

We believe such recognition is linked to the need for PASS to be highly innovative given its small size as an organisation. For example, over 2011/12 we tested 3 exciting and ground breaking hypotheses that went right to the heart of Hertfordshire PASS endeavouring to achieve its aim as 'a user-driven charity using employment, and being an employer of carers / PAs to enable disabled people to live independently'. The 3 hypotheses were:

1. The struggle a young person has in developing their independence, through becoming an employer of their care staff can be used as suitable evidence for an apprenticeship……
2. There are mutual and additional benefits to training and developing apprentices in 'being an employer' at the same time as apprentices in 'being a carer', and
3. There are also mutual and additional benefits to training and developing young disabled people as apprentices in 'being an employer' alongside young disabled people as apprentices preparing for work (as an employee).

In bringing apprentice employers of carers together with apprentice carers, and other apprentices preparing for work, we feel we created a unique 'melting pot' that threw up some fantastic results, matched too by some major challenges.

The 'fantastic results'…..

In working to test hypothesis 1, Hertfordshire PASS started to develop its new apprenticeship in being an employer of PAs in summer 2011, in full consultation with Andrew Bird and Hanna King - 2 existing PASS staff members with experience of employing their own PAs. This led to the appointment of 3 young disabled people as apprentice employers at the end of September, and in partnership with Hertfordshire County Council, and Hertfordshire Care Providers Association, the appointment of 3 apprentice carers, or PAs to work with them.

Political support

Given we felt our new programme had (and still has) the potential to address some significant national challenges such as meeting the government's vision for adult social care, cuts in disability services, a significant growth in demand for PAs and the employers to employ them etc, we invited Stephen McPartland, the MP for Stevenage to visit us, and after 2 visits (including PASS's AGM) he said:

"I was proud to meet some of the new apprentices and learn from Andrew and Hanna the journey they had undertaken in developing this concept. It is an amazing project and I am delighted that they are leading the way with such an innovative apprenticeship scheme. I look forward to working closely with them and keeping Ministers informed of our progress."

Such 'keeping Ministers informed' included PASS's local MP brokering a meeting between PASS's Manager, Nigel Fenner and the Rt Hon John Hayes (Minister of State for Further Education, Skills and Lifelong Learning) who also expressed plenty of interest in the programme.

Independent evaluation

In addition to getting an independent view from MPs, PASS also secured funding to have the new apprenticeship programme independently evaluated and a report on the first 3 months was published in early March 2012 by Margaret Martin. In summary this concluded that there was certainly some truth in hypothesis 1, and hypothesis 2, although more work was needed to confirm this - and funding was sought (and found) to extend the evaluation for a further 9 months. Margaret Martin also concluded

"the programme has been designed and run by the disabled people themselves, using innovative training models in order to address issues which are important to disabled people and their PAs……which is at the cutting edge of innovation……is entrepreneurial…..and is probably unique".

Generating national interest

In addition to politicians, the apprenticeship programme also attracted the interest of some key individuals / organisations from across the country including Tony Phillips (Realife Trust), Joe Whittaker and Tara Flood (both Alliance for Inclusive Education), and Julie Stansfield (In-Control).

Mixing apprenticeships in being an employer, with other apprenticeships.

As far as testing hypothesis 3 was concerned, it was not possible to do this through the independent evaluation, however it was noticeable that there are benefits in mixing together those who are endeavouring to develop their expertise in being an employer (of PAs) with those who are developing their expertise in being an employee.

Those who were developing their expertise as an employee were doing so as apprentices on placements at Henkel, POhWER, Hertfordshire County Council Adult Care Services, and St Albans City Youth FC.

Fundraising successes.

In addition to all the above fantastic results, PASS was able to largely secure the resources necessary to deliver the above programmes. Credit for this goes to Stuart Sapsford, PASS's fundraiser who having been appointed on 1st April 2011 (on a 6-hour / week contract) proceeded to raise over £150,000 during the financial year. In addition to 'hard cash', PASS was also able to secure a significant number of (second hand) laptops from Henkel, as well as have a number of highly innovative bespoke pieces of accessible equipment made by REMAP, including a page turner and a push bar extension on the rear fire door for wheelchair users.

PASS’s Payroll Service.

Lastly, mention must be made of the invaluable work that goes on 'behind the scenes' supporting the programmes referred to above. For example PASS can boast a Payroll Service (- for disabled people who employ their own care staff) that in addition to being in existence since 2003, works with over 80 disabled people across Hertfordshire. In addition to providing payslips, P45s, and P60s the service also provides telephone support with one very satisfied customer reporting

"the PASS payroll service makes the difference to me with it's personal approach, just being able to leave your details and those of your PA and just sitting back to let someone else work out all the details is so easy and asking a question of a person and not a computer makes the service so easy and accessible to use. If you have ever tried to talk to a computer or ask an automated answering system a question and not getting an answer you'll know what I mean. Or have you sat there on the telephone pressing button one for customer service and button two for another service and then getting put in a queue followed by someone who doesn't know you from the other callers, you will also know what I mean. As they say you get what you pay for and you certainly do with this service from PASS. Without it I would have to reconsider being an employer of a PA and go back to those agencies sending strangers through my door everyday."

Support Services

Another 'behind the scenes' excellent service is PASS's Support Services, which provides reception, office, admin, marketing, and HR support as well as a proposed new 'information service' providing support (in being an employer of PAs) run by disabled people, for disabled people - to complement what PASS's Payroll Service is already providing.

The major challenges

Finding a training provider and suitable apprenticeship

The challenges PASS had in 2011/12 included finding both a training provider and suitable apprenticeship for 'employers of PAs'. Despite approaching 10 further education colleges or commercial training providers, PASS was unable to enrol the 3 employers of their PAs on a suitable apprenticeship. The reasons given include there not being a suitable apprenticeship for the work the employers of PAs were doing, plus the 3 employers of PAs not achieving Functional Skills Level 2, and not working enough hours in the week (15 compared with the 30 hours / week set as the standard). In independently evaluating PASS's efforts to work with such training providers and the apprenticeship framework, Margaret Martin reported that the challenges PASS has encountered

"derive ultimately from trying to fit disabled people into educational models designed for able-bodied people. In terms of Functional Skills the National Apprenticeship Service allows "reasonable adjustments" to be made for disabled people, but there is no obvious guidance on how this can be interpreted by colleges. Their reluctance to take risks in a tight financial climate is understandable. The unique nature of the (being an employer of PAs apprenticeship) programme, designed by the disabled people themselves (not a tried and tested, off-the-shelf model), and using evidence for portfolios from "lived experience", may also appear to be high risk for some providers".

Funding dependent on outcomes

Whilst PASS was largely successful in securing funding for its work, it had problems with 2 of these 'pots' because they were linked to achieving apprenticeship outcomes, which PASS failed to do, for the reasons described above. This meant grants being frozen and reduced after lengthy and difficult negotiations, putting

a lot of pressure on PASS. As Margaret Martin subsequently reported in her independent evaluation, there are tensions "between the requirements to meet particular targets and "milestones" defined in advance by funders, and the reality of barriers" encountered by pioneering organisations like PASS, which "are national issues, and the practical challenges this presents for training providers need to be addressed. More flexible models of outcomes need to be agreed for work of this kind….. which focuses on "lived experience" in quite a unique way".

PASS and the recession - and its deficit.

As with all organisations the current recession has had an impact on PASS. However, whilst the trustees considered the possibility of making staff redundant on 2 occasions over the year, such decisions were averted because of PASS's successful fundraising. PASS also considered taking on a contract with the local authority which whilst it offered funding, would have taken PASS away from its core work. Fortunately, such 'mission drift' ( - a real problem for small charities) was averted because of PASS's fundraising efforts, however a compromise was agreed with the local authority where a PASS staff member was seconded for 6 months onto the programme in question.

Despite PASS's fundraising efforts, it made a deficit of £27,933, compared with a surplus of £32,863 in the previous year. The deficit in 2011/12 includes a £9,374 deficit in the Unrestricted Funds (sometimes referred to as the General Fund) which is a cause for concern, however this was exacerbated by PASS having to settle up the expenses, amounting to £5,777 it had incurred in successfully defending itself in a long running employment tribunal case that ended with PASS being awarded compensation in May 2010. The remainder of the deficit ie £3,597, is the result, we feel of the difficult economic times.

Lack of office and training space.

Whilst PASS had fantastic offices in Welwyn Garden City these were mostly open plan, small and relatively expensive. Through Owen Parry's (Chair of PASS trustees) connections with POhWER, PASS moved in June 2011 into premises in Stevenage over twice as big (including a dedicated training / meeting room), and ¾ of the rent PASS had been paying.

The future

The Trustees agreed a 5 year plan on the 1st April 2011, which Hertfordshire PASS is largely adhering to. This plan focuses on growing PASS's:

WorkABILITY programmes:

- Work Club
- Work experience, and
- Apprenticeships

employerABILITY programmes:

- Further development / piloting of the apprenticeship in 'being an employer of PAs', and
- Payroll and support, and

Support Services including:
- Publishing User-driven 3 ( - the 3rd book PASS has published on the experiences disabled people have in accessing employment, and becoming a more effective employer of PAs).

In addition, PASS is also considering creating a Community Interest Company which would enable it to operate more effectively as a social enterprise.

"It's so fantastic to be a normal person"

- the last word from one of the PASS staff members who serve on the Board of Trustees - as reported at its 21st July 2011 meeting:

"I used to travel to PASS using a taxi but it meant I was paying out more than I was getting in my pay-packet, so I started to use the bus, which has saved me a lot of money…… I realized my disability does not get in the way of me being a normal person… I started at PASS as a Junior Apprentice and then moved on to be the Access to Work Officer; at this time I was still living in a residential home…however 5 or 6 weeks ago I moved into my own flat…and it's the best thing I've done…; there were so many barriers in my residential home that did not allow me to lead a normal life….. Now PASS say I am such an inspiration to them…. Andrew Bird says I'm so determined to get things done…. I love the fact that they let me take risks whereas in my residential home they would not let me do that. Recently (two staff) and (PASS chairman) have discussed the changing of my role to include 'Benefits'….but it's just so fantastic to be a normal person…"

 

 

Gold Medals, the Paralympics and Apprenticeships

I was fortunate to go to both the Olympics and Paralympics, and given their amazing success, I've been wondering what impact they might have on Hertfordshire PASS. What encouraged me greatly was that Gold Medals are Gold Medals whether Olympic, or Paralympic. In the work that we do / aspire to do, 'achieving an apprenticeship' is comparable to winning the Gold Medal, however at present only the able bodied can 'win'. Given what we've seen and marvelled at in both the Olympics and Paralympics, why can't there be two different routes to the same Gold Medal end - applied to 'achieving an apprenticeship'?

(The above represents the personal views of Nigel Fenner following discussions with Margaret Martin who is currently engaged in independently evaluating Hertfordshire PASS's pilot 'apprenticeship' in being an employer of PAs / carers. These views are not necessarily those of Hertfordshire PASS.)

Margaret's response:
Thanks Nigel, that was an interesting discussion in the light of our visits to the Paralympics and watching Arthur (Hertfordshire PASS Trustee) do the torch relay. The other correlation with the Paralympics is that the route to the same medals is not an inferior or lesser route, it’s a different one. In fact you could argue that it’s a tougher one in many respects for those involved and for those who support them. There is an important parallel with the current deliberations about the apprenticeship framework for disabled people in employing their own care staff. Some in policy and tertiary education suggest that it is best to go down the “exceptions” route within the current apprenticeships programme. I think that this would be similar to saying that Paralympians are unable to follow the Olympian “route” so had to be given their own route on this basis. No, it is different, and should be recognised as a route in its own right – otherwise the status of disabled people who want to employ their own care staff in the apprenticeship programme would be as “exceptions to the rule”.
I know these are tricky negotiations, and a way forward needs to be found even if it means compromise and flexibility on both sides. It does feel to me that there is a principle at the bottom of this debate which we should not shy away from. As Hanna said at the National Steering Group meeting in August, “as soon as you put the word disabled in front of somebody everything becomes ten times harder!” It’s a good time to raise this whilst the Paralympics are fresh in people’s minds. The word “para” in Paralympics means “alongside” (Greek) – maybe that’s an indication of what is being sought by Hertfordshire PASS in the apprenticeship programme.
(As with Nigel’s Blog, these are my thoughts and not necessarily those of Hertfordshire PASS. Margaret.)

What a Personal Assistant (PA) wants from their employer - on their first day

We're 6 months into piloting our new apprenticeship in 'being an employer of PAs'  with 3 young disabled people working with 3 apprentice PAs. This has given us opportunity for the 'employers' to experience working with different PAs. Over the last 6 weeks or so, we've been working up to such a change, by following the processes and procedures required in finding and appointing a PA, culminating in a 'first day' working together.

At the end of this 'first day' recently I asked everyone to recall what they had covered over the previous 6 weeks, and this is what they shared:

• The importance of honesty, confidentiality, responsibility, and independence
• The need to separate the personal from the professional
• To reflect on and use experiences
• The importance and use of a Job Description, and Person Specification
• The use of an application form
• The management of interviews, references, and the contract of employment, and
• Considerations early on such as income tax, induction, and the 'first day'.

Having compiled this list I then asked 'what do they think is the most important consideration for the first day of employment of a PA?'.

Almost immediately one of the PAs said "honesty", then another said "independence….because when I work for someone I want to know what they can do, and the things they can't".

Whilst we've always focused on the relevance of independence (and not just the apprenticeships as 'ends in themselves'), I was astonished at this comment, given I had expected other more practical issues to be raised as requiring consideration on a 'first day'.

In reflecting on all of this I recall a friend, and mentor who spent many years as a Prison Governor, say to me "you only become truly independent, when you know and name your dependencies". In other words there is no shame in all of us being honest about the things we need help with, because it's only through doing this that we become clearer about those things we can do for ourselves.

And for a young 17 year old apprentice PA, this is what she would want to explore with you on her 'first day' of work for you.

Hertfordshire PASS's integrated approach to enabling disabled people to become more independent - and parochial government departments.

(This blog represents the views of Nigel Fenner and not necessarily those of Hertfordshire PASS.)

This last week I was considering making an approach to a government department given they have been advertising the availability of funding. By way of preparation I asked one of our senior staff what progress he had made a number of months ago when he invited the government minister responsible for the department to visit us. He told me he had received a letter suggesting we try a different government department given it was more relevant to PASS's work.

This last week I was also writing a funding application where one question asked 'what demand and need is there for the organisation's objectives?' and I wrote the following:

"Hertfordshire PASS’s key objective or aim is to enable disabled people to be more independent. We use employment (through our WorkABILITY programme), and ‘being an employer of care staff’ (through our EmployerABILITY programme) as the means by which this is achieved. The demand for WorkABILITY grows out of the exceptionally high levels of unemployment amongst disabled people (50%) compared with the non-disabled population (20%), linked also to recent Welfare and Benefit reforms where there is increasing pressure on disabled people to secure employment. As a result disabled people need our services all the more.

The demand for PASS’s ‘being an employer of care staff’ work, we call EmployerABILITY, grows out of many disabled people wanting to remain in their own homes rather than being taken into Local Authority or private care. Given the cuts in public spending there is extra pressure on disabled people to ‘go it alone’, but without this being adequately resourced ( - as highlighted by a recent National Audit Office report ‘Oversight of user choice and provider competition in care markets’ published 15 September 2011).

One of the benefits of operating the EmployerABILITY programme, which prepares disabled people to be better employers of their care staff, is that it makes them significantly more employable, which links directly to PASS’s WorkABILITY programme. Not only is such a (unique?) ‘one stop shop’ creating a demand in local disabled people, it is also generating interest from a political point of view both locally and nationally.

There is also demand for our apprenticeship programme because PASS is the only organisation in the UK providing a specialist service for young disabled people, delivered by young disabled people – so the National Apprenticeship Service inform us.

Lastly we feel there is demand for what we do because it is user-driven. Where users decide on what is to be provided, and how, and deliver it, it will, by definition meet the needs of their peers. (PASS has published 5 books / papers on its user-driven work – available on request.)"

I had  thought to write a bit more about the demand and need for our work in this funding application, but I was worried the charity we were applying for funds to, might lose sight of what PASS does, a bit like the government department that encouraged us to go elsewhere.

We believe it is one of PASS's strengths that to enable disabled people to become more independent we use programmes in employment, and 'being an employer of care staff', not just separately, but together sometimes. In addition we try very hard to be user-driven. Unfortunately such an integrated approach may well be a weakness in terms of raising the profile of our work with the relevant (and quite separate) government departments, at local and national levels. For example

• employment is the responsibility of the Department of Work and Pensions, and in relation to apprenticeships the responsility of the Department of Further Education, Lifelong Learning and Skills,
• 'being an employer of care staff' is the responsibility of Social Services (now called Health and Social Care), and
• PASS's user-driven work, the responsibility of the Department for Disability Issues.

So perhaps it is no surprise one of the above departments referred us on to one of the others when we wrote to the Minister responsible, but it is nevertheless disappointing.

I don't think we'll change the way we work though. As Ernest Becker ( - the Pulitzer Prize winner) wrote we live "in an era of hyperspecialization (where) we have lost the expectation of.....delight.....(where) thought (and insights) span several fields of knowledge".

We hope heads of government departments might come and share in our delight. We'll see.

Hertfordshire PASS's AGM and the integrity of its user-driven work

(The following represents the views of Nigel Fenner, and not necessarily those of Hertfordshire PASS.)

I feel we had an excellent Annual General Meeting (AGM) last Friday which included the active participation of Stephen McPartland, our local MP, and Carol Latif, the Mayoress of Stevenage.

We try hard to be a 'user-driven charity….' so most of the AGM presentations were delivered by two trustees and 7 staff regarding the work they 'drive'.  As our local MP remarked, in responding to all these presentations….."with Hertfordshire PASS, you get what it says on the tin".

But what is 'user-driven' when you open this tin? Is it just about disabled people employed by Hertfordshire PASS leading the organisation's projects, or is it much more than this?  To answer this question, let me share two recent experiences I've had over the last 10 days…..

Firstly one of our senior staff ( - who recently finished his apprenticeship with PASS) was in, what we call the 'hot seat', where he was asked questions about the experience of being an apprentice by new apprentices and staff.  Here is part of the dialogue which took place:
Question: What do you  feel are the greatest differences or similarities for you between school and the apprenticeship you did here at PASS?
Answer: ( - which was immediate) I was bullied at school  - which made me stronger.
Response by one of the new apprentices: Stronger - you're kidding!!?
Answer: I don't regret having been bullied…..Of course it was something I hated….it was a living hell….but I see now that it has made me stronger…...
Question: What might Hertfordshire PASS do through its apprenticeship programme  - to make our apprentices stronger?
Answer: It's clear to me that because Hertfordshire PASS is user-driven I have been put under different challenges which have had the same effect of making me stronger.
(This quote / dialogue has been used with permission.)

The other experience relates to a comment made by one of PASS's existing apprentices during a discussion on 'what our 'starting point' was on our journey to independence?' The staff member said 'if I had not had so many tantrums when I was younger I would not have been sent to (name of residential home) by my mum…...which forced me to be independent…... If this had not happened I don’t think I would be where I am now…..in leading on the work I do for PASS'.  (This quote has also been used with permission.)

What I feel these comments tell me about user-driven work is that it is not enough just to put our staff into positions of responsibility in 'user-driving' PASS's work, as there also needs to be opportunity for all of us to explore and understand what experiences we've had in the past, that 'drive' us now as individuals. This is about the integrity of PASS's user-driven work.

In psychology going on this personal journey is called individuation. As far as PASS is concerned we call it independent living, and refer to it in our AIM statement: To be a user-driven charity using employment and 'being an employer of care staff / PAs' to enable disabled people to live independently - which is 'what it says on the tin'.

Foolishness, disability and the UK becoming more competitive in a global market.

(This blog represents the personal views of Nigel Fenner, and not those of Hertfordshire PASS.)

The current economic uncertainty here and in Europe, and what the UK might do to 'grow its economy' enough to be able to pay off its debts is a key challenge at the moment. I get a sense many people feel that a return for the UK to manufacturing (beyond our reliance on 'banking and finance') is considered key - following the trend set by Germany over the last few decades. From reading the papers and watching the news on TV, I understand we're good at high-tech manufacturing ( - like Formula 1 racing cars), and also innovation in 'bio-technology', and computing.

So what do we need to do to enhance such 'high-tech-ness' and innovation? Steve Jobs (Founder etc of Apple) talked about 'staying hungry, and staying foolish' which I heard on Radio 4's Today Programme, the day he died - on the 6th October. This might have passed me by except that later in the programme there was a feature on a new play opening at Hampton Court Palace entitled 'All the King's Fools' exploring the relationship between Henry VIII and his court jesters, or fools, whose role "was not only to entertain the king but to bring him truth, (given) the fools were thought to be conduits to the divine - able to channel the word of God to the monarch" (BBC News online). According to Dr Lipscomb (Lecturer in Early Modern History at the University of East Anglia) the "natural fools" in the king's court "might well equate to somebody with learning difficulties or learning disabilities today".

So, are there any 'natural fools' that Steve Jobs might have referred to, to exemplify what he meant? He might have mentioned Bill Gates of Microsoft who is autistic, or Albert Einstein with Aspergers Syndrome, or Alexander Graham Bell, the inventor of the telephone, who had a learning disability, as did Thomas Edison who invented the electric light bulb. In addition both Henry Ford, and Leonardo da Vinci had dyslexia.

(Look also at a blog I wrote in 2009 entitled 'Boppi's song and Darwin's survial of the fittest': http://nigelfenner.blogspot.com/2009/09/boppis-song-and-darwins-survival-of.html )

Today though in our society, it strikes me that having a disability is by definition viewed negatively, so that there is little opportunity for disabled people to develop any capacity to be 'conduits to the divine', and / or become the next generation of innovators needed at this time in the UK.

I hope though at Hertfordshire PASS we give people with a 'learning or physical challenge' ( - the term that the PASS staff who are disabled prefer to call themselves) opportunity to innovate. This comes from being user-driven so that now we have staff in place who lead on pioneering innovative solutions promoting independence for their (disabled) peers. Such innovations we can boast include an apprenticeship programme resulting in Hertfordshire PASS being one of only two charities listed in the Top 100 Apprentice Employers in the UK for 2011 by City & Guilds, and the National Apprenticeship Service. We're also pioneering the first ever (so we are told) apprenticeship in 'being an employer of personal assistant(s) / carer(s)' so enabling (disabled) people to live independently, rather than being taken into care by the local authority.

I'm not saying that what we're doing can solve the UK's current economic woes, but with economists and politicians 'scratching their heads' regarding what should be done, we do feel we have something to offer.

The health impact of employing your own personal assistant / carer

Hertfordshire PASS was considering applying for a health impact award with Glaxo Smith Kline, so instigated a study on its 98 Direct Payments users who employ their own personal assistant(s) / carer(s). Whilst we decided not to apply, we feel the need to publish some important results. What follows therefore is the report we prepared - subsequently sent to all 98 users.

INTRODUCTION.
Hertfordshire PASS aims to be a user-driven charity using employment, and ‘being an employer of care staff’ (- through the use of Direct Payments) to enable disabled people to live independently.

In addition to enabling people to live independently, Hertfordshire PASS believes its work may have an impact on the health of the people it provides a service for.

As a result a questionnaire was prepared (appendix 1) and sent to the 98 Direct Payment users (ie ‘employers of care staff’) who access PASS’s Hertfordshire PASS’s Payroll and Support Service.

RESULTS.
Response rate
Of the 98 who received ‘the impact on your health of employing your carer(s)’ questionnaire, 35 were returned to PASS – a response rate of 36%. Of these, 2 questionnaires were sent back blank.

Changes to health – comparing average scores
The average score for health before employing a carer for the 33 Direct Payment users was 4.0 (on a 0 to 10 scale) - equivalent to Poor to Average health, and 6.0 after employing a carer - equivalent to Average to Good. A paired t-test shows this is not a significant difference statistically, however, many of the comments listed below demonstrate how important employing one’s own carer is for health. (We would need a bigger sample than 33 to prove 'employing your own PA / carer improved health'.)

Reasons given as to why employing a carer has an impact on health.

A respondent....

....who rated their health as good, then very good, once they employed a carer reported: “I’m more confident with help can do much more. Not so much at risk when having seizures as the carers take care of me.”

....who needed help with bathing, cleaning and shopping, who went from ‘very poor’ health to‘average’ health reported: “I can get out and about”.

....with multiple health problems went from ‘very poor’ to ‘average' reported: “there is less stress”.

....with multiple health problems went from ‘very poor’ to ‘poor’ and reported “better diet management, significantly increased independence and management of conditions and its symptoms”.

....with depression who was housebound who reported poor health before having a carer, and good health after reported “I feel in control again”.

....who because they were “always falling, so cannot go anywhere” had poor health, then very good health once they had a carer reported: (I now have a) “balanced lifestyle, enjoying activities”. (Has having a balanced lifestyle, reduced the falling?)

....who reported her health as poor because “I went without meals. Had no motivation to struggle to get dressed. Saw no one from one day to the next. Forgot my medication. Couldn’t keep my house clean. Just very very depressed”. Once employing their own care staff, their health improved to very good because “I feel looked after, depression has gone. I eat regular, healthy meals. I love going to my “day care” too and having a carer get me up and motivated for the day. Its made me very happy.”

....whose health went from average to good and included the comment: “my health has improved now as all the carers I employ look after me very well”.

....with angina etc whose health moved from poor to ‘average to good’ reported: “I feel more secure that I have someone in every day to help me.”

....slowly losing her mobility, whose health went from average to good reported: “maintained my cleanliness..” once she employed her own carer.

....reported very poor health because of a brain haemorrhage and stroke when 3 months pregnant, and very good health after employing a carer because “the help I receive has enabled me to concentrate on improving both mentally and physically…to help looking after my son. I couldn’t manage without the help I receive”.

....who reported speech problems and confusion if they go to places they don’t know, and average health, reported good health after they employed their carer whilst adding: “I now have bit more confidence in myself also my speech is getting there; still a long way to go. Still need someone with me when I go out”.

....who was “not able to get out of bed or wash or dress” went from very poor, to average health given their carer gave “help with daily tasks. Has made a great impact so less stress”.

....with multiple health issues moved from very poor, to average health because employing their own care staff meant they were “not so tired all the time, help cooking, shopping, cleaning, child care, more time to rest and pain not so bad 27/7 with ability to rest”.

....with progressive Multiple Sclerosis reported average health both before and after employing a carer however they reported “my general health is good but obviously my disability has increased so my carer is indispensible”.

....rated their health as average because “more stressful trying to keep up with everything (as well as being) quite dependent on my husband for help”. After employing a carer they reported their health as very good and “more independent and therefore stress levels have diminished both for me and my husband”.

LINKS TO THE ACADEMIC RESEARCH.
The above findings tally with the academic research, for example that reported by a Social Care Institute for Excellence report (briefing 20) entitled ‘The implementation of individual budget schemes in adult social care’ published 2007, and updated 2009 which states: “positive outcomes for satisfaction, quality of life, social integration and health have been reported by older people, physically disabled people, people with mental health problems and people with learning disabilities who use a personal assistant they have chosen” (and provides 4 references to substantiate these claims).

CONCLUSIONS - AND WHAT NEXT?
Hertfordshire PASS’s service clearly has an impact.
The findings from the questionnaires demonstrate that Hertfordshire PASS provides an invaluable service to disabled people, in enabling them to be more effective employers of their care staff which in turn clearly has a positive impact on the health of some very vulnerable people.

Offering PASS’s service to other Direct Payment users.
In Hertfordshire PASS’s experience, there has been an increasing trend for many Direct Payment users to move to cheaper payroll providers which do not provide the additional telephone support provided for 2 days every week by Hertfordshire PASS. It is therefore hoped, for the more vulnerable disabled people, that they be signposted to Hertfordshire PASS’s excellent service – which includes plans for its telephone support to be extended by early 2012 for a further 2 days / week, staffed by disabled people, for disabled people.

THANKS
Finally thank you to all Hertfordshire PASS's Direct Payment users who participated in the survey, to Sylvia Bishop for the excellent service she provides them, and to Karl Hunt and Sharon Willing who processed the data.

Nigel Fenner (Manager – Hertfordshire PASS)
13th September 2011

Appendix 1
Hertfordshire PASS
The impact on your health of employing your carer(s) - QUESTIONNAIRE.

Hertfordshire PASS ( - who manages your payroll) wants to find out what the impact of you employing your care staff has had on your health, so would be very grateful if
you would answer a few questions on this.
1. Before employing care staff or Personal Assistants my health, in
general, was….(circle one answer, please)

Very poor

Poor

Average

Good

Very Good

Can you describe what health issues you had before employing care staff?


2. Since I started employing care staff or Personal Assistants my health, in
general, has been

Very poor

Poor

Average

Good

Very Good

Can you describe what changes (if any) to your health have taken place since you
started to employ care staff?


Thank you. We will circulate the answers to the above questions to all Hertfordshire PASS’s Payroll clients in September.

Nigel Fenner (Manager Hertfordshire PASS).

Please return this questionnaire to Hertfordshire PASS using the enclosed stamped addressed envelope provided – by the end of August. Thanks.