Using a home care agency - A question and answer guide for Disabled people

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Introduction
Questions and Answers
Where to get more information
Brokerage Schemes
Questions you could ask an agency

Thanks!!

We would like to thank the following people and organisations who have provided comment on and/or information for this publication.

Ian Atkinson; British Association of Domiciliary Care Organisation; British Nursing Association; Peter Bryan; Allison Duddy; Gateshead MBC Social Services Department; Louise Hook; Ron James; Lynn Patterson; United Kingdom Home Care Association; Bob Watson.

Please note that their inclusion here does not necessarily mean that they endorse everything that we have written.

Gateshead Personal Assistance Pilot Project

Introduction

Who should read this booklet

'Using an Agency' has been written for Disabled people who want to use workers from a domiciliary care (also known as home care) agency. This could be for anything from the odd hour a week, a fortnight's holiday, to regular weekly assistance. It will also be useful if you are helping to organise assistance for a Disabled friend or relative.

Using a Question and Answer format, it gives you an understandig of issues that might arise if you choose to employ workers via an independent commercial care agency (such as the Home Care North East or Allied Medicare) or one run by a voluntary organisation (such as Age Concern or Leonard Cheshire).


Why we have written it

At present, there is not much information available if you are thinking of using an agency for the first time.

For most people, their only experience of home care is using a council run service. We have found that many Disabled people are nervous about using the alternatives such as using agency staff or employing their own workers.

By talking to a number of Disabled people, we were able to find out what it was that concerned them. We have written this booklet to give you the answers to the most commonly asked questions about using agency workers.

We have also produced a separate booklet on recruiting your own personal assistant. This is available free of charge from GPAPP at the address opposite.


Who we are

GPAPP is funded by the National Lottery Charities Board to support Disabled people who live or work in Gateshead and who wish to use personal assistants to enable them to carry out everyday tasks.

If you decide that you want to use agency workers, then GPAPP can assist you in a number of ways:

• after reading this booklet, if there is anything you are unclear about then we can help to clarify it
• we have an up to date list of local agencies
• we can offer you support and advice about managing your agency staff
• we can put you in contact with other Disabled people who have used agencies and who can tell you about their experiences
• we can advise you on sources of funding for your Personal Assistance, managing these monies and other budgetary issues
• GPAPP can support you if you have any problems or difficulties with your agency workers. If for any reason we cannot help, we will be able to put you in contact with someone who can

We also advise and support people who use personal assistance provided through:

• social services home care
• health service nursing care
• a brokerage scheme, where staff are employed on your behalf through another organisation
• directly employing your own workers

Questions and Answers

These are some of the questions that we have been asked by people thinking of using a home care agency. We can only give a brief introduction in a guide like this. If you would like more information, please contact GPAPP.

What is a home care agency?

It is an organisation which provides you with a personal assistant who can carry out a range of personal assistance/support tasks (including nursing care if you wish) in your own home. They charge a fee for providing the service.

Home care can be provided by voluntary organisations, charities and private (usually run for profit) agencies. Social Services and the local health authority can also provide home care but we are not looking at their work in this guide.

Home Care is sometimes known as Domiciliary Care.

What is a personal assistant?

We have used this term to emphasise the difference between a care approach and the personal assistance approach to providing you with support in your home and with social activities.

A personal assistant is someone that works under your direction, following your instructions, to provide you with the assistance that you require. You decide and control the work that they undertake.

A home carer is someone who looks after you, providing assistance in the way that suits them or their employer and that they think is best for you.

You should tell the agency the approach that you wish to adopt.

What kind of work can personal assistants do?

Personal assistants can assist you with:

Personal needs - things like getting up and going to bed, dressing, washing, eating, toileting and so on.

Medical needs - dressing and wound care, bladder and bowel management, administering medication and so on. Only qualified nursing staff can carry out these types of medical tasks.

Domestic needs - shopping, laundry, cleaning, household tasks, driving and so on.

Social needs - getting to work, studying, having fun, conversation, company, going to meetings and so on.

Agencies sometimes specialise in different types of work, but usually they will try to provide any service that you require. You should ask if they can help with a specific service.

 

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"Usually when I go out in my van it's to go to a specific appointment or meeting. I really enjoy having the freedom to ask a personal assistant to drive me around almost aimlessly, just taking in the scenery and what's going on".

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What if I just want my house cleaned or some washing done?

Personal assistants provided by a home care agency will do cleaning although most would see themselves as primarily assisting you with your personal and social needs. If you only want domestic help, you might be better off using a specialist cleaning agency rather than going through a home care agency.

 

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"I cannot manage to clean the house myself. I've had two home care workers before and they said they couldn't do house work. I wasn't satisfied with the amount of work they did, so I've gone to a private cleaning agency. Iv'e got a canny worker who comes in here now. They do all my housework".

 

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There are a number of organisations providing general domestic services such as cleaning, laundry and ironing. They will come to your home and you can pay them on an hourly basis.

Most of the local firms are listed in the Yellow Pages under 'Cleaning and Maintenance' and 'Domestic Services'.

Why would I want to use an agency?

Because you:

• want more control over your personal assistance needs
• want some choice over who provides your assistance
• want a flexible service
• want assistance that social services and/or health can't or won't provide
• want someone else to deal with all the employment, tax and National Insurance side of things

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"The big advantage for me of using an agency is the convenience. They pay all the personal assistant's tax and National Insurance contributions and they have proper insurance. But the big disadvantage is the cost".

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Where would I get the money from to use an agency?

Generally, you would be expected to pay yourself using income such as benefits, Disability Living Allowance, wages, savings, compensation, care insurance policy and, if you receive it, the Independent Living Fund.

How do I find an agency?

All the main local agencies are listed in the Yellow Pages phone book under 'Nurses' agencies and 'care agencies'.

The United Kingdom Home Care Association (UKHCA) will send you a list of their local members, all of whom have to agree to work to a minimum set of standards. Find their address in 'Appendix 1'.

GPAPP can provide you with details of local agencies that we have been told about by other Disabled people. Or that we have used ourselves.

Do agencies have brochures and price lists?

Virtually all the agencies have brochures and/or leaflets. You may have to dig a little to get a comprehensive price list from some of them.

What does it mean when an agency says it is registered?

It does not necessarily mean that the agency meets minimum standards of home care, which is what you may think. There is currently no national scheme for inspecting or regulating home care agencies as such and no one has responsibility for registering them.

There are, however, some types of registration or licensing that you may come across.

Registered company - simply means that the care agency is a business and has limited liability to pay off debts if it goes bust.

Employment agency - they are registered with the Department of Employment to supply workers to people. They have to meet minimum standards such as checking staff qualifications and maintaining confidentiality.

Nursing agency - licensed by the local council to supply nursing staff. They must supply you with staff properly qualified for the job. If you need nursing care, only a fully qualified nurse or medical practitioner should decide who to send out to you.

Social services registration - some social service departments do run voluntary registration or accreditation schemes for home care agencies. Because they sometimes use agency workers to provide services for their clients, social services can insist that the agency meets minimum standards before they will get them any work. If they meet the standards, then they are put on an approved register or an accredited list of approved providers.

Unfortunately, these registers are not usually made public. However, if you ask, most of the agencies will happily tell you if they provide personal assistants to a social services department.

If you have a social worker, you could also try asking them for details of the agencies that they generally use.

Does it matter if an agency isn't registered anywhere?

There may be a number of reasons why an agency is not registered in any way.

• an agency could be a charity not a company
• it could employ all its own staff so not be registered as an employment agency
• it may not employ or provide nursing care so there would be no point in registering as a nursing agency

However, if you are looking for nursing staff, you should really only use an agency that is registered as a Nursing Agency.

We would also recommend that any agency you use is a member of a home care association. The associations are trying to set minimum standards and do police their own members to some extent.

What should I look out for in an agency?

It is important that you feel you can trust and get on with the agency staff. You will get a feel of the agency from their publicity, from talking to them and, maybe, from other users. You should trust your gut feelings if you have any negative thoughts about an agency.

 

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"I really like the agency I'm using now. They answered all my guestions when I first joined them and sent me the information I asked for straight away".

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To help you make your mind up, we have produced a list of questions you can ask an agency in Appendix 3.

You could also ask GPAPP or other Disabled people if they have used a particular agency or know
anything about it.

Will an agency based in Newcastle provide staff in Gateshead?

Yes, there is absolutely no reason why not. Because there are so few agencies based in Gateshead, people often use agencies based elsewhere.

However, the agencies usually employ staff from their local area so, depending on where you live, there may sometimes be problems finding people willing to travel. You may also be asked to pay a supplement to cover travel expenses.

The best advice is to shop around.

How much does it cost?

Prices do vary between agencies so you should contact at least two, get an idea of costs. It can be cheaper the more hours you use and if you are making a regular arrangement with an agency.

As with many things, price isn't necessarily a guide to quality.

Do make sure that the price you are quoted is the price you will pay. The agency may add on VAT, travel expenses and National Insurance payments.

Does it cost more at weekends and public holidays?

It can do, depending on the agency and the wages they pay their staff. Ask in advance for a full price list.

What am I paying for?

The personal assistant's wages, National Insurance, VAT (on all or part of the hourly rate depending on the type of agency) and a contribution towards the cost of running the agency's office (rent, phone, equipment, office staff and so on).

The agency may also use part of the money to provide basic training and insurance cover for their personal assistants. If the agency is a private company, you will also be contributing part of your hourly charge towards their profits.

All these charges are usually included in the standard hourly rate and you will normally only be required to make one payment. The agency should arrange to pay any tax, National Insurance and VAT that is due.

Are there a minimum number of hours?

No. There are agencies which advertise anything from 1 to 24 hours a day. However, there is usually a minimum charge for a short visit. You may find it is better value to pay a little bit more and get an extra hour.

Do I have to use an agency every week?

No, although some offer lower charges if you use them on a regular basis. Many people just use agency personal assistants to provide personal assistance during holiday or respite breaks.

 

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"I regularly use a specialist personal assistance scheme run by a charity when my mother goes off on holiday. It can be strange until you get used to it, getting over the feeling that you have to entertain your personal assistant !"

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Can I use more than one agency?

Definitely, the choice is yours.

How do I sign up with an agency?

Once you have decided on the agency that you want to use, it is usually a simple process to sign up with them. It can quite often all be done over the phone in one day.

However, if your needs are quite complex always ask the agency to come out to discuss things with you first.

Do I need to involve social services?

If you are happy arranging the service and are paying for it yourself, say from your income, Disability Living Allowance or savings, then you do not need to involve social services or tell them what you are doing.

However, if you would like to discuss your personal assistance needs further or would like more advice, you can contact your local social services office and ask them to carry out a community care assessment.

Will I be able to meet the personal assistant from the agency before I accept them?

Not usually, but do ask the agency if you particularly want to meet someone. Do remember, if you have any problems you should be able to get a personal assistant changed very quickly.

Will I need to have a contract?

You should insist on having a contract with the agency before you let a personal assistant into your home.

 

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Conditions of Engagement This contract is between (name) (hereinafter called the user) and (name) (hereinafter called the provider) for the provision of services to (name). A specification of services has been prepared and is attached to this document which sets out the service to be provided.

 

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The contract should set out in clear terms the service the agency will be providing, how it will be provided, when it will provide it and at what cost. It will also list the things that you have to do such as when you pay the bill, how to cancel and so on.

You should read your contract thoroughly, including any small print. If you are unclear about anything ask the agency. The workers at GPAPP will also be happy to go through it with you.

GPAPP has a copy of a recommended contract produced by the Continuing Care Conference that you can look at.

I don't like filling in forms. How much paperwork is involved?

Usually, you will be asked to read and sign the contract, either in advance or when the worker first turns up. You will also be asked to sign a time sheet confirming how many hours a personal assistant has spent with you.

You will have to pay the bill when it arrives, either by cheque, postal order or by setting up a direct debit.

Everything else can be dealt with by the agency. If it isn't the choice is yours as to whether or not to use that agency.

When do I pay the agency?

If you only hire personal assistants occasionally, you will usually be sent a bill after each visit. If you set up a regular weekly package then you can normally arrange to pay either weekly or monthly.

If you are paying in arrears, make sure that you keep a record of how much you owe as you can run into financial problems quite quickly.

Who employs the personal assistant?

Unfortunately, this question isn't as easy to answer as we might like. There are probably three main types of agency that you will come across, each with a different relationship to the personal assistants that work with them.

• the agency directly employs a number of personal assistants that they then allocate to work with clients. They employ the personal assistant, pay the wages, arrange insurance and deal with all the paperwork and other bills.
• the agency acts like an employment agency, finding work for the personal assistants on its books and taking a fee in return. The personal assistant is classed as being self-employed and is usually responsible for paying their own tax and national insurance.

  They may also have to arrange their own insurance cover. However, you only pay one fee to the agency and they pass the money on to the personal assistant.

• the agency introduces you to a personal assistant, who you then employ. The agency charges you a regular fee for the introduction. You have to pay the personal assistant's wages separately, and you are responsible for paying any tax and national insurance that is due. You may also have to arrange additional insurance cover.

 

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"I got a card through the door recently advertising a cleaning firm. I arranged for them to come around on Saturday morning. When I came to pay I was told that I had to pay him for the hours worked and pay the agency separately for sending him round. I couldn't be bothered with writing two cheques so I've got a different agency in now".

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The important thing for you is to find out the answers to the following questions:

• does the agency deal with paying the personal assistant or are you expected to pay them separately?
• who collects any tax and national insurance that the personal assistant may be liable for?
• is the personal assistant fully covered by insurance to work in your home?
• who is responsible for the quality of the work and actions of the personal assistant?

If you are happy with the agencies answers, fine. If not, use another agency.

Do the personal assistants have to be insured?

Yes. Any personal assistant coming into your home should be insured against:

• any damage or harm they may cause to you or to your belongings
• any damage or harm the personal assistant may cause to other people or property
• any damage or harm that may happen to them whilst they are working for you

If the personal assistant is an employee, the agency should have Employer's Liability Insurance and Public Liability Insurance which will provide most of the above cover.

Some agencies say that their staffs are self-employed and don't automatically provide insurance for them. In this case, the personal assistant should have Malpractice/Professional Indemnity Insurance which covers them against claims for injury or damage. You should always ask to see a copy of their insurance certificate.

If you have Home Contents Insurance you should tell your insurer if you are regularly using agency staff. You may be covered for accidents to 'domestic servants'. You can also now take out specialist 'Care User' insurance policies which specifically provide cover for Disabled people using personal assistants. Ask GPAPP for more information on this.

If you are using a personal assistant to drive your vehicle, make sure that they are covered by your Car Insurance. If you are travelling in the personal assistant's car, make sure that their insurance covers you.

Will I have to arrange insurance?

You may have to arrange cover under your Home Contents Insurance if the personal assistant is not fully insured by the agency.

You may also want to consider taking out a specialist 'Care User' policy.

If the personal assistant is driving you in either your vehicle or their own, you will have to make sure you are covered by car insurance.

Do I pay travel expenses?

Not for the personal assistant's travel to and from your home, although you may be asked to contribute if you live a long way from the agency's base.

If the personal assistant is accompanying you on public transport, you would usually be required to pay their fares. If you are using the personal assistant's car, you would pay them an agreed mileage rate.

Can agencies provide personal assistants at short notice or in an emergency?

Yes. Most can cope with being rung the day before and several advertise emergency services where you can ring on the day. Agencies are often used by other organisations to provide workers at short notice.

 

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"I use a large commercial agency which has a lot of workers on call. They can always find staff to cover shifts at very short notice - last week my regular p.a. rang in sick and they got me someone within an hour!"

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What if my p.a. doesn't turn up?

Normally if a personal assistant can't come they will have arranged a temporary replacement with the agency. Very rarely, however, someone just doesn't turn up.

If nobody turns up, contact the agency immediately. They should still be able to provide you with a replacement if you need or want one there and then.

In an emergency situation where you feel you are at real risk and cannot get help from anyone else such as family or friends, contact your GP or health visitor, the social services or, if you have tried everything else, contact the ambulance service.

Can I arrange for personal assistants to sleepover in my house?

Yes. Several agencies provide a night service. You would usually pay a set charge for the whole night rather than an hourly rate. Normally, you pay more if the personal assistant attends to you more than twice in a night.

You must provide suitable sleeping or resting facilities for a personal assistant when they are on a sleepover at your house.

Is there any limit to the hours that someone can work for me?

New regulations were introduced on 1st October 1998 which limit the hours that people should work. On average, someone should work no more than 13 hours in a day or 48 hours in a week and they should have at least one full day off a week.

Generally, night workers should work no more than an average of 8 hours a night. However, it is thought that this does not apply to personal assistants working in your home. It also does not apply to sleepovers where the 'on-call' hours are not classed as working time.

In any event, the law requires that the agency, not you, must ensure that anyone who works for them (whether directly employed or self-employed) complies with the new regulations.

What if I'm out with a personal assistant and I find I need longer than I booked?

Whenever possible, you should be realistic about the time that you need and book a personal assistant for enough hours.

If you are unavoidably detained, say because of traffic holdups, hospital appointments running late and so on then the personal assistant will usually understand. However, you will have to pay them for the extra time involved. They will also need to confirm that they are still covered by the agency's insurances if they work beyond the contract time.

 

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"I was at a training course last week and they'd arranged a taxi to pick me up at 4 o'clock. It hadn't come after half an hour so it was obvious my worker was going to finish later than I'd arranged. I checked that she was OK for another hour and then we rang the agency to extend the time and add it to her timesheet".

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If you just want to change the hours once you are out, discuss it with the personal assistant. If they are agreeable then you just need to contact the agency and add the extra hours to the personal assistant's time-sheet.

But, you must understand that personal assistants may have other commitments and be unable to work longer than initially agreed.

Do the personal assistants keep time-sheets?

Yes. They would normally bring a time-sheet with them and write down the number of hours that they have worked for you. You just have to sign the time-sheet to agree that it is correct. You should always be given a copy for your own records.

You should never sign a blank time-sheet and you should always make sure that you are only signing for the actual number of hours worked.

What kind of people work for agencies?

All kinds of people - GPAPP knows of Disabled people who have had students, trainee nurses and doctors, retired people. People fitting in work around childcare, aspiring musicians, young, old and middle aged.

Will the personal assistants be checked and have references?

There is no national test at the moment as to whether someone is fit to work as a personal assistant in your home and there is no recognised qualification.

However, you should check that the agency has at least got references from a previous employer(s) before a personal assistant starts work for you.

Some agency workers who also work in care homes and/or for social services and the NHS may have been checked for a criminal record, but this is not always the case.

You should always ensure that a childminder has had a police check and is registered with social services.

Will the personal assistants wear uniforms?

Sometimes. If you prefer they didn't, tell the agency and they will normally respect your wishes.

Will they have identification?

Yes, they should always carry an identity card and you should not allow anyone into your house without seeing proper identification.

Do the personal assistants have training?

There is no nationally recognised qualification for home care personal assistants and no legal requirement for the personal assistants to be trained.

Some agencies do, however, provide on-the-job training for their personal assistants in health and safety, food hygiene, moving and handling and so on.

In the case of registered nursing agencies, staff will always have a recognised nursing qualification if their work with you requires it.

In most cases, the best training will be provided by you, with the personal assistant following your clear instruction as to what you want done and how you like it done.

Can I ask an agency personal assistant to lift me out of my bed or wheelchair?

Yes, but you will need to talk it through with the agency first and jointly assess with them what is required.

Home care personal assistants will not, and should not, lift or move someone unaided. Whenever possible, they are required by Health and Safety law to use equipment in order to avoid the need for manual lifting. They should also be wearing appropriate clothing which allows them to have a full and unrestricted range of movement.

However, they should also listen carefully to how you like to be moved and any decision must include your preferences whenever possible.

Will the personal assistant know what to do?

Quite often they will have worked for other Disabled people and will have some idea of what is required. However, they will be willing to follow your instructions, doing what you want in the way that you like it done. You might find it helps to have things written down before you first meet with them.

They should also have received some training from the agency. If you have a specific need(s), the agency should try and match you up with someone who has experience or training in this.

Should I give my worker a rest break?

It depends on how many hours they are working for you at any one time. If they are only working for an hour or two, a worker will not expect to take a break.

But the law does require that all workers are given at least a 20 minute (unpaid) break if they are working for more than six hours at a stretch.

You should, if you have somewhere suitable, provide a private space for your personal assistant to take their break.

What do I need to provide for the personal assistant?

It would partly depend on what you were being assisted with.

If appropriate, the agency should make sure that the personal assistant brings with them any protective clothing (aprons, gloves, etc.) that they may need.

However, it is a good idea to have some disposable gloves available to cover all eventualities such as changing cat litter trays, etc.

You would be expected to provide cleaning materials and, if the personal assistant is cooking for you, tea, coffee and so on.

If you are being moved or lifted you should have the appropriate equipment which is regularly and properly maintained.

If the personal assistant is with you for more than six hours, they are legally entitled to at least a 20 minute unpaid break. You should provide them with somewhere that they can sit, away from you if they wish.

If they are on a sleepover at your house, you must provide suitable facilities for a personal assistant to sleep or rest on.

You do not have to provide a personal assistant with food or refreshment if you don't want to, but you should provide them with somewhere to make a drink or a meal. Some agencies do require that you provide breakfast for a personal assistant who has been on a sleepover.

What about health and safety?

In law, you owe a general duty of care to anyone coming in to your home. It is your responsibility to provide a healthy and safe workplace, making sure that equipment is maintained and that there are no obvious hazards such as loose or frayed carpeting.
It is the personal assistant's responsibility not to do anything which might endanger either your safety or their own at any time.

Therefore, you should never ask a personal assistant to do anything which might put their or your own safety at risk, You must understand that, although rare, they may have to say "No" to an instruction they believe to be unsafe.

If this happens and you disagree with the personal assistant's judgment, speak to the agency. Don't insist that the worker carry on regardless.

Agencies should provide all their staff with basic health and safety training. You could ask the agency this when you first contact them.

You could also ask your personal assistant what training they have had and if they have an appropriate certificate you can see.

Some agencies will carry out a health and safety assessment of your home before supplying you with a worker. You should ask the agency if there is anything you would like them to advise you on.

The Health and Consumers Services Department at Gateshead Council (telephone 477 1011) can provide you with general advice about Health and Safety and hazards in the home.

If you want advice on lifting, moving and handling, ask your GP to arrange a visit from a health visitor or District nurse.

Can an agency personal assistant give me medication?

Most personal assistants would be able to assist you to take recognised medication and change simple dressings, in the same way that a relative or friend might assist.

However, if you require assistance with things normally undertaken by a nurse or doctor such as injections, wound care, bladder and bowel management and so on, then you would need to hire a suitably qualified personal assistant from a nursing agency.

What will the agency tell the personal assistant about me?

An agency would probably consider it good practice to give a personal assistant details about your condition, situation and assistance needs.

If there is anything that you don't want a personal assistant to know, perhaps until you get to know them better, tell the agency in advance. They should always respect your right to privacy.

 

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"The agency I use knows that they shouldn't tell my personal assistants anything about my impairment when they first come. Sometimes I've found that people make assumptions about you and your needs if they think they know something about your impairment. They can fall into "I know best" mode. I like to choose if and when I tell someone this kind of information. Most of the time I don't because it's totally irrelevant ".

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Will the agency talk to social services or my GP about me?

The United Kingdom Home Care Association code of practice states that a member agency should not talk about you to anyone else without your specific permission.

You should also be able to see a copy of any information that the agency keeps about you.

Will the personal assistant respect my confidentiality?

You have an absolute right to expect that anything you tell a personal assistant or that they find out through working for you will be kept private.

A privacy and confidentiality clause should be included in any contract with an agency and you should complain immediately if you suspect that a confidence has been broken.

How do I complain if I'm not happy about something?

If you feel that tasks have not been done correctly, your worker is often arriving late or you are dissatisfied with anything else, you should complain.

The agency should have given you written details about how to make a complaint - who to contact and how to contact them and what to do if you are still dissatisfied.

All agencies who are members of the United Kingdom Home Care Association must have a clear written complaints procedure. You can also use the "UKHCA Complaints Procedure" if you have a complaint you cannot sort out with the agency and want to take further.

Similarly, the social services department is required by law to ensure that any agency it uses has an adequate complaints procedure.

What if I think the personal assistant provided is useless?

Complain, and ask for a different personal assistant.

One of the advantages of using an agency is that you have easy access to a pool of personal assistants and can pick and choose.

However, you should be reasonable and not complain for frivolous reasons. Otherwise, you may find that the agency refuses to supply you with workers.

Also, be sure that you are not asking the personal assistant to do something that is not really part of their job or something that you haven't agreed with the agency. Read your contract again to check what it says.

I wouldn't want a man to work for me. Can I ask for a woman?

If you would genuinely not feel comfortable having a man to assist you then you can specify that you only want a female personal assistant. This applies whether you are a man or a woman.

Similarly, some men may only feel comfortable with a male personal assistant.

You should never, however, choose simply on the grounds that "cleaning is women's work" or "a woman wouldn't be strong enough". It's not true, it's discrimination and it's illegal.

Can I ask for a personal assistant with similar interests to me?

Yes. If you have any particular interests, likes or dislikes, you should tell the agency and they should try to match you up with someone you can get on with.

You also have a clear right not to accept a personal assistant you are not compatible with and the agency should always accept this.

If I get to know them well, can I request a specific personal assistant?

Most agencies will try and meet requests for a specific personal assistant. It is part of their role to match people up with the most suitable personal assistant for them. A good agency should in any event get to know you and the kind of personal assistant that would suit you best.

 

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"Once someone has been several times, I am able to get a clear idea about how good they are. Often I will get their home phone number and contact them directly if I need a worker. Although we bypass the agency, they are quite relaxed about this situation, since we still record the hours on the agency time sheets and the agency still gets paid in the same way".

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Can an agency personal assistant look after my children?

You can ask an agency to supply you with a personal assistant who will assist you to look after for your children. In this case, they would be working under your direction, carrying out the tasks that you are not otherwise able to do.
If you want someone to look after your children whilst you do something else, go out, are at work or whatever then you are looking for a childminder rather than a personal assistant.

Social Services can supply you with a list of registered childminders in your area who will have been proberly trained and will have been checked with the police.

You can also contact a specialist childcare agency. These are listed in the Yellow Pages phone book under 'Nanny and childcare agencies'.

I like to go swimming. Can I ask for a personal assistant to go in the pool with me?

There is no reason why not. There are many examples of Disabled people using personal assistants in this way.

 

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"My mother doesn't like swimming so that meant I didn't get to go. Now I go once a week with a worker from the agency and it's terrific. Swimming is one of the best forms of exercise but it can be cold sometimes!"

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However, you need to be realistic about what it is reasonable to ask a personal assistant to do and give the agency full information about the activities you want to get involved in.

Make sure that if you are planning to get involved in a sporting activity that the venue has the appropriate equipment to meet your needs, such as a pool hoist.

If I go out with my personal assistant, who pays their bus fares, meals,
entrance fees and so on?

You are required to pay for your personal assistant when they are working for you. Some venues allow personal assistants in free or at a reduced price.

You can also get reduced fares on trains (but not the Metro) for your personal assistant. Ask GPAPP for more information.

Can I get someone to go on holiday with me?

Yes. A number of agencies advertise holiday escorts who will accompany you on holiday. You will have to pay all their costs as well as the normal agency fee.

Some disability and holiday organisations offer holiday accommodation with assistance provided. Gateshead Council on Disability can give you information on this.

I have a van/car. Can I get someone to drive it for me?

Yes. You can ask an agency to supply you with someone who drives.

Check that the personal assistant has a current clean licence and make sure that your insurance will cover them.

Some insurance companies insist that all drivers have to be over 25 and have clean licenses and they may require them to be named on the policy.

I really like my agency personal assistant. Can I employ them myself and save money?

Yes, but not without the prior agreement of the agency and usually you will have to pay the agency a one-off fee.

Both you and the personal assistant have a legally binding contract with the agency. This usually requires you to pay a fee to the agency if you want to directly employ someone that the agency has introduced to you.

Are there alternatives to using agency personal assistants?

Yes, there a number of other ways you can arrange personal assistance, including:

• you can directly recruit your own personal assistants, advertising, interviewing and employing them yourself
• using a brokerage scheme, where staff are employed on your behalf through another organisation
• district nurses and other specialist services such as physiotherapy provided through your GP or hospital consultant
• asking social services to carry out a community care assessment to see if you might be eligible to have a home help or home care workers

GPAPP can provide you with more information (and support if you wish) on any of these schemes.

Where to get more information

Age Concern (Gateshead)

341 - 343 High Street
Gateshead
NE8 1EQ

0191 477 3559 (voice)
0191 478 5307 (fax)

Offers advice and support to anyone aged over 55. They can also send you a range of fact sheets produced by national Age Concern including one called 'Finding Help at Home' (Fact Sheet number 6).

Gateshead Personal Assistance Pilot Project

John Haswell House
8/9 Gladstone Terrace
Gateshead
NE8 4DY

0191 477 3558 (voice)
0191 477 1260 (fax)
0191 478 4082 (minicom)
gpapp@disabilitygateshead.org.uk (e-mail)

Provides information and support to any Disabled person interested in using personal assistance. We can also put you in touch with Gateshead Council on Disability which offers advice and information on all aspects of disability including adaptations, equipment and holidays.

United Kingdom Home Care Association

42 Banstead Road
Carshalton Beeches
Surrey
SM5 3NW

0181 288 1551 (voice)
0181 288 1550 (fax)

Represents independent providers of home care. The Association has a minimum set of standards and all members must agree to follow them. They will send you a list of local members.

Brokerage Schemes

Broker

" someone who acts as intermediary; an agent who negotiates or sets up a contract for you ".

Brokerage schemes refer to the situation where you pay money to another organisation to organise a package of Personal Assistance on your behalf. These schemes allow you to have a personalised package, where you can pick and choose the services you want, without having to worry about becoming an employer.

What would usually happen is that you would meet with someone from the organisation to discuss your support needs and the money you had available. If you wish, the organisation will then advertise for staff to work for you, carry out all aspects of the recruitment and interviewing and effectively be the employer of your workers.

The organisation would also arrange to pay the tax and National Insurance due and organise appropriate insurances. You would be left solely to manage the work and tasks carried out by your workers.

However, if you wish, you could also play a more active part in the recruitment of your workers, perhaps being involved in the interviews and design of the adverts, writing the job descriptions and so on. The organisation will usually do as much or as little as you want them to.

There are a number of Disabled people locally who have set up brokerage arrangements. In the main they are using either Age Concern (Newcastle) or Leonard Cheshire to act as the broker for them.

The main disadvantages of the schemes are, firstly, the additional cost as you will have to pay a brokerage fee to the organisation for managing the scheme for you.

Secondly, they are most suitable for people with fairly substantial assistance needs. If you are looking for a few hours assistance a week, and are able to organise it, you would be better advised to use a private agency or even think about employing someone yourself.

Questions you could ask an agency

• what services do you offer?
• why should I choose your agency?
• do you provide personal assistants in Gateshead?
• are your personal assistants selfemployed?
• if yes, who is responsible for the quality of their work?
• how do you check the suitability of your personal assistants?
• do you have references for all your personal assistants?
• do you offer an initial assessment visit?
• do you carry out health and safety assessments?
• can I meet a personal assistant before they start working for me?
• how much do you charge?
• is there a minimum service that has to be bought?
• does it cost more at weekends and bank holidays?
• would I have to pay any extras such as travel expenses, VAT, tax, National Insurance and so on?
• can I have a brochure and price list?
• how and when do I pay the agency?
• what insurance cover do you provide for your personal assistants?
• what insurance cover, if any, will I be expected to provide?
• what training do you provide for your personal assistants?
• do the staff complete time sheets and will I be given a copy free of charge?
• can I see a copy of the contract I'll be signing in advance?
• what happens if my regular personal assistant is sick or on holiday?
• what would happen if my personal assistant failed to turn up?
• do you provide an overnight service and how much does it cost?
• do you have an emergency out of hours service and how do I contact it?
• can I contact someone from the agency at any time?
• are you a member of a home care association?
• can I get a personal assistant to accompany me on holiday?
• do I need to provide the personal assistant with anything?
• do you provide personal assistants to any of the local social services departments?
• do you have a confidentiality policy?
• do you have a complaints procedure?

"For me the important thing about living independently is the privacy. Knowing my personal assistants will come in only at the times when I need them.

And the basic freedoms. Being able to go to bed when I like and get up when I like. Being able to choose how I spend my time. Being able to choose when and at what time I take a bath, having the luxury of a long soak. Being able to choose what I eat, and have it cooked for me. Being able to have physiotherapy every day, which keeps me mobile".

Peter Bryan
Starting Out Pack