Example 1

"I recently completed a Care Act assessment for a person who was diagnosed with complex needs. X has spent much of the year shielding as they are in the high risk category and live in a quiet part of Shropshire, so they've been very isolated this year. We discussed the possibility of a PA to support them to build their confidence in the community.

X can experience severe anxiety around other people and in busy places. X prefers to communicate online so I regularly contact them via this method to check how they are. Recently, X disclosed that they were feeling very low and spending the majority of time in bed as they had nothing else to do. X said they didn’t feel comfortable having a PA around this time due to having to self-isolate and was worried about the risks this posed. I discussed with X that I may be able to apply for funding for a direct payment. I asked them to have a think about things they enjoyed, or short courses that they'd like to do to keep them occupied.

X identified a Meccano set that they'd like - this would help to keep them engaged in an activity that they are able to do at home, and give them a sense of achievement when completed."

Example 2

Here's Kieran with his bike that was purchased using a direct payment, as he was unable to get to the gym. His parents said:

"It’s been great, he has cerebral palsy so he's not the most mobile of guys and the plan had been to get his PA to take him to the gym, but as he's one of those shielded folk we can’t." 

He's determined to improve his time each day on the bike. 

Example 3

I’m working with a young client who has a diagnosis of cerebral palsy and needs support with most aspects of daily living. When I initially met X she had just had her first child and the whole family, although really happy with their new addition, were finding it difficult to support X and the new baby. We talked about support and I asked if she had any friends or neighbours nearby who help her on an informal basis. X said that she didn’t have many but was receiving support from her sister-in-law. We discussed the possibility of her becoming her PA. 

Following meetings with X, her family, and her sister-in-law we went forward with a direct payment. This has now been in place since December 2019, and working alongside a local care agency provider the PA has been able to work in a flexible way that has supported X in not only maintaining her independence but by already having an established relationship with each other they can work together in an honest and productive way. 

This situation highlights that a little lateral thinking and finding out who provides informal support to an individual can lead to a successful outcome for the service user, and paid employment for a PA who has already been providing support without maybe even realising it.