Personal Assistants not Care Agencies?

I was speaking to the CHC nurse last week about care agencies and the 'deplorable state of the industry' as she put it.

There is a complete dearth of Care Agency placements around here and it tends to be get what you are given and be grateful.

Then the nurse (and she is a wonderfully on the ball there for you type person) said what about PAs?

Turns out that there are a lot of qualified people, who are companies in their own right (that's important - see later) who you can hire directly even using CHC monies.

If you are receiving CHC money ask them to convert it into a personal budget. You will need to set up a bank account for the money they give you and it must not be used for anything else but spending on your care plan. You do not need to keep accounts, just keep receipts electronic or otherwise.

The beauty of this is you write in respite care and days out as well as massage, hydrotherapy and anything else into the care plan and get it agreed. If you want some extra of this or that and its in the care plan you just buy it in and go short somewhere else. So you might use some of the respite money on getting more career time one week.

You must spend the must spend the money with registered companies. You cannot pay just 'someone', or a sister or neighbour unless you make yourself an employer and then you need to keep books and pay N.I and tax. There is free support to do this, but for me it is too much hassle.

These PAs advertise or respond to you on Gumtree and

She advised:

Be careful! Make sure they have a Police Disclosure Check ( ) and do look at it. This is a criminal record statement. Get references and validate them.

Hoping this might help someone.

It's the route I am trying to go down.

Waiving to you all


36 Replies

  • We get direct payments for mum, we have hired 3 PA's, as you said I opened a bank account just to pay their wages. I had contracts drawn up to say they work on a self employed basis therefore they sort out their own tax and N.I, I'm now Kind of panicking about if I'm doing something wrong x

  • Do you mind me asking if the PAs knew each other beforehand? Do they work together on calls?

    You can either employ them as self employed or act as an employer.

  • I don't mind you asking , No they didn't know each other, I advertised on a website called cost me £40 and it was a waste of money I didn't get any respond, my daughter told me there was a group page on facebook job vacancies in Sheffield so I advertised on there for free and had a lot of response. It does work well for us problem is no fall back if 2 are off sick. Xx

  • Yes that's the negative about it, no back up.

    Do they work together or you have one at a time as such?

    I've tried streetlife too which did fine one lady but she has let us down already. .

  • Mum has double handed on a tues and fri in the morning because they shower mum and it needs 2, other calls are single handed even though they should be double handed but dad still wants to be involved and assists with transfers.

    If the pa's are self employed if they don't come they don't get paid, we've had pa's for over 12 month and they never been off sick, it's in their contract that we need 1 months notice for any holidays which gives us time to arrange cover with the other pa's x

  • Sounds like it is working well for you. I'm not physically able to do the transfers but would be simpler if I was.

  • Thanks your posts on this have been very helpful to us.


  • Both ways work . Both can also let you down. You always the options to change between them or use a combination of both private and agency care. I do this for back up.

  • That's good advice - thanks.

    I don't think our agencies are up to it though.

    There is a uge shortage of agency service around here. We're on a waiting list for two.

    They can't get, and keep, the staff. Wages low and conditions very poor.

  • One at time.

  • You are probably OK.

    Self employed is OK as long as you are acting in good faith.

    e.g. Don't ask too closely.

    The training I did on Direct Payments merely specified that they had to be a company... Sole Trader is a company in that respect.



  • We have to register the patient as a sole proprietor and it is under a special code for people who hire caregivers. We can hire anyone we want so long as it is not family. Many people here hire live in from the Philippines . They come on a two year contract. Many are very good hard workers and have taken their health care in The Philippines . There is a free job search site called Indeed Job search. Employers can post jobs for free also.

  • Thanks - That's really helpful.

  • I've not heard of that before. What if you don't like them once they get here from so far away....that would be my luck I think.

  • There is an agency that brings them in they either have to find them another placement or they can stay for two years on their temporary work permit.

    There are a lot of temporary foreign workers in this country. I have not heard of any going back before their permit expires. They change jobs sometimes if their client goes to nursing home or passes or it does not work out.

  • Do you know what the agency is called?

  • After 5 years they get leave to remain. THe NHS uses this attractive bait a lot.

  • Sorry, that should have read citizenship. Leastways that is the case with the NHS.

  • The social worker has always said to me PAs are better in some ways but as Mum needs double up calls And four calls a day I've not been able to find any to cover all the calls or work as a pair. I wish we could but then also if they are sick you have nothing to fall back on like with an agency. It is swings and roundabouts and the last week we have had I wish we didn't need any but I'm not physically able to do it

    We have a direct payment though for the care budget but here there is no funds for anything apart from calls.

  • You can have more than Care Calls in the care plan and thus the budget.

    Ask for a review of the car plan if you want this.

    If it is a social services Direct Payment you can even have days out on the care plan - anything which preserves the fullest possible life.

    As a professional I have even drawn up care plans which included cinema for someone who could not get out of the house to socialise. (Severe Mental Health problems).



  • Yes we had things put in care plan but got told only budget available for calls nothing else. We aren't on CHC. I've still not got my head around doing appeal and again social worker said today you are not eligible as I asked due to situation we are in with care company quitting last week.

  • They've made that up then, locally. It does not comply with the Care Act.

    Much better to go for CHC.

    Even if you can't get your head around appeal write a brief letter saying that you are appealing and will write and give reasons in due course. This stops the time out clock and you can then get it together in your own time.

    PM me if you would like some support for an appeal. I have material which may help.



  • Hi yes I've done that first stage after advice from your lovely self. I've read all the information you sent from care to be different but I just can't get my head around it. My head is total mush these days and abc is too complicated now lol

  • I've just been through the no abc thing... just let me know if I can help.





  • Thanks you have enough on your plate. I will pull something together I'm sure even if is just my opinion of the DST. I can't get my head around reading a 140 page guidance on the legalities and guidance to quote at them

  • Thanks - this is helpful to us - I had not thought about the double up problem.

    Hadn't considered sickness either.

    Thanks again.


  • What do mean by double up calls? Is that a person requiring a two person transfer? If you have a Waverly ceiling lift 1 person can easily do it. We got funded for one of those portable lifts and ceiling track. You need two people to use the other lifts that you roll to where you need to take a person.

  • Yup, I did.

    We're not quite at the lift stage yet (very close)

    I've been told that two professional carers can manage her.

    Or, getting real - one spouse!


  • The problem I worry about with this is, what happens when you need to change from a PA to full time care in a home. Does CHC need to reassess you, as you are not classed as being on their books by then?

    Lots of love


  • Very informative Kevin as always! Thx you for posting!

    I've certainly missed your wise words!! X

  • We call it self managed care here in Alberta. Alberta Health gives you an amount that you are assessed for. It is deposited into the clients checking account for personal care. I had to get an employer buisness number. You can hire on your own or through an agency. You must sent a quarterly report. They send you forms. keep bank statements and invoices. And pay stubs.You need to do these even if you go through an agency. Agencies charge a lot more per hour than private caregivers but if you have problems the agency deals with theirs. We have all seen that you can have problems either way. We are allowed to keep one months payment the rest has to be returned if not used. This money can be used for respite in your own home but not a government funded facility.

  • Seems much the same.

    Still a headache eh?

    Y'know, I had a look around those seldom visited cupboards in the house earlier... I don't know how it hapened, but I'm clean out of magic bullets!


    Good to hear from you :)

    Hugs to you and yours.

  • We are out of those too. guess we will have to go back to the red wine solution.

  • You could always try the White wine system. It works quite nicely as well.

    Lots of love


  • Will do that tonight . hubby has his first fall today. Not injured .The us sion on his wheelchair tipped up and he slid out while being transferred. The velcro let go on the oe side. still wairing on seating clinic. 6 months and they canceled again this week.

  • Ouch! You've done well, if this is his first fall and he is now in a wheelchair. Sorry, I have forgotten where you are. If in the UK, you do know that if you can't get hubby back into his chair, it is alright to dial 999.

    Lots of love


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