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Interim/Quantum
When the euphoria of being successful at the end of your claim and securing your child’s future, wears off, you enter another difficult phase. This one however is not as long or as uncertain, but most people find it very difficult and intrusive. Your home will feel like the revolving door in the picture. In Interim the Defence and your Team will be quantifying the claim. That is putting a figure on the injury, and costing up present and future care needs.
This is another complex calculation and often fraught with disagreement on both sides. Basically, the Defence want to reduce the amount of money your child receives and your Team want to increase it. Ultimately it usually ends up somewhere in the middle, again following Joint Settlement Meetings to iron out the details.
Each side (although they sometimes have joint experts) have experts who look at the needs of the child for life, and work out the costings. There are care experts who will look at the child’s care for life and if care staff are needed, cost up and decide the level of care. They will also look at occupational and physiotherapy needs, speech therapy needs and so on. The physical care needed for the child will last its lifetime, so therefore needs to be very comprehensive. A major firm employed by legal teams quite frequently, is Maggie Sargent & Associates. Click here for more information on what Care Experts do https://maggiesargent.co.uk/
Some of the experts who will assess needs are: Care, Accommodation, Ophthalmologist, Neurologist, Music Therapy, Orthopaedic, Assistive Technology, Educational Psychology, Neuropsychology, Physiotherapy, Speech and Language, occupational therapy.
Housing for the child will also be assessed during Interim and funds allocated from the claim. Each of these ‘heads of claim’ are eventually agreed by both sides. When that happens, the case is formally ‘settled.’ A judge will rubber stamp this agreement.
During the quantifying period the claim is overseen by a Case Manager. Case Managers will oversee the different specialities such as physiotherapists, occupational therapists, housing specialists etc to cater for the needs of the child now and into the future.
Many people find constantly having appointments with two sets of experts assessing all aspects of their child’s life very intrusive and stressful. However, it is very important to understand that your Solicitor needs to prove that your child needs certain cares, therapies, equipment etc even though you cannot see that now. Even if the child currently has no need of two carers, or a night carer, they may in the future, and if its proven a necessity, then money is put aside for that time.
At times you will feel you are fighting again for what your child needs. Many disabled people need regular hydrotherapy, and a small hydro pool with hoisting and usable all year round, is often a sticking point, but if you can ask the Case Manager to provide evidence to support your wish it is often possible. As you see, it is not a simple case of saying what your child needs, it is proving it and fighting for it.
Your legal team will explain the need to prove your child needs this funding, even though the whole process is intrusive and exhausting.
During Interim, you will receive Interim Payments. These are paid from the Claim and are given if requested for various reasons. You may also receive some of your ‘Past Care’ payments, although they may only be paid at settlement. It’s always worth asking if some of this can be paid as soon as it is assessed. This is money that would need to have been paid to carers had you not provided care. It is less NI and tax, so about 80% of a carer’s wage. Included in this are all the things you have provided and paid for over the years, such as equipment, specialist therapies, blenders and so on. You may not get the full amount back, but everything you have provided over and above what a normally developing child would have had, should be repaid. Travelling costs to appointments, parking, etc should all be claimed for.
Often during Interim the family are asked to move into rented accommodation if their own house is deemed not suitable for their child’s needs. Most family homes with a disabled child are not suitable, either because of size, lack of adaptations, lack of accessibility and so on. This rental property will come out of the overall claim, but families will be given an interim payment for the additional costs etc. Again, your solicitor will discuss with you the pros and cons of rental accommodation. During quantum it is worked out how much care your child needs for life because space in their forever home will need to be added on for carers.
The life expectancy of your child will be estimated and it will affect the claim, but as it is a complex area you need to discuss this with your solicitor, and the implications it has overall. Regardless of life expectancy, the claim will make care payments for life. This is a very difficult conversation to have, but if you are prepared, it may be easier. They use standard life expectancy charts, taking into account such things as level of disability, tube feeding and so on.
At some point you will look for a new home for the child for life. The claim will pay for the house and adaptations. A second move is problematic but not impossible, so it should be right in the first instance wherever possible. The Case Manager will oversee adaptations and everything to do with the house, with your cooperation. However, it is important to understand that this is your child’s house and, if they lack full capacity, will be managed by a court appointed Deputy. If you own your own home, look at renting it out to provide you with some extra income or pay off your mortgage. Again discuss the implications of housing fully, with your solicitor. Every child and every case is different, so housing needs careful thought and decision making.
Interim can last 2 to 3 years, is a difficult period, but ultimately worthwhile. If your child is very young following admissions you may go into a ‘stay’ until around puberty. This is an extended Interim period where you will be given interim payments but the case is not fully financially settled. This is because there may be an evolving picture of disability which cannot be fully seen until the child is older. It allows for issues to develop which can then be taken into account when the final settlement figure is reached.
Settlement
Following the quantification of the claim in Interim, and an agreement on all sides on the various amounts allocated for different areas of the claim, Settlement is reached. A settlement agreement is drawn up and is legally binding on all sides. This agreement is then ratified by the High Court. The parents can be there when this happens. It is simply a judge who is rubber stamping the agreement, and he will usually say a few words to the parents. These proceedings are held in private and there are strict reporting restrictions, so the settlement remains confidential unless you decide otherwise.
If the Defence and your team of experts reach vastly different sums for certain ‘heads of claim/loss’ (basically the different areas where payments need to be made to compensate for loss) and cannot reach agreement at a Joint Settlement Meeting, it may need to go to court for a judge to decide on fair recompense. It’s quite rare for this to happen as mediation is usually successful. Following settlement you will need to negotiate life with Carers, Case Managers and Deputies, in many circumstances.
Professional Deputy
Joint Deputy
Paralegal
A deputy is appointed by the court of protection to oversee the use of your child’s funds. They are qualified solicitors with an expertise in Deputyship. Deputies have overall control of the child’s funds but must work within the bounds of the COP. (Which see). A Deputy usually has an assistant (a paralegal) who can deal with day to day finances and who is less expensive to contact than the Deputy. Some parents opt to be a Joint Deputy and work with the Deputy to make the process work more smoothly and efficiently. It is cost effective, but can sometimes be difficult to set up. It is hard after years of managing your child’s affairs to hand over control to a stranger, and being a joint deputy can work well in this situation. If you are not happy with the Deputy, or the Case Manager, you can change them. The Court does not make changing deputies an easy or cheap process, but it can be done. Ultimately you must have a good working relationship with people who play such a prominent role in you and your child’s life.
(Source Gov.UK Deputies)
Case Managers
A case manager is not a profession as such but a term used for someone who brings together multiple disciplines to perform the task of managing the affairs of a person who requires a high level of care.
Case managers usually have experience in a registered field, such as physiotherapy, occupation therapy and so on, but at present the field is unregulated, and as such great care is needed in choosing a case manager, as not all case managers have adequate skills.
There are moves being made to regulate and register case managers, and IRCM (Institute of Registered Case Managers) is an organisation who are trying to do just this. They aim to register highly skilled individuals with professional qualifications in the healthcare field to operate as Case Managers. They describe a case management as “a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual’s health, wellbeing, social care, education and/or occupational needs, using communication and available resources to promote quality, cost-effective and safe outcomes” (IRCM 2022)
Case Managers assess, plan, and review the needs of each individual client. They work for the client, but are expected to communicate and cooperate with the family as a team. Case managers are not employed by the family, but the family has the final say on who is employed. They are paid by the Deputy who is managing funds. They are paid for from the child’s award and money will be allocated for a case manager for life, if it is proved necessary during quantum. This is why it is especially important during quantum to utilise the skills of a case manager.
Relationships with case managers and other professionals dealing with the child’s needs, can sometimes be difficult, therefore it is important to choose someone you feel comfortable with and feel is competent in their field. I would recommend looking at BABICM or CMSUK types of organisations with registered members, simply because it takes out some uncertainty in a difficult situation. However, the choice is yours, as there are several ways people find good case managers. Personal recommendations are often successful.
Parents can begin to feel they have no control over the child they have cared for alone for many years, so it is important you have a ‘good fit’ with your case manager and trust their judgement. Case Managers must put the ‘client’ at the heart of their practice. This is your child not you or your family. However they also have a Duty of Candour – an obligation to be open, honest, and transparent with the service user and other relevant people. As the parents you are the most relevant people, not the Deputy, or any other person involved with your child’s care. Always remember that and remind others if necessary.
It is not essential to have a case manager, especially once the case is settled, but if the child has high physical care needs, coordinating carers to give round the clock care, organising therapy sessions, organising equipment, housing and adaptation needs etc, can be exhausting. Just understanding employment law is a major hurdle. Having someone who works with you to coordinate care can take an enormous strain off the parent child relationship and release parents to do the fun stuff with their child.
(Source BABICM and CMSUK)
Some of the services a Case Manager provides
- Source therapists: Occupational therapy, Physio, Speech and Language, music and hydrotherapy. Can even help source therapies such as yoga if it benefits the child
- Source care providers and deal with staff issues, rota issues and holidays
- Deal with invoices from care agencies
- Source any equipment needed
- Deal with the Personal Health Budget
- Check in with the family weekly
- Regularly update the Deputy and request funds as needed.
- Can become a trusted member of the team and someone to talk to
- Help organise travel and holidays
There are other Case Manager organisations but these three will give a good idea of the work a case manager does and what security can be offered.
I do not recommend any organisation over another, but suggest you research carefully to find your best fit.
