Example section for Indefinite Awards

Lorna is 68 years old and has had a severe head injury that has significantly impacted their personality a year ago. They live on their own in a rented flat and have current input from mental health services, who have been providing input. They also suggested Lorna should apply for PADP.

Lorna is supported by twice weekly support sessions from a mental health support worker and daily home care visits.

Their brain injury and the changes in personality they have experienced are permanent with low probability of full remission, with symptoms remaining stable and enduring. Lorna takes significant levels of medication to manage these.

Lorna reports that they have learned to live with their condition and their main restrictions are self-care and when they come into contact with other people. Care staff report that Lorna

• need encouragement or motivation to get out of bed in the morning;
• need frequent and repeated prompting to eat;
• need assistance to manage their medication;
• will not wash unless prompted;
• will not wipe after using the toilet without prompting;
• will not change their clothing unless prompted;
• are unable to engage and communicate with people independently without overwhelming anxiety.

The case manager establishes that Lorna satisfies the daytime condition and is therefore entitled to the lower rate of PADP. They check the decision-making guidance on review periods. They then review other relevant factors outlined in this chapter to understand the likelihood of Lorna’s needs changing.

They identify that Lorna has a lifelong condition. Despite the injury only occurring about a year ago, Lorna has stable symptoms. There are likely to be small changes in need over time, but it is highly unlikely that their condition will either improve or worsen to a degree that would impact entitlement. This is due to the nature of the condition. The case manager decides it would be reasonable to award an indefinite award based on the likely longevity and complexity of their condition. They make the determination and submit the case for internal quality assurance.

Mohammed, aged 72, was involved in a car accident 9 months ago which has left him with tetraplegia. Mohammed states in his PADP application that he requires full-time care and uses a wheelchair.

He has indicated that he needs significant support with a number of bodily functions.

In his application, it is noted that during the day, Mohammed needs:

• encouragement and assistance to eat and drink
• supervision due to problems with swallowing
• assistance with communicating with others
• assistance to navigate his home in his wheelchair
• assistance with carrying out physiotherapy
• help to take medication to reduce muscle stiffness

At night, Mohammed:

• needs help with their toileting needs
• needs assistance to clean up after an accident
• requires reassurance to settle throughout the night due to their discomfort

After familiarising themselves with Mohammed’s case, the case manager establishes that Mohammed:

• has met the backwards test
• has both daytime and night-time care needs and is therefore entitled to the higher level of PADP
• has a lifelong condition, which suggests that a review is inappropriate.

They consider the other factors outlined in this chapter to establish whether there are any aspects of Mohammed’s circumstances that would mean an indefinite award wouldn’t be the best choice for Mohammed.

The case manager determines that Mohammed should receive an indefinite award and submits their determination for mandatory quality assurance.