Bush & Co Care Solutions provides specialist care management and employment support for directly employed support workers, creating safe, sustainable and person-centred care packages within the home.
Our service is flexible around the needs of each client. When Choosing Bush & Co Care Solutions, there are two ways we can support the direct employment of support workers.
Bush & Co Care Solutions is the employer
We can act as the named employer of the directly recruited support worker team as a third-party provider. We manage the employment relationship and associated client account alongside care management, HR support and clinical governance.
Supporting the existing direct employment arrangement
Where the client, family or another party remains the employer, we can continue to provide the specialist infrastructure and support needed to manage the care package effectively. This can include direct employment care management, ongoing HR and employment support.
Whichever is right for your client, our focus remains the same: creating person-centred, consistent and cost effective care built around the individual.
Support for directly employed care packages
Direct recruitment enables clients to build a consistent support worker team around their individual needs, routines, preferences and lifestyle.
Our specialist team brings together care management, HR and employment expertise and clinical governance to support the people delivering care and those receiving it.
Depending on the needs of the care package, support can include:
HR
- Recruitment advertising
- Interview support
- Onboarding
- Payroll and pensions
- Employee relations including absence management
- Leaver processing
Care Support and Management
- Care planning and care reviews
- Supervision
- Medication management
- Incident/accident support
- Rotas
- Family liaison
Clinical Governance
- Clinical training
- Competency sign-off
- Risk assessment
- Training support
- Annual case audits
- Safeguarding
Employer: Bush & Co Care Solutions is the named employer of the directly employed support worker team.
Client Account Management: Bush & Co Care Solutions manages the agreed care funding associated with the package in line with the relevant funding and commissioning arrangements.
A third-party providers’ responsibility for Personal Health Budgets
A third-party arrangement is one of the recognised ways in which a Personal Health Budget can be managed.
Under this model, an organisation that is legally independent of both the individual and their NHS commissioner takes responsibility for managing the agreed budget and arranging the associated care and support.
Where Bush & Co Care Solutions provides this service, we can act as the employer of the directly recruited support workers and manage the care package in accordance with the care plan provided by the commissioning body.
This provides a clear provider relationship while retaining the benefits of a care package created specifically around the individual.
How we manage budgets as a third-party provider
Your client’s Personal Health Budget can be delivered in different ways, depending on the funding route.
Local Authority Funded Care
Delivered as a direct payment, a council-managed budget or through an Individual Service Fund, where the provider holds and manages the funds on the client’s behalf.
NHS Funded Personal Health Budgets
These follow the same principle under different names – a direct payment, a notional budget held by the ICB or a third-party arrangement where an approved provider manages the budget.
Bush & Co Care Solutions operates as the third-party provider across both routes.
We hold and manage the funds so the client and their family are never the employer of care staff and never have to deal with payroll, PAYE or day-to-day fund administration.
All whilst keeping full choice and control over who provides the care and how it is delivered.
Direct Employment Care Management
Our direct employment care management service provides the day-to-day oversight and support needed to establish and maintain safe, effective and well-led care at home. Advantages include:
- Day-to-day oversight for safe, care at home
- Experienced care managers, whether or not Bush & Co is the employer
- A solution that works with or without a case manager, who can then focus on rehabilitation
- Lead on supervision, medication, rotas, care planning and clinical governance
Our care managers are highly experienced in the implementation of care packages in the home and the ongoing management of support staff; ensuring safe, effective, well-led and compliant care with dignity and respect whether Bush & Co Care Solutions is the named employer or another party retains the employment relationship.
Whether working in tandem with case management or independently, the primary focus is to ensure the provision of ongoing care over the long-term quality of care and the transition between milestones.
If your client does have a case manager supporting their rehabilitation, our care managers can support them in all administration and compliance tasks related to care; meaning the case manager can focus on rehabilitation outcomes and be on hand for changes in circumstances such as times of crisis, work or education.
Our care managers lead on important tasks such as support worker supervision, medication management, rotas, family liaison, care planning and care reviews, clinical training, competency sign-off and other critical clinical governance actions.
HR and Employment Support for Directly Employed Support Workers
Our care managers and Head Office team support with all HR elements on direct employment, from recruitment advertising and interview support through to onboarding, payroll and pensions, employees relations (including absence management) and leaver processing.
If Bush & Co Care Solutions is not the named employer, clients still don’t have to worry about the HR responsibilities legally required or insurance and our experienced team includes roles responsible for HR administration, support worker training, onboarding and compliance co-ordination and payroll.
This support is built to support all aspects of direct employment within the home to lend a helping hand and clients do not need to use our care management service to access our standalone HR and employment support.
Support Worker Onboarding Package
We appreciate that there may be cases where specialist support in terms of direct employment best practice is needed or outsourcing HR administrative tasks would be beneficial. You can choose Bush & Co Care Solutions to carry out all onboarding tasks on behalf of your client, which includes all pre-employment vetting and checks, through to the issuing of contracts and the creation of an HR file. We then hand over a fully compliant HR file to manage.
HR File Health Check
HR compliance is vital in keeping both clients and support workers, carers and rehabilitation staff safe. Bush & Co Care Solutions holds a wealth of HR experience, particularly within the care sector and we understand the complexities and time involved in ensuring compliance. Our health checks include a review of offer letters and contracts, DBS certificates, gaps in compliance, job offers and Right to Work documentation. They can also be used in a number of scenarios including the TUPE of support workers and annual audits,
Care Needs Assessment
Whether your client is living at home, in a residential setting, or you're simply seeking reassurance that their care arrangements are appropriate and sustainable, our service provides clear, objective guidance around safe and effective care. Our assessments are focused exclusively on care provision and are particularly valuable for:
- applications for continuing healthcare or social care funding;
- evidence gathering in funding disputes and ensuring care quality; and
- appropriateness and safeguarding.
FAQ
What is direct employment care management?
It is the day-to-day oversight of care at someone’s home. Our care managers set up the care package and then manage the support worker team. This includes leading on supervision, medication, rotas, care planning and clinical governance.
Do we need Bush & Co Care Solutions to be the employer to get HR support?
No. We can support the client, family or another named employer. You can also use our HR and employment support, without our care management service. That covers actions such as recruitment adverts, onboarding, payroll, pensions, absence management and leaver processing.
How do you manage a Personal Health Budget as a third-party provider?
We hold and manage the funds. The client and the client’s family are never the employer of care staff. They do not have to deal with payroll, PAYE or day-to-day fund administration. They will retain full choice and control over who provides the care and how it is delivered.
What did the Lumb judgement decide about Personal Health Budgets?
In Lumb v NHS Humber & North Yorkshire ICB [2024] EWCOP 57, the Court of Protection ruled that managing a Personal Health Budget direct payment as a "representative" is outside the authority of a standard property and affairs deputyship. A deputy would need specific authority, which requires a specific court order.
Can a deputy manage a Personal Health Budget and the care staff employment?
Not under a standard deputyship. The court can authorise a deputy to manage direct payments, but this needs a specific order. If a deputy takes this on without that authority, the person receiving care should not be expected to pay the costs.
How can Bush & Co Care Solutions help deputies following the Lumb judgement?
We can act as a third-party provider. We hold and manage the Personal Health Budget and employ the support worker team, in line with the commissioner's care plan. This means the deputy does not need to take on the direct payment or employment responsibilities.
Further information
