Direct payments scheme for Community Care
1. Background
The Community Care (Direct Payments) Act 1996 came into force 1 April 1997. The legislation had three main aims:
- To increase choice for service users
- To give service users more control over the services they receive
- That local authorities should work in partnership with service users to implement Direct Payment Schemes
2. What is a Direct Payment?
A Direct Payment is a cash payment made instead of community care services i.e. Homecare, Daycare, and Respite/Short Breaks.
"... existing direct payments schemes have enabled disabled people to secure assistance with personal and domestic tasks inside and outside the home, such as getting in and out of bed, dressing, having a bath, preparing a meal, doing housework and laundry, going shopping, going to college etc." (page 5 - Policy & Practice Guidance)
The Direct Payment can be used to obtain an alternative services by:
- Contracting with a care agency
- Employing someone (usually referred to as a Personal Assistant or a P.A.)
This means recipients take responsibility for the provision of their service. They have control over who they employ, they decide when they work and how they work.
It is up to the recipient to decide which service provider they use. The Department cannot specify any service providers that cannot be used or on what basis as this would not be in the spirit of direct payments and it would remove the choice and control from the recipient.
3. Who is eligible for Direct Payments?
People eligible for Direct Payments are:
- Any adult over 18
- Carers aged 16+ for services to meet their own needs
- Persons with parental responsibility for disabled children for services to the family
- 16 and 17 year old disabled children for services that meet their own assessed needs.
They also have to be:
- In receipt of (or to be assessed for) community care services (home care, daycare etc.), which can be a mixture of Local Authority services and some Direct Payments
- Willing and able to manage Direct Payments. They do not have to be able to manage alone, a friend, relative or someone who they trust can assist in managing their Direct Payment.
From 1 February 2000 Direct Payments were extended to people over 65 years old to fund non-residential care services such as home care and other support e.g. money to help people rehabilitate after a period in hospital so that they do not need to rely so much on social services over the longer term (Department of Health Open Document - 1 February 2000).
4. Who is not eligible for Direct Payments?
"The Act does not allow social services departments to make payments to third parties to manage on behalf of the user where the user is not in control. This is true even where the services provided to the user are intended specifically to help the carer." (page 5 - Policy and Practice Guidance)
The following people are not eligible for Direct Payments:
- Anyone not willing or able to manage Direct Payments
- Anyone who is not free to arrange their own community care services because they are restricted in their freedom to do so by the mental health or criminal justice legislation they fall under
- Anyone in permanent residential care (short stays are allowed)
If Direct Payments are to be discontinued, Social Services will give notice to the recipient up to 2 months.
Where it is necessary to discontinue direct payments without giving notice, the Policy Guidance states that these exceptional circumstances should be explained to people before they begin to receive direct payments.
There are cases where Social Services believe a recipient is at risk or there may be suspected financial abuse.
5. What Direct Payments can be used for (and what they can't)
Direct Payments can be used:
- As part of a mixed package so, for example you could receive Meals on Wheels, Homecare and a Direct Payment instead of attending a Day centre
- To pay for short periods of residential care of not more than 4 weeks
- However: Where two periods of residential care are less than four weeks apart they should be added together to make a cumulative total or if the two periods are more than four weeks apart they are not added The cumulative total calculated this way, cannot be more than four weeks in any twelve month period.
Direct Payment cannot be used:
Direct Payments cannot normally be used to employ close relatives or anyone who lives in the same household. In exceptional circumstances Social Services can allow this.
Direct Payments cannot be used for:
- Health therapies
- Personal Assistant expenses
- Food costs
- Home decorating
- DIY, building work
- Gardening
- Plumbing
- Electrical work
- Police checks
- Risk assessments
- Accountancy bills
- Council charges
6. How Direct Payments are calculated and other payment details
Direct Payments replace community care services so they are an alternative way of providing services, not an additional way of funding them. Direct Payments must represent value for money to the local authority, and be as cost effective as the services which the authority would arrange.
"local authorities may, if they choose, make direct payments at a greater cost than the cost of arranging the equivalent service, provided they are satisfied that this is still at least as cost-effective as arranging the services, i.e. that the increase cost is justified by the greater effectiveness arising from enabling the person to manage his or her own services and live independently".
Where applicable, independent living funding should be sought by the assessor.
Limit of Direct Payments
The maximum amount that would normally be funded by Direct Payment is equivalent to the cost of residential care.
The amount is based on the number of hours on the care plan and includes enough leave to cover employer and employee Tax and National Insurance contributions and leave enough to at least cover the legal minimum wage.
Starting Direct Payments
Bury recipients' first Direct Payment includes a one-off Start-Up cost of £150.04, in addition to an Annual Payment amount.
This Start-Up amount is for new recipients to pay for advertising for staff and employer's insurance. The Annual Payment at the start of every new financial year is made up of:
- 4 weeks' holiday pay
- 1 week's sick pay
- 8 Bank Holidays
- The Contingency Fund is £200.00 per year. Any use of this fund must be approved by the Direct Payments Manager before using it (wherever possible).
"Charging" for direct payments
The Policy and Practice Guidance states:
"local authorities should treat people who receive direct payments as they would have treated them under the authority's charging policy if those people were receiving the equivalent services".
The Direct Payment recipient will complete a financial assessment form and be financially assessed in the same way as if they were getting community care from the authority. Once calculated Social Services will invoice recipients for the amount to pay on a 4 weekly basis.
7. Responsibilities of Direct Payments Recipients
All Bury recipients will agree and sign a contract before the Direct Payments starts. The contract specifies that the Recipient must agree to:
- Take on the responsibilities of being an employer, for example, recruiting and managing staff, dealing with tax and National Insurance payments
- Provide audit returns to the Direct Payments Team every 13 weeks
- Make contingency plans so that back up is already arranged in case of an emergency, for example, if a PA calls in sick. If a contingency plan breaks down, the Local Authority must take responsibility for arranging an emergency service
Monitoring and Reviewing
Monitoring and Reviews should be carried out to satisfy the local authority that people's arrangements are meeting their needs. However "... if the local authority is not satisfied that those arrangements will be adequate, its responsibilities towards the user are the same as if no payment has been made." (page 10 Policy and Practice Guidance).
The Direct Payments support worker will also monitor the use of Direct Payment to make sure the recipient is satisfied with Direct Payments and is able to use the scheme.
Comments and Complaints
Direct Payments recipients can use the Complaints procedure in the same way as anyone else for whom the social services department has a power or a duty to provide a service.
"... People may make complaints about any action, decision or apparent failing of the local authority, but not about services which they have secured from independent providers (including people they employ directly) using direct payments". (page 10 Policy and Practice Guidance)
A copy of the complaints leaflet should be provided to each Direct Payments recipient by the Direct Payments support worker.
8. Assessment - The Care Manager's Role
Care Managers or Social Workers will use the same process for referral, assessment and care planning with service users, in the same way whether or not Direct Payment is considered is an option.
Before referral, the Care Manager's (Social Worker's) role is to:
- Explain Direct Payments to the person (this doesn't need to be in great detail, the DP support worker will provide all the information)
- Ensure that the service user understands they've been referred to the DP support worker and that we will be in contact with them
- Refer the person to the DP support worker and send copies of an up-to-date needs assessment, carer's assessment (if relevant) and care plan to the DP support worker
- This should make clear how many hours and at what times of the day and of the week their assessment covers
9. Direct Payments Support worker
When the DP support worker receives a referral, the support worker will:
- Send an introductory letter and information to the service user
- Arrange an appointment to provide more information to a service user
- Visit the person interested and help them decide if the Service User wants Direct Payments and the Support Worker will assess whether the service user is willing and able to manage Direct Payments (with or without assistance)
- If direct payment is agreed, explain the contract and get it signed, and arrange payment. The payments are made 4 weekly in advance. They will only be made into a dedicated bank account, that is an account that has been opened specifically for Direct Payment monies (although it may also be used for other support monies such as ILF)
- Conduct a 6 weekly review to ensure that the Direct Payments package is working out; and agree further reviews as needed
- Make arrangements for a financial audit needs to be completed
every 13 weeks
- Undertake a full review on an annual basis
Support Provided by Direct Payment Support Worker
The Support Worker offers support, advice and training on all aspects managing Direct Payments as well as arranging the Direct Payments themselves.
- Employment Advice - we can advise recipients on all aspects of employment such as tax and National Insurance, recruitment and managing staff. We will also "sit in" on interviews and can offer rooms to hold interviews in
- A Payroll Service – We recommend using our Payroll service, a local company called PayPartners, who are also on hand to offer advice on employment issues
- Any other information and support that assists service users towards the goal of Independent Living
Other useful sites regarding Direct Payments
Further information about Direct Payments nationally can be found on the Department of Health website:
Department of Health - Direct payments
NCIL – National Centre for Independent Living
For further information on Direct Payments, please contact the team on 0161 253 7366 or 253 6576.
E-mail k.bennett@bury.gov.uk or s.powell@bury.gov.uk
Information Leaflets
