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4.3 Direct Payments

RELATED GUIDANCE

DoH, Care and Support Statutory Guidance - Issued under the Care Act (2014) (link added August 2016)

AMENDMENT

This chapter was updated throughout in March 2016, and should be re-read.


Contents

  1. What are Direct Payments?
  2. Who can Get Direct Payments?
  3. Agreement to Consider Direct Payments
  4. How Often are Direct Payments Made?
  5. What is the Process?
  6. Direct Payments can be Spent on Employing a Personal Assistant (PA)
  7. Direct Payments can also be Spent On
  8. Hospital Stays
  9. Direct Payments can not be Spent On
  10. What are the Benefits of Direct Payments
  11. Decisions Not to Make Direct Payments
  12. Changing Needs
  13. Stopping Direct Payments
  14. Monitoring Arrangements
  15. Reducing the Amount of Direct Payments
  16. Repayment and Recovery of Direct Payments
  17. Ceasing Direct Payments


1. What are Direct Payments?

A Direct Payment is money given to children aged 16 years or over who have a disability and to parents/carers aged 16 or over of young people, by the authority, to enable them to buy in support that is assessed as being needed, instead of the authority providing that support through their own services. Direct Payments do not effect benefits.

Direct Payments can be made for special educational provision, health care and social care provision.

Local authorities must offer the option of Direct Payments in place of services currently being received. For both education and social care the local authority must be satisfied that the person who receives the Direct Payments is able to manage the direct payments either by themselves or with whatever help the authority thinks the applicant or nominated person will be able to access; will use them in an appropriate way to meet the needs in question and that they will act in the best interests of the child or young person.

Regulations governing the use of Direct Payments for special educational provision place a number of additional requirements on both local authorities and parents before a Direct Payment can be agreed. These include requirements to consider the impact on other service users and value for money and to seek agreement from educational establishments where a service funded by a Direct Payment is delivered on their premises.

Direct Payments for health require the agreement of a Care Plan between the Clinical Commissioning Group and the recipient.


2. Who can get Direct Payments?

Direct payments are available to children with disabilities and their families in Newcastle.

Those who have been assessed as meeting the criteria for disabled children’s services. Children and young people who have Education, Health and Care Plans/their parents have the right to request a Personal Budget, which may contain elements of education, social care and health funding, and may be delivered by way of Direct Payments. Under the Children and Families Act 2014, this covers those aged 0-25 having special educational needs and disabilities. Direct payments are available if a child or young person is disabled and aged 16 or over or is a carer or parent aged 16 or over for a child with disabilities. No-one can be forced to have a direct payment. Direct payments can also be made to a willing and appropriate person on a disabled person’s behalf if they lack the mental capacity to agree to and manage direct payments themselves.

Direct payments cannot be used to pay for services from a spouse, partner or a close relative living in the household unless the local authority consider it is necessary to do so. However, a direct payment can be used to employ a relative if they are not living in the household.

Direct payments can only be made if an assessment by Children’s Social Care has identified needs which it is agreed are the responsibility of the Directorate to meet as agreed in the child's plan. The amount of money which is given as a direct payment would normally be no more than the cost of the service if it had been provided by the Directorate itself. Appropriate support is available for the person with Parental Responsibility. Direct Payments are initiated through the Care Plan and it is therefore necessary for every potential recipient of Direct Payments to have an assessment of their needs and a Child Plan.

Direct Payments can be used to meet all or part of service provision to meet the child/family’s needs.

Parents/carers may use Direct Payments to employ staff directly or to employ staff from an agency to meet their needs. Service users may not employ close relatives or adults living at the same address to provide services.

Once individuals start to receive Direct Payments the Local Authority is absolved of responsibility for meeting service needs in relation to services for which Direct Payments are being made. Parent/carers in receipt of Direct Payments are responsible for all aspects of employment once the Direct Payments start, including, for example, keeping all relevant records relating to the employment of staff.

Direct Payments may not be used to purchase services from the Local Authority or to purchase services which would normally be provided by the NHS.

Direct Payments are based on an hourly rate or overnight rate with additional payments to meet start-up costs (advertising, interviewing and employing staff), allowances for holiday pay and sickness pay for staff.

The social worker conducts their assessment of need to identify services required to meet the needs of the individual and completes the Care Plan.

The Social Worker discusses with the potential service user whether they wish to consider Direct Payments to meet their needs either in full or in part, instead of having services provided wholly by Children’s Social Care.


3. Agreement to Consider Direct Payments

When agreement is reached between the parent/carer and the social worker to consider Direct Payments then the social worker should:

  • Inform the service user of services offered by Disability North;
  • Complete the Disability North referral form and send to Disability North;
  • The social worker should arrange a joint visit with Disability North staff to provide information to the family;


4. How Often are Direct Payments Made?

Direct Payments are paid in advance into a bank or building society account specifically set up for this purpose, to be paid on a four weekly cycle unless there are exceptional circumstances. If the direct payment is assessed as being needed at key times e.g. school holidays, then payment will be made accordingly.


5. What is the Process?

The arrangements for Direct Payments will be included in the child’s/young person’s Education, Health and Care Plan, following an Education, Health and Care Needs Assessment. See Children and Young People Aged 0 -25 with Special Educational Needs and Disabilities Procedure.

Newcastle Children’s Social Care will ensure that the safety arrangements for children using direct payments are made stronger by encouraging every parent/carer or young person who employs a personal assistant to work with a child receives an Enhanced Disclosure and Barring Service (DBS) check.

When the parent/carer agrees to have Direct Payments, CWD social worker will refer the family to Disability North send the budget authorisation form to the Team Manager, CWD Team with a detailed breakdown of charges and payments.

The team manager will authorise the funding request, the social worker will record this as an activity on care first and inform the family and Disability North of the decision taken.

The social worker will visit the family and explain the responsibilities of the Local Authority and the family within a Direct Payment arrangements form. The social worker should ensure that the DP3 form is completed.

When the DP3 is signed the social worker should ask the family to complete the DP4 form, confirming the bank account details where the funding will be held.

The social worker should scan the DP3 into Total View (do not scan DP4 to Total View as it contains confidential financial data). The DP4 form should be sent to the Direct Payments Team for processing.

The social worker should liaise with the Direct Payments Finance Team to establish the date of the first payment of the Direct Payment and communicate this to the family and the provider.


6. Direct Payments can be Spent on Employing a Personal Assistant (PA)

  • To take the young person/child into the community to access an activity, support inclusion, going to a club etc.;
  • To work with the child directly within the home, to give parents and siblings a break;
  • To stay overnight to give respite to parents;
  • Or a registered childminder or child home carer (for children aged under 8).


7. Direct Payments can also be Spent On

  • Using an approved agency to provide direct care to meet your child/family's needs;
  • After school clubs and holiday play schemes for your disabled child;
  • Residential overnight breaks for your disabled child;
  • By agreement with the Team Manager for direct payments, any service which meets your assessed need for a short break;
  • Special educational provision specified in an Education, Health and Care Plan.


8. Hospital Stays

It could well be that those in receipt of Direct Payments require stays in hospital. This would not necessarily mean that the Direct Payments should cease. Guidance advises that consideration should be given by the local authority, the carer, the holder and NHS Trust to as to how the payments might be used to meet non-health needs or to ensure that the employment arrangements can be maintained. For example, the holder may prefer some personal care tasks to be undertaken by the carer rather than hospital staff. However, the personal care and medical input need to be tailored so as not to interfere with the medical treatment. (Terminating or suspending the carer’s employment may lead to a delay of continuity of care and a delay in discharge).

In instances where the authorised or nominated person requires hospital treatment, the local authority must conduct an urgent review to ensure the holder continues to receive the care and support they need. This might include the duties to be carried out by a temporary nominated person, or through short-term authority arranged care/support.


9. Direct Payments can not be Spent On

  • Employing someone without DBS and CPR checks or references or someone subject to a drug or alcohol treatment requirement, youth rehabilitation order or released on licence;
  • Permanent residential accommodation, though they can be used for occasional short breaks, if the local authority agrees, for up to 120 days in any 12 month period. (Note: where two periods of short –term care are 4 weeks or less apart, then the cumulative total of the stays should be added and not exceed 4 weeks if the stay is to be funded by Direct Payments).


10. What are the Benefits of Direct Payments?

Direct Payments allow parents and young people greater choice flexibility and control, to employ their own workers at times convenient to them and in the way they wish, to provide an individual service to meet their needs. Payments made do not affect welfare benefits.


11. Decisions Not to Make Direct Payments

Where the local authority decides not to make Direct Payments it must inform in writing the child’s parent or the young person of its decision and reasons in a format that is accessible to them and in line with the Data Protection Act. It must also advise of their right to request a review of the decision.


12. Changing Needs

If the service user's needs change, a re-assessment must be carried out and the Care Plan reviewed. Changes in service provision which result in changes to Direct Payments must be notified to Children’s Social Care Finance.


13. Stopping Direct Payments

Where Direct Payments are no longer required, the Team Manager should send the appropriate form to Finance Department.


14. Monitoring Arrangements

Monthly invoices are received from Children’s Social Care for each service user and the Admin Support Worker must check these against the order;

  • Audits.

The local authority must monitor and review the use of Direct Payments by the recipient at least once within the first three months of Direct Payments being made, and when conducting a review or a re-assessment of an Education, Health and Care Plan. In addition, a recipient may make a request for the local authority to review the making and use of Direct Payments and the local authority must then consider whether to carry out a review.

When carrying out a review, the local authority must consider whether:

  • It should continue to secure the agreed provision by means of Direct Payments;
  • The Direct Payments have been used effectively;
  • The amount of direct payments continues to be sufficient to secure the agreed provision;
  • The recipient has complied with their obligations on the use of the Direct Payment.

Following a review the local authority may:

  • Substitute the person receiving the Direct Payments with a nominee, the child’s parent or the young person, as appropriate;
  • Increase, maintain or reduce the amount of Direct Payments;
  • Require the recipient to comply with either or both of the following conditions;
    • Not to secure a service from a particular person;
    • To provide such information as the local authority considers necessary.
  • Stop making Direct Payments.


15. Reducing the Amount of Direct Payments

Where the local authority decides to reduce the amount of Direct Payments, it must provide reasonable notice to the recipient, and must set out in the notice the reasons for its decision.  

The local authority must reconsider its decision, where requested to do so by the recipient, but is not required to undertake more than one reconsideration of a decision. When conducting its reconsideration, the local authority must consider the representations made by the recipient (and where the recipient is a nominee, any representations made by the child’s parent or the young person) and must then provide written reasons to the recipient (and to the child’s parent or young person, where the recipient is a nominee) of its decision following the reconsideration. The local authority may reduce Direct Payments following reasonable notice despite the fact that a request for reconsideration has been made.


16. Repayment and Recovery of Direct Payments

The local authority may require the recipient to repay part or all of the direct payments, where:

  • The circumstances of the child or young person have changed in a manner which has an impact on the appropriateness of the agreed provision;
  • All or part of the Direct Payments have not been used to secure the agreed provision;
  • Theft, fraud or another offence may have occurred in connection with the Direct Payments;
  • The child or young person has died.

It must give notice in writing to the recipient, setting out the reasons for the decision, the amount to be repaid and a reasonable timescale within which the amount must be repaid.

The local authority must reconsider its decision where requested to do so by the recipient (but is not required to undertake more than one reconsideration of a decision). When conducting its reconsideration, the local authority must consider the representations made by the recipient (and where the recipient is a nominee, any representations made by the child’s parent or young person) and must then provide written reasons of its decision following the reconsideration to the recipient (and to the child’s parent or young person, where the recipient is a nominee).

The local authority may only seek repayment of any portion of the Direct Payments that has not already been spent on the agreed provision.


17. Ceasing Direct Payments

The local authority must stop making Direct Payments if:

  • The recipient has notified the local authority in writing that he or she no longer consents to receive the Direct Payments;
  • The recipient ceases to be a person to whom a Direct Payments may be made;
  • Following a review, it appears to the local authority that;
    • The recipient is not using the payment to secure the agreed provision;
    • The agreed provision can no longer be secured by means of Direct Payments.
  • At any point the local authority becomes aware that the making of Direct Payments is;
    • Having an adverse impact on other services which the local authority provides or arranges for children and young people with an Education, Health and Care Plan which the authority maintains; or
    • No longer compatible with the authority’s efficient use of its resources.
  • It has taken reasonable steps to ascertain whether the young person consents to Direct Payments and the young person has not notified the local authority of their consent.

Where the local authority decides to stop making Direct Payments, the local authority must first give notice in writing to the recipient setting out the reasons for its decision.

The local authority must reconsider its decision where requested to do so by the recipient (but is not required to undertake more than one reconsideration of a decision). When conducting its reconsideration, the local authority must consider the representations made by the recipient (and where the recipient is a nominee, any representations made by the child’s parent or young person) and must then provide written reasons of its decision following the reconsideration to the recipient (and to the child’s parent or young person, where the recipient is a nominee).

End