Direct payments - managing your own care and support

What is a direct payment?

Direct payments are where you are given money and the control over any care and support services you receive, instead of having the council organise your support.

A direct payment can be used to pay for all or just part of your support.

You can choose to have a direct payment to pay for some of your support and social services could arrange the rest of it.

How do direct payments work?

Recipients receive an amount of money from the council to meet the service user’s assessed needs and agreed outcomes. Payments are made, in advance, into the account opened for direct payments (if applicable) and at the intervals indicated in the Direct Payment Agreement.

The direct payment is used by the recipient to purchase services, equipment, employ their own personal assistants or to support them with activities that meet the service user’s agreed outcomes.

If a recipient decides to employ their own staff they will need to decide what they can pay the staff allowing for all the expenses they need to pay out of the direct payment. It is important to remember that the money received not only has to pay employees but also any costs associated with being an employer i.e. National Insurance contributions, holiday pay, admin costs etc.

Recipients will need to complete an expenditure form and keep it for auditing purposes. The type of information required will depend on individual circumstances and will be indicated in the Direct Payment Agreement. This may include bank statements, receipts, invoices, copies of wage slips and an expenditure form.

In choosing to receive a direct payment instead of direct services, recipients accept full responsibility, both legal and otherwise, for arranging care and support services for the service user.

The recipient must:

• only use the money to meet the agreed Outcomes as detailed in the support plan
• open a separate bank account approved by the council which must be used solely for the direct payment (unless it is has been agreed otherwise with your social care worker) - the recipient will need to provide their bank statements as part of the financial monitoring process and must keep a record of all money paid in and withdrawn from the bank account
• complete a monthly expenditure record showing how the direct payments are being spent, and keep this record along with all receipts/invoices, wage slips and bank statements - these must be available to be seen by the council upon request - recipients must also promptly provide any additional information, records or documents the council requests to monitor the bank account, the direct payments, the services obtained, and compliance with the conditions within the Direct Payment Agreement or this supporting document
• sign an agreement with Rutland County Council to ensure that they understand the principles and conditions of the scheme
• accept and comply with the responsibilities associated with the employment of staff i.e. PAYE and National Insurance contributions and maintaining records (see ‘Being an Employer’ Information Pack DP16 for further information)
• allow the council reasonable access to any records regarding the workers or agencies the recipient makes payments to if needed for audit purposes
• inform the council of any change in circumstances including the service user going into respite care or being admitted to hospital (the direct payment may be paid at a reduced rate during this time)

Before making a decision, information and advice is available from your social care worker or the direct payments support worker.

Who can have a direct payment?

You must be eligible for support from the Social Services department at the council.

Examples of people who could receive a payment are:

• older people who need support to live safely and independently within their own home and community
• parents of a disabled child

You will also need to:

• agree to the legal requirements of the scheme
• be able to manage a direct payment, with support if needed

Read more about the laws which govern direct payments.

What can a direct payment be used for?

To buy services that meet your assessed needs and the agreed outcomes in your care and support plan.

Examples include:

• personal assistance in your home
• short breaks
• respite care
• support to access activities
• services to support carers
• aids, adaptations and equipment to help you remain in your own home

What can't a direct payment be used for?

• paying for long term residential care
• buying in health care tasks normally provided by and paid for by the NHS Continuing Healthcare service
• you are not usually allowed to employ a close family member who lives with you - this is only allowed in very exceptional circumstances

See the 'Who Could Provide the Care and Support I Need' section for more information.

Ask your social care worker if you have ideas for using your direct payment that you are unsure about.

Is there a charge for direct payments?

You may have to contribute to your direct payment. This depends on your circumstances and what your payment is for.

The council will carry out a financial assessment with you, to work out if you need to pay anything towards you direct payment. Any contribution you make will be the same as you would make had the council provided your support directly.

How much money will I get?

There is no minimum direct payment. The amount of direct payment received will depend on a number of factors:

• the outcome of any community care assessment or self assessment
• the outcome of any assessment regarding financial contribution
• what the direct payment is for i.e. equipment, personal care, a short break/respite, accessing activities

Where the payment is a lump sum to purchase a short break/respite, the payment will be made at the rate that the council would pay if they were arranging the service directly. Any contribution payable by or on behalf of the individual would be subject to the normal financial assessment process. 

In all cases, it is also a good idea to allow for a ‘contingency’ fund in case of unforeseen events i.e. having to pay for cover during staff absence.

The council may (but is not obliged to) assist with additional expenditure where this cannot be met from the direct payments budget. This can include:

• reasonable costs for the recruitment and retention of staff i.e. advertising, DBS checks, training
• retainer fee for a personal assistant when the individual goes into hospital or has a short break (direct payments may be paid at a reduced rate during this time)
• other costs such as statutory sick pay, statutory maternity pay, where these are not refundable through the National Insurance Scheme
• other costs associated with being an employer i.e. Insurance and ‘start up’ payroll support costs

Will my benefits be affected?

No. Direct Payments are made to support assessed needs and are not viewed as income. Payments will not be taken into account by the benefits agency.

Will I be liable for tax?

As an individual, recipients will not be liable for the payment of Income Tax on the direct payment, as this is provided solely for the purchase of care/support services and is not viewed as income.

If recipients decide to use the direct payment to employ personal assistants, they then become an employer. As an employer, recipients will be responsible for ensuring that all relevant Income Tax and National Insurance payments are made and workplace pensions are offered if applicable. You can discuss these matters in more detail with HMRC or an independent financial adviser.

What happens if I start a direct payment and find it does not work for me?

You need to let the council know, in writing, that you don’t want to receive a direct payment anymore. The council will make arrangements for your care and support needs to be met, and you may need to have a re-assessment at this point. 

As this can take some time to complete, let the council know as soon as you decide you don’t want a direct payment anymore. We will work with you to aim to make the most appropriate changes with minimum disruption.

Individuals who have appointed someone to receive direct payments on their behalf should notify the council, in writing, if they wish to change the person appointed, or receive the direct payment themselves.

What help is available to manage a direct payment?

The direct payments support worker and your social care worker can give you any information and advice you may need.

You can appoint someone to receive the payment on your behalf, to manage paying for and arranging your support. This needs to be agreed with your social worker first.

You can set up a trust to manage your payments. A trust is a group of people who can make the support arrangements you want. You are still in control, but the will do the work. You will be at the heart of the decision making process.

You can use a payroll service to take on some or all of you payroll obligations if you employ your own support staff. There is a charge for payroll services, which you will need to budget for from your payment.

Some services also offer a 'managed account' or 'third party account'. They receive the payment and handle all invoices etc on your behalf.

Who could provide the care and support I need?

You could:

• employ your own support workers or a personal assistant
• have a mixture of services. using social services provision, employing your own staff or buying services from a private agency
• buy short periods of residential care (short breaks or respite)
• pay a care agency or self employed worker - you still choose the staff but they will not be employed by you

If you use an agency to provide your personal care, they must be registered with the Care Quality Commission.

If you use a self employed worker, ask to see proof of their employment status.

There may be times when a friend or family member is able to support you in achieving your support plan outcomes, if their expenses were met.

Any payments must be for expenses only, otherwise your friend or family member may be seen as your employee and the money would be taxable.  You would need consent from the council if the person fits in one of the categories below.

Unless the council agree, you must not use a direct payment to pay someone (including expenses) who is:

1. your spouse or civil partner, or someone living with you as if your spouse or civil partner
2. living in the same house as you, and is you parent, parent-in-law, son, son-in-law, daughter, daughter-in-law, stepson, stepdaughter, brother, sister, aunt, uncle, or grandparent
3. living in the same house as you and is the spouse or civil partner of anyone listed in point 2
4. living in the same house as you as if they are spouse or civil partner of anyone listed in point 2

If you receive a payment on behalf of someone who lacks capacity, you must get a DBS Check or see an existing certificate for anyone providing services paid for by the direct payment.

The role of social workers and occupational therapists

Social workers and occupational therapists make sure that your needs are fully assessed and that a direct payment is suitable for you.

This can be done by completing a care and support assessment or carers assessment.

For aids, adaptations and equipment, you can complete a self-assessment.

Your assessment will be a joint activity and is your chance to talk about your support needs and what you would like to achieve. 

You and your social worker or occupational therapist will try to come to an agreement on how your needs can best be met.

Your assessment helps establish whether or not your needs are eligible to get support from the council.

Equipment

After an assessment for adaptations or equipment, individuals may decide that they would prefer to choose and purchase their own item rather than have the council supply it.  In this situation, Recipients could receive a direct payment to meet the cost of a standard/suitable item. Recipients might choose to purchase a more expensive item and meet the extra costs themselves

Reviews

The social care worker will make contact within six months of the direct payment commencing in order to discuss how well things are going. On an annual basis, the Social Services department will make contact to ensure that the service user’s needs are continuing to be appropriately met, and that the recipient is managing the direct payment.

This will help individuals/recipients to look back at what has been achieved, and if the direct payment will remain the same based on the individual’s needs.

Changes in circumstances

If you feel that the service user’s circumstances or needs change you can ask for a review at any time by contacting the Adult Duty Team            

Tel: 01572 758341

E-mail: dutyteam@rutland.gov.uk

Failure of services

If care arrangements fail, and alternative arrangements cannot be made, the Social Services office should be contacted for assistance if required. The worker will try to arrange for help to be provided to deal with the immediate problem.  It must be recognised however, that a direct replacement for the usual service cannot be guaranteed at short notice.

Termination of direct payments

The Direct Payment Agreement sets out some of the circumstances which may result in the direct payment being terminated.  In addition, the law requires that the council terminate direct payments in certain circumstances and the direct payment will terminate upon any of those circumstances occurring.

Such circumstances may include (but are not limited to):

• if consent to the direct payments is withdrawn, or the recipient no longer has capacity to consent to direct payments
• circumstances change which prohibit the recipient from receiving direct payments
• the council are no longer satisfied that the recipient is capable of managing the direct payments
• the council are no longer satisfied that direct payments are an appropriate way to meet the needs of the service user
• the council are no longer satisfied that the recipient will act in the best interests of the service user
• if a recipient is receiving direct payments on behalf of a service user who lacks capacity and the council reasonably believes that the service user no longer lacks capacity
• if the direct payments are not being used to obtain the support agreed in the service user’s support plan, or that support can no longer be obtained by direct payments
• if the council becomes aware that the direct payments are having an adverse impact on other services which the council provides or arranges for children or young people with an ECH plan maintained by us, or the direct payments are no longer an efficient use of the council’s resources

Let us know

Rutland County Council is keen to receive your comments on services generally, not just in relation to complaints.

We would welcome any views you have about any of our services. For example, if you feel a service is working particularly well, we would like to know this.

Tel: 01572 722 577 or email: letusknow@rutland.gov.uk