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3.1.5 Direct Payments

This chapter has been added to the manual in January 2018.


Contents

  1. Direct Payments
  2. Eligibility for Direct Payments
  3. Frequency of Payment
  4. Direct Payment Process
  5. Use of Direct Payments
  6. Hospital Stays
  7. Decisions Not to Make Direct Payments
  8. Monitoring and Review
  9. Repayment and Recovery of Direct Payments
  10. Ceasing Direct Payments


1. Direct Payments

Direct Payments allow parents and young people greater choice, flexibility and control, to purchase services and employ their own workers at times convenient to them and in the way they wish, to provide an individual service to meet their needs.

A Direct Payment is a cash sum of money paid on behalf of a child or young person who has a special educational need, a health need or a disability social care need. This money is paid through Cambridgeshire County Council on behalf of all the above. Direct Payments do not affect benefits.

Local authorities must offer the option of Direct Payments in place of services currently being received, or where eligibility has been assessed. For both education and social care the local authority must be satisfied that the person who receives the Direct Payment: is able to manage the Direct Payment 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.

Cambridgeshire County Council’s Local Offer for children and young people with Special Educational Needs and Disabilities (SEND has a section about personal budgets and direct payments for children with disabilities. At the link below there is the most up to date information on:


2. Eligibility for Direct Payments

Young people over the age of 16 or parent/carers of children under 16 Those who have been assessed as meeting the criteria for disabled children's services are eligible for Direct Payments. Children and young people who have Education, Health and Care Plans and 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.

As the young person approaches 18 the Social Worker will complete an Adult Carers (carer of a person over 18) Assessment and Carers’ Support Plan, if applicable, ready for implementation after the young person turns 18. The Social Worker will also support the adult carer to complete a ‘What If Plan’ and ensure that this is registered with Carers Trust Cambridgeshire.

(Please see the Step By Step Guide to Adult Assessment Process).


3. Frequency of Payment

Direct Payments are paid in advance into a bank or building society account specifically set up for this purpose, as a one off payment or on an agreed regular basis. If the direct payment is assessed as being needed only at key times e.g. school holidays, then payment will be scheduled accordingly.


4. Direct Payment Process

For short breaks and social care direct payments the arrangements will be included in the child or young person’s support plan following assessment.  It will be reviewed and updated at least annually, or more frequently if needed, as part of the Child in Need or Looked After Child review.  

Parents can manage the Direct Payment on their child’s behalf, but if they prefer, Cambridgeshire County Council has commissioned Purple (www.wearepurple.org.uk) to assist with the management of Direct Payments. This service is free and they also offer managed accounts and payroll services which help with paying wages, tax and National Insurance etc. Many people using Direct Payments, who employ someone directly (i.e. not through an agency), use a payroll service to cut down on the amount of paperwork. There will be a charge for these additional services which will be accounted for out of the personal budget.

Disabled young people aged 16 or over can manage Direct Payments themselves, if they want to and have the capacity. Even doing a small part of this for themselves can help them get used to being independent.

See also Children and Young People Aged 0 - 25 with Special Educational Need and Disabilities Procedure.


5. Use of Direct Payments

5.1 Employing a Personal Assistant

A personal assistant might:

  • Take the young person/child into the community to access an activity, support inclusion, going to a club, volunteering, etc.
  • Work with the child directly within the home, to give parents and siblings a break;
  • To support with personal care;
  • Support the development of independence skills, such as personal care, traveling, using money;
  • Be a registered childminder or child home carer (for children aged under 8).

5.2 Other possible uses

A Direct Payment can only be used to meet the needs and outcomes agreed within the Care Plan/Young People’s Plan.

  • Contracting with an agency;
  • Buying equipment agreed by Social Care;
  • Assistance to purchase short breaks (respite);
  • Assistance with essential domestic care tasks, which are essential to meet the assessed needs of the child as evidenced in the care plan;
  • Assistance to access facilities or activities to promote social inclusion;
  • Assistance with initial start-up costs, such as advertising;
  • To support the child’s independence and preparation for adulthood.

5.3 Inappropriate uses for direct payments:

  • To buy permanent residential care;
  • To purchase any residential care (excluding specialist activity holidays);
  • To purchase overnight short break respite outside of the family home without the express permission of the Social Care Team/Unit;
  • To buy services owned by Cambridgeshire County Council or any other Local Authority;
  • To buy health-related services or equipment that should be provided by the NHS, unless a health personalised budget is in place to facilitate this;
  • To make major adaptations to your home that would come under the Disabled Facilities Grant;
  • To employ a partner or a close relative who lives in the same household unless Social Care Services are satisfied that someone’s needs could not be met any other way.


6. Hospital Stays

When a child or young person under 16 years needs to go into hospital, the parent, carer or the person managing the Direct Payment, should contact the local authority straight away to discuss support needs and the direct payment.

If needs change the support plan and direct payment will change as required. If a direct payment is no longer needed, payment can continue for a limited period to allow the person managing the Direct Payment time to ensure that any contractual obligations around termination of the support can be met. Where a Young Person is 16 years or older and in receipt of Direct Payments, hospitalisation may 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. This would require discussion on an individual basis.

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 would in initially involve working with the family to identify someone able to take temporary responsibility for sustaining the existing services.


7. 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 carer 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.


8. Monitoring and Review

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 thereafter at least annually. This will normally be following a review of the Plan or a re-assessment. 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 meet the assessed need of the child;
  • 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.

Where the local authority decides to reduce the amount of Direct Payments, it must provide at least two weeks’ 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. This would normally be undertaken by the Service Manager, based on case information provided by the SW/CSW. 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.


9. 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;
  • The direct payment has not been spent within the timescale of the agreed support plan;
  • 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 moves out of the area and ceases to be the responsibility of the local authority;
  • The child or young person has died.

Written notice must be given 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). This would normally be undertaken by the Service Manager, based on case information provided by the SW/CSW. 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.


10. 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 at least two weeks’ 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). This would normally be undertaken by the Service Manager, based on case information provided by the SW/CSW. 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