FACTSHEET No. 20

Community Care Direct Payments

This factsheet is a basic introduction to community care direct payments.

Introduction

If you have been assessed as needing particular care services you can get cash to arrange and pay for them. You can have a combination of some services provided directly by social services and others arranged by yourself with direct payments. Direct payments may give you more control over the way your care needs are met.

Direct payments can be used to purchase any services which meet your assessed needs. Direct payments cannot be used, however, to purchase care in a care home, apart from periods up to a maximum of 4 weeks (120 days for children) in any one year. Separate periods in a care home of less than 4 weeks are added together towards the maximum only if you are at home for 28 days or less in between.

England and Wales

To get a direct payment you must be one of the following:

• a disabled person
• a carer
• a person with parental responsibility for a child with a disability

You must also be aged 16 or over and assessed as needing community care services or services as a carer. You must be willing to have and be able to consent to having direct payments and be able to manage these payments (alone or with assistance). You cannot be forced to have direct payments

In England and Wales, direct payments have been extended to people who lack the mental capacity to agree to and manage direct payments themselves – payments can now be made to a willing and appropriate person on the disabled person's behalf.

You cannot have direct payments if you are subject to criminal justice legislation.

In England there are plans to bring the personalisation agenda to all community care service users by 2011. This system will allow you to write your own care plans and decide how your needs will be met. The system will incorporate direct payments and individual budgets.

Northern Ireland

You are eligible to receive direct payments if you are over 16 and have been assessed as needing personal social services. This includes carers.

Scotland

If you live in Scotland you can get direct payments (or ‘self-directed support’) if you are assessed as needing an eligible care service. There are some exceptions to this. Carers do not receive services in their own right so cannot get direct payments for caring. If you cannot give consent or manage your affairs, a representative can receive and manage direct payments on your behalf.

Payments to family members

In England, Northern Ireland and Wales, direct payments cannot normally be used to pay for services from your spouse, partner or a close relative (or their spouse or partner) living in your household, other than in exceptional circumstances agreed with the local authority. You can use your direct payment to employ a relative if they are not living with you.

You cannot use a direct payment to purchase services from the local authority.

The rules regarding family members are similar in Scotland but a local authority can make direct payments to employ relatives who live in the same household, where the authority is ‘satisfied that securing the service from such a person is necessary to meet the beneficiary’s need for that service’.

In Scotland you can also use direct payments to purchase services from your local authority.

How much are you paid?

Local authorities must make direct payments at a rate equal to their estimate of the reasonable cost of the service to meet your assessed needs and fulfil your legal obligations if you employ your carer/s (eg national insurance payments, employers’ liability insurance, holiday and sick pay). If you choose a more expensive way to meet your assessed needs than is ‘reasonable’, you will have to pay the extra cost yourself. Payments made will not affect your benefits.

You may be asked to contribute towards the cost of your care. The amount of your contribution will be calculated using the same charging rules as for care arranged by the local authority (see Where can I find more information below).

You will either be paid your direct payment net (with the charge taken off) or gross (where you pay the amount you are assessed to pay in the same way as if you were getting a service).

If you are unhappy with the amount of payment you are offered or any other aspect of the direct payment, you should use the complaints procedure (see Where can I find more information below).

Personalisation and the Right to Control

The Right to Control is a new legal right for disabled adults. It aims to give you more choice and control over the support you need to go about your daily life. It proposes that agencies should work together to provide personal budgets made up of several funding schemes. Formore information see Where can I find more information below.

Where can I find out more information?

The Low Incomes Tax Reform Group (LITRG) has produced a report, Independent living, direct payments and the tax system, which identifies a number of tax traps and suggests how the system can be made friendlier your needs. It is available at www.litrg.org.uk.

You can find out more information about direct payments on the Department of Health website.

For any further information regarding these factsheets and publications, please contact CARA on+44 (0) 844 478 0015 -Mob: +44 (0) 795 695 2645 -Fax: +44 (0) 872 115 8436 -Email: info@cara-online.org.

Updated 8 April 2011