Community care direct payments

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

If you have assistance with managing direct payments you still have the final responsibility for how the money is spent. You must not be subject to certain mental health or 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 have been assessed as needing personal social services. This includes carers.

Scotland

In Scotland, a local authority social services department must offer direct payments for certain services to all eligible people. Eligible people include:

• disabled people who are aged 16 or over
• people with parental responsibility for a disabled child
• attorneys or guardians with the power to act for a disabled person
• people over 65 who, due to age or frailty, may have community care needs
• non-disabled people receiving care services, eg people who are homeless, refugees or ex-offenders, or those fleeing domestic abuse or recovering from drug or alcohol dependency.

Carers do not receive services in their own right so cannot get direct payments for caring.

Provision for personalised budgets (see above) were introduced recently in Scotland.

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 in exceptional circumstances 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 Factsheet F3 - charging for community care). 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 Factsheet F6 - community and residential care - complaining about assessments or charges).

WHERE CAN I GET HELP?

You should seek further advice if you want to challenge a decision about your benefit. You can get help with your appeal at a local advice centre, such as a citizen's advice bureau. You can get more information about this from our factsheet F16, Finding a local advice centre, which is available at www.cara-online.org

Central Africa’s Rights & AIDS (CARA) Society has also published Benefit appeals - A guide to benefit appeals for advisers and disabled people. This guide helps you prepare for an appeal tribunal and will increase your chances of success at the hearing. It takes you through all the stages of the benefit decision-making process from the moment you receive an unsatisfactory decision through to the tribunal hearing.

It is available to have a look at it on our website at www.cara-online.org or by contacting Central Africa’s Rights & AIDS (CARA) Society on Tel: +44(0)20 7254 6415(voice and minicom) - Mob.:+44(0)7956 95 26 45 - Fax: +44(0)872 115 8436 - Email: caraas@hotmail.com

Updated July 2009