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Direct Payments

STATUTORY GUIDANCE

DoH, Care and Support Statutory Guidance - Issued under the Care Act 2014 (2014)

AMENDMENT

This chapter was updated in November 2017. Minor amendments were made throughout the chapter, in line with local practice.


Contents

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


1. What are Direct Payments?

Direct Payments are cash payments which enable you to organise and purchase services to meet identified needs following an assessment by Together for Children Sunderland. In this way direct payments provide you with the flexibility to make decisions for yourself and provide opportunities for you to have more choice and control over the support that you receive.

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

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

Together for Children Sunderland must offer the option of Direct Payments in place of services currently being received. For both education and social care Together for Children Sunderland 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 Together for Children Sunderland 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 Together for Children Sunderland 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.


2. Who can get Direct Payments?

Those who have been assessed as meeting the criteria for disabled children’s services aged 16 or over. 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 Together for Children Sunderland 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.


3. 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, as a one off payment or on a weekly basis. If the direct payment is assessed as being needed at key times e.g. school holidays, then payment will be made accordingly. A support services provider such as Penderels Trust are able to assist with all aspects of a direct payment, for example helping you to manage your care money.


4. What is the Process?

Together For Children Sunderland Direct Payments Handbook for Disabled Children explains in detail the full process in respect of Direct Payments.

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.


5. 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 child-minder or child home carer (for children aged under 8).


6. 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.


7. 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 advise Together for Children Sunderland straight away to discuss the continuation of the payment.

It is possible that the payment will continue for a time-limited period, if only to allow for the person managing the Direct Payment to ensure that any contractual obligations around termination of the support can be met. However, there might also be an issue of continuity of care post-discharge to consider in some instances.

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 Together for Children Sunderland, 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, Together for Children Sunderland 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.


8. Direct Payments Can Not be Spent On

  • Employing someone without Disclosure and Barring Service and CPR checks or references, or someone subject to a drug or alcohol treatment requirement, youth rehabilitation order or released on licence; or anyone who may pose safeguarding concerns to the child;
  • Any services already provided by Together for Children Sunderland e.g. Residential or Outreach support services.


9. 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.


10. Decisions Not to Make Direct Payments

Where Together for Children Sunderland decides not to make Direct Payments it must inform in writing the child’s parent or the young person of its decision and reasons and the right to request a review of the decision.


11. Monitoring and Review of Direct Payments

Together for Children Sunderland 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. These reviews will take place at the Children with Disabilities Placement and Resource Panel and will be reviewed subsequently following the first review at a minimum of six monthly intervals. In addition, a recipient may make a request for Together for Children Sunderland to review the making and use of Direct Payments and Together for Children Sunderland must then consider whether to carry out a review (see also Section 7, Hospital Stays).

When carrying out a review, Together for Children Sunderland 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;
  • That any direct payments not used for the purpose agreed must be claimed back from Penderels Trust or the individually managed direct payments account.

Following a review Together for Children Sunderland 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 Together for Children Sunderland considers necessary.
  • Stop making Direct Payments;
  • The Parent or child if over the age of 16 years old, must be notified of the decision of the Placement and Resource Panel by the Social worker within 24 hours of the decision being made.


11. Reducing the Amount of Direct Payments

Direct payments are subject to assessment and review.

Where Together for Children Sunderland 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.

Together for Children Sunderland 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, Together for Children Sunderland 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. Together for Children Sunderland may reduce Direct Payments following reasonable notice despite the fact that a request for reconsideration has been made.


12. Repayment and Recovery of Direct Payments

Together for Children Sunderland 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 Social Worker, following consultation with the recipient, will liaise with Penderels Trust and establish if there are monies to be paid back. If it is identified that there are monies to be paid back to Together for Children Sunderland, Penderels Trust or the person responsible for managing the direct payment account will send the amount back to Together for Children Sunderland Finance Team.

Together for Children Sunderland 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, Together for Children Sunderland 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).

Together for Children Sunderland may only seek repayment of any portion of the Direct Payments that has not already been spent on the agreed provision.


13. Ceasing Direct Payments

Together for Children Sunderland must stop making Direct Payments if:

  • The recipient has notified Together for Children Sunderland 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 Together for Children Sunderland 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 Together for Children Sunderland becomes aware that the making of Direct Payments is:
    • Having an adverse impact on other services which Together for Children Sunderland provides or arranges for children and young people with an Education, Health and Care Plan which Together for Children Sunderland maintains; or
    • No longer compatible with Together for Children Sunderland 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 Together for Children Sunderland of their consent.

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

Together for Children Sunderland 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, Together for Children Sunderland 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