Direct Payments

1. Using this Procedure

Sections 2, 3, 4 and 10 apply to all practitioners working across all areas of Adult Care and Support.

All other sections of the procedure should be used:

  1. By frontline practitioners working in social work teams; when
  2. A Care and Support Plan/Support Plan has been signed off; and
  3. A Direct Payment is to be arranged; to
  4. Understand and use the local process for arranging a Direct Payment; and
  5. Work effectively alongside both the Direct Payment Support Service and the Payments and Provider Maintenance Team.
Although this procedure may be helpful to those people based within the Direct Payment Support Service or the Payments and Provider Maintenance Team, it does not provide specific guidance about the role of those teams in arranging, monitoring or reviewing Direct Payments, or any other associated actions that may be required. Anyone carrying out such actions should refer to available local processes.

2. Promoting Direct Payments

The Care Act expects you to promote the use of Direct Payments. This means that whenever you identify that a Direct Payment may be an appropriate way to manage all (or part) of a personal budget you should discuss the benefits of doing so and support access to a Direct Payment.

This could apply:

  1. When giving information and advice at any time;
  2. During initial discussions about how eligible needs could be met;
  3. When Care and Support Planning/Support Planning;
  4. During statutory reviews; or
  5. Throughout any process of monitoring.

3. Providing information and Advice about Direct Payments

General information and advice

You are expected to be able to provide general information and advice about Direct Payments whenever:

  1. A person/carer asks for it (reactive); or
  2. You have identified a need for it (proactive).

The following is a list of all the information that you should be able to provide:

  1. When a Direct Payment can/cannot be provided;
  2. How a Direct Payment can/cannot be used;
  3. Who can/cannot manage a Direct Payment;
  4. The process of arranging a Direct Payment;
  5. How often a Direct Payment is normally paid;
  6. How any assessed financial contributions should be made;
  7. Where prepaid cards are appropriate, how they work; and
  8. How Direct Payments are monitored and reviewed.

This procedure will support you to provide general information and advice about the process of arranging, monitoring and reviewing a Direct Payment.

'Direct Payments-A Route to Independence' is a local information resource that can be emailed or given to anyone who is interested in having a Direct Payment. It can be found in the Local Resource area by clicking here.

In the Local Resources area you will also find a Flowchart setting out the different methods of managing a Direct Payment and the circumstances when each method can/cannot be used. This includes Virtual Wallet, prepaid cards, payments to a High Street bank and council management.

Details about when a Direct Payment can/cannot legally be provided, and how it can be used is available within the 'Direct Payments' section of the Care Act resource, which can be accessed by clicking here.

If you require any further support you should:

  1. Speak to your line manager; or
  2. Contact a practitioner from the Direct Payments Support Service.

The Direct Payments Support Service can be contacted via email at direct.payments@croydon.gov.uk.

Virtual Wallet Support Team:
info@myvirtualwallet.co.uk
03300582692

Information and advice about employing a Personal Assistant

Although you are expected to provide general information and advice about Direct Payments you are not expected to be able to provide specific information or advice about employer liabilities and responsibilities where a person intends to employ a Personal Assistant.

Where such information or advice is required you must however take steps to ensure that the person/carer has access from:

Independent Lives
advice@independentlives.org
01903219482

Consent

If you find yourself providing information and advice that is specific to the circumstances of a particular person/carer, you must consider who you are providing it to, and whether it is appropriate to provide it to them.

Normally it will only be appropriate to provide this information to:

  1. The person/carer; or
  2. Somebody else where clear consent of the person/carer has been given; or
  3. Where the person lacks capacity, a Deputy appointed by the Court of Protection to make decisions about financial matters; or
  4. Where the person lacks capacity, a Donee of a Lasting Power of Attorney who is authorised to make decisions about financial matters; or
  5. Where the person lacks capacity, and there is no Deputy or Donee a person that you deem it in their Best Interests to provide the information to.

Accessibility

All information and advice that you provide must be given in a way that the person/carer receiving it will best be able to understand and use. This is a legal requirement of the Care Act.

Click here to read more about how to provide information in an accessible way under the Care Act.

If you provide information and advice but feel that person/carer for whom it is intended will need additional support to understand it then you should consider:

  1. Whether the information can be provided in a different way;
  2. Whether you can take any additional steps to support the person/carer to understand it (for example talking through the information on the telephone or in person);
  3. Whether it would be appropriate to appoint an independent advocate to support the person/carer to understand and use the information.
Need to Know
For the sole purpose of understanding information and advice there is no duty under the Care Act to provide an independent advocate. This must be a local decision, taking into account the available evidence and presenting circumstances. If you are not clear what the local arrangements are for the provision of independent advocacy for information and advice you must speak with your line manager before making a referral.

4. Direct Payments and Mental Capacity

General guidance

A person who lacks capacity to request or manage a Direct Payment is still legally entitled to receive one as long as:

  1. A legally authorised person has deemed it in their Best Interests (a Deputy or a Donee of a Lasting Power of Attorney); or
  2. Where no legally authorised person exists, you deem it to be in their Best Interests; and
  3. There is a suitable person available to receive and manage the Direct Payment.
Need to Know
A suitable person is a person who;
  1. Is willing to receive and manage the Direct Payment; and
  2. Is capable of managing the Direct Payment; and
  3. Is deemed likely to arrange support and services that are in the Best Interests of the person.

Before proceeding to arrange the Direct Payment you should check that your manager is in agreement that the person proposed as a suitable person is such.

When an agreement is reached about their suitability this should be:

  1. Confirmed in writing to that person; and
  2. Recorded in the Personal Budget.

The suitable person should, wherever possible be involved in the development of the care and support plan. During this process, give the suitable person information regarding the direct payments processes, as well as information and advice on using and managing the direct payment, so that they understand their legal obligations to act in the best interests of the person requiring care and support.

Fluctuating capacity

If a person has fluctuating capacity a suitable person must be appointed to receive and manage the Direct Payment but:

  1. The suitable person must agree to the person with Care and Support needs making decisions about how the Direct Payment is used during periods where they have capacity to do so; and
  2. You must be satisfied that this is going to be the case before arranging the Direct Payment.

Monitoring a suitable person

You must make appropriate and proportionate arrangements to monitor the Direct Payment when you have concerns that a suitable person:

  1. May not be able to manage the Direct Payment; and/or
  2. May not arrange support and services that are in the Best Interests of the person; and/or
  3. Where the person has fluctuating capacity, may not permit them to make their own decisions about how the Direct Payment is used when they have capacity to do so.

Click here to access the procedure for monitoring a Direct Payment.

5. Nominating a Third Party

A person with capacity may wish to nominate a third party to manage the direct payments on their behalf. For example, if they have a physical disability that makes doing so problematic.

In this case you should consider any circumstance where it would not be appropriate for a third party to be involved, for example, the nominated person may not wish it, or there may be conflicting interest, or the person requested to assist may live too far way for it to be practicable.

In any case make it clear that if the person does choose to have a third party manage the direct payment for them and if the third party misuses the payment, the ultimate responsibility lies with the person themselves, not the third party.

Before proceeding to arrange the Direct Payment you should check that your manager is in agreement that the third party is suitable to manage the direct payment.

When an agreement is reached about the suitability of a third party this should be:

  1. Confirmed in writing to that person; and
  2. Recorded in the Personal Budget.

Where a third party person is going to be managing the direct payment, wherever possible involve them in the development of the care and support plan, as long as the person with support needs agrees to this. During this process, give the third party information regarding the direct payments processes, as well as information and advice on using and managing the direct payment, so that they understand their legal obligations as the direct payment recipient, including the need to ensure that the person remains in control about how the direct payment will be spent.

6. Before Arranging a Direct Payment

In all circumstances

Before arranging a Direct Payment you must be satisfied that all of the following apply:

  1. The person with Care and Support needs is not excluded from receiving a Direct Payment under the Care Act; and
  2. Where the person receiving or managing the Direct Payment is the person with Care and Support needs, they are capable of managing it (with or without support); or
  3. Where the person receiving or managing the Direct Payment is not the person with Care and Support needs, they are willing and capable of managing it; and
  4. Where the person with Care and Support needs lacks capacity, the Direct Payment will be used by the suitable person to arrange services that are in their Best Interests; and
  5. The Direct Payment is the most appropriate way of arranging the required support or services; and
  6. If the Direct Payment will be used to employ a Personal Assistant, that employer related costs have been taken into account; and
  7. The Direct Payment will not be used to pay for Care and Support provided by a relative living in the same household; unless
  8. This has been agreed through the Care and Support Plan sign-off process.

Note: For guidance about the 4 consecutive weeks in a care home rule see 'Needs that May Not be Met by a Direct Payment'

Need to Know
A Direct Payment cannot be provided to meet the needs of any person who is subject to a requirement, license or order under criminal legislation that requires them to undertake drug or alcohol rehabilitation, behaviour therapy or testing.
Need to Know
A Direct Payment does not have to be provided when;
  1. It is more cost effective for the Local Authority to commission the required service directly; so long as
  2. This does not have a negative impact on any flexible manner in which the service needs to be provided.

If you have any doubts about any of the above conditions you should:

  1. Seek the support and advice of your manager; or
  2. Seek advice from the Direct Payments Support Service; and
  3. Consider the need to apply or recommend that conditions are placed on the Direct Payment; or
  4. Consider the need to make appropriate and proportionate arrangements to monitor the Direct Payment.

Click here to access the procedure for monitoring a Direct Payment.

Direct Payments to purchase Section 117 After-Care

If a person is to be provided with Section 117 After-Care under the Mental Health Act 1983 they are legally entitled to receive a Direct Payment, and to use the Direct Payment to purchase After-Care so long as all of the above conditions apply.

Direct Payments if the person already has a Health Direct Payment

If the person with Care and Support needs already has a Health Direct Payment you should:

  1. Speak to your manager; and
  2. Explore whether the two Direct Payment's can be provided as a single payment; and
  3. If so, follow any local processes for arranging this; but
  4. If not, arrange for a separate Local Authority Direct Payment in the normal way.

7. Arranging a Direct Payment

When to use this section of the procedure

This section of the procedure should be used when:

  1. A person or carer has requested a Direct Payment; or
  2. You have deemed it to be in their Best Interests; and
  3. You are satisfied that there is no reason why the person, their nominated representative or a suitable person (if they lack capacity) should not receive a Direct Payment; and
  4. The Care and Support Plan/Support Plan has been signed off.

Applying and recommending conditions

The Local Authority is legally permitted to place conditions on a Direct Payment if it feels it necessary and appropriate to do so. These include:

  1. Prohibiting a named individual from providing care; and
  2. That certain information must be provided to enable effective monitoring.

Indicators that conditions may be required include concerns about:

  1. A person's ability to receive or manage the Direct Payment (even with support);
  2. The ability of the person's nominated representative or a suitable person (if they lack capacity) to manage the Direct Payment;
  3. Whether the suitable person will arrange services based on what is in the person's Best Interests;
  4. If the person has fluctuating capacity, whether the suitable person will permit them to manage the Direct Payment when they have capacity to do so; and
  5. The Direct Payment being used to purchase care from a family member living in the same household (without agreement to do so).

If you feel that it is necessary and appropriate for a condition to be placed on a Direct Payment you should:

  1. Seek the advice of your manager; and
  2. If they are in agreement, advise both the Direct Payments Support Service and the Payments and Provider Maintenance Team of the condition that is to be applied; and
  3. Make appropriate arrangements to monitor that the condition is met; or
  4. If the condition relates to the provision of information to the Payments and Provider Maintenance Team, recommend that the Payments and Provider Maintenance Team apply and monitor the condition.
Need to Know
Even though a condition can prohibit a named individual from providing care using the Direct Payment the Local Authority cannot dictate who should provide the care.

The process of arranging a Direct Payment

Checking the Care and Support Plan/Support Plan

Firstly double check the Care and Support Plan/Support Plan to make sure it is clear:

  1. Which outcomes the Direct Payment will be used to meet;
  2. The gross amount of Direct Payment agreed (the cost before the financial contribution is taken into account);
  3. The actual amount of Direct Payment to be paid (the gross amount less the person or carers financial contribution); and
  4. The amount that the person or carer will need to contribute (the financial contribution amount).

Signing the Direct Payments Checklist

When the Care and Support Plan/Support Plan has been checked the Direct Payments Checklist must be completed.

Depending on the person's capacity and who will be managing the Direct Payment this should be completed with either:

  1. The person only; and/or
  2. The person and the third party they have nominated; or
  3. The suitable person only.

The Direct Payments Checklist should then be signed by all parties, and each should be provided with a copy.

Need to Know
Where a third party or suitable person is signing the checklist it is important to verify their identity and/or legal authority e.g. by seeing a driving license, passport or Lasting Power of Attorney.

Referring to the Direct Payments Support Service

When the Direct Payments Checklist is signed this should be filed, and a referral made to the Direct Payments Support Service who will continue and finalise the process of arranging the Direct Payment.

The referral should include details of the approved weekly personal budget and the outcome of the financial assessment. Without this information it cannot be allocated to a Direct Payments Support Service advisor.

You should explain to the person or carer that the Direct Payments Support Service will complete the process, which will include:

  1. Agreeing how and when the Direct Payment will be provided;
  2. Reiterating and answering any queries about how the Direct Payment can be used, and what records need to be made; and
  3. Where applicable, providing information and advice about employing a personal assistant.

Direct Payments Support Service processes

The procedures and processes for the Direct Payments Support Service can be found in the Local Resources area of this procedures site by clicking here.

8. Delays

Delays in arranging the Direct Payment

Delays in arranging the Direct Payment must not lead to delays in the meeting eligible needs.

If a delay in arranging the Direct Payment occurs you must:

  1. Seek the support and advice of a manager as required; and
  2. With the agreement of the person (or in their Best Interests if they lack capacity) refer to the relevant sections of the Commissioning and Brokerage procedure; to
  3. Arrange any interim services that are required, ensuring that the statutory obligations of the Local Authority are met.

Click here to access the Commissioning and Brokerage Procedure.

Delays in employing a Personal Assistant or arranging services

The duty to meet eligible needs is not discharged until:

  1. The Direct Payment is being provided; and
  2. Services and support to meet eligible needs is in place.

If there are delays in employing a Personal Assistant or arranging the required service you should consider whether:

  1. You are able to support in the arrangement of a service; or
  2. Other support can be provided (for example an advocate); or
  3. An independent person or organisation can support in the recruitment of a Personal Assistant.

If a delay persists you must:

  1. Seek the support and advice of a manager as required; and
  2. With the agreement of the person (or in their Best Interests if they lack capacity) refer to the relevant sections of the Commissioning and Brokerage procedure; to
  3. Arrange any interim services that are required, ensuring that the statutory obligations of the Local Authority are met.

Click here to access the Commissioning and Brokerage Procedure.

Any interim services should be commissioned by the Local Authority, and an adjustment should be made to any future Direct Payment paid to the person.

9. Monitoring how a Direct Payment is used

The Payment and Provider Maintenance Team undertake quarterly financial monitoring on all adult direct payments paid to self-managed direct payments accounts held with a high-street bank.

When additional monitoring may be needed

Appropriate and proportionate additional arrangements to monitor how the Direct Payment is being used should be considered when:

  1. A one-off Direct Payment has been provided to make a specific single purchase; or
  2. Conditions have been placed on the Direct Payment; or there are concerns about
  3. Delays in arranging services and support to meet eligible needs; or
  4. A person's ability to receive or manage the Direct Payment (even with support);
  5. The ability of the person's nominated representative or a suitable person (if they lack capacity) to manage the Direct Payment;
  6. Whether the suitable person will arrange services based on what is in the person's Best Interests;
  7. If the person has fluctuating capacity, whether the suitable person will permit them to make their own decisions about how to use the Direct Payment when they have capacity to do so; and
  8. The Direct Payment being used to purchase care from a family member living in the same household (without agreement to do so).

Agreeing your role

Your role in monitoring the Direct Payment should be:

  1. Agreed by your manager; and/or
  2. Agreed with the Payments and Provider Maintenance Team; and
  3. Clearly recorded.

Depending on the nature of what is being monitored, it may be more appropriate for monitoring activity to be completed by the Direct Payments Support Service.

(One role of the Direct Payments Support Service could be to help the person prepare their quarterly returns for submission to the Finance Team).

When you have been tasked with monitoring how a Direct Payment is being used part of this monitoring should involve checks with the Payments and Provider Maintenance Team that the money is being spent appropriately through the quarterly returns.

The Payments and Provider Maintenance Team can be contacted at SwiftPaymentTeam@croydon.gov.uk.

Recording monitoring activity

All monitoring activity should be recorded within the timeframes set out in the Local Standards of Timeliness of Recording. This can be found in the Local Resources area by clicking here.

The person undertaking monitoring activity is responsible for recording it. Where applicable this includes both the Direct Payments Support Service and the Payments and Provider Maintenance Team.

Any monitoring activity that you carry out should be clearly recorded. In particular the following should be recorded:

  1. Whether any specific item to be purchased with a one-off Direct Payment has been purchased as intended;
  2. Whether concerns remain/exist;
  3. Whether on-going monitoring activity is required;
  4. Whether the on-going Direct Payment remains appropriate.
If monitoring raises further concern about the appropriateness of the Direct Payment (or the abilities person receiving it) you should refer to the procedure for raising concerns about an existing Direct Payment, which can be accessed by clicking here.

10. Concerns about an Existing Direct Payment

The following are some of the concerns that could exist regarding a Direct Payment:

  1. The person does not appear to be able to receive or manage the Direct Payment appropriately (even with support);
  2. The person's nominated representative or a suitable person (if they lack capacity) does not appear able to manage the Direct Payment;
  3. The suitable person is not arranging services based on what is in the person's Best Interests;
  4. If the person has fluctuating capacity, the suitable person is not permitting them to make their own decisions about how to use the Direct Payment when they have capacity to do so; or
  5. The Direct Payment is being used to purchase care from a family member living in the same household (without agreement to do so).

Concerns about an existing Direct Payment can arise at any time and, if you are working with a person who is using a Direct Payment you should:

  1. Have conversations about how the Direct Payment is working as and when you feel they are required (not just during statutory reviews); and
  2. Be vigilant to some of the possible concerns that could arise; and
  3. Ensure that they are reported to the person best placed to respond (if this is not you).

Concerns can also be identified and raised by:

  1. The person with Care and Support needs;
  2. The person receiving or managing the Direct Payment (if not the person with Care and Support needs);
  3. The Direct Payments Support Service;
  4. The Payments and Provider Maintenance Team;
  5. A healthcare professional (e.g. a community or district nurse);
  6. Another social care professional or practitioner (for example an Occupational Therapist or reablement worker);

If you identify, or become aware of any concerns you must:

  1. Record the concerns and the evidence for them;
  2. Seek the support and advice of your line manager as required;
  3. Take steps to resolve any issues that you are able to resolve;
  4. Notify your line manager of the concerns and action taken (if not already done so when first identified); and
  5. Seek support from the Direct Payments Support Service where appropriate; and
  6. Notify the Payments and Provider Maintenance Team if matters cannot be resolved without their involvement.

Ultimately the team with responsibility for reviewing the Care and Support Plan (or Carer's Support Plan) should decide (in consultation all those involved) the best course of action to take, which could include:

  1. Placing a condition on the Direct Payment;
  2. Increased monitoring activity;
  3. Variation of the Direct Payment;
  4. Suspension of the Direct Payment; or
  5. Withdrawing the Direct Payment.
Click here to access the procedure for varying, suspending or ending a Direct Payment.

11. Reviewing a Direct Payment

Using this section of the procedure

This section of the procedure should be used when carrying out the statutory review of:

  1. An on-going Direct Payment made to a person with Care and Support needs (or a carer with Support needs); or
  2. A one-off Direct Payment being used across the year (rather than to purchase a specific item).

If a one-off Direct Payment has been provided to purchase a specific item appropriate arrangements should be made to monitor whether the item has been purchased as intended soon after the payment was provided.

The timing of a Direct Payment Review

Initial reviews of a Direct Payment must take place no later than 6 months after the first payment is made.

Further reviews must take place no less than every 12 months after that.

It is prudent to carry out more frequent reviews when:

  1. There are conditions placed on the Direct Payment; or
  2. The Direct Payment is being monitored because there are concerns.

Unscheduled Reviews

Upon commencement of the Direct Payment the person/carer or any suitable person or third party receiving/managing it should be advised to notify the council of any change in circumstances that could affect the Direct Payment.

An unscheduled review should be triggered when:

  1. A change in the person/carer's circumstances has been reported and a Direct Payment may no longer be suitable; or
  2. Monitoring activity has identified an issue or concern; or
  3. The person/carer wants to end, decrease or increase the Direct Payment; or
  4. A third party or suitable person no longer wishes to receive/manage the Direct Payment.

An unscheduled review is not required when the person is admitted to hospital unless they no longer wish to use a Direct Payment or this may no longer be suitable. In all other cases amendments can be made in line with the terms of the Direct Payment Agreement (see Varying, Ending or Suspending a Direct Payment).

Combining a Direct Payment Review with another review

If you are carrying out the Direct Payment review you should make arrangements to do so alongside any other statutory review that is taking place at that time, unless there is a valid reason not to do so.

This includes the review of:

  1. A Care and Support Plan;
  2. A Support Plan; or
  3. An Education, Health and Care Plan (EHC Plan).

The purpose of a Direct Payment review

The purpose of the review is to:

  1. Reflect on what is working and not working about the Direct Payment;
  2. Consider what may need to change about the Direct Payment;
  3. Make sure the Direct Payment remains the most appropriate way to provide the required services; and
  4. Make sure the Direct Payment is supporting the person/carer to meet their outcomes as intended.

In order to achieve its purpose the following must all be reviewed:

  1. How well the process of receiving payments is working;
  2. How well the Direct Payment is being managed;
  3. Whether records required by the Local Authority are being maintained by the person receiving/managing the Direct Payment;
  4. Whether information is being provided to the Local Authority as required;
  5. Whether the Direct Payment is being used as anticipated;
  6. Whether the Direct Payment is supporting the person/carer to meet the outcomes in their Care and Support Plan/Support Plan.

If the person employs a personal assistant

If the person employs a personal assistant, before carrying out the review you should request the quarterly returns from the Payments and Provider Maintenance Team and check them for any signs that they may not be complying with their responsibilities as an employer around tax, national insurance and pensions. E-mail: pre-paid.cards@croydon.gov.uk.

The Payments and Provider Maintenance Team can be contacted at SwiftPaymentTeam@Croydon.gov.uk.

As part of the review conversation you should:

  1. Discuss any anomalies in the quarterly returns; and
  2. Review the employee contract to make sure it includes terms and conditions around pay, holidays, notice and disciplinary procedures; and
  3. Review mechanisms used to ensure the health and safety of any personal assistant.

Where appropriate support should be requested from the Direct Payment Support Service to help resolve issues and get things back on track.

Who must be involved

There is a legal requirement to involve the following people in a Direct Payment review:

  1. The person receiving Care and Support; or
  2. The carer receiving Support;
  3. Any carer the person has;
  4. The person to whom the payments are being made (if this is not the person receiving Care and Support or the carer);
  5. Any person who is providing administrative or management support;
  6. Anybody the person asks the Local Authority to involve;
  7. In the case of a person who lacks capacity, anybody authorised by the Mental Capacity Act to make decisions about Care and Support provided to the person (a Deputy of Power of Attorney); or
  8. Where no authorised person exists, anybody the Local Authority deems to be interested in their welfare.

The role of the Payments and Provider Maintenance Team and Direct Payments Support Service

It is not possible to carry out a Direct Payment review without the involvement of the Payments and Provider Maintenance Team because they are the only people who will be able to provide information about:

  1. Whether records required by the Local Authority are being maintained by the person receiving/managing the Direct Payment; and
  2. Whether information is being provided to the Local Authority as required.

They may also have been involved in monitoring existing concerns, or have gathered other information that may be prudent to any decision about the on-going appropriateness of the Direct Payment.

If the Direct Payment Support Service including Independent Lives, have been involved in monitoring the Direct Payment or helping the person understand and comply with employer responsibilities they should also be involved in the review.

There are a number of options for involving either team in the review, ranging from:

  1. Consultation only; to
  2. A full joint review.

The nature of the Payments and Provider Maintenance Team and the Direct Payment Support Service in the review will depend on:

  1. The complexity of the Direct Payment;
  2. The existence of any concerns or conditions; and
  3. Should be agreed in advance with them.

Light touch reviews

It is possible to carry out a light touch review of the Direct Payment (even if any other review is not light touch), so long as:

  1. The person (or their representative) is happy to continue using and managing the Direct Payment;
  2. The Direct Payment remains an appropriate way to meet the eligible needs identified in the Care and Support Plan; and
  3. The Local Authority has no concerns about how the Direct Payment is being managed or used.

In order for the outcome of a light touch Direct Payment review to be sufficient you must be satisfied that the Direct Payment is:

  1. Appropriate to meet the needs set out in the Care and Support Plan;
  2. Being well managed;
  3. Being used appropriately to meet the needs and outcomes identified in the Care and Support Plan.

Using the Care and Support Plan/Support Plan review procedures

You should refer to the Care and Support Plan/Support Plan review procedures in your team's area of this site for general advice about:

  1. Arranging reviews;
  2. Gathering and using information;
  3. Using advocacy;
  4. Deciding the method of review;
  5. Having effective review conversations; and
  6. To ensure that all requirements of any other statutory review being carried out at the same time are met.

Deciding the outcome of the review

Possible outcomes

There are 4 possible outcomes following a Direct Payment review:

  1. No changes required to the Direct Payment;
  2. Changes to one or more element of the Direct Payment;
  3. Suspension of the Direct Payment; or
  4. Termination of the Direct Payment.

If the person is experiencing difficulty managing their responsibilities as an employer it may also be an outcome to request support from the Direct Payment Support Service to help resolve issues and get things back on track.

Deciding the outcome

Throughout the process of review you should talk to the person (or their representative)/ carer and others involved about the likely outcome of the review, endeavouring to reach an agreement about this as the process progresses.

The Local Authority is however responsible for making the final decision about the outcome of the review. This is a decision that you should make:

  1. In agreement with the Direct Payments team; and always with regard for
  2. The views of the person/carer about the outcome;
  3. The impact of the outcome on the person/carer's Wellbeing; and
  4. The views of anyone else consulted in the process.

The decision that you make about the outcome of the review must be evidence based and robust. This means you must be able to demonstrate the information that you have used to reach a decision if challenged.

Managing disagreement about the outcome

There may be times when the person/ carer, their representative or another person disagrees with the decision that has been made about the outcome of the review.

In this situation you should be open to reviewing the available evidence to ensure that the decision is robust. You should be open and transparent about the evidence sources you have used and take steps to try and support the person/carer to understand the decision you have made.

Where ongoing disagreement persists you should make the person (or their representative)/ carer aware of their right to complain about the decision that has been made.

People and carers can be directed to the Croydon Council website for information about the adult social care complaints process.

Click here to read the complaints policy and procedure.

Making a formal record of the review

Wherever possible, you should make a formal record of the review as part of the formal record of any other statutory review that is taking place at that time, unless there is a valid reason not to do so.

This includes the review of:

  1. A Care and Support Plan;
  2. A Support Plan; or
  3. An Education, Health and Care Plan (EHC Plan).

You are responsible for establishing:

  1. The current review framework used by your team for recording purposes; and
  2. The timeframe for making a formal record; and
  3. Any particular local requirements for recording a Direct Payment review.

If you are unclear you should speak to your line manager before proceeding to make a formal record of the review.

The following information about the Direct Payment should be clearly but proportionately recorded:

  1. Any issues or concerns about how the processes of receiving and managing payments is working;
  2. Whether records required by the Local Authority are being maintained by the person receiving/managing the Direct Payment;
  3. Whether information is being provided to the Local Authority as required;
  4. Whether the Direct Payment is being used as anticipated;
  5. Whether the Direct Payment is supporting the person/carer to meet the outcomes in their Care and Support Plan/Support Plan;
  6. Whether the Direct Payment is still the most appropriate way to meet the person/carer's eligible needs;
  7. Whether any changes are required to the Direct Payment; and
  8. Whether the Direct Payment will continue;
  9. The views of the person/carer and the person receiving/managing the Direct Payment about all of the above.

The person/carer and anybody responsible for receiving or managing the Direct Payment must be provided with a copy of the formal record.

Actions following the review

Deciding the timeframe for the next review

If the Direct Payment is to continue the next statutory review must be carried out within 12 months. However, the date can be earlier and decisions about the timeframe must consider:

  1. The need to monitor any aspect of the Direct Payment;
  2. When other statutory reviews are scheduled to take place (as a combined review should be arranged wherever possible);
  3. Whether the Care and Support Plan/Support Plan is stable.

The agreed timeframe for the next review should be clearly recorded on the formal review record and any Care and Support Plan/Support Plan.

If you are unclear about an appropriate timeframe for review you should:

  1. Seek the advice of your line manager; and
  2. Obtain the views of the Payments and Provider Maintenance Team.

Monitoring

Click here to access the procedure for arranging monitoring.

Varying, Suspending or Ending a Direct Payment

Click here to access the procedure for varying, suspending or ending a Direct Payment.

Reimbursement of unused monies

If there are monies in the Direct Payment account that have been paid but not used you should discuss this with your line manager and the Payments and Provider Maintenance Team to make a decision about reclaiming the money.

12. Varying, Suspending or Ending a Direct Payment

Varying a Direct Payment

Variations to a Direct Payment include:

  1. The addition or removal of a condition;
  2. An increase in the Direct Payment paid;
  3. A decrease in the Direct payment paid;
  4. A change to the person receiving or managing the Direct Payment.

Note: Before any increase is implements you should check with the Finance Team to make sure monies have been used appropriately, and also seek any additional funding agreement that may be required.

Temporary variations for hospital admissions

In line with the terms of the Direct Payments Agreement if the person has been in hospital for more than 2 weeks the Direct Payment should be reduced by 50% for a period of 2 further weeks, after which the payment will be suspended.

To request the variation contact the Payments and Provider Maintenance Team.

Contact SwiftPaymentTeam@Croydon.gov.uk or Direct Payment Support Service at: pre-paid.cards@croydon.gov.uk.

Suspending a Direct Payment

A Direct Payment may be suspended when there are concerns about:

  1. A person's ability to receive or manage the Direct Payment (even with support); or
  2. The ability of the person's nominated representative or a suitable person (if they lack capacity) to manage the Direct Payment; or
  3. Whether the suitable person will arrange services based on what is in the person's Best Interests; or
  4. If the person has fluctuating capacity, whether the suitable person will permit them to manage the Direct Payment when they have capacity to do so; or
  5. The Direct Payment being used to purchase care from a family member living in the same household (without agreement to do so); but
  6. It is felt that with some support the issues can be resolved and the Direct Payment resumed.

In line with the terms of the Direct Payments Agreement payments should also be suspended if the person has been in hospital for more than 4 weeks.

To request a suspension contact the Direct Payment Support Service at: pre-paid.cards@croydon.gov.uk.

The following must be clearly recorded:

  1. The reason that the Direct Payment has been suspended;
  2. How long the Direct Payment is likely to be suspended for; and
  3. How the situation will be monitored or reviewed.

Arranging alternative services and support

If a Direct Payment is suspended the duty to meet eligible needs for Care and Support/Support still applies. This means you must:

  1. Seek the support and advice of a manager as required; and
  2. Refer to the relevant sections of the Commissioning and Brokerage procedure; to
  3. Arrange any interim services that are required, ensuring that the statutory obligations of the Local Authority are met.

Click here to access the Commissioning and Brokerage Procedure.

Investigating potential fraud

If there is evidence that money is being used inappropriately you must make a referral to the Corporate Anti-Fraud Team (CAFT). The Direct Payment must not be recommenced until the outcome of their investigation is known.

Ending a Direct Payment

The Direct Payment must be ended if:

  1. The person/carer no longer wishes to revive the Direct Payment (when it is being paid to them and they have capacity to make this decision); or
  2. The person/carer becomes subject to a requirement, license or order to undergo drug or alcohol rehabilitation, behaviour therapy or testing; or
  3. A person with Care and Support needs moves into a care home; or
  4. The carer is no longer a carer as defined in the Care Act;
  5. The person/carer receiving the Direct Payment dies.

The Direct Payment must also be ended if any of the following situations apply and no resolution to continue the Direct Payment can be found:

  1. The person managing the Direct Payment has breached a condition of the Direct Payment Agreement;
  2. The person managing the Direct Payment has not been using the Direct Payment to meet eligible needs;
  3. The person with Care and Support needs has become permanently incapacitated and there is no suitable person to manage the Direct Payment;
  4. The Direct Payment is being used to pay for a family member living in the same household to provide care without prior agreement;
  5. A Direct Payment is no longer deemed the most effective way to meet the person/carer's needs.

To request a Direct Payment is ended, contact the Direct Payment Support Service at pre-paid.cards@croydon.gov.uk.

Arranging alternative services and support

If a Direct Payment is suspended the duty to meet eligible needs for Care and Support/Support still applies. This means you must:

  1. Seek the support and advice of a manager as required; and
  2. Undertake further Care and Support Planning/Support Planning as required; and
  3. Refer to the relevant sections of the Commissioning and Brokerage procedure; to
  4. Arrange any alternative services that are required, ensuring that the statutory obligations of the Local Authority are met.

Click here to access the Commissioning and Brokerage Procedure.

Reporting potential fraud

If there is evidence that money is being used inappropriately you must make a referral to the Corporate Anti-Fraud Team (CAFT) for full investigation.

Reimbursement of unused monies

If there are monies in the Direct Payment account that have been paid but not used you should discuss this with your line manager and the Payments and Provider Maintenance Team to make a decision about reclaiming the money.