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4.3.2 Direct Payments


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


Click here to view the Direct Payment Flow Chart


In July 2016 this chapter was given a general refresh throughout, and a new Section 7, Hospital Stays was added.


  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

1. What are Direct Payments?

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 the authority to enable them to buy in support that is assessed as being needed, instead of the authority providing that support through their own services i.e. residential care or outreach services. Direct Payments do not affect benefits.

2. Who can get Direct Payments?

Those who have been assessed as meeting the criteria for the receipt of services and are:

  • Parents of a child with disabilities under 18;
  • Young people with disabilities (16-18).

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 regularly basis according to the assessed need. For example, if the direct payment is assessed as being needed at key times e.g. school holidays, then payment will be made accordingly.

4. What is the Process?

  • The child and/or family's needs are first assessed by a Social Worker;
  • As well as completing an Initial Assessment of Need, they will also make an assessment as to whether the parent/carer or young person is willing and able to administer direct payments, with appropriate support being provided;
  • The Social Worker will then present a request to a Resource Panel of Managers and service providers who will decide whether Direct Payments are the most appropriate option to meet the need and how the funds should be allocated;
  • Once agreed, the Direct Payment Manager will contact the person concerned to explain how the scheme works and draw up a 'Letter of Agreement', discuss any PA recruitment needs and initiate direct payments with the finance team;
  • A Direct Payments Advisor will then visit to explain in detail  the responsibilities of the recipient of the direct payment as an employer and will continue to give on-going support and advice as required;
  • Ongoing review of the direct payment will be made jointly between the Direct Payment Advisor and the social worker to ensure the needs of the child continue to be met and the money administered appropriately;
  • Those direct payments not used within a three month period will be returned to the Local Authority.

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 for a short break.

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 child with disabilities;
  • Residential overnight breaks for your child with disabilities;
  • By agreement with the Team Manager for direct payments, any service which meets your assessed need for a short break.

7. Hospital Stays

It could well be that those in receipt of Direct Payments require stays in hospital. This would 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. 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, the local authority 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.

7. Direct Payments Can Not be Spent On

  • Employing someone without DBS and CPR checks or references;

  • Permanent residential accommodation, though they can be used for occasional short breaks, if the local authority agrees, for up to 120 days in any 12 month period. (Note: where two periods of short –term care are 4 weeks or less apart, then the cumulative total of the stays should be added and not exceed  4 weeks if the stay  is to be funded by Direct Payments).

8. 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. Payments made do not affect welfare benefits.