Direct payments were brought in to help people have more control over their care. I have found them to be really helpful and a much better alternative to agency-led care. They’ve allowed me to have a more “normal” life. Yes I too HATE that word. But, doing what I want, when, where and how I want, like the adult I am, shouldn’t be a revolutionary idea. Direct payments make that a reality.
What are direct payments?
Direct payments are usually made to cover someone’s care and sometimes to help to pay towards equipment. For many, it gives a lot more control over how and who provides their care. It does come with some responsibilities too, so it isn’t for everyone. They are different to personal health budgets. They are just for health care rather than social care and are supplied by the NHS not social services.
Who can get direct payments?
Anyone that has eligible care needs and has had a full needs assessment and isn’t living in a care home. You also need to have the capacity to make informed decisions, and be able to deal with some paperwork. Parents of children who have had a needs assessment can also apply for direct payments.
How do I get direct payments?
You would need to have a full needs assessment completed by a social worker. If you’ve already had one and are currently receiving care, contact your social worker.
Direct payments are paid into a bank account which is only to be used for direct payments, or onto a pre-paid card. How much you will get depends on your care needs and the result of a care act needs assessment.
Does it affect any benefits I receive?
Not directly. But many people receiving direct payments are now finding that they are being asked to contribute towards their care through their PIP (personal independence payments). If you can show you have high disability related costs, you may well be exempt. Every council has slightly different rules on asking for contributions from benefits, so make sure you clarify what the rules are with you’re local council. If you have savings over £26,400, you will be asked to contribute something towards your care, how much this is will depend on your amount of hours and level of savings.
Why are direct payments better than care provided by the council directly?
Direct payments mean that you can choose who provides the care, and how and when it happens. You can decide how your hours are spent (as long as what you do adheres to your care plan). Some decide to have all your care done by one person. Others may have separate workers for different tasks, days, or times of day. Others may separate it by days or by times of day. But all of that can be decided by you and your assistants. You may be able to get more hours employing people privately than going through an agency for care.
What are the drawbacks?
You need to need to keep records such as accounts. Make sure DBS checks are completed (previously known as CRB checks). Make sure that they have the right to work legally. Complete and submit timesheets. Keep tax records. Make sure that the working environment complies to health and safety reg (much easier than it sounds). Most councils will also ask you to have a payroll system in place. You will need to submit your records to the council on a regular basis. Also, you are an employer. Thus you have to deal with any potential grievances, pay, annual leave, and tax. You will need liability insurance (which is normally paid for you). It is up to you to make sure that you have cover if your carer calls in sick (this is covered by some insurance policies).
What if I feel I can’t get my head around the paperwork?
Theres the option of a managed account. If you have a managed account, some of the role can be passed on, but this does restrict the flexibility a little. Alternatively, you can also ask someone to be your appointed person, who can sort out your direct payments account, rather than paying a company to do so. Most councils will ask you to instruct a payroll company to act on your behalf to register you with HMRC as an employer, and calculate your employee’s pay. A payroll company will normally calculate your tax and produce pay slips for you. Some will also provide contracts.
You submit all details of PA’s timesheets to the payroll provider. The payroll provider will then generate a payslip from the timesheet, and liaising with the managed account provider, pay wages direct to the PA. If you use an agency, they will submit invoices to the current managed account provider and the account management will pay it from the managed account.
The difference between a standard Direct Payment and a Managed Account
The current managed account provider will submit monitoring returns as requested in line with the Council monitoring guidance.
Standard Direct Payment Managed account The Direct Payment monies are paid direct to you, an agent or the appointed authorised person. We will pay the money direct to the managed account on your behalf. Usually you have to set up a separate bank account purely for the Direct Payment. We then pay the net Direct Payment into this account. We pay the net Direct Payment into a managed account bank account. You are responsible for paying the personal assistant and any other invoices/cheques/standing orders/direct debits relating to the management of the Direct Payment. You submit all details of PA’s timesheets to the current payroll provider. The current payroll provider will then generate a payslip from the timesheet, and liaising with the managed account provider, pay wages direct to the PA. You using an agency/provider will submit invoices to the current managed account provider and this will generate payment of the relevant invoice. You pay the social care contribution into your Direct Payment bank account. You will pay your contribution towards your social care to the managed account. You are accountable for all expenditure and ensuring the monitoring returns are submitted to the Council.
Who can I employ?
You can employ a care agency, an individual, and in occasional situations – a relative who doesn’t live with you (but this differs depending on where you live in the UK). You can employ a friend if you feel they would be suitable for the position, but be aware that employing a friend can change your friendship (think about how you would feel if a disciplinary matter came up). Its important to list the tasks involved and what skills are needed for you to identify a suitable candidate.
How do I find potential assistants?
There are facebook groups that allow you to advertise for PAs. Most payroll companies will also assist you by advert on their website. There is also universal job match. This is a government website which anyone can view. Anyone with a government gateway ID (which is given to you when you register as an employer with HMRC) can also advertise for free. Gumtree charges you to advertise but this often gives you a much wider base to search from. There are also sites like PAPool and care.com. These allow you to advertise for free but charge to contact those who are interested.
My personal experience
I first had direct payments after having 6 weeks of reablement care (which really wasn’t a good experience). They allowed me to be able to do normal things again – like going shopping, geting up and geting dressed when I wanted to. At first, I was given a good amount of hours. It really gave me a lot of freedom to get my life back. But when I moved, I was given very limited hours. That gave me a bit of help but I still felt quite reliant on my partner, who isn’t always available.
Now i’ve been reassessed and I still feel I haven’t been given enough hours. But I will be appealing their decision and hope to be able to get enough to get things back to how they were beforehand. The paperwork has never been a big issue, that’s been fairly manageable. Finding appropriate candidates for the job has been the hardest part. Care.com is where I’ve had the most success but even then it’s been patchy. I haven’t felt that people having experience as a PA has always been helpful. Sometimes people can get stuck in doing something in one way, which doesn’t always work for you. Having someone who is willing to learn how best to do things for you is the idea situation.
Do you feel direct payments would work for you? Whats your experience of them? Tell us more in the comments below!