Darlington Association on Disability

From April 2003 every local authority offers those who are eligible, money, instead of arranging services for them.  When local authorities gives someone money in this way, it is known as Direct Payments. People get this money to arrange services for themselves to meet their social care needs.

Direct Payments give you the opportunity to make more of the decisions, which affect your life and be in control of your own care arrangements.  One of the ways you can use a direct payment is to employ and manage your own staff which means you get the assistance you need when you want it, how you want it and from the person you have chosen to give it.

Unlike other services, which are provided for you, Direct Payments enables and encourages you to be in control of a system you create and manage yourself.

To receive a Direct Payment you need to be able to consent to a Direct Payment and be able to manage it with support if necessary and available.  Where someone does not have the mental capacity to consent to a Direct Payment the local authority can appoint a suitable person to receive the Direct Payment on behalf of the person that needs the support.  The suitable person can then manage the Direct Payment to ensure the persons needs are met and the Direct Payment is being used in the best interests of the person receiving the support.

If you are a disabled person or carer, whatever your impairment, who needs support to live independently in your own home, and you fulfil the eligibility criteria, then you can choose to receive a Direct Payment instead of receiving services or support organised and paid for directly by the council.

Most local authorities are developing a system of Self Directed Support. This aims to give people maximum choice and control over their lives, which leads to increased opportunities and better outcomes.

One of the ways that the council are achieving this is through the use of Personal Budgets.  A Direct Payment is one way in which you can choose to use your Personal Budget. 

To be able to receive a Direct Payment as part of your Personal Budget you need to have gone through either a Carers Assessment for carers or a Community Care Assessment if you are a disabled person.  This involves completing a support plan and getting this agreed with the local authority social care.  Please visit the

http://www.darlington.gov.uk/health-and-social-care/adult-social-care/

http://www.redcar-cleveland.gov.uk/resident/adult-children-health/adult-care/adult-care-services/Pages/What-Is-Adult-Social-Care.aspx

http://www.durham.gov.uk/article/5690/Adult-social-care-and-health

We recommend that you make a self-assessment of your needs before the Care Manager visits you.  Some people find it helpful to keep a diary for a week or so before the assessment, recording what they do, how long it takes, and what help they receive, as well as what they would like to be able to do if they had the necessary assistance.  This means that services should fit in with your needs, and not the other way round.

Each person’s need for assistance will be different, and so there are no hard and fast rules. However there are certain general principles which can guide you into making a good self-assessment.

Remember that your assessment will determine the number of hours of assistance you need and therefore the amount of money you get. So it is important that you think carefully about what you need to enable you to live a full life in the community.

Using your Direct Payment to buy support from services and organisations

One option for using your Direct Payment is to choose a home care agency (also known as a domiciliary agency) to provide care.  Usually choosing an agency means you will not be the employer and the agency will be responsible for wages, insurance, managing staff etc. You will maintain choice and control as you will make the arrangements for when, where and how your support will be provided.

The agency will invoice you for their services, which you pay from your Direct Payment bank account.

Advantages

• You can pick an agency of your choice and meet with them before you agree to them supporting you.
• An agency worker will attend at the times you specify, if the agency worker happens to be off sick or takes some holiday the agency will arrange someone else to attend.
• The agency has all of the responsibilities of being the employer, rather than you employing a support worker.
• There are different ways you can pay an agency, by cheque or electronic transfer. Either way an agency should provide you with an invoice of support you have received.
• If something goes wrong say for example a support worker doesn’t turn up or you don’t get on with someone, you can call their office to talk things through.

Disadvantages

• You have to trust the agencies decision on the suitability of a worker.
• You don’t always get the same person supporting you. This can be difficult especially where personal care is involved.
• Agency workers often have more than one person to support throughout the day therefore you may feel rushed because they have to get to their next service user.
• Agency workers are sometimes limited with the duties they can carry out for you. For example some agency workers would not be able to work up a height i.e. to change a light bulb.
• Agency rates can be high, often charging the full direct payment rate and enhanced rates on a weekend. Any expenses would be charged in addition to the hourly rate such as mileage.
• An agency can get your bill incorrect, it is advised that you check through all of your invoices.

What you need to check

You should check that the agency provides a written breakdown of all of their costs, and ensure that you have a written agreement of your arrangements with the agency of what support will be provided. It is important to make sure you have all the information you need and don’t get caught out by unexpected costs, e.g. extra charges for bank holidays and mileage. Some agencies may charge a rate that is higher than the Direct Payment rate paid to you, and you may have to cover the difference from your personal funds. You should discuss any additional costs with your Care Manager.

Agencies that provide personal care are legally required to be registered with the Care Quality Commission (CQC). You can ask the agency to show you details of its registration.

Before deciding to buy a service from a particular agency, it is recommended that you find out:

• The agency’s CQC registration
• Their insurance policy
• Has the staff undertaken a Disclosure and Barring (DBS) check and other pre-employment checks
• How staff are managed
• How they ensure you as a customer are happy with their service
• If all staff are employed by the agency and all tax and insurance payments are met
• How complaints are dealt with
• How staff cover work over holidays/ sickness
• What training staff are given and what experience / qualification they require of their staff
• What risk assessments will be carried out
• If you can get a breakdown of the hours staff work so you can make sure you are paying the correct amount
• How much the service will cost

After you have been working with members of staff for a while you may think about employing them directly rather than through the agency. Some agencies will allow this but may have conditions. If you think you may want to go down this route, you can get support from the Direct Payments Support Service.

These are just a few suggested questions that you might want to ask when investigating options for agencies, if there is anything else you need to know be sure to contact the agency and find out how they can support you with your specific circumstances.

If the agency tells you they will not be able to continue providing care for you, please contact Adult Social Services and ask to speak to the Duty Team as soon as possible or out of office hours the Emergency Duty Team.

The Direct Payments Support Service has a list of domiciliary agencies that you can look into. You can get a copy from the office or visit the Care Agencies list.

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