SECTION 1: DIRECT PAYMENTS: ARE THEY RIGHT FOR YOU?
'…I am glad that I have started small with direct payments, as I now know that I can manage it. It has had a very positive impact on Scott's and his family's life, and so I hope that as he gets older, and moves into adulthood, I will be able to expand his direct payments so that he can have a stimulating and active adult life with all the support he may require…' (Parent of a child on the autism spectrum).
What are direct payments?
4. Direct payments are money your social work department can give you to buy the support you need to live at home and maximise your independence. You get this instead of a service that they might normally give you, such as home help or a day service. You spend the money on getting the support you need.
5. Direct payments are for self-directed care, in other words you direct the care or support you need. The assistance is there to help you lead your own life by choosing the support you use, where you use them and who you get them from. They are about living more independently by reducing or removing the barriers that you may experience in the world around you that stop you leading a better quality of life.
6. That's not to say they're right for everyone. Councils have a duty to offer you a direct payment but you don't have to take one if you don't want to. If you have direct payments and want to change your mind, that's OK. You just need to speak with your care manager or social worker and ask them to stop your direct payment and arrange council or provided services for you instead.
7. There is another kind of direct payment to do with benefits, whereby benefits get paid straight into a bank account or post office account. Please contact the Department for Work and Pensions on Tel No. 0800 88 22 00 if you wish to find out about this. Direct payments for self-directed care do not affect any other benefits that you may be receiving. But like any other care service provided by your council, you will be means tested to see whether you are able to make a contribution towards the total cost of your care.
Can you get direct payments?
8. The following groups of people are eligible to receive direct payments:
- Disabled adults to purchase community care services.
- Disabled people aged 16 and 17 to purchase children's services.
- Disabled people with parental responsibility to purchase the children's services their children have been assessed as needing.
- Parents and people with parental responsibility for a disabled child to purchase the services the disabled child has been assessed as needing.
- Parents and people with parental responsibility for children whose health or development may be impaired or below a reasonable standard without services from the local authority.
- Disabled adults and 16 and 17 year olds to purchase housing support services.
- Older people aged 65 years and over who are assessed as needing community care services due to infirmity or age.
- Those community care service users aged 65 or over who are accessing Free Personal and Nursing Care can arrange for the personal care element of the package to be made as a direct payment. (More information is available in section 14.)
- Attorneys and guardians, with the relevant powers can receive direct payments on behalf of people who are unable to give consent to arranging their own services.
9. Annex A describes the legislative context for direct payments eligibility. It also describes the groups of people who at present cannot receive direct payments under certain mental health or criminal justice legislation.
Assessment of need
10. Your social worker or care manager will need to spend time with you to find out what support you need and what it is possible to provide. This is called an assessment and developing a care plan. If you wish to receive direct payments you will not be treated any more or less favourably than people for whom your local authority arranges the direct provision of services.
11. Before your assessment, it is a good idea to keep a diary for a week or two to see what help and support you need each day. Some councils ask you to fill out a form before your assessment. Councils will ensure their procedures are accessible. Some local support organisations are able to spend time with you to prepare you for your assessment so that you can get the most from it. This is called pre-assessment work.
12. Once you have had your assessment, there are a number of people on hand who can help you reach a decision about whether to use direct payments. Family and friends who know you well can be invaluable. Professionals like social workers can also give you all the information you need.
13. And you don't need to have a direct payment to meet all your needs. It's quite possible to take a 'mix and match' approach and have some very individualised services and others such as using day centres. It's up to you.
14. At the end of the assessment of your needs you will agree a care plan, that sets out how those needs will be met. Annex C is a checklist of what this should contain.
What can direct payments be used for?
15. Direct payments can be used to buy support to live in your own home, so it might be to have a bath or get washed and dressed. It could include getting the house cleaned or food prepared. Out of the home it could be to support you in college or to enjoy leisure pursuits more. It may even be used to pay for someone to go on a short break with you. Direct payments are an opportunity to meet the assessed needs of the whole person in creative and flexible ways, for example, to assist with specific recovery needs for those experiencing mental illness. This is discussed in more details in paragraphs 116 and 177, and section 13.
16. You can buy support to meet your needs in various ways, for example, from a service provider such as a care agency or voluntary organisation, a local authority such as your own or a neighbouring one, by employing personal assistants ( PAs).
Example: Direct payments promoting flexibility and freedom
'Fantastic scheme, makes our life so much easier, can't praise it enough. Help from our local direct payments support organisation is only a phone call away at all times.'
Kirsty has Huntington's disease which affects her mobility and speech. She also experiences problems with occasional choking.
From an initial direct payments package of 10 hrs a week with one member of staff, she now has 6 care assistants providing cover from 8.00 am till 10.00 pm 7 days a week with her partner covering the overnights.
Kirsty and her partner have found many advantages with direct payments as it has allowed her greater flexibility and freedom in how she lives her life. She can live in her own home and gets on very well with all her staff. She bakes, and with a new wheelchair, she can now go out in the car and go for walks. She especially loves getting her hair done; dressing up to go out with her newly painted nails (which she could not manage herself) and being able to keep up her appearance as she was used to doing).
Setting up direct payments
17. If you decide to try direct payments, the council will let you know what you can and can't spend the money on. You need to show the council that the care you want to buy will give you enough support.
18. You must have a separate bank account for your direct payments. If you don't have one now, it is easy to set one up. You will need to show how you are spending the money by writing it down. Lots of people get a book keeper to help with this.
19. Sometimes people can be put off direct payments by what they see as 'red tape'. There are support organisations in most parts of Scotland who can work through the paperwork with you and help you manage. They can offer practical help, for example, with buying services from a service provider. If you are daunted by the idea of recruiting and employing your own staff (personal assistants ( PAs), they can help with this, for example, you can get help with the process of paying your staff through a pay roll service.
20. Your council will give you details of your local support organisation. Please contact them to see what help they can offer you. Details of 24 local support organisations across Scotland are listed in Annex E.