The Scottish Government

Disability Working Group Satellite Group 4

Direct Payments in Scotland

On 1 June 2003, it became a duty for local authorities to offer direct payments to disabled people who had been assessed as requiring community care services, including people with learning difficulties, parents of disabled children, attorneys and guardians.

Direct payments are made by the social work department following a community care assessment (or children's assessment for a disabled child). The payment is made so that the person can organise and pay for their own services - instead of the local authority providing services.

If done properly, direct payments provide an individual with flexibility, choice and control over how their services are provided. If the authority is prepared to give an individual the freedom to make decisions about the use of the direct payment without imposing too many rules, the benefits can be huge. The attitude of the local authority is crucial as potentially they can limit how much a direct payment recipient can adapt and tailor services.

Direct payments allow people to manage their own support needs. Individuals can choose to have a direct payment for all their needs or to have one as part of their package along with directly provided services. If an individual has a fluctuating condition and requires a greater amount of support at short notice, direct payments may allow them the flexibility to meet this need.

Another advantage is that direct payments support independent living and can enable people to lead fuller lives in the community. For example, direct payments could be used to pay for support to go out during evenings or weekends when mainstream services are usually more difficult to get. They can also be used to help support people back into work or education, and to pursue their own interests.

Managing a direct payment

The current guidance states that someone should be 'willing and able' to manage a direct payment 'alone or with assistance'. Supported decision making plays a major role in helping people with learning difficulties and mental health problems both to consent to and manage direct payments. The amount of help someone gets should be geared to their wishes, needs and choice of support arrangement, not to any perceived level of ability or disability. Direct payments enable people to become more independent. However, 'independence' does not necessarily mean either living alone or doing everything for yourself.

Overcoming some of the barriers to direct payments

Research published by a range of organisation such as the Joseph Rowntree Foundation, has found a range of barriers to disabled people accessing a direct payment, and provided some suggestions to overcome them. These include:

1. Difficulties accessing a social worker

In many areas there is a shortage of social work staff, which means some people will not have a designated social worker or care manager. This may mean that an individual will have to wait some time for a community care assessment (whether they wish to access directly provided services or a direct payment).

There is no easy way to overcome this barrier, other than to keep in regular contact with the local social work department.

2. Lack of social work awareness of direct payments

Some people have found that there is still a lack of awareness of direct payments amongst social work staff. Many local authorities are combating this by providing regular staff training and refresher courses to ensure staff are aware of their duty to offer direct payments to eligible people.

People can access information and support from local direct payments support organisations and centres for independent living (CILs), contacts available from Direct Payments Scotland. These organisations offer a range of services which may include: information and advice on the option of direct payments, support through the assessment process (including information on self assessments), peer support and training on how to be a good employer.

3. Lack of support

People may need different sorts of support to manage their direct payment at different times, and there is no set model. Support can come from one, or a combination, of family members, friends, independent advocates, user-led support organisations, circles of support or independent living trusts.

They can ask third parties to undertake some, or indeed all, of the management of their direct payment. The two main things to manage in a direct payment are:

• Properly looking after money from the social work department.
• Making sure it is spent on support that meets a person's assessed needs.

It is crucial that people are supported to choose if a direct payment is the best option to meet their assessed community care needs, and given the right support on how to manage payments from a support organisation that is independent from the local authority.

(Further information is available from the Direct Payments Scotland fact sheet 10: Helping with Consenting and Managing with Direct Payments).

4. No money available

One of the main barriers to the development of direct payments in Scotland may be the way in which current care services are financed and organised. Understanding this better might help lift some obstacles to future change. Therefore, the DPS Finance Project was established and a report published in 2003 to assist progress.

Where local authorities are having difficulties releasing monies from existing budgets, they should advise potential recipients of the amount of time it may take, and keep in regular contact to inform people how the situation is progressing.

5. Complaints Procedure

Where an individual is unhappy about the assessment they receive, time it takes, or not being able to access a direct payment because their needs are not seen to be of a high enough priority, they should talk with their social work department to try to amend the situation. If an individual is still unhappy they can then go through their local authority's complaints procedure, which is available from their social work department.

Direct Payments Scotland (DPS)

Direct Payments Scotland is a user-led organisation, funded by the Scottish Executive to increase the uptake of direct payments throughout Scotland. We aim to achieve this through a national information service, by identifying and addressing training needs for support organisations and local authorities, helping to set up support organisations to help people to manage direct payments, and raising awareness amongst community care service users, local authority staff and service providers. We have a helpline to answer queries on any aspect of direct payments, call 0131 558 3450 (open Tuesday & Wednesdays 10-12pm, and Thursdays 2-4pm).

DPS Learning Difficulties Pilot

Direct Payments Scotland has employed a part-time development worker to run a learning difficulties pilot project. It aims to help develop direct payments for people with learning difficulties in 2 pilot local authorities in Scotland (South Lanarkshire and Stirling).

The pilot projects objectives are to:

• Provide information and raise awareness about direct payments to people with learning difficulties, their carers, professionals and support organisations in pilot sites.
• Encourage uptake of direct payments amongst people with learning difficulties in the pilot sites.
• Look at existing practice to see what works and use this to inform work in pilot sites.
• Work with advocacy groups and help to build more user-involvement in support organisations from people with learning difficulties in partnership with existing support organisations.
• Develop local information on direct payments aimed at people with learning difficulties.
• Develop local procedures specific to direct payments and learning difficulties.

If you'd like to find out more about direct payments, the learning difficulties pilot, or for contact details of local user led support organisations, please contact the Direct Payments Scotland helpline on 0131 558 3450 or email info@dpscotland.org.uk, website: www.dpscotland.org.uk

Growing up……..

My son Andrew left special school in July 2003 as he was almost 19 years old. Person centred planning had been done with him and there were some key themes which evolved during that process.

He liked animals, being outside, working hard, doing some sport and socialising with peers. We already had been using a direct payment very successfully during the previous year for evenings or week-ends. It therefore seemed appropriate for us all to decide that it would be worthwhile to have a direct payment to provide a fulfilling lifestyle for Andrew pursuing his interests and meeting his particular needs.

Andrew has severe learning difficulties and complex uncontrolled epilepsy. He requires 1:1 support wherever he goes and also needs lots of help in explaining tasks or new situations. Each PA must be very diligent in assessing each situation for safety as Andrew has many seizures.

I knew it would be a challenge to achieve this programme but am delighted to report that Andrew has a full week, having three jobs which offer 2 hrs per session on a farm, a garden project and a small Co-op Supermarket. He also does riding, swimming and attends college all with a PA.

We have six staff working for us on a part time basis and they are a wonderful team. When we have our team meetings we all learn together with Andrew, parents and staff.

Thanks to direct payments for making this possible. It has surpassed our expectations for Andrew's adult life.

By Elsie Normington, Parent.

A Different Option