1. Direct Payments Debbie Waldron 22nd June 2016

2. What will we cover? What is a direct payment
Who can have a direct payment
What can direct payments be used for
Benefits of direct payments
Setting up direct payments
Monitoring of direct payments
Payment cards
Success of direct payments and increasing up-take
Case Study

3. What is a direct payment?
Everyone who has assessed eligible needs is offered a Personal Budget
People can choose to have their budget as a commissioned service arranged by Herefordshire Council or as a direct payment or a combination of both
A direct payment is a monetary amount paid to people so that they can arrange their own care and support instead of the council arranging this for them

4. Who can have a Direct Payment?
Anyone that has been assessed as having eligible needs and is:
A disabled person 16 years and above
A parent (or person with parental responsibility) of a disabled child
A carer aged 16 and above, for services to meet their own assessed needs/outcomes
A disabled person with parental responsibilities for a child, to support their parenting role
Appointed suitable person for someone who lacks capacity

5. What can you use a Direct Payment for?
Direct Payments can be used to meet needs and agreed outcomes as outlined in the support plan
For example:
To use an Agency to meet care and support needs
Employ a personal assistant to provide care and support needs and the associated employment costs such as payroll, advertising, recruitment and employment support services
To purchase Day opportunities or activities
To purchase respite (must not exceed 4 consecutive weeks in 12 week period)
“The direct payment is designed to be used flexibly and innovatively and there should be no unreasonable restriction placed on the use of the payment, as long as it is being used to meet eligible care and support needs”.

6. What are the benefits of Direct Payments?
Choice – the person can choose who provides their care and support and when it is provided. (Choice of agencies and PA’s and when support is provided)
Flexibility – the person can arrange care and support /Day opportunities for the days and times that they choose. They may not need or want the same amount of support each week
Control and independence - the person can decide who provides their care and support or other services without having to come back to the authority to arrange or re-arrange. The person can manage and be responsible for their own budget.

7. Workflow and setting up Direct Payments
Referral
Assessment – (Adults) also make referral to Welfare Rights for financial assessment
Direct payment discussed
Indicative Budget (Resource Allocation System)
Direct payment offered
Support Planning
(Adults) Broker purchases direct payment
(Children’s) approved by team A5 sent to Children’s Finance
Sent to Direct Payments Team for set-up meeting
Allocated Worker, DP Team and person meet to sign Direct Payment Agreement and bank details form if not having a payment card.
Payments start
Monitoring of accounts commences

8. Monitoring of Direct Payments
Direct Payments have to be paid into a separate account so that they can be monitored by the Direct Payment Monitoring Officer.
Accounts are sent in at regular agreed intervals if they have their own account or viewed on-line by the Monitoring Officer if they have a payment card account.
The accounts are monitored to ensure being spent on assessed needs and outcomes as agreed in the support plan.
Also to ensure that client contribution and personal top-up are being paid; balance high or low; HMRC and other employment responsibilities are being met if employing a personal assistant.
A report is sent to the person outlining any problems and actions to be taken. A calculation of surplus is sent if there are excess funds in the account
Copy is up-loaded into Mosaic.
The Adults Wellbeing Team are alerted if there are any issues to be addressed and the teams work together to resolve.

9. What is a payment card account and the benefits?
Operates like an ordinary on-line bank account
Payments for services can be paid as normal, bank transfer, standing order, direct debit
Can be used for telephone banking if person doesn’t want to use or have on-line access
The person doesn’t need to open a separate bank account a card account can be opened for them.
Account can be set up quickly – account details available within an hour
A nominated person can operate the account
The account cannot go overdrawn
The person must keep receipts but doesn’t need to send in accounts for monitoring
Reduction in paper based records and cost of postage
Monitoring team has real time access to the accounts and how money is being used.
Monitoring team receive reports and alerts to notify of low, high balances, unexpected spend
More efficient retrieval of surpluses and closing balances

10. Success of Direct Payments
“Local authorities have a crucial role to play in prompting the use of direct payments and enabling people to make request to receive direct payments in an efficient way”
Timely advice and support to enable informed choice and efficient set-up of direct payments by:
Giving out Flyers and Fact sheets on direct payments including separate ones for Carers and being a suitable person, easy read information leaflet and payment card guide.
Involving a Direct Payment Advisor (Adults). Can be contacted by phone, and in Mosaic at every stage, Assessment, Review and Support Planning and available for home visits to discuss and answer any queries about direct payments.
Competent support planning to enable confident budgeting:
Ensuring all costs have been included to avoid overspending
Ensuring person has appropriate support:
How is the person going to manage their direct payment
Do they need employment support provider and have employment costs been included
Use the good practice checklist to ensure all areas have been covered

11. Increasing up-take of Direct Payments
Ensuring that all Adults Wellbeing teams undergo Direct Payments Induction
That everyone assessed with eligible needs is offered a Direct Payment and encouraged to take ownership for arranging their support
Involving a Direct Payment Advisor at the Assessment stage to ensure timely advice given and throughout the process if required. Especially where employment of personal assistants is being considered
That people with eligible needs are made aware of the benefits of Direct Payments and the use of the payment card
Engage in discussion at reviews to identify any gaps in the market and provide feedback to commissioning about gaps in the market.
Encourage support providers to engage with people to understand the services they need and how they wish to source them
Increase the available choice of personal assistants by working with commissioners
Aligning processes for commissioning and contracting support provision for children’s services with adults