This resource has been specifically developed in relation to direct payments for adults with social care needs. It may also be of value to people working with children or people working in health with either adults or children.
About this guide
This guide has been coproduced with people with lived experience of direct payments, family carers, social work practitioners, principal social workers, finance managers and commissioners and providers in adult and children’s services using Curators of Change ‘Over a Brew’ methodology for Partners in Care and Health. It has been supported by Self-Directed Futures, Colligo Labs and the National Direct Payments Forum. To produce the guide, an extensive search and review of existing materials was undertaken alongside three co-production workshops, and a roundtable.
The guide aims to support adult principal social workers in providing social work practice leadership in relation to direct payments. It also aims to support council finance and audit staff in working with their operational colleagues and with people who use direct payments, to ensure finance and audit processes for direct payments are both effective and proportionate. It is recognised that each council may use different staff roles to undertake the audit of direct payments. For simplicity, in this guide, we use the term “finance and audit staff and managers” to cover all roles.
Introduction
To improve the take-up of direct payments, it is key that principal social workers (PSWs) and senior managers give good leadership to social work practitioners on the development and implementation of direct payments and that social work practitioners witness PSWs championing their use. There is no obligation for people who draw on social care to use the direct payment option, but it should be offered and explained to every eligible person.
The workshops highlighted that social work practitioners remain unfamiliar with direct payments and the law surrounding them. It is highly likely that many people will not know about the option, and take-up will inevitably be lower than if it is offered as a matter of course. PSWs need to lead the way on encouraging the take up of direct payments.
The guide aims to support PSWs and finance and audit staff and managers to:
- make sure that all practitioners are working within the spirit of the Care Act (2014)
- deliver a model of direct payments that complies with statutory guidance
- lead the development, implementation and promotion of direct payments
- ensure that people with, and thinking about having, a direct payment are supported to achieve their life goals
- ensure that direct payments are offered in a non-bureaucratic way
- ensure that any system of financial management and audit is fair, appropriate and proportionate, and does not burden the person using direct payments or social work practitioners unnecessarily
‘Self-direction is about much more than simply choosing how money is spent. It’s a broader approach that allows people to shape every aspect of their support – who provides it, when and where it happens, and how it fits into their life. Some people use direct payments to employ their own personal assistants, others use them to buy support from small, community-rooted providers. In some areas, people are supported by user-led organisations or brokers to plan creatively and flexibly, using individual service funds (ISFs) to pool budgets, purchase shared support, or gradually build up independence through personalised approaches. What matters most is that people are in the driving seat – with the right support in place to make that happen.
‘There’s also a growing range of informal and collective approaches that sit alongside traditional models. People are using circles of support, co-housing arrangements, shared lives, and micro-enterprises to build more sustainable and values-driven lives. Technology is playing a part too – not just in the form of digital budget tools, but in how people connect with each other to share ideas, support and resources. The system often focuses on the mechanics of funding, but true self-direction is about relationships, trust and long-term investment in what matters to each person.’
Chris Watson – Self Direct Futures
It comes back to, again, the culture in an organisation. How that culture works in the context of supporting people with direct payments is a fundamental issue. And then the other thing, particularly thinking about PSWs and finance managers and social worker teams and finance teams, is finding the time to understand each other's perspectives”.
- Roundtable participant
Direct Payments – a short history
By the Independent Living Group
The concept of direct payments was established in the 1980s by a group of pioneering disabled people unwilling to accept the limitations of the services available to them and the adverse effect this had on their ability to live an ordinary life. Entwined with the development of the Independent Living Movement in the UK, this group of people, led by the late John Evans, played a crucial role in empowering disabled individuals to promote their rights and greatly enhance their quality of life.
Payments in lieu of services from a local authority, at that time, were unlawful courtesy of the 1948 National Assistance Act. The first direct payments were ‘indirect’ payments because the money reached the individuals via a provider willing to act as a vessel for the funds. This required a huge amount of trust in all directions, between the councils making the payment, the provider and the individual receiving the funds. The result was better outcomes for the individuals in receipt of payments and demonstrable cost savings for local authorities.
Following a campaign for direct payments to become legal, led by the newly formed British Council of Disabled People (BCODP), the Community Care (Direct Payments) Act 1996, came into force in April 1997. This legislation allowed local authorities to make cash payments to disabled people, enabling them to arrange their own care and support services instead of relying on services provided directly by local authorities. Initially only available to younger physically disabled adults, access to direct payments was later expanded to include older people, parents of disabled children and carers.
Direct payments are now the mainstay of adult social care in England and cited as the government's preferred mechanism for personalised care and support. Trust remains the most crucial element of a successful direct payment scheme and collectively we must ensure it remains central to the relationship between individuals in receipt of funding and the public bodies making and monitoring payments.
Just on trust, trust works both ways. People have to have a reason to trust the local authority. And I think that's something we should take away from today actually, is that why should I trust the local authority if I know that there's breaches to the care act happening left and centre?”
- Roundtable participant.
We're talking very much about how we should automatically trust people. What about people? Why should people automatically trust a public body if there's so much evidence of actually bad practice? I was just reflecting on that in my mind, and I thought it was quite a powerful thought.’
- Roundtable participant.
Summary of key points
Principal social workers are responsible for making sure:
Social work practitioners are familiar with how direct payments work and can explain them to colleagues and people who draw on services.
- That social work leaders and social work practitioners know the law.
- They also understand the spirit of the law and concepts like the social model of disability and the community versus gift model [Simon Duffy].
- That social work practitioners know how to co-produce thoughtful, creative and effective care and support plans (and support plans for unpaid carers) that identify eligible needs to be met and outcomes to be achieved with the direct payments, rather than lists of tasks. Lists of tasks can limit flexibility for the person and can cause difficulty for the person auditing whether the direct payments have been spent on the right thing.
- Enabling senior leaders and elected members to learn about and understand direct payments.
There is support to deliver good practice by:
- Creating clear practice guidance on direct payments.
- Having direct payment champions who know all there is to know about them.
- Running direct payments learning sessions so social work practitioners can ask questions that they are uncertain about.
Finance and audit staff and managers should:
- Be clear about the purpose of direct payments
- Know the law, the guidance, and the spirit of the law on direct payments
Know the law about managing and auditing direct payments
- Be clear about the minimum legal requirements – what must be managed, monitored and audited and any repercussions/consequences for people who take direct payments.
- Balance audit procedures against trusting people to know what works for them and their intention to do the right thing.
- Look at audit tolerance levels from a pragmatic point of view; is it worth the cost and effort to chase someone for a receipt for, say, £12?
See the person
- Go out and meet people who take direct payments outside an ‘audit context’ to see and understand how direct payments are supporting people to live their best lives.
- If people have spent their budget on something that’s not detailed in their care and support plan, check that it met an agreed need and, if it did, do not claw it back. Talk it through and be clear about future use of the budget.
- If someone has ‘misspent’ their budget, start by giving information, advice and guidance. If it was a genuine mistake, then say ‘don’t do it again’ but don’t claw back punitively.
- When there’s a build-up of funds in someone’s direct payment account, ask if the unspent money reflects unmet need rather than seeing it as an opportunity to reclaim money.
Note on language: Some councils are moving away from the language of “audit” in favour of “reconciliation”, to encourage a less confrontational, and more informal, approach, and to differentiate it from the quite separate, internal audit of council procedures.
How to use this guide
This guide is a reference point when promoting legal literacy and encouraging practitioners to be aware of, and carry out, council duties in relation to offering direct payments.
- The guide covers three key questions for leaders to consider:
- What does good practice look like?
- What are the barriers to change and how can we address them?
- How can we ensure the people with (or thinking about having) a direct payment have access to advice that is independent of the council?
Under each question listed above, the guide considers the perspective of a person with a direct payment, or thinking about having a direct payment, using the following I statements:
- I have confidence in those supporting me with my direct payment and that they are applying any legal frameworks fairly, and proportionately.
- I have support to manage my direct payments from social care and finance staff who promote my feelings and preferences and respect my right to choice and control.
- I am supported by social care and finance staff who prioritise the care and support that makes sense for me above organisational financial considerations.
- I get clear information, advice and guidance about direct payments which reflects the law and is relevant to me.
As you read this guide it is important to remember:
- Direct payments originated from the Independent Living Movement of the 1980s – This movement was led by disabled people who wanted to have more control over their own lives, including their care and support, and felt that if they managed their support themselves this would enable them to be more independent than if their care and support was managed by council social services.
- It is the responsibility of all PSWs, social work practitioners and finance and audit staff and managers to understand the relationship between the Care Act 2014, the Care and Support Statutory Guidance and the Care and Support (Direct payments) Regulations 2014.
- The content of this guide applies to all social work practitioners working to support and promote the uptake and audit of direct payments, not just those in a leadership role.
- Statutory duties in relation to direct payments in England are provided in Appendix 1. Further information about personal health budgets is provided in Appendix 2.