Direct payments

Direct payments are money payments made to individuals who ask for one, to meet some or all of their eligible care and support needs. This page has been created to give you the information you need to help decide whether to ask for a direct payment.

A direct payment is a way for you to receive your personal budget as a payment into your own bank account, giving you more choice and control over how your care and support are arranged. Instead of the council organising services for you, you can use the money to get the support that best suits your needs. The support you choose must meet the outcomes agreed in your support plan.

Guide to ‘direct payments’

Generally anyone assessed as having eligible care needs, where those needs will be met outside of residential care, can ask for a direct payment. We must agree with you that a direct payment is the right way to meet your needs. This means we must agree that a direct payment is value for money and enables you to meet your agreed care outcomes.

We can also make direct payments available for people who lack mental capacity to ask for one. Lacking mental capacity means that the person is not able to make their own decisions about direct payments, because of some sort of mental disorder such as dementia. Where we agree that having a direct payment is in a person’s best interests and offers value for money, we can make the direct payment to an authorised person instead. You can read more about what an authorised person is.

There are some people that the law stops us making direct payments to, for example people who are subject to certain mental health or criminal justice legislation.

Direct payments can be used in a range of ways, to meet the assessed eligible needs and outcomes agreed in your support plan. Your worker will decide with you how you can use your direct payment.

People who have direct payments often like them because they feel they have more choice, flexibility and control over the care they receive. For example:

Choice – you can employ a personal assistant(s) (PA) of your choice to provide support at the times you want
Flexibility – you can arrange care or activities for the time and days that you want
Control and independence – you can make your own care arrangements directly, without needing to ask us to do this for you. You can choose to buy additional hours of support from your own personal funds.

There are some things you cannot spend your direct payment on, for example:

Anything illegal
Normal household costs such as rent, food, utility bills or other day to day expenses
Long term residential care (in a care home or nursing home)
Employing your partner or a close family member living in the same household as you
Employing the same person to manage your direct payment and deliver care to you
Anything not previously agreed and documented in your support plan
Services that do not meet the agreed outcomes in your support plan.

If you think you might like a direct payment, the worker who completes your assessment will be able to advise you and guide you through the direct payment process.

You don’t have to decide straight away. We can arrange temporary services to meet your immediate needs, while you take time to think about it.

If you decide that you would like a direct payment in future, after your assessment, contact your usual worker. If you are not sure who your worker is, please contact the Single Point of Access (SPA) on 01472 256 256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

If we agree with you that a direct payment is the best way to meet your needs we will tell you how much we will pay to you. How much we pay to you depends on your needs and how you are going to use the direct payment to meet them.

Depending on your personal circumstances, you might be asked to make a contribution to meeting the costs of your social care. If you have savings and capital above £23,250 (ignoring the value of the home you live in), you are not eligible for a direct payment to manage your social care needs.

If you are offered a health direct payment via a Personal Health Budget (PHB) you do not need to make a contribution towards the costs of meeting your care needs.

We usually make direct payments through a direct payment card account. You can find out more about direct payment card accounts on our Direct Payment card accounts FAQ (PDF, 220KB) .

You can ask us to make the direct payment to you, or you can nominate someone to receive the direct payment for you. You can read more about what a nominated person is.

Paying towards your care

Although Continuing Healthcare (CHC) and some mental health aftercare services are free, all adult social care services are chargeable. The amount charged for social care depends on individual circumstances and is calculated after a financial assessment. The amount of direct payment we pay you will be reduced by the amount we assess you can afford to pay towards your social care costs. This amount is known as your assessed client contribution.

You will receive a letter from the focus community care finance team confirming what your assessed client contribution will be. It is important that you pay your contribution into the direct payment account regularly, so that you have enough money to pay for the care agreed in your support plan.

You can only spend your direct payment on meeting the needs that we have agreed in your support plan. If you want to choose help that we think is more than you need, you will need to pay for the extra costs from your own funds. Your direct payment will not include any more money than we think you need.

It is important that you tell the community care finance team straight away about any change of financial circumstances. This may include an increase/decrease or other change in any benefits, savings, income and expenses that are included in your financial assessment. If you don’t tell us about a change of circumstances within one month from the date it happens, you may end up having to pay a large bill at a later date. Any increase in benefit will be taken into account from the date it was awarded. This may result in a backdated charge.

Nominated or Authorised Persons

In some cases, someone else can receive the direct payment on your behalf.

Nominated Person – Where a person has the mental capacity to decide, they can ask for someone else to receive a direct payment on their behalf.

Where a person has the mental capacity to decide, they can ask for someone else to receive a direct payment on their behalf. This person is called a nominated person.

Where we agree, a nominated person receives the direct payment on behalf of the person with needs. What the nominated person does can differ, depending on whether the needs the direct payment is intended to meet are health or social care needs.

If the direct payment is being used to meet social care needs, the nominated person usually helps the person with needs to manage their direct payments, but they do not take full responsibility for the arrangements made using the direct payment. For example, if the direct payment is used to employ someone, the nominated person is not the employer (the person with needs is the employer).

If the direct payment is being used to meet healthcare needs the nominated person is responsible for managing it, and for complying with all the obligations that come with having a direct payment. For example, if the direct payment is used to employ someone, the nominated person is the employer (the person with needs is not the employer).

A nominated person must not be:

someone who is going to be employed using the direct payment or
someone from whom the direct payment will be used to buy a service
anyone else the law says cannot act as a nominated person

The details of an authorised person are recorded in the support plan of the person with needs. We usually include the nominated person in all reviews of the direct payment so that they understand their legal obligations to act in the interests of the person with needs.

Before we make payment to a nominated person, we must be satisfied that:

they agree to receive the direct payment on behalf of the person with needs
they understand what level of help they have agreed to give the person with needs, to manage the direct payment
they are able to give that level of help to the person to manage their direct payment, with or without extra support
a direct payment is an appropriate way to help the person with needs, and offers value for money.

In some cases we might ask that an enhanced criminal record certificate is obtained. The cost of criminal record checks via the Disclosure and Baring Service (DBS) will not generally be met by us or included in the direct payment amount.

Where we agree to make payment to a nominated person, both they and the person with needs must sign a direct payment agreement with us, agreeing to their responsibilities. Sometimes we work with the person with needs and the nominated person to change the agreement slightly, to make sure it is right for individual situations. Care professionals will talk through the agreement first, before asking anyone to sign it. Anyone who wants to act as a nominated person can seek independent advice if they want to.

The direct payment agreement sets out in detail what is expected of a nominated person. The nominated person must comply with this agreement, which can be found on the direct payments page.

If a direct payment is being used to meet social care needs, as a minimum, key responsibilities of the authorised person include:

acting in good faith, and taking proper care when acting for the person with needs
checking that direct payment monies have been received from us, and are enough to meet the person’s needs
not spending the money on anything outside of the person’s support plan
keeping records of what is spent, and showing them to us if we ask
if asked, joining in with our regular reviews of the direct payment, to check monies are properly being spent and the person’s needs are being met
not spending the direct payment on anything illegal
letting us know promptly if there are any changes in the person’s circumstances, of which they are aware.

The nominated person might agree with us, and with the person with needs, that they will give them more help than is summarised above.

If the direct payment is being used to meet health care needs, as well as taking on all the responsibilities set out above (for social care needs), the nominated person will comply with all the obligations that come with having a direct payment. This means they will be responsible for any contracts of employment or for services, not the person with needs.

The responsibilities of a nominated person receiving a direct payment to meet healthcare needs are more like the responsibilities of an authorised person.

We will ask that an enhanced criminal record certificate is obtained. The cost of criminal record checks via the Disclosure and Baring Service (DBS) will not generally be met by us or included in the direct payment amount.

A nominated person who is managing a direct payment can get help, if they need it. Care professionals can advise on the help available. If we agree that the nominated person needs help, the reasonable costs of the help will be included in the direct payment. We will agree what help the nominated person needs by recording it in the support plan.

If you think you might like to nominate someone to receive a direct payment on your behalf, contact your usual worker. If you don’t have a usual worker, contact the Single Point of Access (SPA) on 01472 256256 or for health direct payments the Continuing Healthcare Hub on 0300 330 2990.

You should not allow someone who you have not agreed to be a nominated person to access your direct payment account.

Authorised Person – Someone who manages a direct payment on behalf of someone with eligible care and support needs, who lacks mental capacity.

An authorised person, is someone who manages a direct payment on behalf of someone with eligible care and support needs, who lacks mental capacity. This could be a friend or family member. An authorised person who receives a direct payment is legally responsible for managing it, and for complying with all the obligations that come with having a direct payment.

An authorised person is usually already appointed as a representative for the person with needs, for example someone with:

Registered Lasting Power of Attorney (LPA) for ‘Property and Affairs’ or ‘Personal Welfare’
Registered Enduring Power Attorney (EPA)
Court of Protection Deputyship.

This does not include ‘appointeeship’ from the Department of Work and Pensions.

Where no one is already appointed as a representative for the person with needs, we can consider if the person who wants to act as authorised person might be suitable to do so.

The details of an authorised person are recorded in the support plan of the person with needs. The authorised person is included in all reviews of the direct payment.

Direct Payments are available to people who lack the mental capacity to decide about having a direct payment, if care professionals agree it is in their best interests to have one. The Mental Capacity Act 2005 (MCA) sets out what care professionals must take into account when considering a person’s mental capacity, and what is in their best interests.

We will only make direct payments to someone who wants to act as an authorised person where we think:

a direct payment is an appropriate way to help the person with needs, and offers value for money
making the direct payment in this way is in the best interests of the person with needs
the person who wants to act as authorised person
- will act in the best interests of the person with needs, in arranging the care set out in their support plan
- is willing and able to manage the direct payments, with or without help
- is already appointed under the MCA, or if not, someone who is appointed under the MCA agrees the person is suitable and we also agree that they are
there is no legal reason for us not to make the direct payment in this way.

When we decide whether someone is suitable to act as an authorised person (excluding those already legally appointed),we might ask them to give us information, or consult with others about them (such as anyone interested in the welfare of the person with needs), to help us make the decision, in their best interests.

In some cases we might recommend that an enhanced criminal record certificate is obtained. The cost of criminal record checks via the Disclosure and Baring Service (DBS) will not generally be met by us or included in the direct payment amount.

Anyone who wants to be an authorised person must sign a direct payment agreement with us, agreeing to their responsibilities. You can read a standard version of the agreement on the direct payments page. Sometimes we work with the person who wants to act as authorised person to change the agreement slightly, to make sure it is right for individual situations. Care professionals will talk through the agreement first, before asking the person who wants to act as authorised person to sign it. Anyone who wants to act as an authorised person can seek independent advice if they want to.

Because people who lack capacity to make their own decisions can be especially vulnerable, extra protections apply. The authorised person must act in the best interests of the person lacking capacity by:

doing whatever they can to help or encourage the person to participate in decisions
trying to identify and take into account all the things that the person would take into account if they were acting for themselves, including their past and present wishes and feelings and any beliefs and values likely to influence their decisions
not making assumptions about what might be in the interests of the person solely on the basis of the person’s age, appearance, condition or behaviour
consulting others when making decisions
ensuring a record is kept of the process of working out the best interests of the person (for any major decisions)
telling us if they think the person has regained the ability to make their own decisions.

The direct payment agreement sets out in detail what is expected of an authorised person. The authorised person must comply with this agreement. The agreement can be found on the direct payments page.

Key responsibilities of the authorised person include:

acting in good faith, and taking proper care when acting for the person with needs
checking that direct payment monies have been received from us, and are enough to meet the person’s needs
arranging the help set out in the person’s support plan
complying with any legal obligations that arise from the arrangements made using the direct payment
keeping records of what is spent, and showing them to us if we ask
joining in with our regular reviews of the direct payment, to check monies are properly being spent and the person’s needs are being met
not spending the direct payment on anything illegal
letting us know promptly if there are any changes in the person’s circumstances.

This is only a summary. Anyone who wants to act as an authorised person must read the agreement carefully before signing it. If there is anything they do not understand, they should ask the care professional working with them to explain.

An authorised person can get help to manage the direct payments, if they need it. Care professionals can advise on the help available, such as payroll services, recruiting and managing personal assistants and undertaking DBS checks. If we agree that the authorised person needs help, the reasonable costs of the help will be included in the direct payment. We will agree what help the authorised person needs by recording it in the support plan.

Someone who wants to act as an authorised person, can ask for a direct payment on behalf of the person with needs.

In most cases, the person who wants to act as authorised person will already be appointed as a representative of the person with needs, under the MCA. If not, and there is someone else who is appointed under the MCA, that person must support the request.

Direct payment agreements

If you have a direct payment to meet your needs, we will ask you to sign an agreement with us. This is so that you and we will understand what we are each responsible for.

There are different types of agreement. Which type of agreement we use depends on whether:

you are able to decide for yourself to have a direct payment, or
if you can’t decide about direct payments for yourself, someone else has made the decision for you.

Our staff will talk you though the agreement that is relevant to your situation before you sign it. We are sharing the agreements on this page, in case anyone would like to read them in advance.

You MUST read any agreement in full before you sign it.

A person can decide for themselves and will receive their own direct payment.

A person can decide for themselves and choose a nominated person to receive payment.

A person cannot decide for themselves and someone has made a decision on their behalf.

If you are a carer and want to receive a direct payment.

Agreement 4 carer with capacity to request a direct payment (Word, 83KB)

Getting support at home

One of the ways you can use your direct payment is by paying a home care agency to provide care in your own home. If you use an agency, the staff who work with you are normally employed directly by the agency, so you will not be their employer and therefore not responsible for managing them or paying their wages.

You will still have some choice and control over your care, as you will make arrangements directly with the agency and be able to say how, when and where your support is provided.

If you are eligible for Continuing Healthcare (CHC) you will be offered a notional budget if you decide to use a home care agency. A notional budget means that your budget is held by CHC on your behalf and the CHC team will make payment directly to the service who is providing your care in line with your personal support plan.

You must always ensure that you have fully discussed your arrangements with the agency and that you have a clear agreement and breakdown of all costs in writing. This will avoid any unexpected costs, such as additional charges for mileage and bank holidays, which you may not previously have agreed to pay. The agency will send you an invoice for the support they have provided, normally once every four weeks or monthly. You will the pay the invoice from your direct payment account.

Your direct payment amount will only include enough money for the care we think you need. If you want to buy more care than that, you will need to pay the additional cost using your own money. Most agencies will send you a single invoice for all of your care – the care that your direct payment funds, and any extra care that you fund. If the total cost of your care is being paid from the direct payment account, you must add your own money into the account to cover the cost of the extra care before making payment to the agency.

This is to make that the balance of your direct payment account is enough to pay for services to meet your assessed needs. Alternatively, the agency may invoice you separately for any extra support you have agreed to buy.

The cost of any extra care you pay for is in addition to any assessed client contribution you make towards the costs of your social care (continuing health care and mental health aftercare needs are met for free). Before agreeing to buy extra care, you should consider whether you can afford and keep up with the payments. We advise you to discuss any additional costs with your usual worker during your support planning.

You can only use your direct payment in the way that we have agreed with you. We must be satisfied that the way you plan to use your direct payment offers value for money.

All agencies providing personal care are required by law to be registered with the Care Quality Commission (CQC) and you can ask the agency to show you its CQC registration.

Your usual worker can also provide you with a list of registered care agencies that are used and approved by us, and all registered agencies are listed on the CQC website. If your direct payment is funded by continuing healthcare (CHC), you must check that the agency complies with any obligation that the organisation has to be registered as a member of a profession regulated by a professional body.

The CHC team will manage your notional budget on your behalf and make sure that appropriate checks are made.

Before you decide to buy a service from a particular agency, we recommend asking the agency the following questions:

About its registration with the CQC
How it manages its staff and how often someone will check you are happy with the service you receive
How it would deal with any complaint you may have with its service
To see a copy of their insurance and safeguarding policies
If all their staff have a current Disclosure and Barring Service (DBS) check
If any requirement for professional registration has been complied with
If they directly employ their staff and meet all their tax and national insurance payments
How it arranges for staff cover during holidays or periods of sickness and if someone will discuss this with you when staff cover is needed
What staff training is provided and the relevant qualifications and experience of staff
If it carries out a risk assessment for you and its staff
If you will be given copies of the hours the staff work, so you can pay the correct amount
How much it will cost you to use and pay for the service
How much notice you or they will need to give to end the contract

Please feel free to ask any other questions, to make sure you get the information you want before choosing an agency.

Remember you can always ask for help if you need it. If an agency tells you they cannot provide care for you and you are unable to find an alternative, please contact your usual worker or the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990

Managing direct payments

If we have agreed with you that a direct payment is the best way to meet your care needs, there can be significant administrative tasks to be undertaken, such as bookkeeping or employing and managing care staff, and you must keep us informed of any changes. This includes:

Most people with a direct payment will have a direct payment card account. One of the best things about having a card account is you do not need to send in bank statements showing how you have spent your direct payment. This is because we will be able to see this information ourselves by looking in your account online. The card account allows you to upload invoices and receipts for everything paid from your direct payment account.

Whatever way you receive your direct payment, you need to keep records. This includes paperwork relating to any personal assistants you employ such as payslips, timesheets, payments to HM Revenues and Customs (‘the tax man’), liability insurance and invoices from employment support providers. If you do not have a direct payment card account you will also need to keep bank statements. Documents should be kept for seven years.

When we monitor your account, we will let you know if there is any action that you need to take. For example, you could be asked to pay any arrears in contributions you make to the cost of your social care. You could also be asked to repay money if it has not been used to meet the needs set out in your support plan, or if you have employed your spouse, partner or any close relative without our approval.

We will also check that the balance of the account is not too low or high as part of our annual auditing process. We can offer support and advice with budgeting to make sure you have sufficient funds to meet the cost of your support.

If we think you have excess funds in your account, we will complete an audit and discuss this with you and the worker that supports you (from social care, mental health or continuing healthcare). We will then decide whether the excess funds are needed to purchase support to meet your assessed needs. If the surplus funds are not needed to meet your assessed needs, they will be recouped (returned to us). We will notify you and any third party support provider.

We will always work with you to resolve any issues. You may be asked to repay any money if your direct payment has not been used to buy support or services set out in your support plan. We may decide that you need extra help with your direct payment, and agree that it should be managed by a third party. We can stop the direct payment if you continue to spend the direct payment inappropriately or illegally. We would talk to you about this, and make sure that your needs are still met, but in a different way.

You need to let us know if your circumstances change. If your needs are not being met, we may need to review your care needs. If you are helping manage direct payments for someone else, please contact us to let us know about any changes.

You will have discussed with your worker a plan for what you will do if any of the arrangements you made with your direct payment fail. For example, this could happen if your personal assistant goes off sick or doesn’t show up for work.

Sometimes plans do not work; if this happens, we can help make sure your identified needs are met once you have informed us. You should contact your usual worker first. If you are not sure who your worker is, please contact the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

If you get into difficulty with arranging the care you need, or need a review of your care needs, please contact your usual worker first.

If you are having difficulty managing your direct payments funds, contact your direct payment support provider if you have a managed account. If you do not have a managed account, please contact your usual worker first.

If you are not sure who your worker is, please contact the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

Please let us know if you have to go into hospital for any reason. You can contact your usual worker or the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

Remember to tell any agency you use or your personal assistant, or arrange for someone else to do that on your behalf, so they’re kept informed.

If you employ a personal assistant, the direct payment can continue if the employee’s contract of employment says that they will be retained in these circumstances. A ‘retainer’ may be paid to the personal assistant at 50% of their normal weekly wage, for a maximum of 6 weeks in a 12-month period.

If direct payments do not work for you, we can arrange services for you instead. Simply contact your usual worker or the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

If you want to end your direct payment, you will need to give us at least 28 days’ notice in writing. We will usually give you 28 days’ notice if we decide to end your direct payment. There might be circumstances, such as a serious case of direct payment misuse, when we will not be able to give as many as 28 days’ notice.

You will need to give appropriate notice to any agency or personal assistant that you pay using the direct payment. You will need to pay all outstanding bills up to the end date of your direct payment. Your direct payment will be monitored so any unspent funds can be returned to us.

We must be informed so that the direct payment can be stopped. Please contact the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990. We will need the name of the executor or administrator of the deceased person’s estate, and any solicitor involved.

A direct payment is to pay for care and does not form part of a person’s estate. It cannot be used for funeral expenses. Any money left in the direct payment account, once all contractual obligations have been met, must be returned to us.

If you receive a direct payment, it is very important that you explain to your executor (the person you have named in your Will to deal with your affairs after your death) about your direct payment. If you don’t have a Will, you should give the same explanation to your close family members, who might act as administrator after your death (an administrator deals with your affairs if you have not made a Will). Your executor or administrator will need to find out if there are any outstanding invoices or wages that need to be paid from your direct payment account. They will need to arrange for any contributions you make to the cost of your social care to be paid to us, if there are arrears.

If a personal assistant has been employed, your support provider can help claim from the liability insurance to cover in lieu of notice and redundancy payments. If the account is frozen or there is no access to the account, in some circumstances, we may pay some of the outstanding payments such as salaries. Any money we pay will be recovered once the account has been reactivated or is accessible.

If there is no Will, you will be said to have died ‘intestate’. We recommend that you make a Will because this usually makes it easier to manage your finances once you have died.

Depending on the your level of assets (money and property) when you die, it may be necessary to apply to the Probate Registry for a grant of probate (if you have a Will) or a grant of letters of administration (if you have no Will). The grant provides proof to banks and other organisations of who has authority to access and distribute funds held in a deceased person’s name.

Further information can be found on GOV.UK, Probate estate and Death and bereavement.

People in North East Lincolnshire who are unable to self manage their direct payments can get help with administration from an independent Direct Payment Support Service (DPSS) or third party support organisation. These organisations specialise in managing direct payments, including employment support, payroll and third-party managed accounts.

The money to pay for the reasonable costs of this help will be added to your direct payment amount. We will only pay amounts agreed in advance, as reasonable for the level and type of help you need. If we agree that you can use an alternative or more expensive way of getting help, for example from an accountant, you will be responsible for paying any additional associated costs from your own funds. Some suggested support organisations include:

Care4all Personal Assistant Support Solutions – Telephone 01472 322426 or Care4all
Penderels Trust – Telephone 01472 500335 or Penderels Trust
PayPacket – Telephone 0800 848 8998 or PayPacket
The Rowan Organisation – Telephone 02476 322 860 or The Rowan Organisation

Direct payments and your benefits

Direct payments are not taken into account when income related social security benefits are calculated or when maintenance is calculated under the child support formula. Direct payments are not treated as taxable income by HM Revenue and Customs (the tax man’). However, household benefits may be affected if we have agreed with you that a family member can be employed and paid from your direct payment.

For more information read our Direct Payment Policy (Word, 138KB) .