Eight ways we could make direct payments more accessible

With over 30 years personal and “professional” experience of employing personal assistants, firstly through the Independent Living Fund and then through direct payments, I was invited to take part in the recent Direct Payments Summit as an expert by experience. 

Originally from Wales, I have now lived in Nottinghamshire for over 25 years.  I’m in my early 50s and live independently with my wife Ami and our two crazy cats, with the personal and practical support provided by a team of personal assistants who we employ funded through direct payments. 

We both have cerebral palsy which is our primary medical condition.  I also have a son called Joe from my previous marriage, now in his 20s and who lives and works in Manchester. 

The support provided through direct payments has in no uncertain terms facilitated me to live an active and empowering life, including going to university, having a sports career, being in paid jobs, being an active citizen and raising my son. 

In 2020 I was asked by Nottinghamshire County Council to join a co-production group called Our Voice, to improve the services offered by Adult Social Care and to change cultures and ways of working to be more inclusive, involving people with lived experience.  In recent months this has included me becoming co-chair alongside a carer and Melanie Williams, Corporate Director of Adult Social Care in Nottinghamshire, on a Senior Management Forum called Making it Real. This is a new and exciting venture, and I think I’m right in saying we are still finding our way with it.   

It has to be said, the most rewarding and satisfying part of my involvement in co-production so far, has been working on specific projects around improving the Direct Payment Factsheets (opens new window) which we offer, alongside a project in progress to improve annual reviews, financial audits and overall communication and processes in how the finance team works with people. The next significant project I’d like to be involved in, would be to review what training social care workers receive around direct payments and what actually happens in practice when “offering” a direct payment. 

This brings me very nicely to the purpose of why I was involved in the recent Direct Payment Summit, and why I’m sharing this blog with you: to share the reasons for which I believe direct payments are not being offered and taken up as widely as they should be: 

1. Direct payments are overly bureaucratic – everything from form filling, what records need to be kept and importantly the time it takes for anything and everything to happen.  

2. There should be dedicated teams of social care workers fully responsible for all things involving and relating to direct payments – this would ensure the people doing the job are committed, fully trained, know what they are doing and most importantly would stand a far better chance of having empathy and the ability to build meaningful and trusting relationships with recipients.  This would also go a long way in negating the need to repeat “our stories” time and time again!  

3. How direct payments are promoted or not! – this involves everything from written and verbal communication, to what I strongly believe to be the reluctance of many social care workers to go anywhere near the subject of a direct payment.  I believe they regard them as too complicated or “hard work”, “time consuming” and above all the “giving away” of power and responsibility to people who they intrinsically don’t trust and think lack capacity. 

4. How direct payment recipients are supported – this needs to be far more streamlined with clear pathways to support services when and where they are needed in a timely and appropriate fashion.  They should be funded right from the beginning of a direct payment “journey”, which is when they are often most needed, without having to be fought for. 

5. Direct payments should be made more flexible – I’m a firm believer that although someone’s support plan may say XYZ, their actual support needs can and should also be met in other ways if that works better for them.  The caveats of course being that support needs are being met in a legal and appropriate way. 

6. A campaign around the roll of a personal assistant – I’d like to think that most of us would agree the term “carer” is wrong and inappropriate in the context of what we are talking about today.  People struggle knowing, understanding and explaining what a personal assistant is and does.  We need to inform and educate on this across the board.  And whilst we’re at it, give personal assistants the recognition they rightfully deserve, both in terms of status and pay.  

7. How direct payment recipients and personal assistants “find” each other – this is somewhere people often get lost, it could and should be far more streamlined.  I’d suggest there are far too many “providers” out there, particularly private agencies, charging way over the odds for their “services”.  What I think I’d like to see is each local authority promoting their own “match making” service and discouraging those that you have to pay for. In this scenario each local authority would need to up their game and make this vital service far more “user friendly”, flexible and relaxed about data protection issues to a degree – which also applies to my next point! 

8. Peer support groups for both recipients and personal assistants should be established and funded – virtual and in-person groups should be setup and funded to enable best practice, problem solving, mutual understanding and support as well as the sharing of resources.  Such groups could either be totally independent or in some cases where required facilitated I would suggest by a third-party support service.   

Taking things forward, I would be keen to get involved in any discussions, forums and research, which would hopefully improve direct payments for all of us who draw on them now and for all who will do so in the future. 

To learn more about direct payments and access extensive resources on the subject, visit TLAP’s Direct Payments page (opens new window).