Direct payments – why aren't more people reaping the benefits?

A key feature and focus of Think Local Act Personal’s current work is to understand better the gap between the rhetoric of personalisation policy and the reality of personalised care and support that people who use services experience.

The uptake of direct payments  does not appear to be substantially increasing and we don’t know whether this is because of obstacles in their delivery or whether there are other reasons for this. (In the meantime TLAP has been supporting the sector to think about Individual Service Funds which offer more flexibility but are still an under-used option).

As a sector, we don’t have a clear enough picture to understand the different approaches which councils are taking to implement personal budgets, and direct payments in particular, and we don’t know what the  Health and Social Care system might be struggling with in this area.

To this end TLAP wants to find out what tasks direct payment support services are doing. With this information we plan to design a program of work that helps break down some of the barriers to more effective use of direct payments.

The London Self Directed Supported Forum have produced a survey, guided by their members in London and the South East of England. Working in partnership, we’ll be using this survey nationally.

More blogs by Martin Walker.



Posted on by Les Scaife

Having been involved in Direct Payments since their inception (albeit as a concession) I have found from experience that the main reason for not taking them up is the work involved in being an employer, Tax,NI, contracts of employment records to be kept for audit etc.
LAs have started to use Pay Cards that do cut down on the paperwork, but the recipient then loses control of Direct Payment as the LA then have control of the payments. As well as depositing money into the account, they can also take money out of the account. The Pay Card belongs to the LA even though it is in the name of the recipient, this does away with the flexibility of the scheme like "banking" hours for a special occasion because there is no opportunity to build up the funds in the account for a special occasion.
The concept of Direct Payments is a wonderful idea that gives the recipient choice and control over their life instead of the off the peg services that used to be the only option.
My son enjoys a much more fulfilling life doing what HE wants to do, rather than the limited options of a day center.
There is also the option of taking time to find his way into a type of work that is suitable to him.
All the above has been discussed for years, but no progress has been made, I am on record of giving the message of " we pay more people to talk about, than we do people to actually do it"
The quest you are on is a good one, and I am sure you have good intentions, but if we visit this conversation in a few years time we will find that very little has changed.
Les Scaife

Posted on by Mike Hughes

Too few Social workers understand it, Too Many councils are unsure what is and isn't allowed to be bought, It has a bad rep and needs to be rebranded
Many councils pay a rate of DP that is less than they pay to Care companies so there is an inbuilt inequality, In Birmingham the rate has not been reviewed for several years even though DP recipients not have to pay additional holiday pay and pensions its unfair and whilst the scheme offers flexability to the recipient there is little help and support from Councils who delegate their duty

Posted on by Kirk Wells

My recent experience as a provider is that the council are favouring Managed Services because they have a clear framework to work within which ensures the rates are sufficient. The council also seem to equate a PB DP with becoming an employer and as such are restricted to a much lower rate. Whereas, in reality, it is an individual's right to have a PB DP and commission a provider, AND the council should pay what they deem to be reasonable - NOT a lower "county average" rate! There is a definite disparity locally and people are losing the Control in order to fit into an out-dated, inflexible commissioning model. My view is make the individual (with the right support from their own circles of support) and providers will be far more accountable and as such, the quality of provision will improve.

Posted on by Les Scaife

I have just noticed a post by Sally who says her LA are "forcing" people into using a pay card. The Care Act 2014 states quite clearly that the LA MUST give people the choice of a Pay Card or a Bank Account for their Direct Payments. So if I were Sally I would challenge her LA on the subject of using a Bank Account for her Direct Payments.

Posted on by Mike Hughes

Les In the West Midlands they do off both card and bank but if the potential client wants DP they seem to go to great length extolling the virtues of the card and the distraction of the bank account

Posted on by Les Scaife

Mike, the LA should be challenged if the recipient wants a bank account. The Care Act 2014 is an act of parliament that the LA have to abide to. I have argued this point with my own LA and won the day, I have found that most LAs will tell you only what they want you to know. By working together we will all have more knowledge that will enhance the lives of the people we love and care for.

Posted on by Mike Hughes

My experience is that a large number of SWs are contract or agency, they have no knowledge, no interest in DP they want to get in and get out with clients, couple this with the lack of knowledge the applicant has, along with the misinformation they have , its a recipe for disaster and why IMO the system fails
I would love to educate clients as to their rights and force the LAs to do more, we tried with Chief Officers group when Peter hay ( Birmingham, & John ? Nottinghamshire CC were presidents, we failed

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