Money management - Restrictions on direct payment usage policies
Restrictions on what direct payments (DPs) can be used for are intended to make sure the direct payment user purchases services that meet needs. Overly restrictive conditions, however, can have unintended consequences: reducing flexible approaches to meeting needs and achieving agreed outcomes
Councils sometimes create rules that go beyond the minimum requirements for direct payment holders. Minimum requirements are that the public money is spent on goods or services that are legal, and which meet the customer's needs. In addition to these rules councils may insist that direct payments cannot be used on some specific goods and services, such as cleaning and transport. However, there is no power to impose these restrictions if the outcomes assessment has revealed an eligible need for them.
Undue restrictions on how a direct payment can be spent can reduce the individual's choice and control in how they achieve their agreed outcomes. This can have the effect of reducing the overall effectiveness of the direct payment and reduce the overall value of providing them.
What are the outcomes we want to achieve?
- People are encouraged and enabled to use their direct payment flexibly and innovatively to meet the outcomes outlined in their support plan
- There is a clear and shared understanding between staff and people with care and support needs about what is not permissible use of a direct payment
- The prohibitions placed on direct payment usage are minimal (e.g. nothing illegal and nothing which could be deemed detrimental to people's wellbeing)
- Public money is used effectively
- The process for dealing with any disputes over possible misuse of a DP is clear and simple and affords people the opportunity to re-establish self-management with additional support if necessary
What tools and resources do we need to do a good job? What are the steps we have to go through?
- Clear information available from first point of contact on permitted and non permitted uses of a direct payment
- Direct Payment policy that:
- Clearly sets out the restrictions on direct payment usage including what is illegal, while promoting flexible and innovative user defined means to meet agreed outcomes
- Outlines roles and responsibilities of all stakeholders
- Includes a clear and transparent escalation process for dealing with instances of transgression which assumes trust and promotes people's capacity to continue to self manage their care and support in all but the most serious cases of transgression
- An agreed approach to data collection from direct payment users which focuses on collecting the minimum information needed to establish that people are spending their direct payment legally and in ways which contribute to meeting their outcomes as defined in their support plan
- Councils should bear in mind that they have (and have always had) the power of 'conditions' i.e. Councils can ask for any information they want, within reason.
What are the products we will have at the end of this process?
- Signed direct payment agreement with the actual holder
- Direct payment review (together with a care and support plan review) where appropriate and in accordance with Care Act regulations timetable
- Clear written information to the direct payment recipient where a transgression has occurred as to what will happen next and any lawful actions which the council requires from the direct payment recipient to ensure the direct payment can continue
- Reviewed and renegotiated monitoring arrangements specifying any additional information which the direct payment recipient will need to provide for what period
When does this process start and end and within what timescales should this process be completed?
- Information on direct payments and what they can and can't be used for should be provided with information on universal services and local community resources at first point of contact
- Timeframe for resolving any instances of transgression should be no greater than one direct payment cycle or one month
Who needs to be involved and what is their role? Who is taking the lead?
- Direct payment holder
- Family or carer
- Independent advocate or chosen representative
- Care coordinator
- Financial assessments team
- Leaflet writers
The additional restrictions of Councils mean direct payment holders have to be careful not to transgress the local rules which can vary from Council to Council. These additional rules need to be in place lawfully and in support of a proper purpose. If they are not, they should be removed.
The list of ways to meet needs in Section 8 of the Care Act (care and support, accommodation, counselling, goods and facilities etc) is illustrative and not exhaustive. Flexibility is magnified in the Care Act. The problems lie in the way a limited range of services are costed into the resource allocation system (RAS). Commercial RAS aren't easy to break into and home grown ones depend on what commissioners have costed for. Often costs are only included for three types of services: day care, residential care and home care. A new RAS approach is needed which is based on what clients need to achieve the agreed eligible outcomes, based on how they can make things work best for them.
The Care Act encourages councils to make sure people can use their direct payments creatively and flexibly and that processes for allocating and monitoring payments do not undermine their core purpose