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282 <h2>
282 Direct Payments
282 </h2>
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288 <h3>
288 STATUTORY GUIDANCE
288 </h3>
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289 Care and Support Statutory Guidance (GOV.UK)
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290 AMENDMENT
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291 This chapter was amended by Bexley in April 2017.
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292 </div>
293 <div id="sections">
295 <h3 id="sections_list">
295 Contents
295 </h3>
296 <ol>
297 <li>
297 <a href="#what_are">
297 What are Direct Payments?
297 </a>
297 </li>
298 <li>
298 <a href="#who_can_get">
298 Who can Get Direct Payments?
298 </a>
298 </li>
299 <li>
299 <a href="#how_often">
299 How Often are Direct Payments Made?
299 </a>
299 </li>
300 <li>
300 <a href="#what_is_process">
300 What is the Process?
300 </a>
300 </li>
301 <li>
301 <a href="#spent_on_pa">
301 Direct Payments Can be Spent on Employing a Personal Assistant (PA)
301 </a>
301 </li>
302 <li>
302 <a href="#also_spent_on">
302 Direct Payments Can also be Spent On
302 </a>
302 </li>
303 <li>
303 <a href="#hospital_stays">
303 Hospital Stays
303 </a>
303 </li>
304 <li>
304 <a href="#not_spent">
304 Direct Payments Can Not be Spent On
304 </a>
304 </li>
305 <li>
305 <a href="#benefits">
305 What are the Benefits of Direct Payments
305 </a>
305 </li>
306 <li>
306 <a href="#decision">
306 Decisions Not to Make Direct Payments
306 </a>
306 </li>
307 <li>
307 <a href="#monitoring">
307 Monitoring and Review of Direct Payments
307 </a>
307 </li>
308 <li>
308 <a href="#reducing">
308 Reducing the Amount of Direct Payments
308 </a>
308 </li>
309 <li>
309 <a href="#repayment">
309 Repayment and Recovery of Direct Payments
309 </a>
309 </li>
310 <li>
310 <a href="#ceasing_payments">
310 Ceasing Direct Payments
310 </a>
310 </li>
311 </ol>
312 <h3 id="what_are">
312 1. What are Direct Payments?
312 </h3>
313 <p>
313 A Direct Payment is money given to children who have a disability and to parents or carers, by the
authority to enable them to buy in support that is assessed as being needed, instead of the
authority providing that support through their own services. Direct Payments do not affect
benefits.
313 </p>
314 <p>
314 Direct Payments can be made for special educational provision, health care and social care
provision.
314 </p>
315 <p>
315 Local authorities must offer the option of Direct Payments in place of services currently being
received. For both education and social care the local authority must be satisfied that the person
who receives the Direct Payment: is able to manage the Direct Payment either by themselves or with
whatever help the authority thinks the applicant or nominated person will be able to access; will
use them in an appropriate way to meet the needs in question and that they will act in the best
interests of the child or young person.
315 </p>
316 <p>
316 Regulations governing the use of Direct Payments for special educational provision place a number
of additional requirements on both local authorities and parents before a Direct Payment can be
agreed. These include requirements to consider the impact on other service users and value for
money and to seek agreement from educational establishments where a service funded by a Direct
Payment is delivered on their premises.
316 </p>
317 Direct Payments for health require the agreement of a Care Plan between the Clinical Commissioning
Group and the recipient.
318 <h3 id="who_can_get">
318 2. Who can get Direct Payments?
318 </h3>
319 <p>
319 Those who have been assessed as meeting the criteria for disabled children's
services. Children and young people who have Education, Health and Care Plans and their
parents have the right to request a Personal Budget, which may contain elements of education,
social care and health funding, and may be delivered by way of Direct Payments. Under the Children
and Families Act 2014, this covers those aged 0-25 having special educational needs and
disabilities. Direct Payments are available if a child or young person is disabled or is a carer
or parent for a child with disabilities. No-one can be forced to have a Direct Payment.
319 </p>
320 <p>
320 Direct Payments can also be made to a willing and appropriate person on a disabled person's behalf
if they lack the mental capacity to agree to and manage Direct Payments themselves.
320 </p>
321 Direct Payments cannot be used to pay for services from a spouse, partner or a close relative living
in the household unless the local authority consider it is necessary to do so. However, a direct
payment can be used to employ a relative if they are not living in the household.
322 <h3 id="how_often">
322 3. How Often are Direct Payments Made?
322 </h3>
323 <p>
323 Direct Payments are paid in advance into a bank or building society account specifically set up
for this purpose, as a one off payment or on a monthly basis. If the direct payment is assessed as
being needed at key times e.g. school holidays, then payment will be made accordingly.
323 </p>
324 <h3 id="what_is_process">
324 4. What is the Process?
324 </h3>
325 <p>
325 The arrangements for Direct Payments will be included in the child's/young person's Education,
Health and Care Plan, following an Education, Health and Care Needs Assessment. See
325 <a href="p_child_disability.html">
325 Children and Young People Aged 0-25 with Special Educational Needs and Disabilities Procedure
325 </a>
325 .
325 </p>
326 <h3 id="spent_on_pa">
326 5. Direct Payments Can be Spent on Employing a Personal Assistant (PA)
326 </h3>
327 <ul>
328 <li>
328 To take the young person/child into the community to access an activity, support inclusion,
going to a club etc;
328 </li>
329 <li>
329 To work with the child directly within the home, to give parents and siblings a break;
329 </li>
330 <li>
330 To stay overnight to give respite to parents;
330 </li>
331 <li>
331 Or a registered childminder or child home carer (for children aged under 8).
331 </li>
332 </ul>
333 <h3 id="also_spent_on">
333 6. Direct Payments Can also be Spent On
333 </h3>
334 <ul>
335 <li>
335 Using an approved agency to provide direct care to meet your child/family's needs;
335 </li>
336 <li>
336 After school clubs and holiday play schemes for your disabled child;
336 </li>
337 <li>
337 Residential overnight breaks for your disabled child;
337 </li>
338 <li>
338 By agreement with the Team Manager for direct payments, any service which meets your assessed
need for a short break;
338 </li>
339 <li>
339 Special educational provision specified in an Education, Health and Care Plan.
339 </li>
340 </ul>
341 <h3 id="hospital_stays">
341 7. Hospital Stays
341 </h3>
342 <p>
342 When a child or young person needs to go into hospital, the parent, carer or the person managing
the Direct Payment, should advise the local authority straight away to discuss the continuation of
the payment.
342 </p>
343 <p>
343 It is possible that the payment will continue for a time-limited period, if only to allow for the
person managing the Direct Payment to ensure that any contractual obligations around termination
of the support can be met. However, there might also an issue of continuity of care post-discharge
to consider in some instances.
343 </p>
344 <p>
344 Where a Young Person is in receipt of Direct Payments, hospitalisation may not necessarily mean
that the Direct Payments should cease. Guidance advises that consideration should be given by the
local authority, the carer, the holder and NHS Trust to as to how the payments might be used to
meet non-health needs or to ensure that the employment arrangements can be maintained. For
example, the holder may prefer some personal care tasks to be undertaken by the carer rather than
hospital staff. However, the personal care and medical input need to be tailored so as not to
interfere with the medical treatment. (Terminating or suspending the carer's employment may lead
to a delay of continuity of care and a delay in discharge).
344 </p>
345 <p>
345 In instances where the authorised or nominated person requires hospital treatment, the local
authority must conduct an urgent review to ensure the holder continues to receive the care and
support they need. This might include the duties to be carried out by a temporary nominated
person, or through short-term authority arranged care/support.
345 </p>
346 <h3 id="not_spent">
346 8. Direct Payments Can Not be Spent On
346 </h3>
347 <ul>
348 <li>
348 Employing someone without Disclosure and Barring Service and CPR checks or references, or
someone subject to a drug or alcohol treatment requirement, youth rehabilitation order or
released on licence;
348 </li>
349 <li>
349 Permanent residential accommodation, though they can be used for occasional short breaks, if the
local authority agrees, for up to 120 days in any 12 month period. (
349 <span class="bold">
349 Note
349 </span>
349 : where two periods of short term care are 4 weeks or less apart, then the cumulative total of
the stays should be added and not exceed 4 weeks if the stay is to be funded by Direct
Payments).
349 </li>
350 </ul>
351 <h3 id="benefits">
351 9. What are the Benefits of Direct Payments?
351 </h3>
352 <p>
352 Direct Payments allow parents and young people greater choice flexibility and control, to employ
their own workers at times convenient to them and in the way they wish, to provide an individual
service to meet their needs. Payments made do not affect welfare benefits.
352 </p>
353 <h3 id="decision">
353 10. Decisions Not to Make Direct Payments
353 </h3>
354 <p>
354 Where the local authority decides not to make Direct Payments it must inform in writing the
child's parent or the young person of its decision and reasons in a format that is accessible to
them and in line with the Data Protection Act. It must also advise of their right to request a
review of the decision.
354 </p>
355 <h3 id="monitoring">
355 11. Monitoring and Review of Direct Payments
355 </h3>
356 <p>
356 The local authority must monitor and review the use of Direct Payments by the recipient at least
once within the first three months of Direct Payments being made, and when conducting a review or
a re-assessment of an Education, Health and Care Plan. In addition, a recipient may make a request
for the local authority to review the making and use of Direct Payments and the local authority
must then consider whether to carry out a review. (See also
356 <a href="#hospital_stays">
356 Section 7, Hospital Stays
356 </a>
356 ).
356 </p>
357 <p>
357 When carrying out a review, the local authority must consider whether:
357 </p>
358 <ul>
359 <li>
359 It should continue to secure the agreed provision by means of Direct Payments;
359 </li>
360 <li>
360 The Direct Payments have been used effectively;
360 </li>
361 <li>
361 The amount of direct payments continues to be sufficient to secure the agreed provision;
361 </li>
362 <li>
362 The recipient has complied with their obligations on the use of the Direct Payment.
362 </li>
363 </ul>
364 <p>
364 Following a review the local authority may:
364 </p>
365 <ul>
366 <li>
366 Substitute the person receiving the Direct Payments with a nominee, the child's parent or the
young person, as appropriate;
366 </li>
367 <li>
367 Increase, maintain or reduce the amount of Direct Payments;
367 </li>
368 <li>
368 Require the recipient to comply with either or both of the following conditions:
369 <ul>
370 <li>
370 Not to secure a service from a particular person;
370 </li>
371 <li>
371 To provide such information as the local authority considers necessary.
371 </li>
372 </ul>
373 </li>
374 <li>
374 Stop making Direct Payments.
374 </li>
375 </ul>
376 <h3 id="reducing">
376 12. Reducing the Amount of Direct Payments
376 </h3>
377 <p>
377 Where the local authority decides to reduce the amount of Direct Payments, it must provide
reasonable notice to the recipient, and must set out in the notice the reasons for its decision.
377 </p>
378 <p>
378 The local authority must reconsider its decision, where requested to do so by the recipient, but
is not required to undertake more than one reconsideration of a decision. When conducting its
reconsideration, the local authority must consider the representations made by the recipient (and
where the recipient is a nominee, any representations made by the child's parent or the young
person) and must then provide written reasons to the recipient (and to the child's parent or young
person, where the recipient is a nominee) of its decision following the reconsideration. The local
authority may reduce Direct Payments following reasonable notice despite the fact that a request
for reconsideration has been made.
378 </p>
379 <h3 id="repayment">
379 13. Repayment and Recovery of Direct Payments
379 </h3>
380 <p>
380 The local authority may require the recipient to repay part or all of the direct payments, where:
380 </p>
381 <ul>
382 <li>
382 The circumstances of the child or young person have changed in a manner which has an impact on
the appropriateness of the agreed provision;
382 </li>
383 <li>
383 All or part of the Direct Payments have not been used to secure the agreed provision;
383 </li>
384 <li>
384 Theft, fraud or another offence may have occurred in connection with the Direct Payments;
384 </li>
385 <li>
385 The child or young person has died.
385 </li>
386 </ul>
387 <p>
387 It must give notice in writing to the recipient, setting out the reasons for the decision, the
amount to be repaid and a reasonable timescale within which the amount must be repaid.
387 </p>
388 <p>
388 The local authority must reconsider its decision where requested to do so by the recipient (but is
not required to undertake more than one reconsideration of a decision). When conducting its
reconsideration, the local authority must consider the representations made by the recipient (and
where the recipient is a nominee, any representations made by the child's parent or young person)
and must then provide written reasons of its decision following the reconsideration to the
recipient (and to the child's parent or young person, where the recipient is a nominee).
388 </p>
389 <p>
389 The local authority may only seek repayment of any portion of the Direct Payments that has not
already been spent on the agreed provision.
389 </p>
390 <h3 id="ceasing_payments">
390 14. Ceasing Direct Payments
390 </h3>
391 <p>
391 The local authority must stop making Direct Payments if:
391 </p>
392 <ul>
393 <li>
393 The recipient has notified the local authority in writing that he or she no longer consents to
receive the Direct Payments;
393 </li>
394 <li>
394 The recipient ceases to be a person to whom a Direct Payments may be made;
394 </li>
395 <li>
395 Following a review, it appears to the local authority that:
396 <ul>
397 <li>
397 The recipient is not using the payment to secure the agreed provision;
397 </li>
398 <li>
398 The agreed provision can no longer be secured by means of Direct Payments.
398 </li>
399 </ul>
400 </li>
401 <li>
401 At any point the local authority becomes aware that the making of Direct Payments is:
402 <ul>
403 <li>
403 Having an adverse impact on other services which the local authority provides or arranges
for children and young people with an Education, Health and Care Plan which the authority
maintains; or
403 </li>
404 <li>
404 No longer compatible with the authority's efficient use of its resources.
404 </li>
405 </ul>
406 </li>
407 <li>
407 It has taken reasonable steps to ascertain whether the young person consents to Direct Payments
and the young person has not notified the local authority of their consent.
407 </li>
408 </ul>
409 <p>
409 Where the local authority decides to stop making Direct Payments, the local authority must first
give notice in writing to the recipient setting out the reasons for its decision.
409 </p>
410 <p>
410 The local authority must reconsider its decision where requested to do so by the recipient (but is
not required to undertake more than one reconsideration of a decision). When conducting its
reconsideration, the local authority must consider the representations made by the recipient (and
where the recipient is a nominee, any representations made by the child's parent or young person)
and must then provide written reasons of its decision following the reconsideration to the
recipient (and to the child's parent or young person, where the recipient is a nominee).
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