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136 <h1>
136 Direct Payments
136 </h1>
152 <div class="section">
152 <h2 id="what_are">
152 1. What are Direct Payments?
152 </h2>
153 <p>
153 A Direct Payment is money given to children aged 16 years or over who have a disability and
to parents or carers, aged 16 or over of young people, 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.
153 </p>
154 <p>
154 Direct Payments can be made for special educational provision, health care and social care
provision.
154 </p>
155 <p>
155 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 Payments
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.
155 </p>
156 <p>
156 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.
156 </p>
157 Direct Payments for health require the agreement of a Care Plan between the clinical
commissioning group and the recipient.
157 </div>
158 <div class="section1">
158 </div>
164 <div class="section">
164 <h2 id="who_can_get">
164 2. Who can get Direct Payments?
164 </h2>
165 <p>
165 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 and aged 16 or over or is a carer or parent aged 16 or over for a child with
disabilities. No-one can be forced to have a Direct Payment.
165 </p>
166 <p>
166 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.
166 </p>
167 <p>
167 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.
167 </p>
168 </div>
169 <div class="section1">
169 </div>
175 <div class="section">
175 <h2 id="how_often">
175 3. How Often are Direct Payments Made?
175 </h2>
176 <p>
176 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 weekly basis. If the direct payment is
assessed as being needed at key times e.g. school holidays, then payment will be made
accordingly.
176 </p>
177 </div>
178 <div class="section1">
178 </div>
184 <div class="section">
184 <h2 id="what_is_process">
184 4. What is the Process?
184 </h2>
185 <p>
185 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
185 <a href="p_child_disability.html">
185 Children and Young People Aged 0-25 with Special Educational Needs and Disabilities
Procedure
185 </a>
185 .
185 </p>
186 </div>
187 <div class="section1">
187 </div>
193 <div class="section">
193 <h2 id="spent_on_pa">
193 5. Direct Payments Can be Spent on Employing a Personal Assistant (PA)
193 </h2>
194 <ul>
195 <li>
195 To take the young person/child into the community to access an activity, support
inclusion, going to a club etc;
195 </li>
196 <li>
196 To work with the child directly within the home, to give parents and siblings a break;
196 </li>
197 <li>
197 To stay overnight to give respite to parents;
197 </li>
198 <li>
198 Or a registered childminder or child home carer (for children aged under 8).
198 </li>
199 </ul>
200 </div>
201 <div class="section1">
201 </div>
207 <div class="section">
207 <h2 id="also_spent_on">
207 6. Direct Payments Can also be Spent On
207 </h2>
208 <ul>
209 <li>
209 Using an approved agency to provide direct care to meet your child/family's needs;
209 </li>
210 <li>
210 After school clubs and holiday play schemes for your disabled child;
210 </li>
211 <li>
211 Residential overnight breaks for your disabled child;
211 </li>
212 <li>
212 By agreement with the Team Manager for direct payments, any service which meets your
assessed need for a short break;
212 </li>
213 <li>
213 Special educational provision specified in an education, health and care plan.
213 </li>
214 </ul>
215 </div>
216 <div class="section1">
216 </div>
222 <div class="section">
222 <h2 id="hospital">
222 7. Hospital Stays
222 </h2>
223 <p>
223 When a child or young person under 16 years 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.
223 </p>
224 <p>
224 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.
224 </p>
225 <p>
225 Where a Young Person is 16 years or older and in receipt of Direct Payments, hospitalisation
does 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 payment 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).
225 </p>
226 <p>
226 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.
226 </p>
227 </div>
228 <div class="section1">
228 </div>
234 <div class="section">
234 <h2 id="not_spent">
234 8. Direct Payments Can Not be Spent On
234 </h2>
235 <ul>
236 <li>
236 Employing someone without a Disclosure and Barring Service check, or someone subject to a
drug or alcohol treatment requirement, youth rehabilitation order or released on licence;
236 </li>
237 <li>
237 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. (
237 <span class="bold">
237 Note
237 </span>
237 : 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).
237 </li>
238 </ul>
239 </div>
240 <div class="section1">
240 </div>
246 <div class="section">
246 <h2 id="benefits">
246 9. What are the Benefits of Direct Payments?
246 </h2>
247 <p>
247 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.
247 </p>
248 </div>
249 <div class="section1">
249 </div>
255 <div class="section">
255 <h2 id="decision">
255 10. Decisions Not to Make Direct Payments
255 </h2>
256 <p>
256 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.
256 </p>
257 </div>
258 <div class="section1">
258 </div>
264 <div class="section">
264 <h2 id="monitoring">
264 11. Monitoring and Review of Direct Payments
264 </h2>
265 <p>
265 The local authority must monitor and review the use of Direct Payments by the recipient at
least once within the first 3 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
265 <a href="#hospital">
265 Section 7, Hospital Stays
265 </a>
265 ).
265 </p>
266 <p>
266 When carrying out a review, the local authority must consider whether:
266 </p>
267 <ul>
268 <li>
268 It should continue to secure the agreed provision by means of Direct Payments;
268 </li>
269 <li>
269 The Direct Payments have been used effectively;
269 </li>
270 <li>
270 The amount of Direct Payments continues to be sufficient to secure the agreed provision;
270 </li>
271 <li>
271 The recipient has complied with their obligations on the use of the Direct Payment.
271 </li>
272 </ul>
273 <p>
273 Following a review the local authority may:
273 </p>
274 <ul>
275 <li>
275 Substitute the person receiving the Direct Payments with a nominee, the child's parent or
the young person, as appropriate;
275 </li>
276 <li>
276 Increase, maintain or reduce the amount of Direct Payments;
276 </li>
277 <li>
277 Require the recipient to comply with either or both of the following conditions:
278 <ul>
279 <li>
279 Not to secure a service from a particular person;
279 </li>
280 <li>
280 To provide such information as the local authority considers necessary.
280 </li>
281 </ul>
282 </li>
283 <li>
283 Stop making Direct Payments.
283 </li>
284 </ul>
285 </div>
286 <div class="section1">
286 </div>
292 <div class="section">
292 <h2 id="reducing">
292 12. Reducing the Amount of Direct Payments
292 </h2>
293 <p>
293 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.
293 </p>
294 <p>
294 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.
294 </p>
295 </div>
296 <div class="section1">
296 </div>
302 <div class="section">
302 <h2 id="repayment">
302 13. Repayment and Recovery of Direct Payments
302 </h2>
303 <p>
303 The local authority may require the recipient to repay part or all of the direct payments,
where:
303 </p>
304 <ul>
305 <li>
305 The circumstances of the child or young person have changed in a manner which has an
impact on the appropriateness of the agreed provision;
305 </li>
306 <li>
306 All or part of the Direct Payments have not been used to secure the agreed provision;
306 </li>
307 <li>
307 Theft, fraud or another offence may have occurred in connection with the Direct Payments;
307 </li>
308 <li>
308 The child or young person has died.
308 </li>
309 </ul>
310 <p>
310 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.
310 </p>
311 <p>
311 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).
311 </p>
312 <p>
312 The local authority may only seek repayment of any portion of the Direct Payments that has
not already been spent on the agreed provision.
312 </p>
313 </div>
314 <div class="section1">
314 </div>
320 <div class="section">
320 <h2 id="ceasing_payments">
320 14. Ceasing Direct Payments
320 </h2>
321 <p>
321 The local authority must stop making Direct Payments if:
321 </p>
322 <ul>
323 <li>
323 The recipient has notified the local authority in writing that they no longer consents to
receive the Direct Payments;
323 </li>
324 <li>
324 The recipient ceases to be a person to whom a Direct Payments may be made;
324 </li>
325 <li>
325 Following a review, it appears to the local authority that:
326 <ul>
327 <li>
327 The recipient is not using the payment to secure the agreed provision;
327 </li>
328 <li>
328 The agreed provision can no longer be secured by means of Direct Payments.
328 </li>
329 </ul>
330 </li>
331 <li>
331 At any point the local authority becomes aware that the making of Direct Payments is:
332 <ul>
333 <li>
333 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
333 </li>
334 <li>
334 No longer compatible with the authority's efficient use of its resources.
334 </li>
335 </ul>
336 </li>
337 <li>
337 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.
337 </li>
338 </ul>
339 <p>
339 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.
339 </p>
340 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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