5 Common Misunderstandings about Direct Payments

It may be helpful to read our Guide to Accessing Free Personal Care before reading this article.

1. The council has only offered me 6 hours a week so is that all I can get?

Firstly, it is important to understand with direct payments the council will assess your needs based on how may ‘hours’ of care they think you need. It is from this number of hours that they then calculate how much money they will contribute to your care based on the councils pre set hourly rate at that time. Eg. If you have been assessed as needing twice daily for 30 minutes and the hourly rate is £15, this means that the council will contribute 7hrs a week or £105. They key word here is contribute! In the majority of cases you will need to top up to access that actual care package you want.

Once you know how many ‘hours’ you are entitled to it become very unhelpful to view the payment in terms of hours of care.   Instead go with the weekly contribution in actual £s. Once you know the weekly amount they will contribute you can then decide how much care you actually want and what you can afford with both the councils money and with your own money to top it up.

It is misleading to think the council will be able to provide enough money to pay for your perfect package of care. View the councils money as a contribution only from which you can build you own package of care on your terms. A helpful rule of thumb we , have found is that usually, in the context of a holistic package of care put together by a family, the contribution from the council may cover 20-25% of the total cost. You can have as many or as few hours of care as you want, provided you can afford to top up as required with your own money.

2. Can I only use a care provider whose pricing structure is the same as what the council will give me per hour for care?

No. Despite what you might be told occasionally, you can use any provider you like, just remember that if you choose a provider whose hourly rate is higher than the council rates(which will likely be the majority of providers these days), you will need to be able to self fund the difference. The principle behind the ‘personalisation’ agenda is all about putting control back to the users of care services. Therefore you are in control and no one can tell you who you can and cannot use your direct payments with. The only caveat is that the money is from the public purse and as such you must be able to justify where and how its been spent and evidence that it has been used for care and support services and not spent on a luxury holiday to the Caribbean!

3. The payments can only be used for personal care.

This is not true but, you may get differing opinions on this depending on who you speak to! In order to answer this question, one must first understand what personal care is and is not. Personal care is helping you to get in and out of bed, it will assist with washing and dressing and toileting, medication prompts and very basic meal preparation. It is not for the provision of companionship, shopping and errands, housekeeping and extended support and other matters of general wellbeing.

The council will often assess a persons requirements for personal care in blocks, ie, bath = 30 minutes, breakfast = 15 minutes, toileting 15 minutes etc to determine their need. We know life does not work like this and particularly as we age we like to take out time to do things in life and indeed if someone is rushing us through personal care tasks it can often become unsettling and do little to help us maintain our sense of independence and control.

Within the context of quality care and quality time it is not always so easy to break down care arrangements into what is personal care and what is not. Now you can see why it is unhelpful to be prescriptive about whether or not it can only be spent on personal care. We tend to subscribe to the notion that, if the support which is being provided is helping to contribute to someone’s wellbeing and independence at home, then the direct payment can be justifiably spent on it.

4. If I want to access direct payments , do I need to become an employer?

No, not at all.  In fact we would generally recommend against it unless you are in a position and are prepared to take on all the legal and employer responsibilities on yourself. If you use a professional established provider of care services like Bright Care, they carry all the legal responsibilities for the safe and proper management of its staff which in turn serve you.

Some people may choose to use a direct payment to hire someone directly. Setting yourself up as an employer is fraught with difficulties and challenges which often cancel out any potential savings of hiring direct as opposed to using a provider, however there is free assistance with this process from charities like Lothian Centre for Inclusive Living www.lothiancil.org.uk.

It has been our observation that setting yourself up as an employer may provide a greater sense of control for a younger adult with full capacity who requires a lot of day to day care and assistance in their life. We would take the general view that in terms of care for older people, setting ones self up as an employer is rarely going to be the best solution with all the added challenges of recruiting and managing staff, staff absences, holiday pay, sick pay and employer liability, the list goes on!

5. Can I nominate the provider but the council will pay them on my behalf?

Yes. Under what is defined as Option 2, they will, but there is caveats! Option 2 is defined by the government as ‘The selection of support by the supported person, the making of arrangements for the provision of it by the local authority on behalf of the supported person and, where it is provided by someone other than the authority, the payment by the local authority of the relevant amount in respect of the cost of that provision’.

We feel that this statement could be somewhat misleading. Firstly, if you choose a provider whose hourly rates are higher than the amount set by the direct payment (which is increasingly most providers) the local authority will not pay the full bill. This would leave a top up to be paid, which can get very messy and confusing in terms of knowing what you owe.

Secondly, if you have chosen option 2, its probably because you do not want the hassle associated of paying a private provider so you if you find yourself being involved in paying a top up you may as well have opted for ‘Option 1’, in which you are responsible for paying the full bill from the care provider. Option 1 is defined as ‘The making of a direct payment by the local authority to the supported person for the provision of support’. When pursing direct payment, generally speaking, we would strongly recommend Option 1 in connection to getting extra financial support for caring for an elderly loved one.