Cash to buy care services

A guide to personalisation and direct payments

One of the biggest shifts in care over recent years has been the rise of ‘personalisation’ – a new way to deliver support to disabled people, older people and carers.

Instead of directly providing services, such as home helps, councils can now give cash directly to individuals to make their own care arrangements. The advantage of this is in giving people choice, flexibility and control. Some people will use the money to buy care from an agency whilst others will directly employ their own staff, even in some cases paying members of their own family to do the care. These cash awards are called "Direct Payments".

The decision to award a direct payment takes place after an assessment by social services. This could be:

• a community care assessment for the person you are looking after
• an assessment for a disabled child under the Children Act
  
• a carer’s assessment of your own needs (Not available in Scotland).

If the outcome of the assessment is that services should be provided, you or the person you are looking after, have a right to ask for a direct payment instead of having the service arranged by social services.

In most cases, the person receiving a direct payment has to have sufficient mental capacity to consent to it. However, they may still be able to have a direct payment even if they lack capacity, as long as they get help from someone else to manage the payment. In cases like this, as a carer, you may be asked to take on the administration of a Direct Payment.

If you receive a Direct Payment there will be various obligations. All users must keep records and submit accounts to social services showing how the money was spent. In addition if you use the Direct Payment to pay for a care worker you will take on the legal role of an employer and all the responsibilities which go with that. In many areas help is available with these sorts of tasks.

If services arranged with the use of a direct payment run into difficulties, you cannot normally make a complaint to social services in the way that you could if they had been arranged directly. However, in that situation you should expect some assistance and advice from social services.

There are advantages and disadvantages to this way of sorting out care. You cannot be forced to accept a Direct Payment. If you would rather have services and not cash, then the council must provide them.