Alzheimer's Society

Direct payments are cash payments given by local authority social service departments to individuals who need community care services. A person must have been assessed as needing services to receive a direct payment, and the payment must be used to purchase the services that the person is assessed as needing. This factsheet explains how direct payments work, and how to apply for them.

Who can get direct payments?

The Community Care (Direct Payments) Act 1996 empowers local authority social services departments to make direct cash payments to people for the community care services that they have been assessed as needing. In April 2003, it became mandatory to offer the direct payments scheme to people in England, who fall within certain rules, although in Wales direct payments are discretionary. Payments may be made to carers and to people with dementia.

Day-to-day control of the money and the care package passes to the person who is best able to ensure that it is spent properly on the most appropriate services for the person.

Local authorities must consider each application to receive direct payments on its own merit.

Local authorities may arrange some services for a person as well as making direct payments to them.

People receiving direct payments can ask a carer or another person to manage them and to act as their agent. If you receive direct payments, you will need to account for how you spend the money you receive. The local authority will tell you what records it needs and what information it will expect you to provide − for example, timesheets or receipts for services provided. This is because it has to satisfy itself that the needs for which the direct payment is given are actually being met.

Direct payments are available to carers and disabled people over the age of 16 who have been assessed as needing services. Any person who receives direct payments must be willing and able to manage them (alone or with assistance).

How does someone request direct payments?

A person with dementia or a carer can request a direct payment by contacting their social services department and asking for an assessment. A social worker will then visit to discuss and assess the kind of support needed.

It can be helpful to draw up a list of the types of support needed before the assessment. For example, someone may need help with cooking, eating, bathing, dressing, shopping, collecting their pension, or going up and down stairs.

What can direct payments be used for?

A range of support services are available, and direct payments can be used to buy either all of the support that a person has been assessed as needing, or just part of that support. Each person's needs are different, so it is important to discuss with a social worker what the direct payment will be spent on. The social services department must agree what the direct payment can be used for.

Are there restrictions on the use of direct payments?

Direct payments are made as an alternative to the provision of services, and are not intended as a replacement for support from families and communities.

Previously, the direct payment regulations and guidance did not allow someone to use his or her direct payment to employ a close relative, regardless of whether they lived in the same household or not. However, the Department of Health has now decided that local councils should determine when a direct payment can be made in respect of care. Local councils will assess a person's needs on a case-by-case basis.

Nevertheless, while councils are free to formulate policies locally, they must, of course, comply with the legislative framework and with general public law principles about the way in which decisions are made.

Consent

Under the current law, in order to receive direct payments, a person must give consent, or must have given consent, at a time when they had the mental capacity to do so. Thus, although an attorney under a lasting power of attorney (or an enduring power of attorney if made before October 2007) cannot give consent on a person's behalf, the attorney can continue to receive direct payments even when a person with dementia has lost capacity if the person gave their consent prior to this. (See Factsheet 472, Enduring power of attorney and lasting powers of attorney.)

However, provisions to extend direct payments to people who lack capacity are included in the Health and Social Care Bill, which is due to be passed in late 2008. The intention is that a third party will then be able to manage the direct payment, including banking requirements, on behalf of the person who lacks capacity.

Personal budgets and individual budgets

Following publication of the government green paper Independence, well-being and choice (2005), it has been proposed that service users be given increasing autonomy over their care arrangements and funding. Eventually, personal budgets and individual budgets will be introduced in every borough to allow people more freedom to manage their care package themselves. A number of different funding streams will be incorporated into this system − for example, Supporting People, Independent Living Funds and Disabled Facilities Grants.

Some local authorities have signed up to a project called In Control. The aim of In Control is to create a new system of social care, in which people will control their support, their money and their lives as valued citizens. Like direct payments and individual budgets, it promotes a system of self-directed support. For more information, see 'Useful organisations'.

Your local Alzheimer's Society branch will always be willing to talk to you and offer advice and information to support your needs.

For more information, Dementia Catalogue, our specialist dementia information resource, is available on the website at alzheimers.org.uk/dementiacatalogue

Useful organisations

Alzheimer's Society

Devon House
58 St Katharine's Way
London E1W 1JX
T 020 7423 3500
   0845 300 0336 (helpline open 8.30am-6.30pm weekdays)
E info@alzheimers.org.uk (general information)
   helpline@alzheimer.org.uk (helpline)
W alzheimers.org.uk

The UK's leading care and research charity for people with dementia and those who care for them. The helpline provides information, support, guidance and referrals to other appropriate organisations.

Carers UK

20 Great Dover Street
London SE1 4LX
T 0808 808 7777 (free carers line)
E info@ukcarers.org
W http://www.carersuk.org/

Provides information and advice to carers about their rights and how to access support, including direct payments.

Department of Health

Richmond House
79 Whitehall
London SW1A 2NS
T 020 7210 4850 
   020 7210 5025 (textphone)
E use the enquiry form on the website (see below)
W http://www.dh.gov.uk/

The government department responsible for health, social care, and the National Health Service (NHS). Provides information and literature on a range of topics, including direct payments. Useful publications include 'An easy guide to direct payments' and 'A guide to receiving direct payments from your local council − a route to independent living'.

In Control Support Centre

4 Swan Courtyard
Coventry Road
Birmingham B26 1BU
T 0121 708 3031
E web_enquiries@in-control.org.uk
W http://www.in-control.org.uk/

A partnership between families, individuals, services, local authorities, government and other organisations working to improve the way that people pay for their services, through Self-Directed Support and Individual Budgets.

National Centre for Independent Living

4th Floor Hampton House
20 Albert Embankment
London SE1 7TJ
T 020 7587 1663
E info@ncil.org.uk
W http://www.ncil.org.uk/

Not-for-profit support, advice and consultancy organisation providing information and advice on independent living and direct payments for disabled people and others working in the field.

Rowan Organisation

Eliot Park Innovation Centre
Barling Way
Nuneaton CV10 7RH
T 02476 322 860
E use the feedback form on the website (see below)
W http://www.therowan.org/

An organisation of disabled people that provides other disabled people with access to information, services and resources. It offers a factsheet on direct payments and can provide advice and practical assistance to people using direct payments in certain parts of the country.

Factsheet 473

Last updated: June 2008
Last reviewed: June 2008

Updated by Sara Wilcox, Legal and Welfare Officer, Alzheimer's Society, and Linda Gabriel, Solicitor, Thackray Williams.