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Direct payments guidance

Introduction

If a social care assessment determines that you need care services or support, you have a right to ask for a Direct Payment instead of having a service arranged by St Helens Borough Council.

The aim of a Direct Payment is to give more flexibility in how services are provided to people who are assessed as eligible for social care support.

This guidance will assist you in operating your Direct Payments account and details what you can and cannot spend this money on.

What is a Direct Payment?

A Direct Payment is a cash payment that allows you to organise care services yourself. Some people use the money to employ an agency while others will directly employ their own staff.

The main methods for receiving a Direct Payment are:

  • Prepaid card - the money is loaded onto a dedicated bank card to allow you to make electronic transactions. This is the council's preferred option.
  • Managed by a third party organisation - the third-party organisation will administer the Direct Payment for you. You remain accountable for ensuring your direct payment is used appropriately.
  • ISF - Individual Service Fund. You can request that your Direct Payment is paid directly to your chosen provider who provides your direct support.

Who can receive a Direct Payment?

Direct Payments can be made to any person aged 16 or over, to people with parental responsibility for disabled children, carers aged 16 and over in respect of carers services, and people who receive a Personal Health Budget.

Personal Health Budgets

People eligible for NHS Continuing Health Care (CHC) and Continuing Care for Children (CC) can request a Personal Health Budget from the Clinical Commissioning Group (CCG) and this can be provided as a Direct Payment.

Payments to family members

You are not allowed to use Direct Payments to employ family members who live with you unless there are exceptional circumstances agreed by the council.

What can I spend a Direct Payment on?

This will be agreed with your social worker in your support plan. It may include:

  • Employing a carer or personal assistant who can support you with your personal care needs. This includes things like bathing, getting dressed, cooking and eating etc.
  • Independent day services.
  • Respite care - if your social or health care assessment has identified that respite care is required, this will be included in your Support Plan.

Examples of respite care include:

  • Respite away from home with a social care provider
  • Respite in the community
  • Respite in your own home
  • Respite in a residential/nursing care home

Your support plan will identify the annual number of weeks respite you are assessed to need. You will be expected to demonstrate that you have utilised the annual number of weeks of respite care that is agreed in your support plan.

What can't I spend a Direct Payment on?

  • Direct Payments are not intended to replace the existing support provided by your family and community.
  • Direct Payments cannot be used to purchase social care services provided directly by St Helens Borough Council. However, you can receive a mixed care package receiving some council services and receiving Direct Payments for you to purchase the rest.
  • The provision of respite care is to provide a break for the carer and cared for; therefore your respite Direct Payment cannot be used to pay for family holidays taken together.
  • Direct Payments cannot be used to purchase primary medical services provided by General Practitioners, emergency treatment services, surgical procedures or physiotherapy.
  • A Direct Payment cannot be used to pay for any NHS charges or services such as prescription or dental charges.
  • Direct Payments are intended to support people in independent living, so you cannot use them to pay for permanent residential accommodation. You may be able to use Direct Payments for respite care in residential accommodation if your Support Plan includes this.
  • Direct Payments cannot be used to pay for anything that is not agreed in your Support Plan.

Financial charges

As with the provision of all adult social care services, there may be a charge, subject to an individual financial assessment. This is in accordance with St Helens Borough Council's charging policy. Your charge, if any, will be dependent on your individual financial circumstances.

There are no charges for children's services and Personal Health Budgets provided by the CCG.

If you are assessed to pay a charge this must be paid into your Direct Payment account. If you do not, your care may be re-assessed, may be reduced or your Direct Payment may be suspended / withdrawn.

The financial assessment will assess your ability to pay based on your income and savings. Allowances are made for some housing costs e.g., rent/mortgage/council tax and disability related expenditure.

Read more information on charging for non-residential services.

How will my Direct Payment be paid?

Direct Payments will only commence once all the necessary Direct Payments paperwork is completed.

You or the person managing your Direct Payment will be issued with a prepaid card.  This card account must be used solely for Direct Payments and the expenditure associated with it.  If it is agreed that a prepaid card is not suitable for you, other options may be discussed with your Direct Payments Advisor.

St Helens Borough Council will make payments for your regular weekly support plan into your Direct Payment account monthly in advance.  

Payments for Respite Care are made in accordance with your support plan on request to the Direct Payments Team.

Payments for replacement personal assistants' holiday cover will be paid on request to the Direct Payments Team.

Managed accounts

If your Direct Payment is managed by an independent organisation, there is no additional funding available for this. Any charge for these services is to be met from your existing Direct Payment.

Becoming an employer

If you decide to employ your own personal assistant to provide care services, you will have legal responsibilities as an employer under employment law. The Direct Payments Advisor can provide you with advice and support, but you must consider these important issues before deciding to employ your own staff. There are also several other organisations that can provide you with advice listed at the end of this section.

Disclosure and Barring Service

We would advise that you carry out appropriate checks before employing a personal assistant to provide personal care for you. This is mandatory for services provided to children and is completed by the Children & Young People's Department.

Equality Act 2010

Every employee has the right to work in an environment free from discrimination, harassment and victimisation.

As an employer, under the Equality Act 2010, you have a duty to take reasonable steps to ensure your employees work in an environment free from:

  • Less favourable treatment (discrimination),
  • Threatening, intimidating, offensive or humiliating behaviour (harassment)
  • Further detriment because of a complaint of harassment or discrimination being raised (victimisation)

Where these conducts are linked to one or more protected characteristics under the Equality Act 2010: age, disability, gender, gender reassignment, religion, race, sexual orientation, pregnancy and maternity, marriage and civil partnership.

Health and safety

It is your responsibility, as an employer, to make sure that your employees work safely and have a safe place to work in.

As the employer, it is for you and your employees to work out a safe way for tasks to be undertaken, thus reducing risk to a minimum. This could include things like maintaining lifting equipment properly, appropriate training for your staff i.e., food hygiene certificate if their role involves preparing food for you.

The council's Training Section is available to provide advice and support on short training courses that may be available and can be contacted through the Contact Centre.

Employees who work with people in their own homes are at risk if the employer is a smoker and you will need to minimise the risks to employees while at work.

Tax, National Insurance and pensions

Tax and National Insurance

As an employer by law, you must operate Pay as you Earn (PAYE) on the pay of your employees and pay the correct National Insurance contributions to HM Revenue and Customs.

Pensions

The Pensions Act 2008 introduced new rules for workplace pensions in the UK. These changes affect every workplace and make sure that every worker will have a chance to save for their retirement.

Since April 2015, every employer has had to give their workers the opportunity to join a workplace pension scheme that meets certain standards. Depending on how old they are and how much they earn, many workers will be automatically enrolled into the scheme. Other workers will be entitled to join the scheme if they want to.

Employer Insurance

This is a legal requirement that covers you if your personal assistant has an accident, as you may be held responsible.  It also gives cover for possible legal and industrial tribunal costs.  There are insurance providers offering special policies for people employing personal assistants. 

The cost for insurance is to be met from your existing Direct Payment. There will be no additional funding available for this. Evidence of appropriate insurance cover must be provided to the council each year.

Contracting with an agency

There are many agencies that provide care services. Purchasing services from an agency means that you do not directly employ the people who provide your care, and you do not have the responsibilities of an employer. Instead, you have a contract with the agency.

Find information on agencies providing domiciliary care services within the borough of St Helens.

If you engage an agency that charges more than the hourly rate paid by the council, you will need to pay the additional cost yourself.

Reviews and record keeping

Reviews

The council will monitor the quality of care that you purchase with your Direct Payment. This may involve a home visit to ensure that the assessed needs in your Support Plan are being met.

Record keeping

The money you receive as a Direct Payment is for services to meet your assessed social care needs. It remains public money; it is not yours to spend as you wish. You will be required to account for the money and satisfy the council that the needs for which it is giving you Direct Payments are being met. You will be required to comply with all requests for monitoring activity.

If you are an employer, you will also need to keep records for HM Revenue and Customs. All records must be kept for at least three years after the end of the tax year to which they relate. The Direct Payments Advisor can provide advice to you on record keeping and storage.

Direct Payments audit

The council will monitor how you are spending your Direct Payment. It is important that your assessed needs are being met and that the money is being spent appropriately.

Any false claims will be investigated and may result in criminal proceedings.

By monitoring your prepaid account, the council will complete a financial audit of your Direct Payment account. If you do not use a prepaid card, you will be required to provide on a quarterly basis:

  • Bank statements
  • Time sheets
  • Expenditure sheets
  • Invoices
  • Receipts

If you:

  • Spend your direct payment on the services which are not included in your Support Plan.
  • Do not pay your assessed charge into your Direct Payment account
  • Fail to submit your audit paperwork the council within deadlines.

The council can suspend/cease your Direct Payment, transfer your Direct Payment to a prepaid card or arrange for your care to be provided as a commissioned service.

Annual leave and pay rates

Annual leave

Your employee will be entitled to paid annual leave. This should be agreed when an employee starts work and included in the employee's written contract. Almost all workers are legally entitled to 5.6 weeks paid holiday per year (known as statutory leave entitlement or annual leave). An employer can include bank holidays as part of statutory annual leave.

If you employ a replacement personal assistant to cover annual leave of your regular personal assistant you will be required to provide details of the replacement personal assistant to the council who will arrange an additional payment to you.

Pay rates

You will need to ensure that your minimum rate of pay conforms to the requirements of the National Living Wage.

Payroll service

The council provides a free payroll support service. You can ask an independent organisation to provide this service for you if you prefer. Any charge by an independent organisation must be paid from your existing Direct Payment.

Statutory payments

You may need to pay your employees' statutory payments even when they are not actually working for you - for example, if they are sick and entitled to statutory sick pay or on maternity leave and entitled to statutory maternity pay.

If your personal assistant is on long term absence or has given notice, you should contact the Direct Payments advisor immediately for advice.

Employer responsibilities

The council will expect you to fulfil your responsibilities as an employer. Failure to do this may result in the council withdrawing your Direct Payment and arranging services to meet your needs.

Recovering Direct Payments

In some circumstances, the council may ask for all or part of the Direct Payment to be repaid. The decision to seek repayment and the amount of money to be reclaimed is at the discretion of the council. Direct Payments may be reclaimed if:

  • The money has been used to purchase a service that was not agreed in the Support Plan.
  • A surplus of more than 8 weeks funding has accumulated in the Direct Payment account.
  • Termination of the agreement to receive Direct Payments.
  • The person receiving the Direct Payment has died.
  • The Support Plan has changed substantially resulting in surplus funds.
  • Theft, fraud or other offences have occurred.

If you are regularly under spending your Direct Payment, your support plan may be re-assessed and possibly reduced.

If we decide to recover funds from you and you hold a prepaid card, payments will automatically be adjusted. If you manage your own account, the council will write to advise you of the amount you must repay.

We will request repayment within two weeks after writing to you. If you do not repay the amount, we have requested we may reduce your future Direct Payments to recover the funds.

Changes you must tell us about

You must tell the Direct Payments advisor about any change of circumstances within 7 days (e.g., going into hospital or residential care, moving address).

We will advise you, depending on the circumstances, whether your Direct Payment may continue, be reduced or be suspended.

What happens if you get into difficulties?

If you get into difficulties in managing your Direct Payment account, you must inform the Direct Payments advisor as soon as possible. If your needs are not being met, the council has a responsibility to help you.

If you decide not to carry on with Direct Payments, then the council will arrange services to meet your eligible social care needs.

If the council does not think you can manage Direct Payments anymore, it may decide to transfer your Direct Payment to a prepaid card or stop the Direct Payment and arrange commissioned services for you.

The council will involve you in any decisions that are being made about your care and ensure that you know what is decided.

How to contact us

There are a number of ways in which you can contact us:

Direct Payments team - Integrated Health & Social Care Services
Tel: (01744) 673297 or 675356
Email: customerfinancedp@sthelens.gov.uk

Payroll support
The Direct Payments team
Tel: (01744) 675359 or 676200 or 676206
Email: customerfinancedp@sthelens.gov.uk

Advice and support

Once you have agreed with the social worker that you would like a Direct Payment, you will be contacted by a Direct Payments advisor.

The Direct Payments advisor will give you advice and guidance on setting up and running your Direct Payment, including:

  • Choosing a care agency
  • Recruitment of personal assistants
  • Job descriptions and contracts
  • Employer responsibilities
  • Tax return advice and responsibilities
  • Record keeping
  • Payroll Support. This is a free support service provided by the council if you employ a personal assistant
  • Workplace pensions

Further advice

Employer advice

Your employer insurance company will offer free employment advice.

HM Revenue and Customs guidance is available from their Enquiry Centre or website at www.hmrc.gov.uk

The Advisory, Conciliation and Arbitration Service provides information, advice, training, conciliation and other services for employers and employees to help prevent or resolve workplace problems. 

General advice

St Helens Borough Council - find information adult care and support services in St Helens.

GOV.UK is the government's site, providing information about all aspects of employment.

NHS Choices is the NHS website providing information about health and a guide to social care, including free confidential advice and support for carers.

Workplace pension advice

The Pension Regulator offers information and guidance on workplace pensions and automatic enrolment.

Tel: 0345 600 1011

NEST Pensions is the workplace pensions scheme set up by the Government.

Tel: 0300 020 0090

Submit a comment, compliment or complaint

Complaints team

Corporate Services department
Tel: (01744) 674360 or 674362
Email: adultcomplaints@sthelens.gov.uk