Personal Budgets and Direct Payments

A personal budget is the overall cost of care and support the local authority and/or health service provides for a disabled child or young person who has extra needs.

A personal budget can be used for:

• Employing a personal assistant (PA) or for purchasing care and support services:
• Buying specialist equipment not provided by the NHS;
• Paying for leisure or educational activities and transport costs.

Direct payments are monetary payments made to assist with meeting a child or young person’s assessed need by the relevant body to fund part or all services as an alternative to commissioned services.

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/practitioner must be satisfied that the parent, nominated person  or young person (who is over the age of 16):

• Is able and capable of manging the Direct Payment either by themselves or with whatever help the authority thinks will be appropriate;
• Is the most appropriate way of arranging the required support or services rather than commissioned services from the relevant body;
• Will use the direct payment in an appropriate way to meet the needs of the child/young person and will act in the best interests of the child or young person.

The options of controlling the personal budget/direct payment are the following:

1. Direct payments – where the young person/parents/nominated person buys, employs and arranges the services themselves such as employing a personal assistant, taking on certain responsibilities as an employer;
2. An arrangement – where the Local Authority, school or college hold the funds and arranges the services (also known as notional budgets);
3. Third party arrangements – where the funding is paid to a person or organisation who acts on behalf of the parents, nominated person or young person.

Direct payments for education are monetary payments to parents of a child with an Education, Health and Care Plan (EHCP) and should be specified in the EHCP. These include requirements to consider the impact on other service users, taking account of value for money and to seek agreement from educational establishment where a service funded by a Direct Payment is delivered on their premises.

Direct Payments for health require the agreement of a Care Plan between the Integrated Care Board (ICB) and the recipient. Direct payments and Personal Budgets also apply to young people who require Aftercare under Section 117 of the Mental Health Act 1983, children and young people receiving Continuing Health Care funding  and people eligible for an NHS wheelchair (personal wheelchair budgets).

See Local Offer - Children's Direct Payments.

A direct payment may be agreed if a disabled child/young person is eligible through a Care Plan, children in need plan or short breaks plan (LA funded), or the family’s needs (by virtue of their role as carers assessed through a carers assessment for a disabled child) or who have Education, Health and Care Plans (EHCP), which may contain elements of education, social care and health funding. Under the Children and Families Act 2014, this covers those aged 0-25 having special educational needs and disabilities.

Direct payments are given to 16 and 17 year old disabled young people directly rather than to their parents or carers. The young person can then decide which services to use. This only applies if the young person is able to organise their own care and support. 

Direct Payments can also be made to a willing and appropriate person on a child or young person’s behalf if they lack the mental capacity to agree to and manage Direct Payments themselves.

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.

Direct Payments are usually paid in advance into a bank or building society account specifically set up for this purpose, as a one off payment or on a 4 weekly basis and this bank account should not be used for any other purpose. If the direct payment is assessed as being needed at key times e.g. school holidays, then payment will be made accordingly.

A Social Worker from Children’s Social Care or Liverpool’s Short Break Service (Fusion) will undertake an assessment in the usual way.

When the Social Worker has identified needs which are the responsibility of Children's Services  to meet, and considered the carer's or 16 and 17 year olds ability to manage the role as an employer, then the worker will offer the option of Direct Payments.

The Social Worker will submit the child’s assessment, care and support plan and budget authorisation form to management for approval.

If funding is approved the Direct Payments Officer in the Self Directed Support team will make sure all necessary arrangements are in place when setting up the direct payments. For eg insurance for any Personal Assistant employed, ensuring contingency funds are available and setting up a payroll provider so payments can be made.

The Direct Payments Officer in the Self Directed Support team will also make arrangements for an Enhanced Disclosure and Barring Service (DBS) check for any Personal Assistants employed and complete the contract of employment with the recipient.

The Direct Payments Officer from the Self Directed Support Team will relay the results of any checks to the Recipient and remind them that repeat DBS checks are required every 3 years.

Social Workers will ensure that carers are fully alerted to the potential risks for children and are provided with advice to minimise those risks; the available UK evidence on the extent of abuse amongst disabled children suggests that disabled children are at increased risk of abuse.

The Direct Payments Officer will ensure that the direct payments recipient opens a separate bank account. 

Once the Direct Payments Officer has confirmed all checks are satisfactory they will ensure the direct payments agreement is completed and signed. A copy will be retained on the child's electronic file. It is important the Direct Payments Officer ensures the direct payments recipient understands the agreement before signing it.

The Social Worker will ensure accuracy of the child’s Care and Support Plan prior to the commencement of the service Direct payments will cease once the Recipients financial responsibility for the personal assistant has ended.

• To take the young person/child into the community to access an activity, support inclusion, going to a club etc.
• To provide care and support to the child/young person directly within their home, to give parents and siblings a break.

• Using an approved agency to provide direct care to meet your child/family's needs;
• After school clubs and holiday play schemes for your disabled child;
• Special educational provision specified in an Education, Health and Care Plan.
• **Overnight breaks for a child/young person, either in their home or the home of the Personal Assistant.
• **To provide care and support to a child/young person in the home of the Personal Assistant.

NB overnight short breaks and care in a Personal Assistant’s own home will be subject to additional assessments and checks; such as home safety checks, DBS checks on any other household member aged 16 and over and any other assessments that are felt necessary to ensure the safe delivery of care and support to the child/young person.

Overnights will be provided and reviewed within statutory social care only.

• Employing someone without Disclosure and Barring Service and Child Protection Plan checks; someone subject to a drug or alcohol treatment requirement, youth rehabilitation order or released on National Offender Management licence conditions, or references;
• Funding a school place or post 16 institutions;
• Any services already provided by the council e.g. Residential or Outreach support services;
• Where provision is already available through a block contract - it is unlikely that a direct payment (as part of a Personal Budget) would be available to access alternative services as this would be determined to be 'double funding' and therefore an inefficient use of resources;
• Anything that has not been identified as meeting any agreed outcomes in the child/young person’s assessment, care and support or EHC plan;
• Anything identified as illegal; gambling, alcohol or tobacco; everyday living costs (e.g. rent/bills etc.); health services (e.g. vaccinations, dental charges, prescriptions etc.).

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.

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. It must also advise of their right to request a review of the decision.

Direct payments will be reviewed by the Local Authority and, where appropriate, the ICB, within the first three months of the first direct payment being made and thereafter on at least an annual basis. If the child or young person has an EHC plan, Direct Payments will be reviewed when this plan is reviewed.

The Local Authority and, where appropriate, the ICB will provide reasonable written notice of any decision to stop or reduce the amount of the direct payments, except in extreme cases where immediate cessation of payment may be appropriate and necessary. For example, payments will be stopped immediately if the Local Authority and, where appropriate, the ICB has reasonable cause to believe misappropriation of funds has occurred.

The Local Authority and, where appropriate, the ICB may stop making, or reduce the amount of direct payments if:

• Payments have accumulated, provided that they are satisfied that the reduced amount is sufficient to secure the agreed provision.
• The conditions upon which the direct payments were made, are no longer being complied with.
• The Recipient is no longer capable of managing a direct payment (in these circumstances alternative arrangements will be explored as appropriate).

The Recipient may request a reconsideration of any decision to stop or reduce the direct payments. *The Local Authority and, where appropriate, the ICB are not required to undertake more than one reconsideration of any such decision*.

The Recipient can also stop receiving direct payments by notifying the Local Authority in writing that they no longer consent to receive the direct payments.

In some circumstances, the Local Authority and, where appropriate, the ICB may require the Recipient to repay part or all of the direct payments (the decision to seek repayment, and the amount of money to be reclaimed will be at the discretion of the Local Authority and, where appropriate, the ICB).

Direct payments may be reclaimed if:

• The circumstances of the child or young person have changed in a manner which has an impact on the appropriateness of the agreed provision specified in their support or EHC plan;
• All or part of the direct payments have not been used to secure the agreed provision and/or have accumulated;
• They have been used otherwise than to secure the provision specified in the child or young person's support or EHC plan;
• Theft, fraud or another offence, such as misappropriation of funds, is found to have occurred in connection with the direct payments;
• The person in respect of whom direct payments have been made has died, leaving part of the direct payments unspent (unless exceptional circumstances apply);
• The child/young person has moved out of the Local Authority area providing the Direct payment.

The Local Authority will give the Recipient reasonable notice in writing stating: the reasons for the decision; the amount to be repaid; the time in which the money must be repaid and the name of the person responsible for making the repayment.

The Recipient may terminate by notifying the Local Authority in writing that they no longer consent to receive direct payments.

The Local Authority will notify the Recipient in writing if it intends to terminate for any of the reasons specified above in Sections 12 and 13 and of the Recipient's right to request that the Local Authority reconsiders its decision.

Direct payments will terminate automatically when the child or young person's care and support or EHC plan is no longer maintained; a decision is made that children's services are no longer appropriate; or in the event of the child or young person's death.

Before a young person is 18, it is important that a young person is assessed through the transition process to meet the statutory duty of both the Care Act and the Children and Families Act and to decide if Adult Social Care is needed and to establish what care and support is still needed or required. This will include whether a direct payment is being offered.  

It is important to note once a young person reaches 18, the care and support package is means tested and a financial assessment will be completed by the local authority to look at what contribution is necessary from the young person’s finances (which does include benefits).