Your guide to self-directed support and direct payments

What is self-directed support?

If you have support needs assessed by a health or social care professional and are eligible for funding from our Adult Care and Health or the NHS, we will commission a service to meet those needs.

Support can be delivered in different ways, according to your needs and preferences. You could if you wish take responsibility for arranging some or all of this yourself, or with the help of someone you know. This is called self-directed support.

You can ask the council to help towards the cost of the care you arrange. This is known as a direct payment.

The council will only contribute towards care that meets assessed eligible needs to a level that the authority would have commissioned a service on your behalf. It is therefore important that you discuss your plans with your care manager and have a clear understanding of what the council contribution can be used to pay for and how much the council will contribute.

Eligibility for adult social care and support is further explained in our Eligibility for adult social care and support guide.

All our adult care and health policies can be found here.

Who is this guide for?

This guide is for you if you:

• are seeking more information about direct payments
• receive support from the council but are thinking about taking responsibility for your own support arrangements
• have had a needs assessment, are eligible for council-funded assistance, are able and have chosen to make some or all of your own support arrangements
• are someone whom the person who is eligible for support arrangements has asked to manage their care on their behalf as a nominated person
• are someone with legal responsibilities for the person who is eligible for financial assistance, for example, you have power of attorney for their health and wellbeing and/or their finances, and are acting as an authorised person
• are someone that the council has identified to manage the direct payment on behalf of the person with assessed eligible needs as a suitable person.

What is this guide about?

The guide explains how self-directed support works. It lets you know:

• the ways in which you can arrange support to meet your needs
• how you can access the money from your direct payment
• how to manage the money and keep records of spending
• how to manage your other responsibilities.

There are a wide range of situations where a direct payment is used – from a one-off respite stay, to 24-hour care for complex health and social care needs. This guide covers different types of situations so there may be some parts that are not relevant to you.

This guide will also be useful for reference after your direct payment has been set up and you are managing independently.

At the end there are telephone numbers for key contacts concerning your care and support. There are also links to further sources of information and support.

Information is correct at time of publishing but be aware that changes can happen at any time and you need to check that details are still correct, especially where meeting legal requirements is important. Sources of information where details are always kept up-to-date are included within this guide.

Assessment of support needs

A health or social care professional will talk with you about your needs and ways to help you stay safe and independent, making the most of the resources you have available within your local community. You may be eligible for support from the council.

If you are, the assessment will establish how much support you need, and calculate an initial figure of how much it would cost to provide the support. This is your estimated personal budget.

Following your assessment

Once your needs have been assessed, you and your care manager (the health or social care professional) will discuss what assistance you need, what goals you hope to attain and the kinds of support that will help you achieve them. This discussion will help you decide whether you will manage some or all of your support arrangements, rather than accept the offer of services arranged by the council.

If you decide to make your own arrangements and are seeking support from the council for a contribution paid by a direct payment you will need to create a support plan yourself or with the assistance of someone you know. That support plan needs to be agreed with your care manager as meeting your assessed eligible needs. Your care manager will confirm the amount of your direct payment and what it can be used for.

Financial assessment

How much support you are offered does not depend on your income and savings, however it may impact the amount Devon contribute or charge you for your care.

With direct payments, as this is delivered as money rather than a service if your contribution is larger than the care package, it is simpler and easier for you to organise this care yourself without support from the council.

Sometimes a financial assessment is completed after a direct payment has been made. If you do need to make contributions or it turns out you are not eligible for council-funded assistance, you would need to reimburse the council for any overpayment.

If you need to contribute to the cost of your care you will receive a monthly invoice, which you must pay from your personal income, not from funds in the direct payment account.

If you choose to take all or part of your personal budget as a direct payment, any benefits you receive will not be affected. A direct payment is not counted as income for tax purposes.

The Devon Card

Once the support and financial decisions have been made, the cost of the support arrangements to meet your needs becomes your personal budget. The money, the direct payment, will be available to you through a Devon Card, the council’s usual way of giving you direct access to your personal budget.

Paper copies of the cardholder guide are available from the Arranging Support Team on request.

A Devon Card is like a bank card, which you can use to pay for your support, however you cannot use it to withdraw cash.

Although we recommend the Devon Card Account as the simplest and easiest way to manage your direct payment, we understand that some people may want to make alternative arrangements due to their own personal circumstances. Please let your care managers know if you want to make different arrangements and we will arrange for someone to contact you to discuss the conditions and requirements for recording and reporting expenditure that will be necessary.

Who will manage the direct payment?

You may have chosen to self-direct your own support, but you can have help from family, friends, or other representatives who will act as the nominated, authorised, or suitable person. You may also use payroll and legal services which we will fund. Please talk to your care manager about any support you need, suitable to your circumstances.

If someone will be managing the direct payment on your behalf the account will be in their name, they will be the person that signs the agreement with the council. We will carry out an identity (ID) check for the person managing the direct payment. This is not a credit check and will not affect the person’s credit rating.

The nominated, authorised, or suitable person will be involved in discussions with you about your care plan as they will have taken on the responsibility of managing your care on your behalf.

Safeguarding

You, your family and carer(s) should know how you can prevent, recognise and report abuse, neglect and exploitation, and any other concerns you may have about your safety or welfare.

For further information on safeguarding please visit our safeguarding adults at risk of abuse or neglect advice.

What kind of support can you buy with a direct payment?

This will depend on your personal situation and the needs identified that you require support for.

A direct payment means you can explore more creative and innovative ways of achieving the goals agreed in your support plan. This means more choice about who provides your support and more control over how it is provided.

The following are some more usual examples a direct payment can be used for support but you can consider new ways of meeting your assessed needs:

• personal care
• getting out and about in your local community
• to attend activities for your physical or mental wellbeing and be able to make the most of the activity
• a period of respite to give your carer a break and to give you a change of scene or company. You might go and stay somewhere else or someone might come and be with you so your carer can go away

When thinking about your plan it is always a good idea to give some thought to contingency arrangements when things don’t work out the way you expected. As an example:

What will you do if your personal assistant can’t work that day because they are sick, their car breaks down or bad weather means they can’t get to you.

• Would you pay them under all these circumstances?
• How will you manage your care needs that day?
• What will your next steps be if your personal assistant continues not to turn up?

However you decide to use your direct payment, it is important to understand what you are buying and how much it will cost, as these will need to be considered within your support plan.

This is your care plan. It should describe the support you believe will best meet the needs described in your assessment. It will form the basis of your agreement with the council about how you will use the money it provides.

Different types of support providers

Agencies

Agencies providing personal care must be regulated and inspected by the Care Quality Commission (CQC). Personal care includes activities such getting washed and dressed.

Other forms of support, for example helping you get out and about in your local community don’t need to be regulated and these agencies won’t be inspected by CQC.

It is important to check that the agency you employ is properly regulated for the services it delivers.

Staff are employed by the agency. This means the agency pays their tax, National Insurance, holiday and sickness pay and carries out the police or Disclosure and Barring Service (DBS) checks.

You can choose any agency you think will best suit your needs. However, if the agency charges you more than the rate given in your direct payment, and the council can identify an equivalent service that can meet your needs at a lower cost you may need to pay the difference in cost. If you believe that you cannot meet your needs with the amount provided you should talk to your care manager.

When an agency provides your support, you should also make sure you understand:

• how they will provide your support
• how well they will tailor their service to your needs
• which staff will be responsible for your support
• how they will cover the holiday and sick leave of the staff you have
• how they will invoice you
• their cancellation policy
• their comments and complaints policy.

You or the person managing the account will need to:

• check the agency invoices as they arrive to make sure you have been billed appropriately for support you have received, raising any concerns with the agency where you believe there are errors
• make payments in a timely manner.

Personal assistants

A personal assistant (PA) is an independent individual support worker who works on a one-to-one basis. This may be with just one person or with a number of different people.

Unlike agencies, as individual workers, PAs do not have to register with the Care Quality Commission, and they cannot get criminal record checks – known as DBS (Disclosure and Barring Service) done for themselves. If you wish to have a DBS check carried out, the council can get the check done for you free of charge.

In most cases personal assistants will be your employees, which means:

• you will be responsible for their health, and safety
• you will need to ensure that you pay tax and national insurance contributions
• you will be responsible for things like sick pay, maternity, and parental leave
• you will need to have a written statement that sets out their working hours and levels of pay
• you may also want to be clear whether travel and subsistence expenses will be paid, what rates they are, and what they cover
• you may also want to be clear about other practical arrangements, for example if the person is going provide you with transport will they be using their own car and if so, you should ask them to complete a declaration saying that the vehicle that use will be taxed, have a valid MOT, and that they have appropriate license and insurance to carry passengers
• you may also want to consider other exceptional payments that form part of your terms and conditions, for example regular payment of wages when you do not receive that care for example because you are staying with family or are in hospital, this is sometimes called a retainer.

Some personal assistants work in a self-employed capacity, as such they are responsible for making their own tax arrangements.

The decision about if your PA is employed or self-employed is made by HMRC you can use this website to guide you about the person’s tax status: https://www.gov.uk/guidance/check-employment-status-for-tax

Further advice is available from HMRC’s Customer Service Team.

Additional support when taking on a PA

Being an employer has responsibilities and we recommend that you use a payroll service to manage tax and pension contributions. As part of your direct payment, we will fund a payroll service to the equivalent of our recommended provider.

As an employer you will be required to have Employers Liability Insurance. Your cover should include access to legal and advice services that will support you manage your responsibilities as an employer.

For further information about becoming an employer:

• GOV.UK – Employing staff for the first time
• Independent living: paying for care

Using introductory or recruitment agencies for personal assistants

Some companies offer ‘introductions’ for people looking for an individual paid support worker or PA. There are often costs for using these services which may not be affordable within your budget.

We recommend using the ‘shout-out’ process before considering these services.

In the event you do wish to use them please discuss this with your care manager.

We recommend that you do not pay providers in advance of services being delivered. You should raise any dispute with them quickly so that actions are taken to correct or remedy the situation.

Other support

Financial administration service

You can choose to have this additional support to help you manage your direct payment. The council will cover the cost of a financial administration service.

Financial Administration Services (FAS) can provide support beyond managing your payroll including the payment of bills to other service providers and agencies. Using this service means that you don’t need to manage a bank account or any payments. You will still need to arrange and manage your care, but you will simply send invoices and timesheets to the FAS who will pay the bills on your behalf.

FAS will pay the bills and manage payments, but they do not arrange or monitor the quality of the care provided.

We work alongside a local organisation called Disability Focus who can provide these services for you. D

Disclosure and Barring Service (DBS)

We would strongly recommend you get a criminal record check, (DBS), for any PAs you employ. The council will cover the cost and the arranging support team will process the check for you.

PA ‘Shout Outs’

The council provides an online service to help you advertise for a PA. Please see our find a personal assistant webpage for full information and a link to the form.

Other providers

Your personal budget can only be spent on activities that meet your health and social care needs but by taking control of your personal budget, you can explore more creative and innovative ways of achieving the goals agreed in your support plan.

This means more choice about who provides your support and more control over how it is provided – you don’t just have to have personal assistants or use an agency. We are always interested in your ideas about how you want to meet your own needs but remember it is important that you discuss it with your care manager and include it in your care plan.

Initial advice and support to help you get started

You will have received your support plan with this guide and other relevant documents. Please read the information carefully or get someone to read it through with you. If there is anything you don’t understand or need support with please contact Care Direct on 0345 1551 007.

We will check in with you after eight weeks to make sure everything you need is in place, you understand how to manage the different elements of your provision and you are happy about managing all your current and future responsibilities independently.

If after three months you are unable to make arrangements for your own support the council will commission services for you, and the offer of a direct payment may be withdrawn.

Once you are managing independently

Over time your support needs may change and you will need a review. You can contact Care Direct on 0345 1551 007 to arrange a review with a care manager.

Further sources of support and information

More information about self-directed support:

• Self-directed support overview
• Our self-directed support policy

Devon County Council’s Client Financial Services

If you have a query regarding your financial assessment or contribution towards your care and support, contact 01392 382334

Devon Carers

For information and/or support if you are a carer for someone call 0345 636 4435.

Employment checks

• Employing staff for the first time
• Check employment status for tax

Age UK

Age UK: Personal budgets and direct payments

Carers UK

Carers UK: Direct payments

Skills for Care

Skills for Care is the strategic body for workforce development in adult social care in England. Skills for Care is an independent registered charity working with 21,500 adult social care employers in England to set the standards and qualifications to equip 1.5 million social care workers with the skills and knowledge needed to deliver high-quality care to people who use services.

Skills for Care has an excellent free pack called ‘employing personal assistants’ with step-by-step guides to all aspects of recruiting, employing and managing a PA. This is available online or you can ask for a pack to be sent to you. It also contains a full set of sample templates. Email info@skillsforcare.org.uk or visit www.skillsforcare.org.uk