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, the expected cost of that support will be described as your estimated personal budget.
The support can be delivered in a number of ways depending on your needs and preferences. We can make the arrangements for you or you can take responsibility for some or all of them yourself, it could be with the help of someone you know. This is self-directed support.
Support needs are the daily activities you need assistance with to live more independently, with dignity and to enjoy a good quality of life.
If you have sufficient needs and have savings below a specific amount, you will be eligible for financial assistance. We will carry out a financial assessment to see whether or not you will need to contribute towards the cost of your support.
Eligibility for adult social care and support is further explained in our Eligibility Policy.
Who is this guide for?
This guide is for you if you:
- 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 a family member or friend of the person who is eligible for assistance and wish to manage the support arrangements and the money on their behalf
- 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
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 personal budget via a direct payment (the sum of money from your personal budget you have access to every month to pay for the support you receive)
- how to manage the money
- how to manage your other responsibilities
When you have decided who will support you and how, more detailed information relevant to the types of provider you have chosen will be available.
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 printing 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 over the telephone or in person about your needs and ways to help you stay safe and independent. They will decide about whether you are eligible for support from the Council.
If you are, the assessment will establish how much support (including short or long term) you would need and generate an initial figure of how much it would cost to provide the support, 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.
The decisions will be detailed in your support plan. You can choose to create the support plan yourself or with the assistance of someone you know or your care manager. Your care manager will write the support plan if you wish but the decisions about your support arrangements must be yours.
You will also have an assessment by the Council’s fairer charging team to work out any financial contributions you may have to make towards the cost of your support. The council carry out financial assessments so they can make sure limited public resources are provided to people with the most need and as many people as possible can be supported.
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 excess you have used to pay for support already provided.
You should also understand that, following your financial assessment, if you need to contribute to the cost of your care, your contribution makes up the first part of the direct payment. We add funds to make up the total direct payment payable.
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.
A cardholder guide is available from the Arranging Support Team.
A Devon Card is like a bank card, you can use it to pay for your support. You cannot use it to withdraw cash. If, in exceptional circumstances, you needed access to cash from your direct payment account to meet goals identified in your support plan, the Arranging Support Team will work with you to find a solution.
The option to have a direct payment bank account instead is available but is not as simple for you or the council (the use of a direct payment bank account is covered in the self-directed support policy).
The total amount will be added to the Devon Card account and you will be invoiced for your contribution amount. Only the Council’s portion of the direct payment would be paid into a direct payment bank account and you would add your contribution.
Your direct payment must only be used to meet the agreed goals summarised in your support plan.
Who will manage the direct payment?
You may have chosen to self-direct your own support for a number of reasons and you may be able to manage everything yourself.
But you may not feel you can or you may not want to manage the money side of things, being responsible for the direct payment and making payments for your support. If this is the case, do you know someone who could manage the direct payment for you and, more importantly, would want to take on that responsibility?
The person must be capable and it would be your care manager’s decision that they are appropriate to manage the direct payment on your behalf.
The options are:
If you have the capacity and are able and willing to manage the direct payment yourself, you would take on the responsibility.
If you would like someone you know to manage the direct payment, they are capable and willing and your care manager has checked they are appropriate, they would take on the responsibility as your nominated person. You should remember that you would still be fully responsible for making your support arrangements.
If you do not have capacity to manage the direct payment yourself or to nominate someone else, your care manager will consider someone who knows you to manage on your behalf. The care manager must be confident that they are willing, appropriate and capable of managing the direct payment, and of arranging your support and taking on all the associated responsibilities. This would be your suitable person.
If you have someone who has legal control of your property and financial affairs or for your personal welfare as lasting power of attorney, they could take on all the responsibilities as your authorised person. If they did not wish to do it themselves, they could arrange for someone else in your life who is capable and willing to be your suitable person.
The different names for someone managing your direct payment and your support arrangements are mainly for the council to understand how that person has taken on the responsibilities for you. Within this guide, when any one of the above are referred to, they will be referred to as your appropriate person.
The important thing is to make an informed decision following assessment because direct payments are not suitable for everyone and not everyone has someone who could be their appropriate person. If you weren’t able to manage alone and didn’t know someone who could support you to manage, the council would take on the responsibility of arranging your support for you.
We will need to carry out an identity (ID) check for you if who are going to manage a direct payment and we will talk to you about the best way to do this.
You, your appropriate person, carer and family 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.
What kind of support can you buy with a direct payment?
This will depend on your personal situation and the needs identified that you needed 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
Different types of support providers
Care agencies are regulated and inspected by the Care Quality Commission (CQC). Agencies recruit staff to provide support at home or in the community. The agency might be a private company or a charity.
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, you may need to pay the difference in cost although you should be able to find at least one agency within your personal budget.
When an agency provides your support, you should also make sure you understand:
- how they will provide your support, how flexible they will be and how well they will tailor their service to your needs
- what 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 will need to:
- check the agency invoices as they arrive to make sure you have been billed appropriately for support you have received
- pay the agency for the support services provided
- pay the invoices promptly from your Devon Card account
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 CQC and they cannot get police checks done for themselves. If you wish to have a DBS check carried out, the council get the check done for you free of charge.
If your support needs mean you will have one or more PAs supporting you only on a full-time basis, you would be advised to employ them directly.
While this means you have to take on the responsibilities of an employer, your personal budget will cover the cost of the hourly rate you will pay them and the additional employment costs, for example, tax and National Insurance. Most importantly, you will be in control.
You may be tempted to take on a ‘self-employed’ PA because you would not have to take on employer responsibilities – you would not have to pay them holiday or sick leave, or redundancy if you needed to end their employment. They would also be responsible for their own insurance and paying tax to HMRC. You should be able to treat them exactly like an agency.
But they are likely to charge a higher rate and you would need to pay the additional amount that your personal budget did not cover.
If there were ever an issue about any of the above, the ‘self-employed’ PA might claim the rights of a PA and, because HMRC do not recognise a full-time PA’s status as self-employed, you may find you would be responsible anyway for all the costs as if they were directly employed by you.
The decision about taking on a PA who says they are self-employed would be yours. The level of risk may be lower if you know the person who will be your PA well and you trust them or the PA is not providing full-time support to you and they support other people as well.
Additional support when taking on a PA
Employer’s liability insurance
This is essential to protect you when you have someone coming into your home to provider a paid-for service. The Council will cover the cost every year. The insurance provider will give advice and guidance about employer responsibilities and written information to help you keep your insurance valid.
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.
Your financial administration service will provide advice and guidance and written information, and take care of some responsibilities, for example paying invoices and payroll.
But, remember, you would still be the employer and your support services will not assume that responsibility.
Disclosure and Barring Service (DBS)
We would highly recommend you get a police check, a DBS check, for any PAs you take on. The Council will cover the cost and the arranging support team will process the check for you.
Introductory agency for personal assistants
An introductory agency facilitates ‘introductions’ for people looking for an individual paid support worker or PA. The agency would select, vet and introduce a self-employed PA to you. They would also facilitate the contract between you and the PA.
You would pay a higher cost for using an introductory agency.
Your personal budget would only cover the standard cost of a PA, not the full cost charged by the introductory agency.
So, if you use an introductory agency, you would need to pay the difference between what the council will fund and what the introductory agency will charge.
An introductory agency may also charge you a separate ‘finders-fee’. You would still take on the responsibilities of having a PA.
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.
Initial advice and support to help you get started
You will have received your support plan with this guide and other relevant documents. An arranging support advisor will telephone you to arrange a convenient day and time to call you back to discuss the set up your direct payment. Please read the information carefully or get someone to read it through with you.
The arranging support advisor will be your contact to advise and support during the initial set up of your direct payment. How much support you would need would depend entirely on you and your personal circumstances.
They 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 you are not quite ready, they will discuss what support you will need over the following month to make sure you will be.
If after three months you are not going to be able to self-direct your own support, arrangements will be made for the council to commission it for you.
Once you are managing independently
Over time your support needs may change and you will need a review. You would contact Care Direct on 0345 1551007 to arrange the review with a care manager.
If you need some information or advice about your direct payment, you would also contact Care Direct and ask for the arranging support team.
The team will help with any one-off issues that arise unexpectedly but it should be remembered that you have taken on all the responsibilities for your support arrangements and their management.
For example, you must have contingency plans in place to cover your support needs in emergencies and when your support workers are sick or on leave. You must manage your financial commitments correctly because you would be liable if you haven’t. The team will be happy to refer you to guidance information or signpost you as required.
Further sources of support and information
From Devon County Council
- Our self-directed support policy
- Charging for Care Service
If you have a query regarding your financial assessment or contribution towards your care and support, contact:
- Devon Carers: For information and/or support if you are a carer, call 0345 636 4435.
About self-directed support and direct payments
- Age UK: Personal budgets and direct payments
- GOV.UK: Applying for direct payments
- The Council’s duties regarding self-directed support and direct payments are now regulated by the Care Act 2014. Guidance, including an easy read guide to the Care Act can be found here
- Carers UK: Direct payments
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.Call 0113 245 1716, email email@example.com or visit www.skillsforcare.org.uk