Adult social care Direct Payments Policy
About direct payments
Policy statement and legal framework
Wandsworth Council is committed to enabling people with eligible care and support needs, and carers with eligible support needs, to have choice and control over how their assessed needs are met. Direct payments are one way of doing this. They are monetary payments made by the Council to a person, or to an authorised or nominated person acting on their behalf, so they can arrange support that meets the outcomes agreed in their care and support plan.
This policy applies to adults aged 18 and over, carers aged 18 and over, and young people preparing for adulthood where adult social care responsibilities apply. It should be read alongside the Care and Support Statutory Guidance, the Care and Support (Direct Payments) Regulations 2014, the Adult Social Care Personal Budgets Policy the Adult Social Care Contributions Policy.
Direct payments are a choice. People do not have to accept a direct payment and can ask the Council to arrange services on their behalf instead. A person may also choose a mixed package of care, where some support is arranged by the Council and some is managed through a direct payment.
The purpose of this policy is to provide a clear and consistent framework for providing, utilising, monitoring and reviewing direct payments in Wandsworth. It aims to maximise independence, personalisation, choice and control while ensuring public funds are used lawfully and transparently to meet assessed eligible needs.
Eligibility
Direct payments must be considered where a person has eligible, unmet care and support needs, or where a carer has eligible support needs in their own right following a carer’s assessment, and the Council is responsible for meeting those needs under the Care Act.
Direct payments can be made where the person requests them, the Council is satisfied that they are an appropriate way to meet needs, and the person can manage the payment either alone or with support. Where a person lacks mental capacity to request or manage a direct payment, the Council may make a direct payment to an authorised person where this is in the person’s best interest, and all legal conditions are met.
The Council will not make a direct payment where the proposed use would not meet assessed needs, where there are significant unmanaged risks, where previous misuse of public funds means a direct payment would not be appropriate unless suitable safeguards can be put in place, or where the person falls into an excluded category under the Care and Support (Direct Payments) Regulations, unless an exception applies.
Direct payments are available regardless of whether the person is required to make a financial contribution. Any assessed contribution forms part of the personal budget and must be paid into the direct payment account as specified by the Council.
Where the Council refuses a request for a direct payment, it will clearly record and explain the reasons for its decision in an accessible way, consider whether proportionate support or safeguards would make a direct payment appropriate, and set out how the person’s eligible needs will otherwise be met.
Carers’ direct payments must be clearly linked to the outcomes identified in the carer’s support plan and may be used for short-term or ongoing support where this is lawful, safe, proportionate and appropriate. They are not a general payment for caring and must not be used as an indirect way of funding care for the cared-for person unless this has been explicitly agreed as the lawful and appropriate way to meet the carer’s assessed eligible needs and outcomes.
Consent and capacity to receive direct payments
A direct payment will only be made where the person gives informed consent and has completed the Council’s direct payment agreement, agreed to the Council’s terms and conditions, understands the responsibilities involved, and agrees to use the payment in line with their care and support plan.
The person receiving the direct payment, or the person managing it on their behalf, must be able to make reasonable and appropriate arrangements to meet the agreed outcomes in the care and support plan. This includes understanding the responsibilities attached to the direct payment, keeping appropriate records, complying with any legal requirements and cooperating with review and monitoring arrangements.
Where a person has capacity to request a direct payment but needs support to manage it, the Council may agree that a nominated person supports them or receives and manages the payment on their behalf. The nominated person must agree to take on the responsibilities attached to the direct payment and must act in accordance with the person’s wishes and agreed care and support plan.
Where a person lacks capacity to request or manage a direct payment, the Council will act in accordance with the Mental Capacity Act 2005. This includes considering the person’s best interests, involving relevant people, and identifying whether there is an appropriate authorised person to request and manage the direct payment on the person’s behalf.
Before making a direct payment to an authorised person for an adult who lacks capacity, the Council must be satisfied that the authorised person will act in the adult’s best interests, will use the direct payment only to meet the needs and outcomes in the care and support plan, will comply with any conditions attached to the payment, and is an appropriate person to receive and manage public funds. The Council will keep this arrangement under review.
Detailed arrangements for how direct payments can be managed, including prepaid cards, third-party arrangements and managed accounts, are set out in section 5.
Determining the personal budget and contribution
The care and support plan must state the personal budget, the amount the Council will pay, any assessed contribution, how the budget will be managed, and the needs and outcomes the direct payment is intended to meet. The direct payment must be sufficient to meet eligible assessed needs and agreed outcomes, having regard to the reasonable cost of securing appropriate care and support, but does not have to fund spending that is not necessary to meet those agreed needs or outcomes.
The person will be required to complete a financial assessment to determine how much, they must contribute towards the cost of their care and support. Where a contribution is assessed, the person must pay this into the direct payment account as directed by the Council.
If the person chooses not to provide the information needed for a financial assessment, or does not engage with the process, they may be required to pay the full cost of their care and support. Failure to pay the assessed contribution may be treated as non-compliance with the direct payment arrangement and may lead to review, debt recovery action, changes to how the personal budget is managed, or the Council arranging services directly where this is necessary to secure care and support.
If a person chooses support that costs more than the amount the Council considers necessary to meet their eligible needs, the Council will discuss the reasons for this and whether the proposed arrangement is necessary, reasonable and sustainable. Any additional costs must be agreed in advance and cannot be assumed to be funded by the Council.
A person may choose to add their own additional funds to their direct payment account, sometimes referred to as a top-up, where they wish to purchase support that costs more than the amount the Council has assessed as necessary to meet their eligible needs. Any top-up must be voluntary, affordable and sustainable, and must be clearly distinguishable from the person’s assessed financial contribution. The Council will only fund a higher amount where this is agreed through a review of the care and support plan.
The Council may review direct payment rates where there is evidence that inflation, changes in employment costs, provider rates or other unavoidable cost pressures mean that the existing personal budget is no longer sufficient to meet the person’s assessed eligible needs and agreed outcomes. Any uplift will be considered through a review of the care and support plan and must be necessary, reasonable, affordable and sustainable.
Inflationary increases will not be applied automatically and must be agreed by the Council before additional expenditure is incurred.
Using and managing direct payments
How direct payments will be managed
Direct payments should be managed in a way that supports choice, control and independence while ensuring public funds are used lawfully, transparently and in line with the agreed care and support plan.
The Council’s standard and expected arrangement is for direct payments to be made through a prepaid card account. This is the default method because it provides a transparent, auditable and proportionate way to monitor expenditure, confirm that public funds are being used in line with the agreed care and support plan, and identify concerns at an early stage. An arrangement that does not use a prepaid card will only be agreed in exceptional circumstances, must be approved in advance by the Council, and must be supported by clear recorded reasons explaining why a prepaid card is unsuitable.
Where an alternative payment arrangement is agreed, it must provide financial transparency, record keeping and audit assurance equivalent to a prepaid card. The person or organisation managing the direct payment must provide bank statements, invoices, payroll records, receipts and any other evidence requested by the Council within required timescales. Where expenditure cannot be effectively monitored or evidenced, the Council may require use of a prepaid card, require a managed account, suspend payments, recover funds, or end the direct payment arrangement.
Where a person is unable or does not wish to manage the direct payment themselves, the Council may agree that the payment is managed by a nominated person, authorised person, third party or managed account provider. Any such arrangement must be lawful, safe, proportionate and in the best interests of the person receiving care and support.
A managed account is not the default alternative to a prepaid card. It will normally only be agreed where the prepaid card option has been considered and is unsuitable, and where there is no appropriate person available and willing to manage the direct payment safely. Before agreeing a managed account, the Council must be satisfied that the arrangement is necessary, proportionate, offers value for money, and is the most appropriate way to meet the person’s assessed needs and manage any identified risks.
All direct payment management arrangements must comply with the direct payment agreement, relevant legal requirements and any review, monitoring or audit requirements set by the Council.
What direct payments can be used for
Direct payments must be used solely to purchase services or support that meet the unmet eligible needs and outcomes identified in the person’s care and support plan. The services or support should promote wellbeing, independence, choice and control, and may be used flexibly where the proposed use is lawful, safe, proportionate, offers value for money, can be evidenced, and is clearly linked to the assessed eligible needs and the care and support plan.
Examples of appropriate use may include employing a personal assistant, purchasing care or support from an agency, accessing community activities, arranging short breaks, or buying equipment or services that meet assessed outcomes, where this has been agreed through the care and support plan and, where relevant, by an Occupational Therapist. For carers, a direct payment may be used to meet the carer’s own eligible support needs and outcomes, in line with the carer’s support plan.
Where a person wishes to use a direct payment in a different or innovative way, this should be discussed with the Council in advance. The Council will consider whether the proposed use is legal, safe, affordable, likely to meet agreed outcomes, represents value for money, and is an appropriate use of public funds.
What direct payments cannot be used for
Direct payments must not be used for anything unlawful, unsafe, outside the agreed care and support plan, unrelated to eligible assessed needs, poor value for money, or contrary to the direct payment agreement or the Council’s direct payment terms and conditions.
Direct payments must not be used in a way that exposes the person or others to avoidable harm, abuse, neglect, exploitation or unsafe care arrangements. The Council retains safeguarding responsibilities and may refuse, suspend, review or end a direct payment where the proposed or actual use creates unmanaged risk or does not protect the person’s wellbeing.
Direct payments must not be used to pay household bills, food, rent, mortgage payments, alcohol, tobacco, gambling, holidays that are not linked to agreed assessed outcomes, general leisure costs, gifts, loans, fines, personal debt, or any services already funded from another public source. They must also not be used as a substitute for services that another public body is responsible for providing, including NHS-funded health services, unless this has been expressly agreed as part of a lawful joint arrangement.
Direct payments must not normally be used to pay a spouse, civil partner, partner, close family member or anyone living in the same household to provide care. Any arrangement must be agreed in writing before payments are made and must include safeguards to manage conflicts of interest, dependency, undue influence or inappropriate use of public funds.
Where the Council agrees that a family member, person living in the same household, or more than one informal carer may be paid, the care and support plan or direct payment agreement must include a written breakdown of the arrangement. This should include the name of each person being paid, their relationship to the person, the duties to be carried out, agreed days, times and hours, hourly rate or payment basis, evidence required to confirm delivery, and contingency arrangements if the arrangement breaks down.
Direct payments, including carers’ direct payments, must not be used simply to pay someone for informal caring or general family support.
Direct payments must not be used to secure residential care, except for short-term respite placements where the Council has explicitly agreed this as part of the care and support plan.
Where a person chooses to live in Extra Care Housing, Supported Living or another commissioned accommodation-based service, the Council will normally expect eligible care and support needs linked to that accommodation to be met through the commissioned provider for that scheme. This is because the accommodation and support model is commissioned to provide safe, coordinated and cost-effective care, including through economies of scale. A direct payment to purchase alternative care or support in these settings will only be agreed in exceptional circumstances where the Council is satisfied that it is necessary, appropriate, safe, affordable, represents value for money and is the best way to meet assessed eligible needs. The person’s choice is the decision to live in that accommodation; this does not automatically create an additional entitlement to a direct payment to arrange separate care where commissioned support is available and appropriate.
Employing personal assistants
Where a direct payment is used to employ a personal assistant, the person receiving the direct payment, or the person managing it on their behalf, will normally be the employer. They are responsible for meeting all legal and practical employer responsibilities, including safe recruitment, contracts of employment, payroll, tax, National Insurance, pension duties, holiday pay, sickness arrangements, employer liability insurance, training, supervision, health and safety, and ensuring appropriate arrangements are in place if the personal assistant is unavailable.
The employer must ensure that the personal assistant is suitable and able to provide the agreed support safely. This may include carrying out right to work checks, Disclosure and Barring Service checks where appropriate, obtaining references, agreeing clear duties and working hours, putting risk assessments and contingency plans in place, and keeping records that evidence compliance with employment, financial and direct payment requirements.
The Council may require evidence that appropriate employer arrangements are in place before agreeing or continuing the direct payment. Where concerns are identified, the Council may require additional safeguards, support or changes to the arrangement to ensure the person’s assessed needs are met safely and appropriately.
Where the personal assistant arrangement involves higher levels of risk, complex care needs, moving and handling, specialist equipment, medication support or other safety-critical tasks, the Council may require additional professional advice or agreement before the arrangement is approved. This may include advice or agreement from an Occupational Therapist, social care practitioner, health professional or safeguarding lead, depending on the nature of the support required.
The Council will provide or signpost to appropriate direct payment support services to help people understand their employer responsibilities, including support with recruitment, payroll, managed accounts, employment advice or record keeping where available. Responsibility for day-to-day employment, supervision and management remains with the employer or person managing the direct payment unless a managed arrangement has been formally agreed.
Monitoring, repayments and ending direct payments
Monitoring and reviewing direct payments
The Council has a duty under the Care Act 2014 to keep care and support plans under review. Direct payment monitoring forms part of this wider duty and will be used to ensure that eligible needs continue to be met, agreed outcomes remain appropriate, risks are identified and managed, and the direct payment remains a suitable and effective way of meeting the person’s needs.
Reviews will consider both the person’s care and support arrangements and the use of the direct payment. This may include whether the care and support plan remains accurate, whether the personal budget remains sufficient and proportionate, whether the payment is being used in line with the direct payment agreement, whether contributions are being paid, whether records are available, and whether the arrangement continues to provide value for money.
A direct payment review may take place alongside a statutory annual review, financial assessment review, audit, safeguarding enquiry, change in circumstances, or where concerns arise. People receiving direct payments must cooperate with monitoring and audit requirements and provide evidence of expenditure when requested. If records are not provided, expenditure cannot be evidenced, or the payment has not been used in line with the agreed care and support plan and direct payment terms and conditions, the Council may require repayment, suspend further payments, change the management arrangement, or arrange services directly instead.
Reviews and audits may include checks that the agreed support has actually been delivered, including evidence of hours worked, timesheets, agency invoices, payroll records, care logs, care notes, commissioned hours compared with delivered hours, missed or cancelled calls, and any other records requested by the Council. Where the agreed hours or support are not being delivered, are lower than the hours funded, or cannot be evidenced, the Council may review and reduce the personal budget, recover surplus or unsupported funds, change the direct payment arrangement or arrange services directly.
The Council will review direct payments initially within the first six months of the first payment and then annually, or sooner where there is a change in need, risk, use of funds, management arrangement, safeguarding concern, hospital admission, residential care admission, or other relevant change in circumstances.
Excess direct payment funds and repayment
Direct payment funds should be used within a reasonable period to meet the needs and outcomes for which they were paid. A build-up of funds may indicate that the care and support plan has not been delivered as planned, needs have changed, contributions have not been paid, or the personal budget is higher than required.
The Council’s policy is that the direct payment account should not hold more than four weeks of the gross direct payment allocation without prior agreement from the Council. Where funds exceed this level, the Council may review the arrangement and seek repayment of surplus funds, unless there is an agreed reason for the balance such as planned expenditure, payroll liabilities, contingency arrangements or timing of invoices.
The Council may recover unspent, misspent, unsupported or misappropriated funds, including where this amount constitutes an underspend, misuse of the direct payment, misappropriation or theft, or where payments have continued after a person’s death, admission to hospital or residential care, a break in service, a change in circumstances, or the end of a direct payment arrangement. Any amount due may be treated as a debt to the Council. Recovery will be proportionate and will take account of any legitimate commitments already incurred.
Where a person repeatedly builds up surplus funds, does not provide evidence of expenditure, or does not use the direct payment to meet agreed outcomes, the Council may reduce future payments, suspend payments, reclaim funds, require a managed account, or end the direct payment arrangement.
Suspensions and ending direct payments
A person may ask to stop receiving a direct payment at any time. The Council will discuss alternative arrangements and, where eligible needs continue, will arrange support in another way.
The Council may suspend or end a direct payment where it is no longer appropriate, where the person no longer has eligible needs, where funds are not being used properly, where risks cannot be managed, where the person no longer wishes to receive the payment, or where an authorised or nominated person is no longer suitable.
Before ending a direct payment, the Council will consider the person’s needs, wellbeing, safety, views and circumstances. Where urgent action is needed to protect a person or public funds, the Council may suspend payments while enquiries are completed.
Where direct payments are suspended or ended, the Council will ensure that eligible needs continue to be met where it remains responsible for meeting those needs. The Council will confirm any decision, reasons, repayment requirements, alternative arrangements and review or appeal routes in writing, unless urgent circumstances require immediate action followed by written confirmation as soon as practicable.
Complaints and policy review
Complaints and disputes
If a person disagrees with a decision about a direct payment, including a decision made during assessment, support planning, personal budget setting or financial assessment, they may use the Adult Social Care appeals process. Where possible, concerns should be resolved early through discussion and review of the decision. If the matter is not resolved, a formal appeal may be made in line with the Adult Social Care appeals process. Appeals should normally be made within 15 working days of the decision and may be submitted online or by email:
Where a person remains dissatisfied after an appeal decision, the Council will explain the next available route. This may include the Adult Social Care statutory complaints process, where appropriate, or referral to the Local Government and Social Care Ombudsman. Information will be provided in an accessible format, and independent advocacy will be considered where the person would have substantial difficulty being involved and has no appropriate person to support them.
Policy review
This policy will be reviewed at least every three years, or sooner if there are changes in legislation, statutory guidance, local practice, financial procedures, safeguarding requirements or learning from audits, complaints or operational delivery.