You are here: Agenda item

Agenda item

Scrutiny Review - Adult Paid Carers - Witness evidence - Verbal


Stephen Day, Head of Service IDLP, and Nicola Martinez –Herrera, Team Manager, Direct Payments were present, and gave witness evidence to the Committee


During the evidence the following main points were made –


·         A personal budget is the amount of money the Council will pay towards any social care and support a service user needs. The personal budget is determined following an assessment of needs under the Care Act. The assessment will confirm what kind of care and support is needed, how much it will cost, how much the service user is able to afford to contribute following financial assessment

·         A personal budget can be paid to the service user or carer, to enable them to make more decisions about how it is spent. This is known as a Direct Payment

·         Direct payments have been in use in adult care and support since the mid 1990’s. The Care Act 2014 confirms personal budgets in law for people with eligible assessed needs and carers, including the right to direct payment. In order to ensure that people are supported to use and manage the payment appropriately, local authorities must provide relevant and timely information about direct payments

·         Direct payments give individuals greater choice and control over the support they receive and how it is provided. For example, one could choose to hire care workers or personal assistants who are always the same people and available when needed, speak the same language, have experience working with a person’s care needs, or is a specific person that has been recommended

·         There are many ways service users could choose to spend the money. A person can make a choice as long as the personal budget is spent on things that meet their needs, and are detailed in their support plan

·         Benefits of Direct Payments – choice and control, flexibility, empowerment, consistency, person centred, creative, can have specialist support, savings to LA which makes more funds available to service clients, local job creation, improved service provision, less prescriptive care, variety of sources of service provision

·         Currently 22% of all Islington community care and support is provided through Direct Payments. This figure has decreased almost 10% since 2017. Feedback from the 2018 service user survey continues to show that DP recipients felt that they had the most choice, and control, over their care and support services, and had the highest percentage of those extremely, or very satisfied, with their service

·         Improving the offer – Personalisation is a key stream of the Adult Social Care Plan 2019-22. Building on evidence from research, the aim is to improve the offer to people who choose a Direct Payment. The aim is to increase uptake to make it the default choice, and are looking at how the market can meet the needs of those who choose Direct Payments. Processes and policies are being reviewed, and work is taking place across departments, and the CCG, to ensure an integrated and co-ordinated approach to personalisation. The aim is to develop a new training offer for social work staff regarding the approach to personalisation, and updated policies and procedures

·         Working with Direct Payment Service Users – have restarted the Direct Payments Forum to engage with all recipients, gather feedback, and guide plans for improvement. Feedback has been really positive. An active working group has been established with service users, and carers, to shape future forums, work on the actions from the forums, and engage DP recipients to network and offer peer support. The working group is developing a training offer for DP employers and PA’S, engaging current providers, and building the local market

·         The role of the Direct Payments team – Provides support, information and assistance to professionals regarding Direct Payments in Islington, e.g. processing referrals, investigating misuse or other issues relating to Direct Payments. In addition, it implements personal health budget/continuing health care, and long term conditions. Also provides support, information and assistance to both new and existing Direct Payment employers, including self-funders. Assists with recruitment campaigns, and employment of PA’s, support with employment disputes, ending employment direct payments/redundancies, and keeping up to date with employment changes

·         The Direct Payments services provide the following assistance – information visits – attend joint visits with practitioners to prospective new Direct Payment users to explain about flexibility, choice and responsibilities for DP employers. DP employment set ups and advice – visits to assist with setting up new or existing employees with the following – payroll, employers liability insurance, DBS checks, redundancy, employment contracts, suspension of DP’s relating to employment tasks, discuss annual leave cover arrangements, and special leave cover arrangements, and employer/employee rights and any other employment tasks

·         Ongoing support provided to existing and new DP employers – liaising with payroll on behalf of service user/family, breakdown cover arrangements, back up agency, maternity advice, and sickness advice, break in service, employment law, ending Direct Payments, supporting with disputes

·         Setting up Personal Health Budget for CCG – service users who are on continuing care or long term condition can now access Direct Payments and these are called Personal Health Budgets. (PHB). They are health funded, and they have commissioned the Social Services Direct Payment team to deliver them. The DP team complete the following tasks for CCG – information visit, costing care plan etc. completing PHB agreements, adding the support plan and provision to LAS, e referrals to DP finance and set up, support with employment and recruitment, and ongoing support. Personal health budgets can be ‘virtual’ budgets

·         In response to a question it was stated that it was felt that the drop in uptake of personal budgets was due to social workers not encouraging  these, and that training is taking place with social work staff in this regard. It was stated that comparative data for other Local Authorities take up of DP could be circulated to Members

·         It was stated that those in receipt of DP were not charged administration fees

·         In response to a question as to the situation where there is a change in condition of a service user on Direct Payments and how this is detected it was stated that notification could be through a social worker or GP or family member. Although there is an Annual Review, vulnerable clients are visited more often to check on them often every 2 weeks





That the report be noted, and that comparative figures in other Local Authorities for the take up of Direct Payments be circulated to Members of the Committee







The Chair thanked Stephen Day and Nicola Martinez- Herrera for attending