Disabled Children and Young People Direct Payments

1. Introduction

Meeting the needs of vulnerable children can be complicated and the procedure contained in this document has been developed to address issues that are specific to Specialist Children’s Services and provides guidance for practitioners when working with families or young people who take up Direct Payments to meet assessed needs. It is supported by a flow chart outlined in Appendix 1: Direct Payment Process Flowchart.

Direct Payments policy is set out in the multi-disciplinary document Direct Payments Policy and Practice Guidance, which should be read in conjunction with this procedure.

2. Children and Families Direct Payments Support Service

The Families and Social Care Directorate has commissioned a dedicated Direct Payments Support Service.

3. Eligibility for a Direct Payment

To be eligible for a Direct Payment a child must be disabled and meet the criteria as a Child in Need for either the Specialist Children’s Services or the Disabled Children’s Service (DCS) (see Disabled Children’s Services Procedure).

4. Child and Family Assessment and Child in Need Plan

A Direct Payment can only be made once a social worker has completed a Child and Family Assessment, and a Child in Need Plan. The Child in Need Plan should identify the child’s assessed needs and how these needs are to be met.

In considering how to meet the assessed needs, the social worker should always offer a Direct Payment, whilst ensuring that this will be in the best interests of the child.

The option and appropriateness of a Direct Payment should be discussed with the family. Where the young person/parent/carer is unable to manage a direct payment but wish to make use of this option, the social worker should seek advice from the Children and Families Direct Payment Service (CFDPS), and consideration should be given to the use of an Independent Living Trust. The family should be provided with a copy of CFDPS leaflet, which gives information about Direct Payments. The family should be advised that they can obtain further information from the CFDPS. Should the young person/parent/carer want to explore the option of Direct Payments, the social worker will then need to make a referral to the CFDPS. A referral form can be obtained from the CFDPS. It is important to work alongside the CFDPS and the family to achieve the best outcomes for the child.

The social worker will establish the cost of any equivalent service provided by the local authority and obtain agreement to the funding of the care package from their manager/supervisor, ensuring that it does not exceed this cost.

Where a Direct Payment is going to be made, the following should be included in the Child in Need Plan:

• The child’s identified needs;
• The level of services required to meet the assessed needs;
• The needs that will be met through Direct Payments;
• Those services that will be provided by some other means.

5. Needs that Can be Met Via the Use of Direct Payments

• A short break as part of a child’s assessed need and Care Plan;
• Personal care and support for the child within the child’s own home where this forms part of the child’s assessed need and Care Plan;
• Personal care and support to facilitate a child to access leisure, cultural and sporting activities within the local community where this forms part of the child’s assessed need and Care Plan;
• Personal care and support necessary to access out of school and holiday activities where this forms part of the child’s assessed need and Care Plan;
• Equipment to support independence following an assessment by a Children’s Occupational Therapist.

Overnight Short Break provided by a Personal Assistant in the child’s own home, where this forms part of the assessed need and Care Plan or short breaks in the home of a Personal Assistant. See Practice Guidance Note for Parent’s Guidance for the use of Direct Payments for overnight support in the home of a Personal Assistant Workers.

To be eligible for a Direct Payment to meet the cost of an overnight short break a child/young person must meet the agreed Overnight Short Break Criteria (see Short Breaks Procedure). Please refer to Appendix 2: Direct Payment Agreement for a detailed breakdown of the costings associated with overnight short breaks.

6. Services that May Not be Purchased Via the Use of Direct Payments

• Where there are concerns that Direct Payments may pose a risk to the safety or wellbeing of the child or young person;
• Purchase of any service from the local authority, e.g. Kent County Council’s residential or fostering short break services;
• Care within a residential school;
• Purchase of care away from the child’s home, including foster care, in excess of 28 days for any single period or 120 days in any twelve-month period;
• Purchase of any care that contravenes the law or government regulations;
• Purchase of services that would usually be the responsibility of another agency, e.g. physiotherapy, speech therapy, home tuition, portage services. It may be possible to reach agreement with the other agencies for them to directly fund such provision;
• Direct Payments relate to the child’s needs following an assessment and are not used to provide care for a disabled child to enable carers to go to work. However they can be considered in exceptional circumstances. Passing the threshold for exceptional circumstances is judged on the individual case, taking into account the complexity of the child’s needs, the environmental circumstances and the wider support network available. They will only be authorised following approval by an Assistant Director.

7. Determining the Cost of a Direct Payment

The amount of a Direct Payment must be related to the cost of the service that would have otherwise been provided to meet the assessed need, and should not therefore exceed that of a similar service provided by Kent County Council.

The actual costing of a Direct Payment to meet the needs identified in the Care Plan is undertaken by the CFDPS Support Worker, with the family. The Direct Payment must be sufficient for the recipient to fulfil his/her duty as a responsible employer e.g. to cover holiday entitlement; National Insurance; training; contingency for sickness cover, payroll costs, etc. The Direct Payment must also comply with legislation governing a minimum wage. The Support Worker will ensure this does not exceed the cost of the equivalent service provided by the local authority. The social worker will need to advise the support worker what this amount would be. The agreed maximum notional rate for one to one support has been set at £12.80 for social hours and £14.80 for unsociable hours across the County.

When considering the potential training needs of a Personal Assistant employed via a direct payment, a training plan should be drawn up at the beginning of a direct payment and reviewed on an annual basis, so that appropriate costings can be included in the direct payment.

Information on costing a Direct Payment can be obtained from the Direct Payment Support Worker. Once completed, the proposed costing will be sent to the Social Worker who should advise their manager/supervisor of the total cost of the care package to the local authority.

In cases where it is difficult to provide a service through a Direct Payment the social worker should consult further with their supervisor/manager and the Direct Payment Support Worker, who will have to consider whether it is appropriate to continue to offer a Direct Payment or whether the child/family's needs can be met in some other way.

8. Setting up the Direct Payment

The Social Worker will ensure that Kent County Councils Direct Payment Agreement is signed by the parent/carer. This Agreement sets out the terms and conditions of using the Direct Payment.

If the young person/parent/carer is unable to manage a Direct Payment but wishes to make use of this option, the social worker should explore the use of an Independent Living Trust in consultation with the Direct Payment Support Worker.

When funding has been agreed, the parent/carer will need to set up a separate bank account for the Direct Payment, or alternatively apply for a Kent Card. This is not necessary where the Direct Payment is for a single payment e.g. for a one-off short break or a piece of equipment. The Direct Payment Support Worker will assist the parent/carer in setting up the account or applying for a Kent Card.

The Social Worker should send the DP1 (Finance Form - available from CFDPS) to the Finance Department at least 10 days before the Payment is due to start.

9. Reviewing the Direct Payment

The Direct Payment Support Worker will review how the parent/carer is managing the Direct Payment at regular intervals agreed with the parent/carer.

The Child in Need Plan will be reviewed at six monthly intervals. Authority to continue payments will need to be given by the budget manager. The review should consider any changes in the assessed need, the services that are required to meet the need, and which services will be provided via Direct Payments.

It should be noted that Personal Assistants are the employees of the parent/carer or the young person themselves and should only be present at the review by the specific invitation of the parent/carer or young person.

The Children and Families Direct Payment Support Worker will complete the DP4 Form and send it to the social worker. Upon receipt of the DP4 Form, the social worker will take steps to recover any unspent money, or review payments if required. To recover Payments, the completed and signed last section of the DP4 should be forwarded to KCC Finance. For Kent Card holders there will be different arrangements to recover unspent money.

10. Safe Recruitment Practices

The Protection of Children Act 1999 enables a person considering employing someone to care for their children, or a disabled 16 or 17 year old who is considering employing someone themselves, to ask the Local Authority to carry out a check to determine that the proposed employee is a suitable person to work with children. When a person with parental responsibility, or the young person, requests such a check, the Local Authority has a duty to comply.

The DBS check will be carried out by the CFDPS and paid for by KCC.

Kent Specialist Children’s Services policy is that everyone working with children should have a current DBS check. Parents/carers/young people should be advised that a DBS check should be carried out in respect of the person they plan to recruit to care for the child/young person, as without this the Direct Payment will not be agreed. It is preferable if the employment of a Personal Assistant can wait until DBS clearance is received (providing this is appropriate), as it avoids actions being taken to terminate employment if the DBS check is unsatisfactory.

If a DBS check has been requested but has not been received by the time the Personal Assistant (PA) is required to start work, the parent/carer/young person should be advised that the PA should not be left alone with the child/young person they are providing care for, until DBS clearance is received. Disclosure and Barring Service checks should be updated every 3 years.

If a PA has been DBS checked and cleared to work with one child and then identified to work with a different child the PA will not need to be DBS checked again unless the DBS check is coming up for its 3 year renewal.

If, during their employment, concerns about the employee’s performance or behaviour are raised in relation to the child/ young person’s safety, it is expected that a review meeting will be held with the social worker at the earliest opportunity. All decisions from this meeting should be recorded and shared with interested parties on a need to know basis. It is likely that the parent/carers/young people will need support from the Children and Families Direct Payment Scheme in these circumstances.

Should the concerns raised be of a safeguarding nature, the Kent and Medway Safeguarding Children Procedures should be followed and a referral made to the KCC Central Referral Unit, and also immediately to the Local Authority Designated Officer.

The following document provides more detailed information on employment issues: Guidance on Direct Payments for Community Care, Services for Carers and Children's Services: England 2009.

11. Positive DBS Checks

If the Children and Families Direct Payment Scheme receives information of concern about an individual, either employed already or being considered for employment through a Direct Payment, immediate advice should be sought from the KCC social work Team Leader. Agreement will need to be reached between professionals about what information is shared and with whom. The Local Authority and the Children and Families Direct Payment Scheme are bound by the Disclosure and Barring Service Code of Practice in respect of the use, handling, storage retention and disclosure of DBS checks. Further information on the DBS Code of Practice is accessible on the Disclosure and Barring Service website.

On receiving positive DBS information about an applicant:

• The information should be passed to the Team Leader/ Social Worker;
• The Team Leader/Social Worker should undertake a risk assessment with the applicant and a decision should be made within four weeks to decide whether the person can be employed as a Personal Assistant. This decision will need to be ratified by a Senior Manager within Specialist Children’s Services;
• On completion of the risk assessment should the Local Authority consider the applicant unsuitable because the use of a Direct Payment would place a child/young person at risk, the applicant should be advised by the Team Leader/Social Worker and the decision confirmed in writing. The applicant should also be informed that the family/young person will be advised not to employ them;
• In consultation with the CFDPS Direct Payment Support Worker, the Local Authority should advise the parent/young person of the Local Authority’s decision not to agree to the direct payment, without giving details of any offences that have come to light. The parent/young person has no right of access to DBS disclosures and it would be an offence for the Local Authority to disclose the information. The Local Authority can however share information with the parent/young person if they have the specific written consent of the prospective applicant, alternatively the applicant him/herself could voluntarily pass the disclosed information onto the parent/young person.

Should the concerns be of a safeguarding nature then the Kent and Medway Safeguarding Children Procedures must be followed and a referral made to the KCC Central referral Unit, and consultation take place immediately with the Local Authority Designated Officer.

12. Contingencies

Where a parent or carer chooses to use Direct Payments the social worker must ensure that they understand their responsibility to take all reasonable steps to arrange and organise the service to meet the assessed needs of their child. This may be achieved through additional support, such as an advocate, or by establishing Independent Living Trust etc. The arrangements must include a robust contingency plan to ensure that the assessed need of the child they care for can still be met in the event of the service they purchase is not available, e.g. the Personal Assistant being ill.

Appendix 1: Direct Payment Process Flowchart

Click here to view Appendix 1: Direct Payment Process Flowchart.

Appendix 2: Direct Payment Agreement

Click here to view Appendix 2: Direct Payment Agreement