Disabled Children and Young People Direct Payments

1. Introduction

Direct payments are monetary payments made to assist with meeting a disabled child or young person’s assessed need to fund part or all services as an alternative to commissioned services.

The procedure contained in this document has been developed to provide 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 Direct Payments Flowchart which can be found in Local Resources of KPON.

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. Direct Payment Support Service for Disabled Children and Young People

The Children, Young People and Education (CYPE) 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 Strengthening Independence Service for Disabled Children (see Disabled Children’s Services Procedure) or a Children’s Social Work Services District team.

Direct payments can be given to 16 and 17-year-old disabled young people directly rather than to their parents or carers if the young person is able to organise their own care and support. 

Direct Payments can also be made to a willing and appropriate person on a child or young person’s behalf if they lack the mental capacity to agree to and manage Direct Payments themselves. This would usually be a parent or someone with Parental Responsibility.

4. Child and Family or Short Assessment and Child in Need Plan

A Direct Payment can only be made once either a social worker has completed a Child and Family Assessment or a Social Work Assistant (SWA) has completed a Short 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.

Where resources within the family and community network have been explored and a need for services has been identified’, in considering how to meet the assessed needs, the social worker/SWA 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 Direct Payment Support Service for Disabled Children and Young People (DPSS)The family should be provided with information about Direct Payments and advised that they can obtain further information from the DPSS. 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 DPSS The electronic referral form is on the Case Management system  It is important to work alongside the DPSS and the family to achieve the best outcomes for the child.

The social worker/SWA 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 and the Decision-Making or Access to Resources Panel, ensuring that it does not exceed this cost.

• 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.

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).

• To meet education needs: Direct payments for education are monetary payments to parents of a child with an Education, Health and Care Plan (EHCP) and should be specified in the EHCP. These include requirements to consider the impact on other service users, taking account of value for money and to seek agreement from educational establishments where a service funded by a Direct Payment is delivered on their premises. The DPSS will support the Special Educational Needs (SEN) team in their use of DPs;
• To meet Health Needs: Direct Payments for health require the agreement of a Care Plan between the Integrated Care Board (ICB) and the recipient and will be managed by the ICB’s Personal Health budget profess. Direct payments and Personal Budgets also apply to young people who require Aftercare services under section 117 of the Mental Health Act 1983, children and young people receiving Continuing Health Care funding and people eligible for an NHS wheelchair (personal wheelchair budgets).

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 Overnight Short Break Units, 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;
• Children under the age of 8 must be cared for in line with the Childminding 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 cannot be used to pay for services from a spouse, partner or a close relative living in the household unless the local authority consider it is necessary to do so. However, a direct payment can be used to employ a relative if they are not living in the household;
• 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 DPSS 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 be in line with Kent County Council’s current agreed notional hourly rates.

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 Council’s Direct Payment Agreement is signed by the parent/carer/young person (where applicable). This Agreement sets out the terms and conditions of using the Direct Payment and can be found in Local Resources of KPON.

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 with the Direct Payment Support Worker if there are alternative options.

When funding has been agreed, the parent/carer will need to 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 applying for a Kent Card (This is the default method of payment, but in exceptional circumstances DP recipients may request setting up a separate bank account for the Direct Payment).

The Social Worker should follow the agreed process for sending the relevant information 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/young person is managing the Direct Payment at regular intervals agreed with the parent/carer/young person.

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.

Following the review the Direct Payment Support Worker will complete the Review Form and send it to the social worker. Upon receipt of the Review Form, if a Reclaim is requiredthe social worker will  follow the agreed process to recover any unspent money, or review payments if required.

10. Transition to Adult Social Care

Before a young person is 18, it is important that a young person is assessed through the transition process to meet the statutory duty of both the Care Act and the Children and Families Act and to decide if Adult Social Care is needed and to establish what care and support is still needed or required. This will include whether a direct payment is being offered or continues to be offered.

In Kent, the Transitions Panel is in place to ensure all young people aged 17 plus who have an appearance of need for ongoing care and support under the Care Act 2014, are considered for transition to Adults Social Care and Health (ASCH). See the Transitions Panels Terms of Reference in the Local Resources section of KPON for more information about the process.

The financial aspects of any care of the young person will remain the responsibility of Children’s Services until the young person is 18 and the Community Team or Strengthening Independence Service will take over financial responsibility from age 18 if the transfer is agreed. 

It is important to note once a young person reaches 18, the care and support package is means tested and a financial assessment will be completed by the finance team to look at what contribution is necessary from the young person’s finances (which does include benefits).

11. 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 DPSS and paid for by KCC.

Kent County Councils 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 Direct Payment Support Service 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 Front Door Service, and also immediately to the Local Authority Designated Officer.

For more detailed information on employment issues the DPSS can advise.

12. Positive DBS Checks

If the DPSS 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 DPSS 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 CYPE;
• 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 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 Front Door Service and consultation take place immediately with the Local Authority Designated Officer.

13. 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. 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.