How to manage direct payments to pay for elderly care

If your parent has opted to receive direct payments to pay for personal care services yourself, there are important things you should know – such as how to compare products and services and how to manage your budget effectively

Direct payments at a glance

Your local authority or trust cannot issue direct payments to your parent without your consent

Direct payments are made by local authorities (or Health and Social Care Trusts in Northern Ireland) to people who need support with their long-term care. Instead of the council (or trust) providing the care services directly, they’ll make payments into your parent’s bank, building society, Post Office or National Savings account. Your parent is then responsible for arranging and paying for their own care and support services

Managing a personal care budget

Your parent may have decided that receiving direct payments will give them the independence, choice and control they want when it comes to organising their personal care

The next step is to work out which providers they’d like to use to fulfil the care plan agreed with the local authority. Naturally, there are rules and obligations set out by the local authority to make sure that everyone does this in a safe and fair way

Your parent must keep receipts to show how the budget is spent and send these to social services

They must only spend the money on care services that meet the specific needs agreed in their care plan

Depending on how much the payment is, they may need to top it up with money of their own.

If your parent can’t account for all spend, or they use it for items not in the agreed care plan, they could be asked to reimburse their local authority

Direct payments cannot be used to pay for informal care from a spouse, partner or close relative who lives with your parent, unless they’re registered as a carer

They may need to take on the legal role of an employer if they pay a person to help  with care

Direct payments cannot be used to pay for permanent residential accommodation, but your parent may be able to use direct payments to pay for occasional short periods in residential accommodation if the council agrees

The rules for direct payments vary around the country. Speak to your parent’s social worker or contactthe council to find out about regional variations

More information about managing direct payments

Many local voluntary organisations provide tailored support with managing your direct payments. For example:

  • organisations working with people who have a learning disability, such as People First
  • mental health organisations, such as Mind
  • Disability Rights UK (formerly the National Centre for Independent Living)

You may also want to:

download the Department of Health, Social Services and Public Safety information booklet on direct payments

search the directory of local carers’ services

Paying for carers

If your parent uses direct payments to employ a carer, they will immediately take on certain responsibilities as an employer. That means tax, national minimum wage, sickness and holiday pay, and liability insurance. Whether they employ someone for a few hours a week or full time, the same rules apply. If that sounds a bit daunting, there are people and organisations that can help

Look at local firms who offer payroll services. They’ll handle tax and National Insurance contributions for a fee

Think about using a home care agency. They’ll deal with all the paperwork, including references and criminal checks, and invoice your parent directly

Ask your social services department about local home care agencies and check them out with the relevant regulator:

in England, contact the Care Quality Commission

in Scotland, contact the Care Inspectorate

In Wales, contact the Care and Social Service Inspectorate

In Northern Ireland, contact the Regulation and Quality Improvement Authority

Comparing products and services

If your parent has decided to purchase care and support products and services , it doesn’t mean they can’t ask social services for help and advice. They’ll be able to tell your parent about local providers and preferred suppliers, so they can shop around for the best deal

Local support groups may also be able to provide information and assistance, while some national organisations may provide tailored support or sell disability aids themselves

Keeping records

If your parent receives direct payments, they’ll need to keep track of the money spent. The council will tell your parent what information they’ll be expected to provide (such as time-sheets signed by carers, receipts for equipment or invoices from home care agencies), as well as how and when to submit this information to them
What to do if circumstances changeDon’t delay in telling the council or trust about a change in circumstances – it could mean your parent gets more money.

If their needs change, contact the council as soon as possible so that they can reassess the level of payments you need – your parent might be entitled to more. Alternatively, if they don’t need to spend the full amount because their condition improves temporarily, or they go into hospital, the council may need to adjust the payments

What to do if circumstances change

If your needs change, contact your council as soon as possible so that they can reassess the level of payments you need – you might be entitled to more. Alternatively, if you don’t need to spend the full amount because your condition improves temporarily, or you go into hospital, they may need to adjust your payments.

If you don’t want to continue with direct payments

If your parent decides they don’t want to receive or manage direct payments  anymore, the council has a legal duty to arrange services instead. Similarly, if the council decides your parent can’t manage with direct payments, they might decide to provide services directly

 

This article is provided by the Money Advice Service.

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