Direct payments and personal budgets

A direct payment is your council care budget paid to you in cash so you can arrange your own support, rather than the council commissioning it for you.

Why people choose them

Control over who and when. You choose the person and set the times, rather than accepting whichever agency holds the contract and whatever visit slots it can offer.

Continuity. Employing your own personal assistant usually means the same face every day, which is the thing families most often say is missing from agency care.

Flexibility. The budget can be used creatively, so long as it meets the outcomes in your care plan.

Better value. A directly employed personal assistant often costs less per hour than an agency, so the same budget buys more support.

What you can spend it on

Anything that meets the agreed outcomes in your care plan. That usually includes:

• Employing a personal assistant directly
• Buying care from an agency of your choice
• Equipment or short courses that reduce your need for support
• Help getting out and taking part in activities, where that is a care plan outcome

What you cannot spend it on

• Anything unlawful
• Long term residential care
• Ordinary living costs like rent, food or utility bills
• Usually, care from someone living in your household
• Gambling or debt repayment

The responsibilities

This is the part to think hard about. If you employ someone directly, you are an employer, with everything that implies:

• Contracts of employment and the right paperwork
• PAYE, National Insurance and pension auto-enrolment
• Employer’s liability insurance
• Statutory sick pay, holiday pay and maternity or paternity pay
• DBS checks
• Cover when your assistant is ill or on holiday
• Records of every pound spent, for the council to audit

Most councils fund a payroll service and many fund a direct payment support service to handle this. Ask what is available before you decide. If it is not offered, ask again.

Managed accounts, a middle way

If the full employer role is too much, ask about a managed account or individual service fund. A third party holds the money and handles the administration while you keep the choice over who provides your care. It is a good compromise and is often not mentioned unless you ask.

You still pay your contribution

A direct payment does not change the means test. Your assessed contribution from the financial assessment still applies, and either you pay it into the account or the council pays a net amount.

Personal health budgets

The NHS equivalent is a personal health budget, most commonly used by people receiving NHS Continuing Healthcare. The principle is the same and the two can run alongside each other where someone has both health and social care funding.

Getting started

Ask your social worker at the needs assessment, or at any review. Councils have a duty to offer a direct payment where you are able to manage one, with support if needed.