Direct Payments Policy Consultation - Public survey

Participants were asked to consider the following eight proposed changes to the Adult Social Care Direct Payments Policy:

1. Unspent funds - we will be more flexible when we look at any unspent funds in Direct Payment accounts. We will no longer automatically claim back unspent funds which are in excess of eight weeks. Instead, we will ask DP clients what their plans are for any unspent funds. For example, they may be planning to spend it later in the year on something that has been agreed will meet the outcomes in their support plan. If this is the case, they will be able to keep the money in their account until they need it.
2. Support from family members - if we think it is necessary, DP clients will be able to ask a family member to manage their Direct Payment and for another family member to be paid to provide their support.  We have also deleted the section that said that a family member living in the same house as a DP client should only be paid to provide their support in exceptional circumstances.
3. Using personal bank accounts – under the new policy it will be possible to have a Direct Payment paid into a personal bank account. Though we will continue to recommend that people set up a separate bank account as this will make it easier for them to administer DP monies and avoid them having to share generic details of other non-DP related financial transactions.
4. Holiday costs - sometimes Direct Payments are used for respite, this means that DP clients might spend some time away from their carer, or the people they live with. They might choose a traditional form of respite, where support is offered on site. Or they may decide to go on holiday with their Personal Assistant or another family member or friend who doesn’t normally care for them. The new policy says that, with our agreement, they can, in liaison with their social worker, use their Direct Payment to pay towards travel and accommodation costs if they decide to go on holiday for respite where this has been identified as an outcome of their Care Act assessment. 
5. Travel expenses - Direct Payments will not normally be used for daily travel expenses, but we may agree to fund reasonable travel expenses if we feel that DP clients need this because of their individual circumstances. 
6. Paying for Council services and using DPs outside the UK – we have removed the statements that said that DP clients could not use their Direct Payment to pay for services from the council or to pay for things outside of the United Kingdom.
7. Paying for leisure activities - we will support DP clients to explore leisure activities that they are interested in and enjoy where these will meet the outcomes included in their support plan. We will not rule out anything unless the items and activities they are suggesting do not meet the outcomes in their support plan. Principles of Best Value will also apply.
8. Periods away from home – DP clients will no longer need to let us know of plans to spend time away from home.

A total of 340 representations were received, with 259 responses from client/carers, 37 from members of staff and 44 from members of the public. A further 61 people were engaged through focus group discussions.

With overall agreement of fifteen percent for proposal three ‘Using a personal bank account’, this was the least agreeable of the eight proposals and was particularly unpopular with staff taking part in the consultation. Proposal six ‘Paying for Council services and using DPs outside the UK’ proved to be unpopular across all groups consulted, with just one in five staff agreeing with the proposal.

For clients and carers, proposal two ‘Support from family members’ proved to be the most agreeable with proposal one ‘Unspent funds’ and proposal four ‘Holiday costs’ a close second.

Strong themes have appeared throughout the consultation.

Responses about what people like about the proposals can be broadly set out into 3 categories:

1. Flexibility and control

Across all proposals, a key theme was that the policy would give greater control and flexibility to the client. It will also give greater flexibility to staff members who will be able to be more creative and have more responsibility when writing support plans. It was noted that this needs to be communicated to practitioners so that support plans can be altered to reflect the flexibility.

2. Mental health and wellbeing

Respondents largely felt that the proposed changes would improve their own, or the person they care for’s mental health and wellbeing. This was particularly prevalent on proposals relating to unspent funds and leisure activities.

3. Cost of living

A key theme across the proposals was that the changes will help ease financial pressures felt by clients and carers. For example, travelling to appointments and other activities set out in the care plan, paying family members, and using Direct Payments to pay for leisure activities.

Responses about how the proposals could be improved can be broadly set out into 3 categories:

1. Language around leisure

Respondents felt that the language under proposal seven: using your Direct Payment to pay for leisure activities could be rephrased. For example, the terms wellbeing or wellness should be used instead. Also, it was found that the language under proposal 6: paying for council services and spending your Direct Payment outside of the UK needs to be clearer.

2. Clarity

A key theme across all proposals was that clarity and training is needed within the policy so that Practitioners can effectively and confidently write support plans and that clients and carers can confidently use their Direct Payment to fulfil their needs. Clarification is needed on proposal three that using the same bank is a choice, not a requirement and how this will be audited. Also, clear guidance on how Direct Payments can be used for holiday and/or respite, and travel. There also needs to be guidance on what leisure activities are acceptable and how this will be managed by practitioners. Furthermore, clarity is needed on whether there are any rules on people spending prolonged periods of time away from home. There also needs to be assurance that the policies will be linked to individual outcomes.

3. Scope for misuse

Another key theme across the proposals was a concern for the possibility of proposals being open for misuse. This was particularly prevalent through the proposals relating to unspent funds and paying family members. Respondents felt that there needs to be a defined process to reduce the risk of misinterpretation as funds are derived from the public purse.

Summary of the feedback we received and the action we plan to take in response to it: