Direct Payments for Children

1. Introduction

"Direct Payments are cash payments, made in lieu of social service provision, to individuals who have been assessed as needing services.

2. Background

Legislation requires Adults and Children and Young People's Services (referred to as Children's Social Care hereafter) make direct payments to all individuals (apart from a very limited number of individuals, the key examples are: patients subject to guardianship/supervised discharge/detained under the Mental Health Act 1983 and on leave of absence or individuals in receipt of a care programme under compulsory court orders) who are eligible for them and want to receive them.

1. A person with parental responsibility for a disabled child (Children's Social Care);
2. A disabled person with Parental Responsibility for a child (responsibility of Adult Health and Social Care);
3. A young person aged 16 or 17 (Children's Social Care). In lieu of services (it is possible to have mixed services of Direct Payments and direct services) under section 17 of the Children Act 1989 (or Section 2 of the Chronically Sick and Disabled Persons Act 1970) in order to meet his/her assessed needs.

Where payments are made to a person with parental responsibility for a disabled child, they are being made on behalf of the disabled child and for the benefit of that child. Children and Young People's Services must be satisfied that a child's welfare will be safeguarded and promoted by Direct Payments and can set reasonable necessary conditions on Direct Payments to secure this. 

The group of children covered by this procedure are those children and young people aged 0-18 whose daily lives are substantially affected by one or more of the following: hearing impairment, visual impairment, learning disability, physical disability, a chronic/life threatening physical illness, communication disorder (including Autistic Spectrum Condition), consciousness disorder (e.g. epilepsy). Note: substantially affected is identified as lasting more than six months.

Each child and his/her carer will have access to the Local Authority's Support Planning and Brokerage Team. This service will give information to children and their carers in order to assist them in deciding whether Direct Payments is right for them and to offer support about their rights and responsibilities should they decide to pursue Direct Payments.

3. Eligibility

In order for a child or carer to receive direct payments in Calderdale the following requirements will need to be satisfied:

1. They have needs which, following an assessment it is agreed are the responsibility of Children's Social Care to meet; and
2. They must be willing and appear to Children's Social Care to be capable of managing a direct payment (see guidance on Ability to Manage).

4. Ability to Manage

It is important that Assessing Workers establish that there is an understanding of what is involved by all of the appropriate individuals involved. However, although carers and 16 and 17 year olds must give their consent to what is being proposed and remain in overall control of their affairs, they can delegate much of the day-to-day management of their direct payments arrangements to others 

When consideration is given to 16/17 year olds managing direct payments Children's Social Care will need to consider their ability to manage. 

5. Employment of Close Relatives

Unless the council is satisfied that it is necessary to meet satisfactorily a person's needs, it will not allow people to use direct payments to secure services from a spouse (husband or wife), from a partner (the other member of an unmarried couple with whom they live), or from a close relative (or their partner or spouse) who live in the same household as the direct payment recipient."

To establish that payment to a close relative is 'necessary' there must be clear evidence that no other satisfactory method of service delivery can meet the assessed needs. Therefore all potential methods must be explored and reasons why they are/are not workable documented and evidenced by the worker undertaking the assessment. 

As with all assessments the question "what would happen if Adults and Children's Social Care do not address this issue?" will inform the relative priority of the need. This is particularly relevant where a relative is currently providing care/support without Direct Payment being deployed. It has to be clear why this arrangement cannot continue. 

The phrase "meet satisfactorily" should be interpreted as objectively as possible. Reasons why alternatives are not satisfactory should be documented and evidenced. It is not sufficient that the child/carer prefers the service to be delivered by a close relative, who lives in the same household. 

The decision to agree to pay a close relative must be made set against the Criteria (see below) at Service Manager level.

Where a decision is made to allow a close relative to be paid using Direct Payments, the decision must be reviewed at a minimum of every six months to ensure the criteria continue to be met.

Direct Payments cannot be used to pay parents, or a person discharging duties in a parenting role, for the care of their own child (birth - 17 years inclusive). This applies whether the parent lives in the same household as the child, or elsewhere.

1. The child has had an assessment and has eligible needs; and
2. The child/carer is willing and able to use Direct Payments and there are no identified concerns;
3. There is clearly documented evidence that the needs cannot be satisfactorily met in any other way than by Direct Payments to a close relative either because of:
   1. The exceptional nature of the care/support tasks involved; or
   2. Exceptional problems in relation to access to the setting in which the tasks have to be carried out; or
   3. Any other exceptional circumstances relevant to the applicant's case.

6. Using Direct Payments

Direct payments are made to enable carers and children to purchase services to meet needs identified by an assessment. Direct payments cannot be used to purchase local authority services.

Carers and children may receive a combination of direct payments and short breaks through an accredited provider or in house services.

Many carers and children are likely to want to use direct payments to directly employ a personal assistant or assistants. This option gives them the most control over the assistance they receive, but it also carries the most responsibility.

The Support Planning and Brokerage Team and the Assessing Worker will make the carers aware that if they are purchasing a childminding service for a child under eight in the childminder's own home that the childminder has to be registered with Ofsted if they are caring for the child for more than two hours a day.

Payments can also be made to enable carers and children to pay for short breaks, following an assessment that confirms this need, provided that this does not exceed more than seventeen nights for a single period and no more than 75 nights in any twelve month period. Carers will need to ensure that any organisation providing short breaks is registered with Ofsted.

Hourly rates, for the employment of personal assistants, have been agreed. If a person with parental responsibility or a disabled young person aged 16 or 17 wish to employ an agency then the Local Authority will only pay the current hourly direct payment rate. The difference between this rate and that charged by the agency will be the responsibility of the person with parental responsibility or a disabled young person aged 16 or 17 to meet. The direct payment rate will also cover recruitment costs, holiday pay, sick leave, insurance and training costs. The rate will not usually cover the transport or accommodation costs of the personal assistant unless there is an assessment which indicates that there is a need to provide these facilities so that the personal assistant can accompany the child and the carer to a setting other than the child's own home. 6.7 The amount paid towards the cost of any short breaks will need to be agreed by the relevant manager. The amount of money which is given as a Direct Payment would normally be no more than the cost of the service then if it had been provided by Children's Social Care itself.

7. Overnight Stays in a Personal Assistant's own Home

This procedure applies to children and young people who have had an assessment of needs, undertaken by the Department, and where that assessment recommends that the most appropriate way of meeting these needs is through a short breaks overnight stay away from the family home. In these circumstances direct payments may be considered and this can include a personal assistant providing care in their own home as opposed to the family home.

There is an expectation that the Department will balance the opportunities afforded by direct payments, for parents to exercise choice and control by employing a personal assistant, with its responsibility to ensure the safety and wellbeing of the children and young people it works with. It is the Department's responsibility to ensure that there are additional safeguards for children and young people for when they receive overnight stays in a personal assistant's own home given the well evidenced research that confirms that disabled children and young people are more vulnerable to abuse and this abuse is under-reported.

• The capacity of the parent in terms of both understanding and meeting the child or young person's needs;
• The values and attitudes of the parent as these will influence the choice of personal assistant and their role of monitoring and evaluating the care provided by the personal assistant. 7.6 The capacity of the parent to monitor and evaluate the standards of care provided by others. This is important given the vigilance that parents will need to exercise as an employer to ensure the safety of children and young people cared for by the personal assistant away from home. Parents and carers will need to be mindful of the signs and symptoms of abuse and the impact of other members of the personal assistant's household on the child or young person;
• Competencies in all the key areas, described above, are critical as these will impact on whether the parent in the role as employer will be able to ensure that personal assistants fulfil all these competencies themselves.

The Social Worker/Community Nurse will need to consider, in conjunction with the Team Manager, whether the assessment will need to be updated to take account of the above requirements.

If the Community Nurse/Social Worker has concerns about the competencies of the parent and that these cannot be satisfactorily addressed then a plan of overnight stays will not proceed on the basis that the "willing and able" criteria have not been met (see direct payments procedure for children).

The Team Manager will make a decision as to whether there are sufficient safeguards in place for the plan to proceed, following consultation with the relevant Service Manager. Once agreement has been reached, then the Social Worker/Community Nurse will arrange to meet with the parent and the child or young person to outline the process to be pursued.

There will be a specific session with the child or young person to ascertain their own wishes and feelings in respect of the proposal for overnight stays with a personal assistant. The Social Worker/Community Nurse in conjunction with the parent will determine the timing of this session. 

The Social Worker/Community Nurse will establish whether the proposals by the parent to monitor and evaluate the suitability of the arrangement are sufficiently robust, taking into account the particular need for the parent to be vigilant in relation to safeguarding issues.

The Social Worker/Community Nurse will discuss the key requirements of the viability assessment so that the parents are clear about their responsibility to be satisfied that the personal assistant can provide appropriate and safe care that will meet the needs of the child or young person. It should be noted that it is not a requirement for a viability assessment to be undertaken, but that it is evident that the key areas of this assessment have been considered in this process. It is the role of the parent to consider the key issues within the viability assessment when considering the suitability of a personal assistant.

The Social Worker/Community Nurse, in conjunction with the parent or carer, will identify any additional issues that are pertinent to their individual child or young person so that there is clarity about the other areas of enquiry that the parent and carer needs to pursue with the personal assistant.

The Social Worker/Community Nurse will outline the additional vulnerabilities of disabled children and young people to abuse and the need for vigilance by the parent or carer, specifically their role to monitor and evaluate the arrangements in terms of any potential signs or symptoms of abuse. The Social Worker/ Community Nurse will need to be confident that these concerns have been understood and assimilated by the parent and that they will be actively vigilant, given that it is their role as the employer, not the local authority, to be accountable for the competency and safe care standards of the personal assistant.

The Social Worker/Community Nurse will submit a report to the Team Manager for his consideration with a recommendation as to whether to proceed to a plan for overnight stays. Once the Team Manager has approved the plan it will be submitted to the Service Manager for approval, given the requirements for Service Managers to approve overnight stay arrangements.

The personal assistant and all members of their family/household over the age of 16 will be required to have a satisfactory enhanced DBS check. In addition the personal assistant and all members of their family/household will be subject to checks with the Local Authority's Human Resources Department, the Safeguarding Children Partnership and the Children's Social Care Database.

The Social Worker/Community Nurse will complete a request for DBS checks via the existing direct payments system. The other required checks will be processed via the responsible admin officer.

A Team Manager or delegated deputy will chair a planning meeting, provided that the plan has been approved and all checks have resulted in a satisfactory outcome. This planning meeting will take place prior to the first overnight stay. The parent, the child or young person, the personal assistant and any other key agencies will attend the planning meeting. The planning meeting will confirm that all necessary checks have proved satisfactory, that the essential needs of the child or young person can be met through the arrangement and that the parent/carer confirms that they are satisfied of the viability of the arrangements of the personal assistant providing the care.

8. Procedure for Making Direct Payments and the Direct Payments Support Service

Assessing Workers will undertake an assessment in the usual way.

When the Assessing Worker has identified needs which it is the responsibility of Children's Social Care to meet, and considered the carer's or 16 and 17 year old's ability to manage (see Section 4, Ability to Manage), then the worker will offer the option of Direct Payments as well as that of short breaks through an accredited provider or in house services.

The Assessment will identify whether there are issues in relation to Moving and Handling or whether a risk assessment in relation to behaviour is required (see Section 10, Reviews of Direct Payments).

If the carer expresses an interest in Direct Payments, then the Assessing Worker will send a DP1 referral and the child in need plan off to the Support Service Support Planning and Brokerage Team. The Support Planning and Brokerage Team will meet with the child and carer to explain what support is available for them to take up the role as an employer.

The Child in Need Plan needs to have all the details of all proposed provision. The child in need plan should indicate which resources are to be provided through direct payments (e.g. number of hours of personal assistance per week) and which through an accredited provider or in house services. The Assessing Worker will highlight any moving and handling and health and safety issues from the assessment on the child in need plan.

The Support Planning and Brokerage Team will cost the child in need plan with reference to the cost of direct payments provision.

The Support Planning and Brokerage Team will then send the budget authorisation form to the Assessing Worker

The Support Planning and Brokerage Team will arrange a meeting with the child and carer. The Support Planning and Brokerage Team will discuss with the Assessing Worker if it is considered that his/her attendance would be useful at this stage. This meeting will clarify the roles and responsibilities of all those involved. Children and their carers will be given a choice about how much support they wish to take up from the Support Planning and Brokerage Team. It should be noted that this meeting may occur at the same time as the initial visit undertaken by the Support Planning and Brokerage Team. 

The Support Planning and Brokerage Team will discuss options with the carer and child and clarify how they wish to use their direct payment (agency, personal assistant, etc.). Then the Support Planning and Brokerage Team will contact the Assessing Worker to confirm the outcome of the meeting. 

If there is a request to employ a close relative living in the same household then the Support Planning and Brokerage Team will advise the Assessing Worker who will then provide a report which will be submitted via the Service Manager (see Section 6, Using Direct Payments). 

Where 16 and 17 year olds are concerned the Assessing Worker will make checks with Children's Social Care' legal advisors in relation to employment responsibilities

The Assessing Worker will submit the budget authorisation form to their manager.

The Support Planning and Brokerage Team will make sure arrangements are in place for insurance cover. All direct payments users who will be employing a personal assistant to meet their care needs must ensure that they have the appropriate personal and public liability insurance cover before any staff they employ begin working for them. The Support Planning and Brokerage Team workers should remind direct payments users of this and check that they have taken out the initial insurance cover. If it is found that a carer is employing a PA without Personal and Public insurance the Local Authority reserve the right to suspend funding. The Support Planning and Brokerage Team workers are not, however, expected to check the detail of the direct payments users' policy(s). It is the direct payments users' responsibility to ensure that they are fully covered. Direct payments users will need to renew their insurance annually. Payments to meet the renewal premium will come from the existing direct payment monies.

The Support Planning and Brokerage Team will advise that standby arrangements will be required; this might include calling on other personal assistants, family, or accredited care agencies.

In a particular instance Assessing Workers might consider that it is appropriate for a direct payments user to have the option of using an accredited care agency to cover in emergencies. If the person for whom the direct payments are being made goes into hospital the personal assistant would receive a half pay retainer. This must be written into the employment contract, or implied through custom and practice. The Support Planning and Brokerage Team should be contacted for further information about the employment rules governing these situations. 

The Support Planning and Brokerage Team will make arrangements for an Enhanced Disclosure and Barring Service Check, checks with the electronic social care record, checks with the Safeguarding Children Partnership, and the Local Authority Human Resources Local Authority. The Support Planning and Brokerage Team will only send the budget authorisation releasing funds to the individual to the Assessing Worker when all the checks have been undertaken and it is clear that there are no concerns as a result (see Section 15, Criminal Records Checks for more details).

When a Child in Need Plan is approved then the Support Planning and Brokerage Team will monitor progress and ensure checks are done when staff are identified. The Support Planning and Brokerage Team will relay the results of checks to the service user and ensure that a repeat DBS check is done after 3 years; this will be triggered by the review system.

The Support Planning and Brokerage Team will advise the carer that when a DBS check reveals no criminal convictions this does not necessarily mean that the personal assistant is a suitable person to work with children and therefore it remains the responsibility of the carer to satisfy themselves that the personal assistant is a suitable person.

Assessing Workers will ensure that carers are fully alerted to the potential risks for children and are provided with advice to minimise those risks; the available UK evidence on the extent of abuse amongst disabled children suggests that disabled children are at increased risk of abuse.

The Support Planning and Brokerage Team will ensure that the direct payments user opens a separate bank account. 

Once the Support Planning and Brokerage Team have confirmed, in writing, that all the checks are satisfactory then the Support Planning and Brokerage Team will ensure that the direct payments agreement is completed and signed. A Copy will be retained on the child's electronic file. It is important that the Support Planning and Brokerage Team ensure that the direct payments user understands the agreement before signing it.

The Assessing Worker will revise the Child in Need Plan prior to the commencement of the service. Direct payments will cease once the carer's financial responsibility for the personal assistant has ended.

The carer or 16 and 17 year olds notifies the Support Planning and Brokerage Team and the Social Worker, when they are in a position to begin receiving direct payments if this has not been previously agreed. A start date is decided on and the Assessing Worker will notify the Support Planning and Brokerage Team by e-mail.

9. Financial Audit

The Audit Officer from the Support Planning and Brokerage Team will undertake independent financial audits in order to ensure that financial procedures have been complied with.

Direct payments will be subject to a three monthly audit. It is agreed practice that monies can be carried forward from one three-month period if there is a child centred decision for doing this; this will always be discussed between the Support Planning and Brokerage Team and the Assessing Worker. It should be noted that there is no capacity to carry forward an underspend from one financial year to the next; it is important that money is used within the appropriate financial year so that children's needs are met as outlined in the relevant assessment.

10. Reviews of Direct Payments

Every Direct Payment arrangement will be reviewed three months after commencement and then at intervals of not more than six monthly. 

The review will:

1. For Children's Social care follow the procedure for the Review of Children in Need;
2. Ensure that the needs, as identified in the Assessment, are now met or are in the process of being met by the Direct Payment arrangement;
3. Consider whether the child's welfare is safeguarded and promoted by the direct payment arrangement. Carers are to be encouraged to give particular consideration to the child's views about how their intimate care needs are met;
4. Ensure that the child's views are represented;
5. Consider the results of any audit undertaken by the Support Planning and Brokerage Team and their advice, the Team will always be invited to the review;
6. Establish the level of support required from the Support Planning and Brokerage Team and if a new moving and handling assessment is required;
7. Advise the Support Planning and Brokerage Team that a repeat DBS check is required prior to the expiry of the previous one;
8. Review the decision to allow a close relative to be paid using Direct Payments to ensure the criteria continue to be met.

11. Moving and Handling and Risk Assessment

When an assessment has identified a Moving and Handling issue or risks associated with managing a child's behaviour then a Risk Assessment will always be undertaken.

The person with parental responsibility should ensure that the Moving and Handling risk assessment is made available to the Personal Assistant and check whether training is required for the Personal Assistant. The person with Parental Responsibility can access the Local Authority's appropriate training course for moving and handling for the Personal Assistant. The person with parental responsibility can request from the Support Planning and Brokerage Team for a moving and handling assessment to be undertaken in their own home, this is a new relatively new service so full details are not available at the moment

Where it is identified that there are risks associated with managing a child's behaviour the Assessing Worker will ensure that the person with parental responsibility understands these; as they have the responsibility for ensuing that any personal assistant employed by them understands these risks and has the competence to manage the risks and therefore the needs of the child appropriately and safely. If the Assessing Worker is concerned that the person with parental responsibility is not managing this safely then these concerns will be discussed and if they persist then the direct payment will not proceed.

Carers will have the choice as to whether to train Personal Assistants or whether to contract this training from a Training Provider. If the carer wishes to access training then they should contact the Support Planning and Brokerage Team who will provide a list of organisations who can provide this. An additional payment will be made to cover these costs.

If the personal assistant needs to use a hoist they can access the hoist training sessions. If the carer wishes to access this training then they should contact the Support Planning and Brokerage Team who will provide a list of organisations who can provide this.

An additional payment will be made to cover these costs.

It is the responsibility of carers to ensure that the training provided meets the training needs of the Personal Assistant as well as ensuring that the needs of the child are safely met.

If a carer determines that their Personal Assistant should be trained by a Training Provider it will be the carer's responsibility to ensure that if they wish to employ the Personal Assistant in the interim period that safe moving and handling or behaviour management methods are used.

16 and 17 year old young people may make their own decisions around employment of personal carers and/or training of personal carers subject to the guidance set out in Section 13, 16 and 17 Year Olds.

At each Review consideration would be given to whether a Moving and Handling re-assessment is required.

12. Child in Need Plan and Costs

The amount of the weekly direct payment is calculated using the current hourly payment rates (see also paragraph 6.6). The hourly rates include an amount to enable carers and children to pay their Employer's National Insurance Contribution (ENIC). The Support Planning and Brokerage Team will provide information about ENIC thresholds.

13. 16 and 17 Year Olds

Direct payments can be made directly to 16 and 17 year old disabled people. Direct Payments for young people introduce a concept of the young person being guided through a transition period where they take joint responsibility, together with their carer, for choices about their child in need plan. When undertaking the planning for direct payments for someone of this age Assessing

Workers will need to ensure that: 

• The young person is able to give informed consent to the plans being made;
• Advocacy is made available if required;
• Other support is available if needed;
• The services the young person intends to purchase will be able to achieve the outcomes identified.

In addition Assessing Workers will need to ensure that:

• Anyone the young person wishes to employ is subject to a DBS and other checks (see Section 15, Criminal Records Checks;
• Checks are made to ensure that any contracts the young person enters into are legally binding. Workers should refer to the Support Planning and Brokerage Team for assistance with this matter.

Where direct payments are being made to someone with responsibility for a disabled child (which can include 16 and 17 year olds) the possibility of preparing the young person for taking full or partial control over the payments should be considered.

14. Financial Arrangements and Carers' Responsibilities

Carers must open a separate bank or building society account, with a cheque book facility, specifically for direct payments. If the payments are to meet the needs of a disabled child the account should be opened in the name of the person with parental responsibility who will be managing the payments. 

Payments will be made four weekly. The usual procedure is for the first payment to be made by BACS. The bank account will be credited on the Tuesday following the payment run. 

Carers should retain the following for audit purposes:

• Bank or building society statements; chequebooks and paying in books;
• Invoices and receipts (e.g. from care agencies and homes);
• Payroll records and any other documents relating to employment of staff including evidence of appropriate insurance cover;
• Timesheets;
• Insurance details.

Carers will need to make these documents available to the Audit Officer from the Support Planning and Brokerage Team, or other section of the Local Authority, if requested to do so.

It is the carer's responsibility to maintain adequate financial records. The Support Service Support Planning and Brokerage Team can be consulted for advice and assistance.

The Support Planning and Brokerage Team will monitor the plan to ensure that the direct payments are spent on the agreed services.

The Support Planning and Brokerage Team will refer to the Assessing Worker if there are differences from the agreed Plan which are persistent or indicate financial mismanagement.

If it is found that the Direct Payments have been spent inappropriately the Local Authority has the right to suspend further funding and if necessary recoup any misspent funds via the Debt Management Team.

15. Criminal Records Checks

Before carers can use direct payments to employ a personal assistant it is necessary to undertake Disclosure and Barring Service and other checks to determine suitability. These checks include:

• Enhanced Disclosure and Barring Service checks;
• Checks of the electronic Social Care database;
• Checks with the Calderdale Safeguarding Children Partnership;
• Checks with the Human Resources Local Authority.

Personal assistants cannot take up their duties until a satisfactory record check has been completed. The Support Planning and Brokerage Team will let service users know from the outset that the final decision about suitability will remain with Children's Social Care.

Each time a new PA is employed a new DBS is required, a previous DBS is not sufficient.

The Support Planning and Brokerage Team are required to verify that the person completing the form is who they say they are. The potential employee will need to show certain documentation as required by Support Planning and Brokerage Team.

The Support Planning and Brokerage Team should send the completed Disclosure Application Form to Human Resources, Calderdale MBC, 3rd Floor, G Mill, Dean Clough, Halifax, HX3 5AH and Human Resources will advise the Support Planning and Brokerage Team of the outcome, which will consist of either a negative or positive response, but no further detail than this. 

When the checks have been completed the Support Planning and Brokerage Team will inform the Assessing Worker and the family.

The Personal Assistant will receive a copy of the disclosure from DBS. 

The Support Planning and Brokerage Team will undertake the other checks.

If any of the checks give cause for concern the Support Planning and Brokerage Team should discuss the situation with the Assessing Worker. A decision should be made as to whether the Local Authority agrees to the making of a direct payment for the employment of the individual in question.

The relevant section of the criminal records check documentation and the Agreement to Records Checks form should be kept in a confidential file and securely held by The Support Planning and Brokerage Team.

16. Discontinuing Direct Payments

If, for whatever reason, a carer or young person is no longer able, or willing, to continue using direct payments Children's Social Care has a responsibility to return to meeting their needs by the provision of services. This would, of course, also be the case if it were Children's Social Care which terminated the payments.

Children's Social Care will cease to make direct payments if there are concerns that a child's needs are not being met by the direct payment arrangement or if this arrangement is not safeguarding or promoting the child's welfare.

Children's Social Care may discontinue direct payments if the payments are not being used for services that the child has been assessed as needing.

Children's Social Care will always discuss with carers as soon as possible if it is considering discontinuing direct payments.

Consideration will always be given to providing greater support to the carer if this is appropriate. A minimum period of notice will normally be given if direct payments are to be discontinued.

Direct payments will be discontinued when a child no longer needs the services for which the direct payment was made.