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Consultations
Direct Payments - New Draft Policy and Practice Guidance
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������ Scottish Disability Equality Forum
The Scottish Disability Equality Forum works for
social inclusion in Scotland through the removal of barriers and the
promotion of equal access for people affected by disability.
We are a membership organisation, representing individuals with any type of
impairment, disability organisations and groups who share its values. We aim
to ensure the voices of people affected by disability are heard and heeded.
SDEF promotes access in its widest sense: access to the built and natural
environment and access to the same opportunities as are enjoyed by other
people in our community. We focus on access to the
environment and access to information and mechanisms promoting two-way
communications. We campaign to improve access in these areas and seek to
become a free source of high quality information on them.
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Direct Payments - New Draft Policy and Practice Guidance
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New expectations of local authorities:�
- To provide a designated direct payments officer within each local authority.
Agree: Take up of direct payments will not improve without dedicated staff with comprehensive knowledge of the features of the scheme, who can take responsibility for promoting it. Problems currently arise out of misunderstanding on the part of service providers involved as to the extent of the scheme. This lack of knowledge means direct payments are not considered as an option in a care package.
- To fund a direct payments support service which should ideally be independent and user-led.
�Agree:� Independent support services are crucial if potential direct payment recipients are to be able fully to access the scheme. Non-independent support faces the danger that recommendations on care provision are subject to budgetary constraints and do not fully meet need. Additionally, support services can provide expert and impartial information and advice that enables direct payment/service recipients confidently to challenge decisions with which they are unhappy.
�Support services that are user-led will enable participants to gain from the experience of others in a���� confidential and non-threatening environment. Decisions on care packages can sometimes depend on the knowledge, or agenda, of staff involved. Peer support would enable service users to determine whether the amount of direct payment support varied across a local authority and whether this had resulted in unmet need.
Application forms for the direct payments scheme are too complex and require stating the same information several times over. SDEF members have indicated that they should be simplified, placed in accessible formats and have jargon removed. Support services would be able to assist applicants but there might be greater uptake if all information were more readily available and accessible from the outset.
Independent advice on finance and benefits could be a feature of the support service, to ensure that people are receiving all the benefits that they are entitled to and are not paying for care that local authorities are obliged to cover. Sometimes people whose needs have changed do not realise that their local authority should provide care and pay out of their own dwindling resources. Some councils provide money advice services but they are not always well known in the community. This could form part of the pre-assessment process.
Support services should be properly funded to ensure that they can meet demand.
- To fund pre-assessment work with potential users, to enable them to get the best from their assessment and care planning.
Agree: Pre-assessment work is essential in order that users fully understand the implications and obligations of taking up direct payments, recognise the benefits that the scheme has to offer and know where they can access ongoing support. Pre-assessment can be used to explain to people how the emphasis on care provision has changed over recent years and that the focus is now on independent living.
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- To fund essential training for direct payments recipients, and training of personal assistants.
�Agree: For the direct payments scheme to work smoothly there is a training requirement on all sides. Recipients who have little experience of recruiting and managing either their own finances or paid carers may struggle without the appropriate training and suffer unduly as a result. As there are obligations in terms of recording how the payments are spent, direct payments providers should not assume that everyone initially has the knowledge or skills to deal with the administration involved.
- To fund direct payments training for care managers, finance managers and local authority directors.
�Agree: For the direct payments scheme to reach its full potential, it is critical that local authority managers and budget holders understand that the move to independent living and the social model of disability underpin the scheme. This should be expounded to all those providing care under the scheme so that the difference between independent living and personal/medical care is recognised and understood.
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- To meet the cost of disclosure checks for direct payments recipients employing PAs.
�Agree: Local authorities should bear the cost of disclosure checks so that it is not an additional burden on the service user. If a recipient uses the services of several PAs the cost of disclosure checks may otherwise be prohibitive.
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- To fund employers’ indemnity for PA employers.
�Agree: Recipients under the scheme who become employers should have access to elements and protection that would comprise best practice in other areas. Employers’ indemnity might be something which service users employing their own staff might not automatically consider.
- To fund direct payments packages during short stays in hospital
�Agree: The continuation of direct payments in the event of short term hospitalisation would result in continuity of care and give the recipient a sense of security. It would help to retain a service provider. In some areas care providers are hard to come by and it would reduce the risk of a recipient being unable to find suitable carers once the payments were resumed and he/she returned home.
9. To recognise that long term best value should take account of an individuals’ quality of life, and allowances made for exceptional circumstances.
Agree: Cost should not be the only consideration when arranging an individual’s care package. The emphasis placed on the social model of disability and identification of the part that training has to play at all levels, should make quality of life issues easier to understand for professionals. �The direct payments recipient should be made aware of the choices available and not pushed into low cost services that are inappropriate.
The issue of cost ceilings is still a matter of contention and perhaps more specific guidance should be provided for individuals and local authorities with respect to arbitrary cut off points.
���� Other Points
Para 25/173: Problems with internal budget management procedures should not be allowed to prevent a person receiving their direct payment entitlement.� Delay in processing payments can result in: stress for the person receiving care; pressure by the service provider upon the care recipient; and an unfair burden on a service provider who continues to provide care without payment. For example, an individual in receipt of direct payments whose needs change so that more care is required and approved by the local authority, should not be left with mounting invoices and a threat of withdrawal of services when the increase in direct payments are not made and internal process cited as reason.� Recourse to formal complaint should not be taken as the usual way to resolve such issues.
Para 32/105: Care options identified during the single shared assessment process should not be dependent on the local budget constraints of the various participants, all of whom should be aware of how they can contribute resources to a flexible care package and have up-to-date knowledge of local public sector service provision.
Guidance in what is regarded as acceptable process timescales may be needed.
Para 182: It is vital that a direct payment recipient has a contact at his/her local authority in the event of emergency arrangements. This is particularly true for out of hours emergencies. Recipients need to be reassured that they have access to emergency care without worrying about the additional cost that the local authority may or may not meet.
Para 231-233: Monitoring and evaluation of direct payment schemes could be included in the Disability Equality Schemes of local authorities and as such, would require the involvement of people with disabilities in this process.� Again Para 150 refers to the low uptake of direct payments for children; this could be included in the impact assessment part of the Disability Equality legislation.
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Scottish Disability Equality Forum
12 Enterprise House
Springkerse Business Park
Stirling
FK7 7UF
01786 446456
www.sdef.org.uk
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� Copyright Scottish Disability Equality Forum 2003-2007
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