Childrens Direct Payment Policy

What is this policy for?
What is a Direct Payment?
Eligibility
How to support with eligibility identity of need?
What is the process of the assessment?
How often are Direct Payments made?
What can a Direct Payment be used for?
Direct Payments for care and support provided under Section 17A of the Children Act 1989
What must a Direct Payment not be used for?
Hospital stays for a child or young person who is in receipt of a Direct Payment
Safeguarding
Employees
Transfer to Adult Services
Recruiting, training, and employing Personal Assistants
Financial reviews/audits
Reviewing the care package
Recovery and repayments
Termination of contract
Death of the service user or carer
Complaints

1. What is this policy for?

Wigan Council wants people to live independently, have control over their lives, be as well as possible for as long as possible and feel safe. A Direct Payment can be a very good way of helping people to achieve that – whilst also taking into account the person's own support networks, assets and strengths to meet their needs.

This document sets out the way we (Wigan Council) provide Direct Payments for children and young people’s care and support needs, their carers, and for those with parental responsibility for a child who has a disability or an Education, Health and Care Plan (EHCP). It covers a range of topics including:

What Direct Payments are
Who can get them
How they are calculated
How they are paid
What they can and cannot be used for
How they are monitored
When a Direct Payment may be cancelled or suspended.

The policy has been written to provide a source of information for those who already have a Direct Payment or are thinking about getting one.

The Legal Framework

The main legislation, regulations and guidance that apply to this policy are:

The Care Act 2014
Care and Support (Direct Payments) Regulations 2014
Care and Support Statutory Guidance issued with the Care Act 2014
Section 117(2C) of the Mental Health Act
Children and Families Act 2014
Mental Capacity Act 2005
Special Educational Needs (Personal Budgets & Direct Payments) Regulations 2014
Chronically Sick and Disabled Persons Act 1970
Children Act 1989
Equality Act 2010.

You can see these acts and guidance on the Government website (external link). Your children and young people’s allocated worker will be able to provide you with further information and ensure you are actively involved in the planning of your care and support to meet your child’s individual outcomes.

2. What is a Direct Payment?

A Direct Payment is a payment made by the local authority to:

Young people aged 16 years or over; or
The parents or carers of a child under 16 years old to enable them to purchase care and support that the child or young person needs to meet the child or young person’s assessed needs, instead of the local authority providing that support directly through services it runs or commissions.

Direct Payments are not part of a child or family’s benefits and receiving a payment will not typically affect benefit entitlements.

The purpose of Direct Payments is to give the recipient choice and control in making decisions (personal budgets), how to best meet their own needs or the needs of their children and family, by providing a flexible alternative to directly provided services. Direct Payments also support the co-production of creative solutions with children and young people and their parents and carers.

Direct Payments can be used alongside other short break packages in place for children and young people.

Direct Payments can be made in connection with special educational provision, health care and social care provision, however there are specific considerations around education and health support which are detailed below.

Local authorities are under a duty to make a Direct Payment where:

The person appears to the responsible authority to be capable of managing a Direct Payment by himself or herself or with such assistance as may be available to the person
The person consents to the making of a Direct Payment (local authorities cannot insist that a person has a direct payment)
The responsible authority is satisfied that the person’s need for the relevant service can be met by securing the provision of it by means of a Direct Payment; and
The responsible authority is satisfied that the welfare of the child in respect of whom the service is needed will be safeguarded and promoted by securing the provision of it by means of a Direct Payment.

3. Eligibility

A Direct Payment can be paid to:

Young people aged 16 years or over who have a disability; or
Parents or carers of a child or young person who has a disability (with appropriate consent if the young person is aged 16 or over)
A Nominee who is a person or organisation formally appointed to receive and manage the Direct Payment on behalf of the child, young person, or parent/carer when they are:
- Under 16, or
- 16 plus but lack capacity, or
- Prefer someone else to manage the payment for practical reasons.

Typically, a nominated person who is administering the payment on behalf of a child or young person will:

Have parental responsibility for the child or young person and provide them with a substantial amount of care, or the consent of a person with such responsibility to administer the payment
Give consent to the provision of a Direct Payment rather than a direct service to the child or young person
Be able to manage the Direct Payment effectively and lawfully (with assistance if necessary)
If using a Direct Payment to employ a Personal Assistant, have the capacity and accept the responsibility to effectively and lawfully manage all aspects of being an employer - including managing payroll, taxation, insurance, background checks, training, pensions and other matters (with assistance if necessary)
Ensure that the use of the Direct Payment safeguards and promotes the child or young person’s welfare and is always used in their best interests
Not be subject to certain mental health and criminal justice legislation which limits the choices they can make.

The schedule attached to the Special Educational Needs (Personal Budgets and Direct Payments) Regulations 2014 (external link) lists all the persons to whom Direct Payments may not be made to.

There may be occasions where we will consider a person outside these 'typical qualities' 16/17-year-olds who are managing their own Direct Payment must:

Consent to receiving a Direct Payment
Be able to manage Direct Payments without assistance or with such assistance as may be available to them.

The local authority will take the necessary steps to ensure appropriate consent is gained and will require a signed agreement with the recipient of the Direct Payment in order to confirm they understand and agree to the responsibilities outlined above.

4. How to support with eligibility identity of need?

If you are new to services or are unsure if your child or young person is eligible, you can contact the First Partnership Hub on 01942 828300 and they will have a conversation with you to find out about your situation and begin the process of establishing if your child has care and support needs that require long term support to help them and you as a family to live your day to day life.

If your child already has an allocated worker – they are the best person to discuss eligibility and Direct Payments. The allocated worker for your child will complete a Needs Assessment with you to discuss:

What is important to them
What they can do for themselves
Where they have difficulties
Any care and support needs, and the impact of those needs on your/their wellbeing
Any formal or informal support received, and if this will continue
What outcomes you/they want to achieve
What are their goals and aspirations
What are their likes and dislikes
What is their voice and how can we ensure this is captured and heard.

The allocated worker will establish what help and support is available to you and your child and which of your needs are eligible for support to be provided by the local authority.

5. What is the process of the assessment?

Prior to discussing the possibility of a Direct Payment with a child, young person or family, the practitioner should consider the support that they could access within the local community and through the Local Offer and Children’s Hubs within their community.

Through the assessment, the worker needs to ensure they have met the child/young person and gathered their wishes and feelings where appropriate, they need to have seen the family home and where the child sleeps, discuss the child's aspirations, likes and dislikes and considered the needs of the child/young person alongside the wider family needs. The worker will need to ensure they have spoken with all agencies working with the child/young person to ensure a thorough and holistic assessment is completed and the right support package is identified.

The assessment completed by the allocated worker should also consider how the recipient of the Direct Payment intends to use the funds if agreed at panel to meet the child or young person’s assessed needs, in line with this policy. Following the completion of the assessment of need the outcome/recommendations will be discussed with the worker's team manager to ensure, as far as is possible, that there is a consistent response to the provision of support through the appropriate use of Direct Payments.

The decision to make an application to the Children’s Disabilities Panel (CDP) will be informed by the assessment of need and agreement by the worker's team manager of threshold having been met for a Direct Payment or other short break offer. If panel is agreed, the worker will complete the CDP panel paperwork. Panel members will want the panel paperwork to have considered:

What is the child/young person’s likes and aspirations and how will these be met and considered through the identified care package?
Who is in the child/young person’s support networks and how do they help support the family as a whole?
What are the desired outcomes for the child/young person with this package of support in place?
When was the last assessment and what did it tell us?
What are the assessed needs of the child?
Has the local offer been explored and what support is being accessed?
Why would this child and family benefit from the identified support package?
What is the child's voice regarding the support package identified?
What is the parent/carers voice regarding the support package identified?

The panel may determine that not all aspects of a personal budget are suitable for provision by way of a Direct Payment based on the children and young people’s needs and alternative support will be considered and identified.

Any Direct Payment must only proceed following agreement at CDP. Following agreement at CDP, a signed agreement accepting the terms of the Direct Payment scheme needs to have been received from the parent, carer, young person, or nominee prior to the Direct Payment commencing.

6. How often are Direct Payments made?

Direct Payments are usually paid in advance into a bank or building society account specifically set up for the purpose, these payments are made on a weekly basis.

The local authority cannot make Direct Payments unless it has provided written notice to the intended recipient of the Direct Payments of:

The name of the service user for whose benefit the Direct Payment is being made
The goods or services which are to be secured using the Direct Payment
The proposed amount of Direct Payments
Any conditions attached to how the Direct Payments may be spent
The dates on which the local authority will make the Direct Payments to the recipient.

The local authority may only make the Direct Payments once the recipient of this notice has provided their written agreement form to receive the Direct Payments:

To use them only to secure the agreed provision
To comply with any conditions attached to the Direct Payment
To notify the local authority of any relevant changes in circumstances
To hold a bank account open for the sole purpose of managing the Direct Payments
To ensure no person not approved in writing by the local authority may use the bank account
To keep and make available to the local authority records of all monies paid in and withdrawn from the bank account. If a Direct Payment is made to a third party managed account, the Council will have access to all transactions made and will use this information to complete the financial reviews and annual audit.

7. What can a Direct Payment be used for?

A Direct Payment may be used to:

Meet costs of accessing community provision, incurred due to the additional needs of the child or young person
Support the inclusion of the child or young person in activities undertaken by their family
Cover part or all of the cost of residential overnight breaks
Cover part or all of the cost of a service from an approved agency or self-employed person to provide direct care to meet a child, young person, or family's needs.

With the written prior agreement of the local authority, a Direct Payment may also be used for:

Any service which meets the assessed need for a short break
Special educational provision specified in an Education, Health and Care Plan
To support in purchasing technology or equipment to meet the needs of the child or young person.

Direct Payments can be used to employ a Personal Assistant which enables your child/young person to develop their skills and build upon their confidence and independence. This can be achieved through them accessing their community or engaging within activities. This could also be to support within the home or to support with sleepovers to give a short break for carers.

If utilising Direct Payments to employ a Personal Assistant, the payment agreed is made up of basic hourly rate, national insurance, pension contributions, holiday pay, sickness cover, training. If additional support to manage payroll services or to act as a payment management service is required, or if insurances related to becoming an employer of a Personal Assistant are needed, these may also be included.

8. Direct Payments for care and support provided under Section 17A of the Children Act 1989

In accordance with the Children Act 1989 children with a disability are ‘children first’. A disabled child is classified as a child in need for the purposes of the Children Act 1989 Section 17. Services for disabled children are provided for by the Children Act 1989 by virtue of their status as a child in need, in addition to the frameworks for assessment, services may be assessed via other legislation such as the Care Act 2014.

Local authorities are required to ‘provide services designed to minimise the effect on disabled children of their disabilities, and to give such children the opportunity to lead lives as normal as possible’. The provision of services needs to be flexible to meet the variety of needs of disabled children and their families. Direct Payments may be made to people with parental responsibility for disabled children.

The Children Act 1989 guidance and regulations (external link)

9. What must a Direct Payment not be used for?

A Direct Payment must not be used for:

Duplication of a service already provided directly to the young person by the local authority, NHS, or an education provider
For a service that the child, young person, or their carer has not been assessed as needing
To employ a relative living in the same household as the child without written agreement from the local authority
To purchase full-time accommodation
To meet a health need that is the responsibility of the NHS, aside from where the NHS is funding this as part of a person’s Personal Budget
To meet a housing need
To fund childcare costs to enable a parent to work
To purchase any service or goods which would otherwise be unlawful, or which would compromise the reputation of the local authority.

In addition, where the recipient of a Direct Payment purchases the service of an individual regarded as self-employed, no part of the Direct Payment may be used to fund their income tax, national insurance, pension, redundancy payment or other related costs of employment.

Direct Payment agreements made to secure services under Section 17 of the Children Act 1989 may attach conditions, including prohibiting the recipient from securing services from particular persons and/or requiring the recipient to provide the local authority with specific information.

9.1 What are the restrictions on employment?

A Direct Payment must not be used to employ someone without undertaking appropriate checks. These include, but are not limited to:

Disclosure and Barring Service checks
Right to work in the UK checks
References from previous employers
Qualifications and certification relevant to any specialist care or support to be provided.

9.2 Permanent accommodation and short breaks

Direct Payments cannot be used to pay for permanent residential accommodation.

Short breaks/respite may be provided in residential units, in hospices, or by foster carers. If there is an actual crisis, for example if the child’s carer is temporarily unable to care for the child due to a sudden illness or the child’s carer is at breaking point, then the child may need to go into emergency respite accommodation. The local authority would have a specifically enforceable duty to provide the child with that accommodation (under section 20(1) of the Children Act 1989).

For the purposes of short breaks, depending on the circumstances the child may be a 'looked after' child or not. 'Looked after' means that the child is in the care of the local authority, but the parent(s) would retain parental responsibility.

There is statutory guidance on providing short breaks for children with disabilities. In summary, the guidance suggests that children whose welfare will be best safeguarded by becoming ‘looked after’ during residential short breaks include:

Children who have substantial packages of short breaks sometimes in more than one setting; and
Children whose families have limited resources and may have difficulties supporting the child or monitoring the quality of care while they are away from home.

A child who has a short break as a ‘looked after’ child will be appointed an independent reviewing officer to check that the placement meets the child’s needs. A short break care plan will be put in place and regular reviews should happen to check that the plan is working effectively.

A child who is not a 'looked after' child will not have an independent reviewing officer appointed to them.

If your child has an assessed need for a short break, you can ask the local authority to provide you with Direct Payments so that you can purchase the necessary services, instead of the local authority arranging the service itself. However, the local authority cannot force the parent/carer to accept Direct Payments if they do not want them.

Direct Payments can be used to pay a relative to provide respite care, if the relative does not live with the child. However, Direct Payments cannot be used to pay an adult who lives in the same property as the child to provide respite care to the child unless the local authority agrees that the payment is ‘necessary for promoting the welfare of the child’.

9.3 Discretionary use

Should a parent, carer or young person wish to use their Direct Payment in ways which are not explicitly permitted or prohibited above, they should seek the opinion of the CDP.

The practitioner will consider the impact of the proposed use on the planned outcomes for the child or young person in determining whether this should be permitted, and the Service Manager may approve their response. Any decision will be made on a case by case basis.

10. Hospital stays for a child or young person who is in receipt of a Direct Payment

When a child or young person under 16 years of age needs to go into hospital, the parent, carer, or the person managing the Direct Payment should advise the local authority immediately to discuss the continuation of the Direct Payment.

It is possible that the Direct Payment will continue for an agreed period, primarily to allow for the person managing the Direct Payment to ensure that any contractual obligations around termination of the support can be met. However, the issue of continuity of care post discharge may also be considered in some instances.

Consideration will be given by the local authority and NHS Greater Manchester Integrated Care Board - Wigan Locality as to how continued Direct Payments might be used to meet non-health needs during an extended hospital stay, or to ensure that the employment arrangements can be maintained. For example, the child or young person may wish to be taken to appointments or activities during their stay. However, any input from Personal Assistants must be provided in such a way that it does not interfere with medical treatment.

In circumstances where the Direct Payment recipient (parent/carer) requires hospitalisation.

In instances where the authorised or nominated person receiving the payment on behalf of the child or young person requires hospital treatment, the local authority must conduct an urgent review to ensure the child or young person continues to receive the care and support they need. This might include consideration as to whether the duties of the usual recipient of the Direct Payment can be carried out by someone else, or through provision of short-term local authority arranged care and support. These circumstances can be considered and discussed within CDP.

11. Safeguarding

If the local authority considers provision of a Direct Payment may pose a risk to a child or young person’s wellbeing or safety, the local authority will not agree to meet needs by making a Direct Payment. The rationale for this will be clearly explained and support provided by a social worker to ensure the family understand the worries.

12. Employees

If you decide to employ a Personal Assistant (PA), you need to be fully aware of your responsibilities. Becoming an employer carries responsibilities and obligations, to HMRC, and people must be aware of this before agreeing to take up a Direct Payment, as they are accepting responsibility to act legally as an employer including:

Registering as an employer
Operating PAYE
Checking that the potential employee has the right to work in the UK
Ensuring employment checks (including Disclosure and Barring Scheme* checks) prior to commencement of work
Ensuring to pay employees at the real living wage
Complying with working time directives and adhering to legislation around holiday, sickness, maternity, and paternity pay
Enrolling eligible employees into a workplace pension scheme
Putting personal liability insurance in place before a person works in their home
Advertising and recruitment, to employ the PA
Keeping employee information safe, secure, and up to date
Maintaining records of hours worked, payments made, training undertaken and diary notes documenting support offered etc. There is an expectation that PAs complete a suite of eLearning courses (core skills/mandatory training) and some of this is accessible via Wigan Council (DP Team) and some via ELfH eLearning for Health (Skills for Care). It would be the responsibility of the parent/carers as the employer to ensure that PAs have completed the training, Health and Safety policy and risk assessment if you employ more than 5 PAs
Contingency planning for when a PA is not available to work
Accident records
Redundancy payments.

*Disclosure and Barring Scheme (DBS) checks must be completed when you employ a PA.

You still have these responsibilities if it has been agreed that you may employ a family member.

We will discuss with you the responsibilities of being an employer and support available when starting a Direct Payment.

There is detailed information about responsibilities when employing a PA available through the Skills for Care Employing PAs Toolkit (external link).

You can also find free information and advice on workplace rights, rules and best practice by visiting the ACAS website (external link).

12.1. Self-employed PAs

If you choose not to employ your own PA and instead use a self-employed PA, they will be responsible for dealing with their own tax and national insurance.

You should ask them for copies of the following documents as proof of their status:

Self-assessment registration number
A signed document from Revenue & Customs saying that the PA is self-employed for care work.

If you do not obtain this proof, then you could be liable for back pay in tax and national insurance contributions if it turns out later that they should have been employed rather than self-employed. You need to obtain these documents even if you are using self-employed PAs provided by a care agency.

If you use the services of a self-employed PA then you should check that they provide:

Public liability insurance (up to £5 million)
Current DBS check – it is advisable that these are updated on a 3 yearly basis
Service contract/agreement (including complaints procedure etc)
Invoices for payment of work completed. Invoices from self-employed PAs are one of the types of evidence you need to keep to show us that you are keeping records and to continue to use a Direct Payment.

A person who works for themselves and finds many customers who will buy their services (which could be you) is an example of how a self-employed person may work.

They will run a business as a self-employed person
They will do their own tax and national insurance deductions and send an invoice for you to pay
They choose the way they want to work and you purchase their services
They will have their own business insurance
They should provide references for you to see
They should also provide major pieces of equipment needed to do their job
They will usually dictate their terms and conditions of services and provide a service contract for you to sign.

You would not usually need to pay them sick pay or holiday pay because you are not the employer, and a self-employed person will usually provide you with emergency cover if they are sick, for example.

12.2 Relatives who live with the child or young person at home

Where a parent, carer or other relative such as spouse or sibling, is resident at the same address as the child or young person, it is not normally permissible for them to be employed as a PA via a Direct Payment. In exceptional circumstances, for example to prevent a breakdown in care arrangements for a temporary period, the local authority may determine that such an arrangement would be appropriate. This will be confirmed in writing by the Children with Disabilities Service Manager, including any additional arrangements for safeguarding, managing the payment, or review of the situation.

Where a parent, carer, or young person over 16 who manages their own payment begins a personal relationship with someone who is currently employed by them as a PA, it is important that this is disclosed immediately in writing to the local authority. Further discussion will be required to ensure that the existing arrangement remains suitable, and to explore the potential for change in family dynamics.

Failure to disclose a change of circumstances of this nature could result in a need for urgent review and possible termination of the Direct Payment arrangement.

12.3 Relatives who do not live with the child or young person at home

In most cases, other relatives may be employed as PAs via a Direct Payment, but it is important that those administering payments take account of the following points in doing so:

Relatives must be employed formally as with any other carer, subject to the same checks and issued with a contract of employment
Payments to relatives will be monitored in exactly the same way and the parent/carer will be expected to keep records as with other employees
All the responsibilities of a responsible employer still fall to the parent/carer including liability insurance, tax and national insurance etc.

12.4 Transferring between a Direct Payment and a direct service

There may be situations where a parent, carer or young person who currently receives directly provided services wishes to transfer to receipt of a Direct Payment, or vice versa. Assuming there is no request for an increase in the level of services, this transfer should usually be able to take place without the need for re-assessment and be agreed by the manager of the team who oversaw the care package alongside the Direct Payment team manager.

Any such change will need to be agreed by the team manager of the allocated team and clearly updated and recorded within Liquid Logic to reflect the changes in the care package. In all cases, the availability and sufficiency of services in the local area which would meet needs should be carefully considered, alongside the need for specifically commissioned services, along with the usual considerations for eligibility for services or Direct Payments.

In cases where an unexpected change of circumstances occurs, it may be necessary for the local authority to urgently modify the provision in place to ensure the safety and wellbeing of a child or young person and these would need to be reviewed and considered through CDP and signed off by the service manager.

13. Transfer to Adult Services

When a child in respect of whom Direct Payments are being made becomes a young person aged 17 plus, the local authority must take reasonable steps to ascertain whether the young person consents to receiving Direct Payments.

If the young person notifies the local authority that they wish to receive Direct Payments, then subject to the eligibility criteria being met, there will be a request for an updated social care assessment. The young person may request that their parent or nominee continue to receive the Direct Payment on their behalf.

If the young person notifies the local authority in writing that they do not consent to the making of Direct Payments, the local authority will stop making Direct Payments as soon as reasonably practicable.

While the Care Act 2014 provides a similar right to request a Direct Payment, the process of assessing eligible care and support needs differs from that for children and young people, as do many of the arrangements around funding health and further education provision.

Colleagues in schools will begin to consider preparation for adulthood at around age 14, often at the annual review in Year 9 for those children with an Education Health Care Plan (EHCP). Continued consideration will take place as the transfer approaches, and it may be determined that the Adult Transitions Team needs to assess any ongoing care needs beyond the age of 18. This includes consideration of ongoing eligibility for Direct Payments, and a new Direct Payment agreement will need to be signed between the recipient and the local authority.

Parents and carers, or young people receiving a Direct Payment who are concerned about transition to adult services should contact the Children with Disabilities Team.

14. Recruiting, training, and employing Personal Assistants

Should a recipient of a Direct Payment wish to directly employ Personal Assistants, they will need to consider a range of additional factors. The Direct Payment Support Team will support new users of Direct Payments with these matters, which include:

Where to advertise for support?

Local job websites and newspapers are often still the best places to reach people interested in care work
While social media can reach many people quickly, it is important that privacy and confidentiality are not breached, and that any potential safeguarding concerns are considered carefully.

What training may be required?

Will your employees need to be trained to manage specific needs, or use equipment in your home?
Will your employees be aware of their responsibility to keep your personal information secure and confidential, or how to report any safeguarding concerns they have?
For your employee to be aware of your child’s likes, dislikes, aspirations and the community groups they like to engage in.

Will your employees be safe?

Have you assessed any potential risks in the work they will undertake, or your home environment?
Have you got sufficient Employers Liability Insurance cover in case an employee has an accident?
Have you ensured you have enough staff, so they are not working long hours a day and/or many hours a week over and above an average working week.

Are your employment and financial processes robust?

Are you aware of all potential tax, national insurance, and pension liabilities for your employees?
Have you provided your employees with a contract of employment?
Are you paying an hourly rate which allows you to cover these additional costs from your agreed Direct Payment amount?
Have you a system in place for keeping accurate records of time work, amounts paid and any disciplinary matters which may arise?

Have you planned for contingencies?

Do you have a plan in place for times that your employees are on holiday or unwell?

15. Financial reviews/audits

The local authority is accountable for the public money it manages. This includes Direct Payments funding. As such, accurate records are required to identify how this money is used to provide services to individuals.

In addition to ensuring that the person’s care and support needs are being met by the Direct Payment, financial reviews/audits will be undertaken to assess the person’s ability to manage the financial responsibility for purchasing services such as employing a PA. All new Direct Payments will usually be reviewed within the first 12 weeks of starting, in addition to a social care support review, to ensure that all legal obligations are met, such as HMRC payments, and to identify if any additional support is needed to manage the Direct Payments. Support will be available from the Direct Payment Team to ensure people feel supported and confident in managing their Direct Payment.

The initial financial review will include reviewing income and expenditure to ensure there is sufficient money to pay for employment related responsibilities (where applicable) and to check the client contributions that are being paid into the account.

Financial reviews/audits are also carried out to safeguard Direct Payment recipients from financial abuse or lack of care provision through insufficient funds.

All Direct Payment recipients will be required to submit receipts and bank statements to the Direct Payment Auditor as part of an annual audit. If it is identified that additional support is needed or there are concerns about the management of the Direct Payment, for example unpaid client contributions, unpaid employment liabilities, unauthorised spending etc, the account may be audited on a more regular basis i.e. 3 months/6 months. If problems persist with the operation of Direct Payments the local authority may review whether the continued operation of Direct Payments is the most appropriate way of meeting the person’s assessed needs.

The Direct Payment Team will contact the Direct Payment recipient when documentation is required. If documentation is not submitted following reminders, this may put the Direct Payment at risk.

When the Direct Payment has been audited, if there are any areas of concern identified the auditor will contact the Direct Payment recipient to discuss.

They will outline any action that needs to be taken within a two-week timescale.

If surplus funds are identified in the Direct Payment account, the auditor will ask for the funds to be returned to Wigan Council via bank transfer. Sufficient funds will remain in the account to cover contingency, outstanding invoices, wages, HMRC liabilities and any other employer liabilities such as PA annual leave cover.

If a Direct Payment is made to a third party managed account, the Council will have access to all transactions made and will use this information to complete the financial reviews and annual audit.

All documents related to expenditure from the Direct Payment account must be retained as the Council will ask to see these as part of an annual audit. If information is not provided to verify expenditure, the Council may consider transferring the Direct Payment to a managed account or explore other care delivery options.

The Direct Payments Team will complete a light touch review of private accounts twice per year in February and September using January and August statements. These are in addition to annual reviews.

16. Reviewing the care package

The Council retains responsibility to review your care and support needs and will therefore arrange a review of the service at intervals of (ordinarily) no more than 12 months to assess that the outcomes as agreed in your child’s assessment and support plan are being achieved.

As a result of the care package review there may be times when the assessor may consider an increase or decrease of the care package which is in place, and this will be further reviewed at CDP.

17. Recovery and repayments

The Council allows you to keep up to 20 times the weekly value of your Direct Payment as a reserve in the account to help meet your child’s assessed eligible care and support needs in a flexible way. Should the balance in your Direct Payment account exceed this amount, your Direct Payment has not been appropriately used, or in case of overpayment, the Council will discuss the matter with you before recovering the excess amount.

The Council reserves the right, after consultation with you and/or your representative(s), to review your Direct Payment and adjust future payments where a significant under-spend of your Direct Payment has occurred. Without prejudice to the rights outlined in the Direct Payment agreement, the Council retains the right to recover Direct Payments in full or in part if it is satisfied that the money has been diverted from the use for which it was originally intended.

We will require you to repay us any surplus monies in the Direct Payment account, having considered any agreed outstanding financial commitments. We will also recover any overpayments made. If a requested repayment is not made, this may mean the Direct Payment ends and your care is provided in a different way.

18. Termination of contract

The Council may discontinue payments and terminate this agreement with immediate effect if you and/or your representative(s) fail to comply with the terms of the Direct Payment agreement and the Council has reason to believe that future monies would be misspent and/or mishandled.

The Direct Payment agreement may be terminated by you by giving 4 weeks' notice in writing to the Council.

The Direct Payment agreement may be terminated by the Council by giving 4 weeks’ notice in writing to you and/or your representative(s) on the following events occurring:

You notify us that you no longer wish to receive Direct Payments
You are no longer able to manage your Direct Payment, even with support, or your needs can no longer be met by a Direct Payment
Your child is no longer eligible for care and support from Wigan Council
You have failed to use your Direct Payment to meet the outcomes of your Support Plan appropriately
You have failed to comply with any of the terms and conditions of this agreement
You fail to comply with the review or financial auditing/monitoring process, including failing to provide requested information
Your child is moved to an alternative care setting
You have failed to disclose any relevant information that should have been considered when calculating the Direct Payments
If we suspect fraud or any other criminal activity has taken place concerning the Direct Payment, we may refer the matter for investigation including to the police.

19. Death of the service user or carer

In the event of the death of the service user or carer, the Council shall arrange to support the family as necessary and, where there is a need, recover any amount of Direct Payment remaining in the account after fulfilment of any payment due for services already delivered to meet the outcomes identified in the support plan.

20. Complaints

Where there are difficulties around setting up Direct Payments these can be resolved between the allocated worker and yourself in the first instance. If there are further concerns identified, these can be discussed with the allocated manager, service manager or service lead.

If there are further concerns regarding the Direct Payments care package allowance or hours awarded at CDP, then there will be an appeals panel, and this would be reviewed by the Practice Director and advice and guidance would be given.

If you remain unhappy about any action or decision within this process, you have the right to complain and you can make a formal complaint through the Wigan Council Complaints Service.

Policy last updated: March 2025