Checking direct payment accounts
This page is about checks that the council makes if you are receiving a direct payment from Children and Young People's Disability Service (CYPDS) or Adult Social Care. You can find out about:
- Why the Council checks your direct payment
- What we look for when carrying out checks
- Additional checks if you employ staff - contingency levels
- The Direct Payment Agreement and your responsibilities
- Misuse or mismanagement of funds
The Council makes regular checks on direct payments in order to:
• ensure the money is being spent appropriately to meet the needs of the person
• protect and account for money that comes from public funds
Checks are done annually to coincide with the Support Plan review. This is the time when we ask you to provide documents to show how your direct payments have been used. Documents can include receipts and invoices. Occasionally, checks are made at other times in the year.
When we make checks, we inform the person that receives a direct payment (or the person who receives it on behalf of their family member or someone else).
When we check your direct payments we look at the following things:
• that the purchased support is in line with the agreed outcomes in the Support Plan
• if a Personal Assistant or Support Worker is employed, there is evidence of: appropriate HMRC payments being made; valid employer’s liability insurance; a payroll company or alternative being used to support with calculating wages
• where a home care agency being used is in England, that its Care Quality Commission registration is evident
• an appropriate level of contingency is held in the account, generally an equivalent of up to 10 weeks' of the direct payment
• any assessed personal contribution is being paid into the account.
If you use your direct payment to employ staff, when your direct payment was first set up, you would have had a discussion with People Plus or the previous Support Service about setting aside an amount of funds to meet unexpected costs or one-off events.
As part of our checking process, we will look at the amount of contingency you have in your account. If there is an excess of the permitted 10 weeks’ contingency, then it is usually redeemed back to us. Direct payments recipients should regularly monitor their account and check the direct payment balance on their prepaid card if they have one, or personal bank accounts, or regularly check with their Payroll company if they use one, to ensure the funds remain below the permitted level of 10 weeks’ contingency.
The person who agrees to taking a direct payment and managing the financial side of it needs to sign a Direct Payment Agreement before the payment can start. This may be the person who is receiving the care and support, or their nominated Suitable Person.
The Agreement sets out the terms and conditions associated with receiving the direct payment. It clarifies what the expectations are for the person who agrees to manage the funds so that they are clear about their responsibilities.
When a direct payment was initially set up, the person responsible for the financial side of the direct payment would have signed a Direct Payment Agreement that committed them to the following:
• ensure accurate and appropriate records are kept of all income and expenditure, including receipts, invoices, and pay slips
• keep supporting documents and records for a period of 6 years
• submit supporting documents when requested as part of checking process.
If requests to provide supporting documents are repeatedly not responded to, we may ask the person to move to another payment method where we can check the direct payment more easily. In extreme circumstances, if the person continues to be unable to provide the requested information, their direct payment may be suspended or terminated and they may be asked to repay used funds.
Direct payments allow a person to pay directly for the care of their choice with a monetary payment from the Council. Care packages are available if the person does not receive a direct payment.
Your responsibilities under the Direct Payment Agreement include:
• using direct payments to meet eligible care needs to achieve the agreed outcomes in the Support Plan
• ensuring services purchased are paid to the service provider accordingly
• complying with legal duties of an employer if you manage staff such as Support Workers or Personal (Care) Assistants
• ensuring any contributions they are required to pay towards the cost of care are paid into the direct payment account
• maintaining up to date records of expenditure, keeping receipts as evidence of spending and co-operating with our checking process
• returning money to us that is over the agreed contingency level
Sometimes, checking activity may identify areas of misuse or mismanagement. The Social Worker, Social Care Practitioner or Health Care Professional will also communicate with the person responsible for managing the direct payment to review the spend identified and discuss this in relation to the agreed outcomes in the Support Plan. Throughout the checking process, we always prioritise the wellbeing of the child or adult who is receiving the care, and they (including the parent/carer) will be encouraged to access additional advice and assistance from People Plus or an independent advocacy service.
If misuse or mismanagement is identified, a further review is required that involves the Direct Payments Team working jointly with the Social Worker, Social Care Practitioner or Health Care Professional and People Plus to:
• resolve any issues
consider any risks with regard to protecting the wellbeing of person who has care needs
• review the circumstances surrounding the alleged misuse.
If there is clear evidence that a spend is not in line with the agreed Support Plan or Care Plan the person responsible for the financial side of the direct payment may be asked to repay all or some of the misused funds.
Options for managing the direct payment will also be considered, for example the account is transferred to a Managed Payroll. Another option is that we make the care arrangements for you, which means the direct payment is stopped.
Concerns regarding fraud
If there are concerns regarding fraud, including fraud committed against other public bodies, the Direct Payment Team and Social Worker, Social Care Practitioner or Health Care Professional have a duty to report it to the Council’s Internal Audit Investigation Team.