Children's direct payments (0 to 18 years)
A direct payment is a cash amount of the personal budget to meet a child or adult’s care needs, as agreed in the person’s Care Plan.
In many cases, a parent can choose to have their child’s care needs met by taking a direct payment so that they have more control over which care services to buy. With a direct payment, you can live more independently because you receive care that is individually tailored to your child and family at a time that suits you.
By taking a direct payment, you are responsible for arranging and paying for the care. Also, how you use your direct payment has to be agreed in the Care Plan.
Find out more about direct payments:
- Who to speak to about receiving care for your child/young person and applying for a direct payment
- Who may be offered a direct payment and what is the alternative
- What you can and cannot use a direct payment for
- Parent/carer assessments
- Setting a direct payment and what it involves
- Getting support to manage your child’s direct payment
- Preparing for Adult Life (14 to 25 years) and direct payments
- What happens after I have received my first direct payment
- Emergency situations and contingency planning
- If you need to be away from home for a while
Who to speak to about receiving care for your child/young person and applying for a direct payment
1. If you have a Social Worker and would like to have your child’s personal budget as a direct payment, contact the Children and Young People’s Disability (CYPDS) service on:
Tel 020 7974 3597 (Duty Manager)
2. If you currently do not receive support from Children and Young People’s Disability (CYPDS) service and wish to receive a direct payment for your disabled child, contact the Early Help service on:
Tel 020 7974 3317 (9am to 5pm – ask for Early Help)
3. Find out more about care and support for disabled children and young persons
Camden’s Local Offer provides information, support and advice to children and young people aged 0 to 25 years with special educational needs and disabilities (SEND) and their families.
It also provides details about access to services, who can access them, how decisions are made and who makes them. This includes advice about Direct Payments:
- You can find out about eligibility criteria for children and young people in the Social Care and Support pages in Camden’s Local Offer.
- The transition to adult life begins from age 14 (Year 9 in school) up to 25 years. This can be a confusing time with lots of questions. Find out about what happens during the transition period and where you can get help and support in the Preparing for Adult Life 14 - 25 pages in Camden’s Local Offfer
Who may be offered a direct payment and what is the alternative
1. Who may be offered a direct payment
Local authorities have a duty to offer a direct payment to anyone who is eligible for social care support. This includes:
- disabled children and young persons with a mental, physical, or learning disability
- adults who have parental responsibility for a child or young person with a mental, physical or learning disability
- children and young people who live in long-term residential care may receive direct payments for non-residential care services. For example, to try out independent living or for additional day activities.
This duty is provided in Section 17A of the Children’s Act 1989 and Section 49 of the Children and Families Act 2014.
Also, all local NHS teams in England have a duty to ask a person who is eligible to receive a Personal Health budget if they would like their health needs to be met by a Personal Health Budget or met directly by NHS Continuing Health Care.
2. An alternative to direct payments
In some circumstances, we may decide that direct payments is not the appropriate option. If this is the case, the Social Worker will give a reason for the decision.
The alternative to receiving direct payments is a care package that we or local NHS team arranges to meet your child’s assessed needs. This means that the care based on your child’s agreed Care Plan is arranged for you.
If the child or young person has an agreed Short Breaks Care Plan with Children and Young People’s Disability Service (CYPDS), the care package offered will be support that CYPDS commission. This consists of a range of local support and activities for children and young persons who live in Camden, which includes:
- specialist developmental play sessions for the youngest children
- home-based learning, key workers, parent participation activities
- services for siblings
- after school and Saturday sessions, advocacy services, overnight sleepover camps, with a focus on physical activity and outdoor play
- a Preparing for Adulthood programme of activities with a specific focus on supporting young people for the future with improved life skills and social skills through enjoyable, fun activities and social opportunities
- a revised Positive Behaviour Support service in the family home and 1 to 1 home and community-based support for disabled children and young persons
- daytime activities as part of community centres for young persons and access to opportunities for employment or voluntary work
Parents and Carers are encouraged to access support that CYPDS commission and if any additional support is required, or the range of activities that CYPDS provide are not suitable for the needs of the child or young person, then a direct payment will be discussed with the family.
The Social Worker will ensure your child’s needs are being met by regularly reviewing their care. If your circumstances change at any time, you need to contact the Social Worker so that their care can be reviewed.
What you can and cannot use a direct payment for
1. Choice and control
Section 19 of the Children and Families Act 2014 states that local authorities in supporting disabled children and young people must have regard to the child and parents’ views, and that they must be provided with information and support necessary to enable them to participate in decisions about their care.
Camden’s Model of Social Work is a model of practice based on a set of guiding principles and the core belief that the relationship between the Social Worker and the Family and the Social Worker and the Child are the key asset. The Model is defined by principles that ensure we prioritise the child's journey through everything we do.
As part of the Model of Social Work, our ‘Promise to Children’ ‘Pledge to Families’ reflect our commitment to listen to what you want and think with you about what is going well in your life. We are also committed to working together with families to promote the wellbeing of children.
2. What you can use a direct payment for
A direct payment must be used to pay for care as set out in your child or young person’s Care Plan. A Care Plan is designed to provide a lot of scope as to how a person’s care needs are met.
What is appropriate use of direct payments to meet eligible support needs will vary from person to person. If your child has a Short Breaks Care Plan, use of direct payments must be in line with the outcomes agreed.
Examples of how a direct payment can be used as part of a child’s assessed needs include:
- a short break (for children aged 5 to 17)
- personal care and support within the family home
- support to facilitate access to leisure, cultural and sporting activities within the local community
- buy personal care and support from a private care agency to be provided in your own home
- buy equipment to enable your child to live healthily and independently following an assessment by an Occupational Therapist, if this cannot be funded by the NHS
- overnight care instead of in-house overnight residential support
- pay a family member to provide administration support to manage a direct payment, where required
- buy short-term care in a respite residential home for up to 4 weeks
Other examples for what direct payments can be used for include:
- pay for a Carer’s transport costs because they are helping a young disabled person to access public transport or travel training to enable the young person attend community activities or employment opportunities, or the Carer is taking the young person out for the day
For children and young people aged up to 18, we normally provide a transport service, but there are some circumstances where a child’s direct payment can be used for transport costs if it is agreed in their Education, Health and Care Plan
If you employ a Support Worker for your child or young person, a stay in hospital should not mean their direct payment is suspended. A direct payment provides flexibility to enable you to fulfil all your employment responsibilities whilst your child is in hospital so that employment arrangements are maintained.
3. What you cannot use a direct payment for
There are some things that a direct payment cannot be used for, such as:
- paying household bills and daily living expenses e.g. utility bills, rent or mortgage, and food shopping bills
- buying health services such as the dentist or chiropody or equipment from the NHS
- paying for care that contravenes the law or government regulations
- anything that is not related to meeting your child’s assessed needs as agreed in the Care Plan
If you have any queries about what a direct payment could be used for your child or young person’s assessed needs agreed in the Short Breaks Care Plan, please contact your Social Worker.
If an agreement needs to be reached regarding use of a direct payment, this will be decided by a Team Manager or Service Manager in Children and Young People’s Disability Service or the Care Team in Camden & Islington NHS Trust.
The purpose of an assessment is to identify the parent’s support needs in their capacity of caring for a disabled child above and beyond what is reasonably expected if the child were not disabled.
Caring for someone can be exhausting and having breaks are crucial for a carer’s wellbeing and quality of life.
In every care assessment for children/young people and families, when the Social Worker makes a recommendation for support, the parent/carer’s own need for a ‘short break’ should always be considered as part of the overall package of care.
The aim of a short break is to enable a child to participate in interesting and safe activities and to provide parents/carers a break from their caring role. This requirement is in line with The Breaks for Carers of Disabled Children Regulations 2011. Further details about what is a short break is available on the Camden Local Offer.
Also, under the Carers (Equal Opportunities) Act 2004, a carer of a disabled child may request a separate Carers Assessment to completed alongside the Child and Family Assessment.
When considering the parent carer’s support needs, the Social Worker should take into account:
- the wishes of the parent carer
- the wellbeing of the parent carer (using the same criteria as for adults under the Care Act 2014)
- the need to safeguard and promote the welfare of the child.
Setting a direct payment and what it involves
Setting up a direct payment may seem a lot of work, but there are good reasons for having one as it enables you or your young person to choose how the care is provided, by who and which service.
Step 1. An assessment of your child or young person’s care
Parents or carers of a disabled child or young person are provided information about direct payments during a Child and Family Assessment or Care Assessment for a young person, or Care Review.
The purpose of an assessment is to identify the parent/carer’s support needs in their capacity of caring for a disabled child that is above and beyond what is reasonably expected if the child was not disabled.
When considering the parent carer’s support needs, the Social Worker should take into account:
- wishes of the parent carer
- wellbeing of the parent carer (using the same criteria as for adults under the Care Act 2014)
- safeguarding and promoting the child’s welfare
If the parent/carer requests it, a separate carer’s assessment may be completed alongside the child and family assessment.
Completing an online self-assessment
If you are applying for a direct payment that will be used specifically to access Camden’s Short Breaks offer for your child aged 5 to 12, you can complete an online Self-Assessment Referral Tool (SART). The SART form is downloadable from the Short Breaks webpage. Alternatively, email firstname.lastname@example.org for a copy of the SART.
Once the form is submitted, the Short Breaks Assessor will review the form and assess the child’s needs and make a decision on thresholds and eligibility for services.
The Short Breaks Assessor will assess the child’s needs by considering the following:
- focus on the child or young person’s needs stemming from their disability
- be based on the assessment framework and take into account all the child’s developmental needs, parenting capacity and environment factors
- consider both the strengths and vulnerabilities of the family environment including the identification of any potential risk to the child
- be child focused and ensure all attempts are made to gain the voice of the child or young person.
The assessment should also contain information about the child’s social care needs that are relevant to their learning and which can be relevant in the Education, Health and Care plan assessment.
This ensures that assessments and plans carried out by the Children and Young People’s Disability (CYPDS) service have clear outcomes that can be aligned wherever possible with other plans to avoid duplication and ensure an integrated approach to support for the child or young person.
The outcome of the assessment will be recommendations as to the level of intervention required based on assessed need and level of risk to the child or young person. This may be statutory intervention or provision of short breaks only.
Step 2. Discussion about direct payments
In finalising the Short Breaks Care Plan and setting out what actions and services will be put in place to address the child’s needs and improve outcomes the Social Worker will discuss direct payment as an option.
The Social Worker will explain briefly what is involved in receiving a direct payment and how you would be able to choose care services to purchase or employ a Support Worker or Personal (Care) Assistant.
The Social Worker will also discuss an alternative to direct payment, which would be services commissioned by Children and Young People’s Disability Service, such as after school clubs, transport or day care, services and support for non-disabled siblings, specialist services such as a referral to CAMHS or other behavioural support.
The Short Breaks Care Plan will also include a finance plan detailing specific provision and the total cost of the care package provided.
More information about setting up a direct payment and what it can be used for can be explained in more detail by People Plus. People Plus specialise in providing direct payment support and they are commissioned by Camden Council.
If you wish to receive direct payments or find out more about what is involved, your Social Worker or Health Care Professional can refer you to People Plus and they will contact you to run through the setting up process.
Depending on how you wish the direct payment budget to be used to meet your agreed outcomes, People Plus will discuss and identify what services could be purchased, or whether community services may be able to meet some outcomes, or whether you could employ a Support Worker to provide your care.
If you wish to employ a Support Worker, People Plus will explain what that involves and support you with the recruitment process, and how to develop a good employer and employee relationship and ensure the quality of care provided is to a standard you expect.
If you agree to use direct payments in the ways discussed with People Plus,they will include those details in your child’s Support Plan or Care Plan.
Step 3. Setting up payment methods
People Plus will discuss with you and support you to set up payment methods and explain what the options are. They will also support you to complete the necessary paperwork.
Step 4. Getting the funds transferred into your account
People Plus will provide your Social Worker with a summary plan that you have agreed, of how the direct payment will be used, along with the start date.
The summary plan will then be recorded on the Children and Young People’s Disability Service (CYPDS) social care record management system.
The Social Worker will notify the Direct Payment Officer in CYPDS to ensure the funds are transferred into your account.
The Direct Payment Officer will write to you and confirm your details are on the payment system and advise you of your weekly amount, the start date, and information about how to manage your direct payment and how we check direct payments and what your responsibilities are.
The funds will then be transferred to the agreed account in the next payment cycle and each month thereafter.
Getting support to manage your child’s direct payment
For a parent whose child receives a direct payment, the finance and administration tasks, such as dealing with invoices and ensuring services or staff that you employ get paid, may seem daunting. But there is support available to help you manage them.
1. Support provided by commissioned Support Service, People Plus
As part of the Council's Direct Payment service, there is independent specialist support available to help you manage your Direct Payment. The service is for anyone who receives a direct payment, including their carers and families.
The specialist support service can help with getting your direct payment set up, provide ongoing support the whole time you receive direct payments, and make the whole process as simple as possible for you.
The support is provided by People Plus. Their contact details are:
Email - email@example.com
Phone – 0330 123 2815
2. Support provided by Managed Payroll companies
If you wish to employ a Support Worker for your child, there are legal responsibilities that need to be met such as submitting tax returns to HM Revenues and Customs and other tasks such as calculating tax and NI and paying staff wages. These tasks and many others related to the day-to -day management of employing staff can be completed by a Managed Payroll company.
Managed Payroll companies charge a small fee, but they will save a lot of time and trouble in the long run because they take on the full administrative responsibility of making payments. In any case, employers are strongly advised to use a Managed Payroll company.
Further information about Managed Payroll companies can be provided by People Plus who may be able to provide contact details of companies that other direct payment recipients in Camden are using.
Preparing for Adult Life (14 to 25 years) and direct payments
In Camden, the journey from being a child to an adult is called Transition. For a parent/carer, this can be a confusing time with many questions and uncertainty with what happens next. The Camden Local Offer provides lots of information about what happens when your child is in Transition and what support is available.
As a young person approaches the age of 18, Social Work and Health Professionals in Children and Young People’s Disability Service work with the parents/carers to ensure there is a smooth transition to Adult services.
Social care that is provided by the local authority is free for children and young people aged under 18 and it is not free to all adults. Shortly before a young person reaches 18, they will need to complete a financial assessment in order to continue to receive direct payments for support to meet their eligible needs.
The purpose of a financial assessment is to determine whether the young adult is required to contribute an amount towards the cost of their care.
Once a financial assessment is completed, the Social Care Practitioner in Adult Social Care or Health Care Professional will review their Care Plan to see if there are any changes to their needs.
Adult Social Care will also confirm with whether the young adult is required to contribute and how much, including how the contributions will be made.
Also, if you have any questions about using a direct payment for a young person whose care is being provided by Adult Social Care, you can contact People Plus on:
Email - firstname.lastname@example.org
Phone – 0330 123 2815
Further information about charging for social care and the financial assessment can be found in Care and support statutory guidance (Chapter 8).
Examples of financial assessment calculations are available in Paying for non-residential care in Camden, downloadable from Camden Care Choices.
What to expect after you have received your first monthly direct payment
1. Ongoing support available
People Plus will continue to provide support on an ongoing basis and throughout the time you receive direct payments.
Examples of ongoing support from People Plus includes:
- provide information and advice to ensure you are receiving good quality care
- identify services or signpost to services that can support you to meet your agreed care needs
- depending on what method you are using to make purchases from your direct payment, People Plus will support you to submit paperwork that is required as part of our checking process
2. Six-week review if you are new to Children and Young People's Disability Service (CYPDS)
Six weeks or thereabouts after your direct payment has started, if you are new to CYPDS, People Plus and the Social Worker will review how you are getting on with the direct payment to see if there are any issues or questions you have.
3. Checking your direct payment
When your direct payment was being set up, People Plus would have explained that the purchases you make with your direct payment may only be for the needs agreed in your child’s Care Plan.
The Direct Payment Officer is required to check that direct payments are used properly and they will regularly check direct payment accounts and raise any spending issues with the Social Worker.
4. Annual review of your direct payment
A formal review of your child’s direct payment takes place regularly, usually annually or just after a year, to check they are continuing to receive good quality care and that care arrangements are working well.
The review will include a discussion to check that the funds are used in the way that it was designed, including:
- any risks to your child’s safety and welfare in regards to taking a direct payment. This is for safeguarding purposes to prevent any potential abuse to people who use a direct payment
- how the financial and business side of your direct payment is going and any amounts that have not been spent.
The review will also be an opportunity for everyone involved in your child’s care to:
- understand any changes to their health or social care needs
- give their views on how well they think your child’s care is being met, including views from the family and advocates
Further information about a care review is available.
Emergency situations and contingency planning
Direct payments are to enable people to live as independently as possible with solutions that are tailored to meet their needs.
In an emergency such as the Coronavirus pandemic when people were asked to prepare for periods of self-isolation, living as independently as possible became more important than ever.
The Coronavirus pandemic required everyone to adapt to living and working in a challenging environment with changing needs and uncertainty. Also, it demonstrated the importance of creating a contingency plan in case of an emergency.
A contingency plan could include the following information:
1. Who to contact for support
Phone 0330 123 2815
Camden Children and Young People’s Disability Service
Tel CYPDS Duty Manager on 020 7974 3597
Camden Children’s Service
Tel 020 7974 3317 (9am to 5pm – ask for Early Help)
2. A list of support tasks
Make a list of the tasks that need to be completed every day/week. It is easy to forget the little things. One suggestion is to do a ‘top to toe’ list. Get everything written down. For example, your regular Support Worker may know to wipe your glasses, but someone else may not think of it.
3. Your Short Breaks Care Plan
Check your Care Plan is up to date and that appropriate people have a copy. If you don’t have a Care Plan, produce a one-page document of the basic information people may need about you and your support needs.
4. Emergency contact list – make sure people on the list know you may need to call them
Make sure you have the contact details of people or organisations you may need to get in touch with such as your Social Worker and contingency care agency. Make sure this list is complete and up to date and that everyone on the list knows that you, or someone else, may call them.
5. Plan ahead
If you employ a Support Worker, talk to them in advance about how you might manage in an emergency situation, such as if one of your Support Workers was required to self-isolate. If you have a team of Support Workers, how might they change their working rota to cover absences.
Find out about your legal obligations as an employer and speak to People Plus for advice.
Get any favourite foods in if you are getting low. You do not need to stockpile food. Make sure you have the medication you need and know where you can get supplies if you need them.
6. Use your direct payment flexibly
If you are concerned about employing an external Support Worker for health reasons, you may be allowed to make temporary arrangements to let a family member act as your paid carer over a short-term period.
Please note that you are required to ask the our permission before making such arrangements. If this is something you would like to consider, please contact your Social Worker.
If you need to be away from home for a while
There may be times when your child or young person needs to be away from home for a while, such as being admitted to hospital, requiring a short stay in a respite care home if they are a young person, going on holiday, or travelling abroad.
1. Hospital admission
If your child or young person is admitted to hospital, we will pay for the direct payment of up to 4 weeks from when the hospital stay began. If you employ a Support Worker and the hospital stay is longer than 4 weeks, the direct payment may be suspended.
Please seek advice from People Plus about how you can meet your legal obligations to the Support Worker that is employed.
2. Short-term stay in a respite care home for a young person
In Camden, a direct payment cannot be used to pay for people to live in a respite care home long-term.
However, short stays in a respite care home can be funded by a direct payment, such as to provide a respite break for a parent carer for example.
Most respite care services for disabled children are located outside Camden and we will commission a place when it is required. Some families have direct payments they can use for this, and a referral from a Social Worker for respite can be made when this is included in the child’s Care Plan. The length of stay in a respite care home needs to be discussed and agreed with the Social Worker.
We can provide up to 4 to 6 respite care stays for a disabled child per calendar year and if there are more complex needs, this could be provided as a regular weekend once a month, pending a Child and Family Assessment. To find out more, contact your child’s Social Worker.
3. Going on holiday or travelling abroad
If your child or young person and the family are going on holiday or travelling abroad, we may pay for the direct payment for up to 4 weeks in a calendar year as long as the following conditions are met before leaving your home:
- you have advised Children and Young People’s Disability Service that your child is going abroad and provided them the address you intend to stay at, a contact phone number, and the dates of the departure and return. If you do not return home on the expected date the direct payment may be suspended or ended which would result in a reassessment of your child’s care needs
- you have demonstrated how your child’s support needs will be met while they are away from home. If you are going abroad, the differences in tax and Health and Safety regulations means it is generally not possible to use direct payments to pay for support or employ staff that are based in another country.
- if you employ a Support Worker, they agree to travel and support your child while being away from home
- the cost of travel, including flights, accommodation and any other expenses related to supporting your child while they are away from home is met by yourself using your own funds. If you employ a Support Worker, they agree to using their personal funds to pay for the above travel costs.
- if you are taking a Support Worker with you, they are covered by liability insurance, particularly while travelling abroad
- Health and Safety regulations are followed to ensure the working environment abroad is safe for the Support Worker to perform their duties
If there are exceptional circumstances for a child who receives direct payments to spend more than 4 weeks abroad in a calendar year, please write to Children and Young People’s Disability Service (CYPDS). CYPDS will take into account of the current Care Plan and whether it identifies any care needs and spending more than 4 weeks abroad in a calendar year.