Direct Payments: Enhancing Community Care Services in Middlesbrough

1. DIRECT PAYMENTS THE MIDDLESBROUGH EXPERIENCE

2. What is a Direct Payment? • The Community Care (Direct Payments) Act 1996 gives Local Authority Social Services Departments the power to make direct cash payments to individuals for community care services they have been assessed for. Direct Payments are a different way of fulfilling existing community care responsibilities

3. Legislation • Carers & Disabled Children’s Act 2000 • New Direct Payments Guidance 2003 , Community Care,Services for Carers and Children’s Services sees: • Power to make direct payments becomes a duty to provide • Key Performance Indicator from April 2004

4. Principles • Empower service users with :- - Independence - Choices - Partnership - Flexibility • Innovative ways of providing care needs

5. Receiving a Direct Payment? • Meet the criteria • Willing and able to manage own care arrangements • Assessment for a possible financial contribution under Council’s Fairer Charging Policy • Open a designated bank account • Agree to monitoring and review of the scheme

6. What can a Direct Payment be used for? • Middlesbrough currently has provided service users with Direct Payments to meet need for:- • Personal Care • Day Care services • Respite care • Transport • Access to social activities

7. What can’t a Direct Payment be used for • Purchase services provided by the local authority • Permanent residential /nursing care • Health or Housing services • Employ a close relative living in the same household

8. Monitoring & Review • Undertaken by local authority and the Support Service to:- • Ensure service users needs are being met • Funding is being used appropriately • Services for which payments have been made have been received • Monitoring carried out monthly • Audit of scheme quarterly

9. Support • Provide service users/carers with:- • Access to information • Access to independent support • Access to advocacy • Monitoring & Review • Access to Payroll service • Provide assurances for active involvement in emergency situations

10. Middlesbrough Scheme • Pilot Project commenced in July 2000 • First Service Users to receive Direct Payments started in Nov 2000 • 1 Physical Disability & 1 Learning Disability • Contract for Support Service

11. Joint Review outcome • At the time of Joint Review towards the end of 2001 Middlesbrough had 4 people receiving a Direct Payment • Joint Review highlighted the “slow growth in the use of Direct Payments” • Key point “Ensure the availability and advantages of DP are actively promoted to staff, service users and carers”

12. Joint Review outcome cont. • A need to understand why Middlesbrough had only 4 people receiving a Direct Payments • A Consultation Group was established including; • Service Users, Carers • Support Service representatives • Social Workers • Financial Services

13. Development • A Development Plan was produced identifying 37 key points including:- • Training, Promotion, Processes and Recruitment • 34 recommendations in the plan were approved by Senior Managers • 29 recommendations have been delivered to date • 5 remaining undelivered are in planning stage

14. Current Position? • 37 service users currently receive a Direct Payment • 27 service users are looking to start the scheme and are in various stages of information, planning, recruitment and training. 15 of these are with Parents of Disabled Children • 22 service users have cancelled the scheme due to admission to residential care, move out of the area, deaths

15. Support Service • Development of Support Service key to successful implementation of the scheme • Independent advice from the Council • From the outset Middlesbrough have contracted with a Support Service. This is with the Independent Living Project who have been the provider since the scheme commenced in November 2000. • 2 Development Workers appointed for Middlesbrough

16. Support Service cont.. • Provide advice,information, training and practical assistance to service users and carers in considering and planning • Monthly Newsletter • Access to Peer Support Groups • Provide training & support for operational staff • Quality of service provided is inconsistent due to level of skill and experience

17. Statistical Information • Of the 37 service users using the scheme • 18 Physical Disabilities • 11 Learning Disabilities • 3 Older Persons • 1 Carer • 2 Mental Health • 2 Parents with Disabled Children

18. What is there still to do? • Direct Payments to be embedded in mainstream/core business • Capacity plan by reviewing the infra-structure • Implement outstanding recommendations • Evidence all Service Users are given the opportunity to make an informed choice.

19. What is there still to do?…cont. • Continued consultation with all parties via the Consultation Group • Continued training for operational staff • Continued promotion of Direct Payments • Review of the Support Service contract & service specification

20. Useful Contacts • Janet Blott , Financial Services Manager Tel 729248 • Fred Taylor, Performance Monitoring Officer Tel 729249 • Independent Living Project Tel 01642 676777

21. DIRECT PAYMENTS TO BE CONTINUED…...