Into Perspective

HOW IS THE FALLING NUMBER OF PEOPLE RECEIVING DIRECT PAYMENTS AFFECTING PERSONALISATION?

Empowering choice

According to the Care Act 2014, if an individual’s local authority agrees to fund some or all of their care services subject to a needs and financial assessment, they will be offered a choice of options for this funding to be received.

Typically, one of these options is to receive direct payments from the local authority, which an individual can use to arrange and pay for care services themselves. Individuals can also use direct payments to pay for non-care services such as transport costs to meet eligible needs, short breaks and leisure activities.

Skills for Care states that ‘direct payments are the main mechanism to deliver the personalisation agenda for adult social care in England’.

Falling figures

The King’s Fund reports, ‘The number of people using direct payments is now lower than in 2015/16 and has fallen for each of the past five years. Overall, only 26.7% of people (38.4% of workingage adults and just 15.5% of older people) drawing on adult social care use direct payments, down from 28.1% in 2015/16.'

Guidance from Age UK highlights that when calculating the amount of an individual’s direct payment, a local authority ‘must balance [the individual’s] personal preferences for how [their] care is delivered against its budgetary constraints. In doing so, the local authority must always aim to promote [the individual’s] wellbeing.’ The guidance continues by adding that this ‘can be a difficult balance in practice.’ This balance is likely to be harder to strike given that much-needed central Government funding is falling short of the sector’s expectations. In April this year, the publication of Government’s policy paper, Next Steps to put People at the Heart of Care, was met by criticism from the adult social care sector and local authorities alike, particularly in response to Government’s plans to reduce the promised financial support for people drawing upon care services.

Professor Vic Rayner OBE, Chief Executive of the National Care Forum, commented, ‘The announcements . . . completely undermine the original vision of person-centred reform.’ While Councillor David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board, said, ‘Given the well-documented capacity issues and levels of unmet and under-met need, it is hard to see how reducing the funding available to begin to address some of the issues can be justified.’

More call for change

In December 2022, the Adult Social Care Committee, having heard from a range of witnesses, including disabled adults and older people, carers, service providers, local authorities, and academics, published a report, A “Gloriously Ordinary Life’’: Spotlight on Adult Social Care, challenging Government to undertake urgent adult social care reforms.

One of the recommendations outlined in the report was to ensure that people who draw on social care have the same choice and control over their lives as everybody else. The Committee believes that this can be achieved by enabling people to make a genuine choice as to who supports them, simplifying the recruitment of personal assistants, and making access to direct payments easier.