Agenda item

The Director of Adult Social Care and Safeguarding submits a report providing the Commission with an overview on direct payments.

The Executive Lead Member for Social Care, Health and Community Safety thanked the Commission for requesting consideration of direct payments. It was noted that is an important topic which has been subject to local, regional and national discussions regarding use, challenges and recognition of the important work with Think Local / Act Personal (TLAP).

The Director for Adult Social Care & Safeguarding presented the report, and it was noted that:

·       Leicester was an early adopter and had celebrated its 25-year anniversary of using direct payments in which we benchmark well with the percentage of people in receipt. 

·       The premise of direct payments is to offer flexibility, choice and control for individuals, although a balance is required as challenges can arise with the use of public money. 

·       The Authority worked with TLAP to co-produce revised guidance to distribute to individuals about direct payments and captured learning from the pandemic where there was an expectation to increase flexibility on direct payments.

·       The Direct Payment Support Service is provided to support individuals in receipt of direct payments to manage the funds. Three providers are contracted to offer a range of services from fully enabling an individual to spend their direct payment award to limited employment support or payroll advice. 

·       The Authority worked with IMPACT at Birmingham University to undertake a year-long study on how black and ethnic minority communities use direct payments - a hyperlink to the research was included within the agenda pack.

·       Challenges persist around the financial audit expected of how individuals are spending direct payments. The flexibility, choice and control allow an individual to decide how to use their award and can limit oversight where the individual chooses a non-contracted provider or personal assistant. Advice is provided but concerns can arise to the ability to fully safeguard individuals using direct payments. Caution is exercised in ensuring direct payments are appropriate for an individual if they may be at risk, but this must be evidenced as choice to use direct payments is a legal right.

·       The use of direct payments in the city overall is positive. A working group has been developed to draw on support and address challenges to promote the benefits and protect public monies. 

The Commission praised the division for its 25-years of advocating the use of direct payments to give resident choice and control but recognised the concerns and risks.

In response to questions and comments from Members, it was noted that:

·       It is recognised that safeguarding concerns are possible with individuals using direct payments, such as the risk of exploitation. Oversight is only possible where an individual chooses a provider contracted with the local authority. The authority is liaising with the CQC about an approved list of agencies to promote to individuals and remove an agency where a safeguarding concern is referred and identified. Individuals can also employ a family member or friend and are not required to inform the Authority of details.

·       Individuals are encouraged to utilise the disclosure and barring service and check references if using direct payments to employ a personal assistant. Training is available for individuals and the personal assistants through the direct payments support service.

·       Safeguarding advice is promoted and communicated through social media and partnerships to ensure individuals and organisations know what harm and abuse may look like and how to report.

·       Direct payments can work well particularly when an individual is confident and can manage with the help from the direct payment support service or family and friends. Some individuals may have complex needs that cannot be supported by contracted providers or have tried and do not like contracted providers in which a direct payment may be more suitable to fulfil the statutory duty and require more support to sustain.

·       The direct payment uplift ensures the individual has sufficient funds to cover changes in fees for a provider or personal assistant to reflect inflation and the national living wage.

·       £43m was spent in 2022/23 on care packages set up as directpayments.

·       The division has two direct payment officers to initiate referrals for individuals that require support to the externally commissioned direct payments support service. This is positively recognised by other local authorities as support for the individual to exercise choice and control is independent of the authority.

The Commission debated the benefits and conflicts of offering direct payment support in-house.

AGREED:

·       The Commission noted the report.