Direct payments are cash payments made in lieu of social service provision, to individuals who have been assessed as needing services.
The aim of a direct payment is to give more flexibility in how services are provided to individuals who are assessed as being eligible for social services.
This means greater choice and control, with clients able to make their own decisions about how their care is delivered. Gone, forever, are the days when people were put to bed too early because that was convenient for the provider. Now the client can make trade-offs about quality and cost which traditionally had been made for them by professionals.
Since 2003, all local authorities have had a duty to offer direct payments to eligible people, as an alternative way of meeting their assessed community care needs.
At that time, Barking and Dagenham LBC had only a handful of people receiving direct payments – the council was in 98th position nationally.
However, today we have more than 350 people in receipt of direct payments, which represents at least £2.6m of annual spend, which is among the best performers in the country.
A study of direct payments has found the system works best where a supportive local authority infrastructure is combined with both an understanding of the principles of independent living and a commitment to partnership with users.
And with publication of the Our health, our care, our say White Paper in January 2006, the Government is calling for an even greater shift towards individualisation of services, offering increased choice and control for people who receive public services.
One option to extend choice for the service-user is the use of an individual budget.
Building on the approach of direct payments, individual budgets are based on the concept of self-directed support, and enable people needing social care and associated services to design the support they require.
It gives them the power to decide the nature of services, as well as counter the disempowering effects of fragmented service delivery, which some people experience when their needs cross different budgets and services. Features include:
l transparently allocating resources, giving individuals a clear cash or notional sum for them to use on their care or support package
l streamlining the assessment process across agencies, meaning less time spent giving/receiving information
l bringing together a variety of streams of support and/or funding
l giving individuals the ability to use the budget in a way that best suits their own particular requirements
l allowing support from a broker or advocate, family or friends, as the individual desires
l being delivered within local authorities’ existing resource envelope. Barking and Dagenham LBC is pleased to have been chosen as one of 13 national pilot sites, and has started delivery of individual budgets over a two-year period to older people, people with learning disabilities, people with physical and sensory impairments, and people who use mental health services. Since September 2006, 27 people have agreed to participate in the pilot, 16 having completed a self-assessment questionnaire and given an indicative allocation, and four individuals going on to complete their own support plans.
Although it’s still early days in the development of individual budgets, we are committed as a borough to driving forward this initiative and to put people and their families in control by offering personalised services, and giving them the freedom to choose the support they require.
We believe our strategic role is to ‘place shape’ our area and would welcome new responsibilities inherent in Lyons and Leitch to achieve this. But this also places an onus on us to put services in the hands of residents, and adult social care is at the forefront of the opportunities to achieve this. w
Rob Whiteman is chief executive of Barking & Dagenham LBC
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