Using direct payments for care

Direct payments allow you to receive cash payments from your local authority to buy in your own care services. This page has information about what you can use your direct payments for.

The NHS guidance about Direct Payments has information about how you can use your payments.

• Direct payments - NHS.UK

Buying care at home

You can use direct payments to buy services from an agency, for example, a home care agency, or to employ a carer or personal assistant.

You cannot use direct payments to buy local authority services. However, you can have a combination of some local authority services and some direct payments.

The local authority (LA) will not usually allow you to use direct payments to pay for services from your husband, wife or partner or from family members living with you. This means the following people:

• parent or parent-in-law

• son, daughter, son-in-law or daughter-in-law - except for children's services

• stepson or stepdaughter

• brother or sister

• aunt or uncle

• grandparent

• the husband, wife or partner of any of the relatives in this list

• a person who lives with any of the relatives in this list as if they were that relative's spouse or civil partner.

The LA may allow payment to someone in the list above if it is satisfied that it is necessary to meet your needs, or, if the person needing care is a child and it is necessary to promote the child’s welfare.

The LA can make direct payments subject to certain conditions, but it must be reasonable about this. For example, it can make direct payments subject to the condition that you:

• do not buy services from a particular person

• provide the LA with information it considers necessary.

You can find out more about employing family members with direct payments from Carers UK.

Employing carers

If you are thinking about using direct payments to employ your own carers, you need to be aware of the responsibilities you will have as an employer and the costs that this will involve. For example, you will have to arrange recruitment, insurance, sick pay and other employee benefits and will need to keep records and accounts.

Carers UK have produced useful guidance on becoming an employer. It is available on their website at www.carersuk.

• More about how much should a direct payment be

• More about help with direct payments

Care home stays

If you usually live at home, you can use direct payments to pay for short stays in a care home. There are strict limits about how long you can have direct payments while staying in a care home. Different rules apply to adults and children.

The Welsh Government guidance about Direct Payments has more information about stays in a care home

• Direct payments - Welsh Government

Other care services

If you usually live in a care home, you could have direct payments for non-residential care services, for example to take part in day-time activities. You could also have direct payments to try out living independently to see if you could manage.

Equipment

You can use direct payments to buy equipment or adaptations that the LA could have provided. For example, you could put the direct payment towards the cost of a better piece of equipment than the LA would supply, and pay the balance yourself.

You cannot use direct payments to buy services or equipment for which the LA is not responsible, for example services that the NHS is required to provide.

The LA will want you to have specialist advice to ensure that the equipment bought is safe and appropriate, especially in the case of major items.

You will need to be clear who will own the equipment and who is responsible for its care and maintenance. Sometimes equipment can be bought at a lower price through the local authority, for example supplying pagers or mobile phones to personal assistants.

The Age Cymru Factsheet, Obtaining disability equipment and home adaptations in Wales, is available on their website at www.ageuk.org.uk/cymru.

Adaptations to your home

You may be able to get a Disabled Facilities Grant for larger adaptations to your home.

• More about Disabled facilities grants