Direct payments: choosing your own carer in Lincolnshire

When the council agrees to fund care, most people assume they take whichever provider turns up on the allocation. You do not have to. A direct payment hands you the budget and the choice, and in a county the size of Lincolnshire, where availability varies a great deal between the coast, the fens and the towns, that choice can matter more than the money.

What is a direct payment?

A direct payment is your personal budget paid directly to you, or to someone acting on your behalf, so you can arrange your own care instead of the council arranging it for you. It covers the same assessed needs and the same agreed outcomes. What changes is who does the arranging, and therefore who chooses.

It is not extra money and it is not a windfall. The amount is whatever the council has assessed as the cost of meeting your eligible needs, minus any contribution you have been assessed to pay. What it buys you is control over how those needs are met and by whom.

Who can have one?

Anyone with eligible care needs who consents to it, and who is able to manage it either themselves or with support. Under the Care Act 2014 the council must offer a direct payment where those conditions are met. A representative can hold one on behalf of someone who lacks capacity, provided the council is satisfied it is in that person’s best interests.

You do not need to be confident with paperwork. Lincolnshire has support services that help set up the account, handle payroll if you employ someone, and keep the records the council will want to see.

What can you spend it on?

Anything that meets the outcomes written into your support plan. In practice that usually means care from a registered agency, employing a personal assistant directly, or a combination of the two. It cannot be spent on things outside the plan, and it cannot be used to pay a close relative living in the same household except in specific agreed circumstances.

The middle option is the one families most often underestimate. Employing someone directly is genuinely cheaper per hour, but you become responsible for contracts, payroll, employer’s liability insurance, statutory sick pay, pension auto-enrolment, and finding cover when your assistant is ill or on holiday. Some people find that entirely manageable. Others discover it on a wet Tuesday in February when nobody is available.

How do you get one in Lincolnshire?

Ask for it during or after your needs assessment. Call the Lincolnshire County Council Customer Service Centre on 01522 782155 and say that you would like your personal budget as a direct payment. The council publishes its direct payment rates and its policy on the Connect to Support Lincolnshire site, which is run jointly with the NHS in the county.

1. Complete the needs assessment and agree the support plan
2. Ask for the personal budget to be paid as a direct payment
3. Set up the separate account the council requires, with support if you want it
4. Choose your provider or recruit your assistant
5. Keep records, and expect periodic audits and a review of the plan

Why do people choose one in a county like this?

Lincolnshire is the fourth most rural county in England, and home care availability reflects that. Coverage that is comfortable in Sleaford or Lincoln can be thin in the fen villages and along the coast, and an allocated provider is allocated from whoever has capacity, not from whoever suits you.

A direct payment lets you go looking. It also lets you hold on to a provider you already trust when your funding status changes, which happens more often than people expect: someone self-funds for two years, their capital falls below the threshold, and the council becomes involved. Without a direct payment, that can mean changing carers at exactly the point when continuity matters most.

The other common reason is a specific requirement. A preference about who provides personal care, a first language other than English, a routine built around chapel on Sunday or a dog that needs walking at seven. None of these are unreasonable, and all of them are easier to arrange when you are choosing.

What are the obligations?

The money is public money and it is monitored. You keep it in a dedicated account, you spend it only on the agreed outcomes, you keep invoices and timesheets, and you send returns when asked. If you employ someone, the usual employment law applies to you as it would to any employer.

• A separate bank account, not your current account
• Records of every payment made from it
• Periodic audit by the council
• A review of the support plan, usually annually or when needs change
• Telling the council promptly if circumstances change

None of this is onerous once it is running. It is worth being honest that the first month is the fiddly one, and that is exactly when people are usually least able to take on admin. If you are setting one up in the middle of a crisis, ask the council what support is available to help you do it, and take it.

Is a direct payment right for you?

It suits people who care who walks through the door, who want continuity, or who have a specific requirement an allocated provider may not meet, such as a language, a gender preference for personal care, or a routine built around something that matters to them.

It suits people less well when nobody has the appetite for the administration and no relative or support service is willing to help. Taking a council-arranged package is not a defeat, and it can always be revisited later once things have settled and someone has the capacity to take it on.

We support direct payment arrangements, and we are glad to explain what invoicing would look like before you commit to anything. If you are weighing it up, call us and ask. We will give you a straight answer, including if we think the allocated route would suit you better.