Agenda item

Report ACH22-003

The Committee considered a report on the initiatives being implemented across the department to increase direct payment take up by residents who used the Council’s social care services.

The Assistant Director for Integrated Commissioning advised that direct payments were social care payments from a Council for residents who had been assessed as needing help and would like to exercise more choice and control over arranging and paying for their care and support services. Some people decided to use direct payments to employ their own personal assistant staff, whilst others bought support from a care agency, or used them to access other services and activities that met their needs and outcomes. Without a direct payment, the Council would arrange a service user’s care and support on their behalf through the use of more traditional commissioned services. A direct payment was designed and provided to be used flexibly and innovatively and was often referred to as self-directed support. Most users of social care services would have an entitlement to choose to have their care and support provided through a direct payment. It was noted that the choice of taking up a direct payment rested with the service user, and Councils could not make direct payments take up compulsory.

The Assistant Director for Integrated Commissioning highlighted that national and local evidence indicated that direct payments encourage those who used them to achieve their social care goals in a way which gave a better quality of life, with greater resilience, and more independence. It also showed that direct payments represented good value for money and a sustainable way of using public resources now and in the future. For these reasons the Council had sought to increase the availability and take up of direct payments by those who used social care services and their carers. Four changes would be introduced:

-  Direct payments as the ‘first choice’;

-  Implementation of a Direct Payment Support Service;

-  Implementation of a Temporary Direct Payment Advisory Service; and,

-  A marketing and learning campaign.

It was noted that as part of the pilot arrangements, it was proposed that the CCG was supported in its direct payment arrangements through the Council’s infrastructure. The Direct Payment Support Service would manage direct payments for both the Council and CCG, with the CCG being charged for the Council’s support. A service level agreement, which carefully set out the terms of this arrangement, would be drawn up with CCG.

A Member said that they would like to see a support structure in place for people who did not want to use direct payments and highlighted the need for centres to be used proactively, for multiple purposes. The Assistant Director for Integrated Commissioning noted that at a previous meeting, a report had been presented to the Committee regarding proposals to increase day opportunities for older people. The growth of direct payment had some impact on the way in which people accessed services that were provided through block grants in the past. The strategy for direct payments sat alongside other strategies to increase day services and tackle loneliness and social isolation. In addition to giving people more choice through direct payments they were also looking to create more opportunities.

In response to questions from another Member, the Assistant Director for Integrated Commissioning advised that when new people joined that system, and when annual reviews took place, service users would be offered the choice of direct payments. It was anticipated that the main growth area would be from new entrants into the service. The Council’s target was to increase the uptake of direct payments to 30% and it was hoped that this would be achieved within the year.

RESOLVED that:

i)  the actions being taken to increase direct payments take up for residents who use social care services through a pilot project be noted; and,

ii)  the Council support direct payment take up for Bromley residents using local NHS services through supporting the CCG in the administration of its direct payments scheme with the costs of this support being met by the CCG.