Using direct payments for care

Direct payments allow you to receive cash payments from your local council to buy in your own care services.

NHS guidance about direct payments

You can read about how you can use your direct payments on the NHS website.

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 can't use direct payments to buy local council services. However, you can have a combination of some local council services and some direct payments.

The local council won't 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 includes 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 council might allow payment to someone in the list above if it agrees it's necessary to meet your needs - or if the person needing care is a child and it's necessary for the child’s welfare.

The council 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:

• don't buy services from a particular person

• give the council information it considers necessary

You can find out more about employing family members with direct payments on the Carers UK websites.

Employing carers

If you're thinking about using direct payments to employ your own carers, you need to be aware of the responsibilities you'll have as an employer and the costs that this will involve.

For example, you'll have to:

• arrange recruitment, insurance, sick pay and other employee benefits

• keep records and accounts

You can read about employing a care worker directly on the Carers UK website.

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.

If you usually live in a care home

You could have direct payments for non-residential care services, for example to take part in daytime activities.

You could also have direct payments to try out living independently, if you want to see if you could manage.

Equipment

You can use direct payments to buy equipment or adaptations that the local council could have provided.

For example, you could put the direct payment towards the cost of a better piece of equipment than the council would supply, and pay the balance yourself.

You can't use direct payments to buy services or equipment for which the council isn't responsible, for example services that the NHS is required to provide.

The council will want you to have specialist advice to ensure that the equipment bought is safe and appropriate.

You'll need to be clear who will own the equipment and who's responsible for its care and maintenance.

Sometimes equipment can be bought at a lower price through the local council, for example supplying mobile phones to personal assistants.

You can read a factsheet about obtaining disability equipment and home adaptations in Wales on the Age Cymru website.

Making adaptations to your home

You might be able to get a disabled facilities grant for larger adaptations to your home. Read about disabled facilities grants.