Our report, Direct Payments for Adult Social Care, provides an insight into an important, but underdeveloped, area of social care provision.

Direct Payments are monies paid specifically to buy services or equipment that help to meet people’s social care or support needs. As an alternative to council-arranged packages, they enable people’s voices to be heard, to make their own choices and take control of their care and support, which helps maintain their independence and well-being. So why is it that, of the 125,415 adults receiving social care in Wales in 2018-19, only 6,262 (5%) were in receipt of Direct Payments?

We found that the systems to manage and support people to use Direct Payments vary widely across Wales with service users and carers receiving different standards of service, and councils are still grappling with limitations in data and evaluation which makes it difficult to assess overall value for money.

And despite evidence around the overwhelmingly positive impact on people’s well-being and impendence, people in Wales are not consistently supported to take up Direct Payments.

But it shouldn’t be like this.

Our report makes 10 recommendations aimed at improving take up and provision. Through our research we have identified and set out the key characteristics of a local authority that effectively encourages, manages and supports people to take up and use Direct Payments.

Different times and new ways of working

Delivering a national review on social care during COVID-19 had its challenges. But by doing so we were able to provide assurance on an important service area at a time when its provision helped to support people’s resilience and well-being more than ever.

By working through the All-Wales Direct Payments Forum and listening to officers’ feedback we established what works well and discussed some of their frustrations around promoting the take up of Direct Payments. We’re hugely grateful to those colleagues who enabled us to conduct the biggest ever survey of current recipients in Wales (probably).

We spoke to over a thousand people – roughly 1 in every 6 Direct Payments recipient in Wales. This provided an invaluable insight into this system and how things can be improved.

The review also provided new experiences to three trainees who had the opportunity to be involved in delivering the work.

Meleri Bethell was a 3rd year trainee and has since been promoted to a Senior Auditor role:

“During my third year as a trainee, I had the opportunity to work on the Direct Payments study as a part of my 12-month secondment with local government performance audit teams.

I enjoyed being able to learn about an unfamiliar topic by taking part in interviews with senior officers from various local authorities, charities and other bodies, and focus groups and forums with those who receive and those who weren’t eligible for Direct Payments. The interviews and focus groups would often last around an hour each, so one of the main challenges for me was to condense the findings into key points and feedback these to the team. I found team meetings with my colleagues extremely supportive and useful to bounce ideas, discuss our collective findings and decide on the next steps and directions of the study.

Having the opportunity to go on secondment to various local government performance audit teams allowed me to gain insight into the variety of work that councils do. No two days were the same!”

Elinor Hallett joined the study team during her 1st year as a trainee:

“I was particularly interested in this study having dealt with social services first-hand when my Grandad required care. Seeing the pressures that social services were under made me realise what an opportunity Direct Payments presented in supporting people’s independence. Everyone is different and their requirements change. Direct Payments provide a great opportunity for people to tailor their care to reflect their complex and changing needs.

I enjoyed understanding about how each council operates their Direct Payments system. We identified the strengths and weaknesses of each to build a picture of what a well operated Direct Payments system could really look like.”

Ismael Diakiesse also spent time with the study team during his 2nd year as a trainee:

“My time involved in this study was a fantastic learning curve. I got to understand more about how each council operates, helping to make conclusive judgements on how and where delivery can be improved. Delivered effectively, Direct Payments can really help to support people’s independence and prevent their needs from escalating.

I particularly enjoyed this work as it gave me a real insight into the dark arts of performance audit. As a trainee who had only previously worked on auditing financial accounts, this project allowed me to take part and see how Audit Wales adds value to support public services to improve through performance audit work.”

Audit Wales’ graduate scheme provides hands on experience of public sector audit combined with studying towards a professional accountancy qualification. Our trainees benefit from a full learning and development programme delivered in a supportive and professional environment. Find out more about our graduate trainee scheme.

What’s next following our Direct Payments review?

We launched our report in April at a webinar attended by over a 100 people [opens in new window]. Attendees had the opportunity to hear from the study team, as well as colleagues from Think Local Act Personal [opens in new window], Welsh Government, Flintshire County Council and Powys County Council.

But the report is not the end of the story. Our survey work generated a wealth of data and evidence which demonstrate what works and why. We’re getting this data out there by publishing it on our website to help councils to address our recommendations, and we’ll be following up to review councils’ response to our report.

Read more about our trainees who contributed to this blog:

Meleri Bethell joined Audit Wales as a Graduate Trainee in 2018 and is now a Senior Auditor. Before joining Audit Wales, she graduated from Swansea University where she studied Physics.

Elinor Hallett joined Audit Wales as a Graduate Trainee in 2020. Before joining Audit Wales, she graduated from Swansea University where she studied Business Management.

Ismael Diakiesse joined Audit Wales as a Graduate Trainee in 2019. Before joining the organisation, he graduated from Aston University where he studied International Business and Economics.