Direct Payments support people’s independence and are highly valued but there are opportunities to improve
Inconsistencies are resulting in people receiving different standards of service.
Direct Payments for adult social care help people live independently and improve their wellbeing, but it is difficult to demonstrate they are value for money.
The Social Services and Well-Being Act (Wales) 2014 encourages Direct Payments to help improve people’s voice, choice and control. Direct Payments are an alternative to local-authority-arranged care or support and can help meet an individual’s or a carer’s need. They aim to give people more choice, greater flexibility and more control over the support they get. Direct Payments can be used to provide help for day-to-day things such as dressing and cooking, and social activities like visiting friends, evening classes and gardening.
Many people we surveyed acknowledged that Direct Payments help them remain independent. One user said, ‘I really like Direct Payments and how it lets me live as independently as I can.’ Another stated that, ‘Direct Payments allows me to have control and more importantly to have the care I need to be able to get the most out of life.’
In 2020-21, social service authorities spent £2.29 billion on all social services. £79.5 million (3.5%) of this was spent on Direct Payments for adults.
Managing and supporting people to use Direct Payments varies widely resulting in service users and carers receiving different standards of service. One user surveyed said, ‘The council does not make it clear how to spend the money. You still have to continually ask questions and the people in the council don’t know the answers. The system is very slow and ‘drawn out’. They are not flexible.’ Despite some significant challenges, local authorities ensured service users and carers were mostly supported during the pandemic, but a significant number of service users and carers we surveyed experienced difficulties.
Our report makes 10 recommendations covering:
- how to improve promotion and awareness of Direct Payments so more people have the opportunity to use them;
- addressing inconsistencies in delivery and management of Direct Payments so people are not missing out; and
- overhauling management information to demonstrate the positive impact and value for money of Direct Payments.
Direct Payments can make an important contribution to meeting an individual’s care and support needs and they are highly valued by service users and carers. The Welsh Government and local authorities need to work together to address weakness in the management and evaluation of performance, which currently means it is not possible to judge how well local authorities are performing and whether Direct Payments represent value for money compared with other forms of social care. There is also a need to address the ‘post-code lottery’ where local authorities are using them differently across Wales, to ensure people are treated fairly and equally.