direct payment alone, intensive support options should be explored to enable them to do so (which may include management by the family).
Even if these payments had been counted as payments to the service user, it remains questionable whether they should have been counted as one-off direct payments as they did not provide access to a broader range of services than would have otherwise been available. Furthermore, it appeared that some other
authorities were involved in similar practice but did not define it as one-off direct payments. These discrepancies have implications for monitoring provision of one-off payments to carers.
Use of one-off
payments
Table 6.7 illustrates the range of purposes for which one-off payments were provided. Overall, they were most frequently given to purchase respite care, including holiday care, short breaks and support for a family holiday, as well as various forms of sitting service, such as night-sitting and a sleep-in service. Although it is likely that the majority of such payments were aimed at carers, one local authority reported payments for ‘alternative respite for a mental health service user and learning disabled service user’ and another indicated that one-off payments were being used for ‘monthly day trips’.
One-off payments for general equipment were also common. Although most local authorities did not specify the type of equipment for which payments were made, examples given included payments for domestic appliances, furniture or carpets, an allotment shed, a ‘light box’ and ‘a guitar to enable a service user to join a band’. In addition, four authorities reported one-off payments for communication equipment, such as a video phone or mobile phone, and five had made one-off payments for aids and adaptations, including the purchase or repair of mobility or hearing equipment, and a dog to assist a disabled person.
Table 6.7: Range of purposes for which one-off payments provided, by country
England Northern Ireland
Scotland Wales Total %
Respite 59 2 3 0 64 32
General equipment 34 0 0 0 34 17
Start-up and administrative costs 22 0 0 1 23 11
Leisure 16 1 1 0 18 9
Transport 13 0 0 0 13 6
Personal assistants/ support costs 9 1 1 0 11 5
Additional costs 7 1 0 2 10 5
Therapeutic 8 0 0 0 8 4
Childcare 3 1 2 0 6 3
Aids and adaptations 4 1 0 0 5 2
Education 5 0 0 0 5 2
Communication equipment 4 0 0 0 4 2
Employment 1 0 0 0 1 >1
Twenty-three authorities reported that they provided one-off payments for costs associated with setting up a direct payment, serving as an alternative to the mechanisms for funding set-up costs described in Section 7. Some of the specific purposes mentioned included payments for Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks, employer liability insurance, recruitment costs and annual expenses. One local authority indicated the payment of start-up costs equal to two weeks payment to ensure cash flow in the account and ‘payment for a training course for a PA working with a disabled child’. A further ten local authorities made payments for ‘additional costs’, for instance to cover ‘back-dated money due’, additional hours or bank holiday costs, a
temporary increase in hours or variation in a care package and to ‘cover a delay in ILF funding’. In addition, payments were reported for personal assistant or support costs, such as covering a PA’s maternity leave, paying for an outreach worker, supporting a client’s return home from hospital, paying for care outside of the authority and paying for palliative care management.
From their inception, direct payments had been envisaged as a means of
promoting independence and aiding social inclusion by offering opportunities for rehabilitation, education, leisure and employment (Department of Health 2003c). Of these, one-off payments were most frequently mentioned in relation to leisure activities (16). Examples cited included: gym membership, classes in pottery, flower arranging, painting and taekwondo and access to community services, including paying for an outreach worker to support a service user to attend salsa classes.
Few local authorities reported the provision of one-off direct payments to enable service users or carers to access education or employment, although several mentioned payment of college fees or assistance to attend an educational course. Only one authority had made a one-off payment to support a young disabled person to undertake work experience.
A small number of local authorities had made one-off payments for therapeutic purposes, for instance to purchase holistic and complementary therapies, such as aromatherapy, massage and relaxation. A very small number also provided such payments to assist with childcare, including play schemes, extra support during school holidays and emergency child support.
Lastly, seven local authorities made one-off payments for transport costs and another six reported one-off payments for driving lessons.
In general, there was little difference in the purposes for which local authorities provided one-off payments across administrative types (see Table 6.8).
Metropolitan districts reported slightly greater provision for respite care, and shire counties reported slightly greater provision for general equipment. Although based on limited data, the findings suggest that London boroughs used one-off payments more frequently as a mechanism for providing start-up and
administrative costs and less frequently for leisure, compared with other types of local authority. In contrast, shire counties and metropolitan districts indicated the use of one-off payments more frequently for transport.
Table 6.8: Range of purposes for which one-off payments provided, by local authority type Unitary authority London borough Shire county Metropolitan district Total Respite 13 14 12 20 59 General equipment 9 6 12 7 34
Start-up and administrative costs 4 9 3 6 22
Leisure 5 1 6 4 16
Personal assistants/ support costs 2 0 5 2 9
Transport 2 0 6 5 13
Additional costs 2 2 3 0 7
Therapeutic 1 2 1 4 8
Childcare 2 0 1 0 3
Aids and adaptations 1 1 1 1 4
Education 1 1 2 1 5
Communication equipment 2 0 2 0 4
Employment 0 0 0 1 1