How Durham direct payments support team encourages clients to spend their money creatively

Despite what many think, direct payments are not just there for the employment of personal assistants. In Durham, service users are encouraged to be more creative, reports Sarah Wellard

Curriculum vitae
Judith Chapman.
Job: Team manager, direct payments support team, Durham.
Qualifications: Certificate of Qualification in Social Work (CQSW).
Last job: Social worker, adult care, Sunderland.
First job: Adult fieldwork team manager, Sunderland.

For older and disabled people in rural areas, limited public transport can limit chances to socialise and cause an isolated existence.

Judith Chapman, manager of the Durham direct payments support team, is helping people use direct payments to get out more and enjoy life.”People tend to think direct payments are only about employing personal assistants,” she says. “But there’s so much potential to use the budgets creatively.”

Chapman gives the example of an elderly woman in the Durham Dales who was offered a place at a day centre. “All she wanted was to get to her macular degeneration group. She loved it and had been going for years. Now she is using her direct payments to pay for a cab to take her there.”

Another woman in her fifties who has had a series of strokes is using direct payments to take taxis to visit her sister and travel to community services such as the local swimming pool. She is also buying in help with practical tasks including correspondence.

“There’s a tendency to think in terms of services to do things for people,” Chapman says. “Sometimes a better way of meeting a person’s needs might be to, say, buy them a washing machine rather than get someone in to do their washing. It might be the best way to enhance someone’s independence – and it’s cost effective.”

When Chapman took the job just over two years ago, her aim was to integrate the payments into the work of the county’s health and social care teams. “The learning disability service had embraced direct payments and people were using them for short breaks and alternatives to day care as well as to employ personal assistants. But other services weren’t really using them. I wanted to move the payments into the heart of social care practice.”

Chapman finds that developing the skills and knowledge of care co-ordinators to promote direct payments with clients is key to increasing take-up. Her team runs training and briefing sessions for managers and front-line staff and have put a lot of effort into going out with care co-ordinators (both social workers and nurses) to help them think about using payments during initial assessments. “You have to give social workers the confidence to use direct payments,” she says. “I want people to see us as a resource. Staff and service users can ring us at any time.”

The team encourages health and social care staff to rethink their approach to assessment to focus on a person’s aspirations rather than their impairment. “For someone with a physical disability a traditional assessment focuses on their problem with walking. With direct payments, the question is about what the person wants to achieve. The priority for a disabled parent might be to take her daughter to school or go shopping to buy her a birthday present.”

Chapman also wants to raise awareness of the scheme among service users and their families and carers. She has secured funding to market direct payments to the public and to employ a peer support worker to develop links with people willing to act as mentors and volunteer supporters. The idea is that people can pass on their own experiences of, for example, managing the administration involved in employing a personal assistant. Another priority is to encourage providers to move away from offering standard packages of care and to become more flexible and person-centred in their approach.

Chapman says some providers are getting the message and one agency is providing disabled people with social opportunities including going to cricket matches or having a meal at the local pub. “The challenge for providers is clear. If people are happy with their services they will keep them. If they’re not they’ll go elsewhere.”

* Develop a plan for actively promoting direct payments with all stakeholders, including providers and prospective users as well as staff.
* Be a resource for care co-ordinators and encourage them to think about direct payments during initial assessments with clients.

* Think that professionals know best how to meet clients’ needs.
* Direct payments aren’t for everyone they work for only some kinds of people.
* Expect people to feel confident about using direct payments just because they are a great idea.

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