How ‘light-touch’ direct payments can deliver for clients and taxpayers

A scheme that gives disabled people direct payments for home adaptations on the basis of self-assessment is delivering independence for service users and savings for the council concerned, says intensive support manager Bill Brittain.

Peter Sheehan, who paid for a ramp with a direct payment, and council cabinet member Linda

In April 2012 Barking and Dagenham council in London introduced a direct payment scheme, giving elderly and disabled people the money to install household adaptations such as showers and enhanced lighting. Applicants complete a simple three-page self-assessment form, available by post or online, and a means test. Eligibility is determined without a home visit – though a telephone call may be made to clarify certain points – and payment is made net of the client’s contribution.

If eligible, they are given almost absolute freedom as to the adaptation and the way that it is installed. The only stipulation is that the money must be used for the purpose specified and any electrical or gas works must be completed by a fully-trained fitter. Recipients are encouraged to get help from family and friends, including their actually undertaking installation works, if they are able to. They can also top up the funding to choose more extensive or costly options.

Grants of up to £4000 are available and a budget of £380,000 has been set aside for the 2012-13 financial year. As of the end of January 2013 grants have been paid to 103 local people, 61 of which were to install showers, and the council expects the budget to be fully committed for this year.

Response to complaints

The scheme is a response to complaints from local people about limited access to funding for adaptations, particularly for level-access showers. It is a preventive service providing early access to adaptations that enable people remain independent and to enjoy all of the facilities within their homes. By making cash payments to people we give them control over the process and we have also found it to be cost-effective because recipients make it happen. 

We are convinced that this initiative will help people to remain independent longer and prevent accidents such as falls. In the long-term this will save public money. Before we set the scheme up we consulted widely with older and disabled service users, the mosque and other community organisations, and council staff. Staff and service users were concerned about how we would ensure that the money is used properly. We had to be honest about the fact that handing over control to services users to meet their own needs does come with some inherent risks. Our experience of direct payments for care services, however, shows us that misuse of funds is very rare. 

Spot checks

However, we have also put in place a system of spot checks, covering about 10% of cases, and all recipients sign an agreement confirming that they will use the money for the purpose specified and understand that they could face prosecution and would have to pay the council back, if they do not. We ensure that grant applicants are offered the help that they need at every stage of the process. This is merely a new option that does not replace the options that were already available to older and disabled people, such as applying for a Disabled Facilities Grant.

Peter Sheehan was the first recipient of this scheme to have works completed; he had a wide door and ramp fitted so he could go outside in his wheelchair, to enjoy his garden.

‘Simple process’

“The scheme is very simple and straightforward and it’s a very fast process,” he said. “I can now access the garden independently and safely, and I’m very pleased with my new doors and ramp.”

Grants can be used for many types of adaptations including, stair lifts showers, enhanced lighting, loud door bells, door widening and fitting downstairs toilets. But the real unique element of this scheme is that the grant is paid to the recipient, who then have the freedom to arrange the works for themselves – in a way that suits them best.

For more information on the scheme email Bill Brittain, who is group manager for intensive support at Barking and Dagenham council in London.  

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