Section 3 - Review of direct payments

12. Review of Care and Support Plans

All Care and Support Plans will be subject to a minimum of an annual review to ensure they remain the most appropriate option for meeting the individual’s assessed needs, and to consider if their needs have changed and if a re-assessment is required.

Where needs and circumstances change the individual has the right to request a re-assessment of their needs for care and support. Further detail about re-assessment is included in the Code of Practice under Part 3 of the Act.

13. Assessments, Reviews and Reassessment

All assessments and reviews will be conducted in a timely manner in accordance with the Act, and should reflect the realities and needs of the individual. The focus will be on the person’s well-being outcomes and any barriers that there are to the person achieving them. The assessor will draw on the person’s strengths, assets, personal relationships and wider community networks and resources to explore all potential solutions.

It is important to ensure that the person’s needs are being met to an appropriate standard and that the person is happy with the arrangement currently in place. Such reviews will be jointly undertaken by a Social Worker to assess whether the Direct Payment is meeting eligible need, and a Direct Payments Officer to review how the Direct Payment is working and whether all documents have been completed.

The focus of reviews will be on:

• Whether the person’s needs/outcomes set in the original care and support plan are being met
• How they are managing Direct Payments
• Is the money being spent appropriately
• Are they receiving the appropriate level of support
• Have the care and support needs changed
• Are the concerns/risks identified in the risk assessment being managed

14. Review of Direct Payments

The Council will review the arrangements for the making of Direct Payments and how they are being used at intervals determined in line with the requirements of the Codes of Practice for reviewing care and support plans, issued under Section 145 of the Act, but in any event an initial review will be undertaken within 6 weeks of the first payment made then at least annually following the first review.

15. Financial Monitoring

The Council is accountable for the public money it manages, including Direct Payments funding. In addition to ensuring the person’s assessed eligible care and support needs are being met by Direct Payments, financial monitoring will be undertaken to assess the individual’s ability to manage the financial responsibility for purchasing services and to ensure there are sufficient funds to pay for employment related responsibilities (where applicable) or if funds are in excess of that needed to meet the agreed outcomes in the support plan.

As such, recipients (or Suitable Persons) of Direct Payments will be expected to keep accurate records to identify how the money is used to provide services to individuals.

In the event that fraud, abuse or misuse of the Direct Payment is suspected, the Council shall investigate and suspend/terminate the Direct Payment as appropriate. In such circumstances the Council will, wherever possible, try to resolve the issues with the individual. The Council will provide the care and support to meet eligible need in the interim or in the long-term if the Direct Payment has been terminated.

If a person misuses or fails to manage their Direct Payment properly, they may incur liabilities to others, or losses, which they do not have money to meet in their Direct Payments account. The Council is not responsible for any such losses or liabilities.

16. Seeking Repayment

The Council will assess whether it is appropriate to seek recovery on a case by case basis, based on the individual circumstances. Further information can be found in the Adult Services Debt Management and Recovery Policy.
In principle:

• The Council is likely to require full or partial repayment of Direct Payments if any condition attached to Direct Payments by the Council is unmet or the Council has reason to believe the payments have not been used to secure the care and support a recipient requires, and their personal outcomes have not been achieved.
• The Council may require repayment of any unspent Direct Payment if they are not required to meet needs as set out in the plan.
• The Council will require repayment of excess funds accumulated in the dedicated bank account where there is no reasonable explanation for the surplus. The Council may also seek to recover excess Direct Payment account balances following the course of the regular financial monitoring of the Direct Payments account. The powers available to the Council are intended to enable it to recover public money that has not been spent for the purpose for which it was intended or to recover money not spent at all. It is essential that before anyone receives a Direct Payment they understand completely the conditions that they will be required to meet.
• Direct Payments do not form part of an estate in the event that someone dies while receiving them. The funds at all times belong to the Council and remains public funds. In the event of the death of the Direct Payment recipient the Council will deal sensitively with the matter, and will contact the Suitable Person or executor of the deceased’s estate to support them through the process of closing the Direct Payment, i.e. meeting any outstanding payments such as wages, redundancy, submitting any final returns to Finance, etc.