Direct Payments – Using support at home organisations

You may want to use your direct payment to pay a home care agency (sometimes known as a domiciliary care agency) to provide care in your own home. If you use an agency, the staff who work with you are normally employed directly by the agency, so you will not be their employer and therefore not responsible for managing them or paying their wages.

You will still have some choice and control over your care, as you will make arrangements directly with the agency and be able to say how, when and where your support is provided.

If  you are eligible for Continuing Health care (CHC) you will be offered a notional budget if you decide to use a home care agency. A notional budget means that your budget is held by CHC on your behalf and the CHC team will make payment directly to the service who is providing your care in line with your personal support plan.

Paying the agency

You must always ensure that you have fully discussed your arrangements with the agency and that you have a clear agreement and breakdown of all costs in writing. This will avoid any unexpected costs, such as additional charges for mileage and bank holidays, which you may not previously have agreed to pay. The agency will send you an invoice for the support they have provided, normally once every four weeks or monthly. You will the pay the invoice from your direct payment account.

Your direct payment amount will only include enough money for the care we think you need. If you want to buy more care than that, you will need to pay the additional cost using your own money. Most agencies will send you a single invoice for all of your care – the care that your direct payment funds, and any extra care that you fund. If the total cost of your care is being paid from the direct payment account, you must add your own money into the account to cover the cost of the extra care before making payment to the agency.

This is to make that the balance of your direct payment account is enough to pay for services to meet your assessed needs. Alternatively, the agency may invoice you separately for any extra support you have agreed to buy.

The cost of any extra care you pay for is in addition to any assessed client contribution you make towards the costs of your social care (continuing health care and mental health aftercare needs are met for free). Before agreeing to buy extra care, you should consider whether you can afford and keep up with the payments. We advise you to discuss any additional costs with your usual worker during your support planning.

You can only use your direct payment in the way that we have agreed with you. We must be satisfied that the way you plan to use your direct payment offers value for money.

Which agency to use?

All agencies providing personal care are required by law to be registered with the Care Quality Commission (CQC) and you can ask the agency to show you its CQC registration.

Your usual worker can also provide you with a list of registered care agencies that are used and approved by us, and all registered agencies are listed on the CQC website. If your direct payment is funded by continuing healthcare (CHC), you must check that the agency complies with any obligation that the organisation has to be registered as a member of a profession regulated by a professional body.

The CHC team will manage your notional budget on your behalf and make sure that appropriate checks are made.

Before you decide to buy a service from a particular agency, we recommend asking the agency the following questions:

  • About its registration with the Care Quality Commission (CQC)
  • How it manages its staff and how often someone will check you are happy with the service you receive
  • How it would deal with any complaint you may have with its service
  • To see a copy of their insurance and safeguarding policies
  • If all their staff have a current Disclosure and Barring Service (DBS) check
  • If any requirement for professional registration has been complied with
  • If they directly employ their staff and meet all their tax and national insurance payments
  • How it arranges for staff cover during holidays or periods of sickness and if someone will discuss this with you when staff cover is needed
  • What staff training is provided and the relevant qualifications and experience of staff
  • If it carries out a risk assessment for you and its staff
  • If you will be given copies of the hours the staff work, so you can pay the correct amount
  • How much it will cost you to use and pay for the service
  • How much notice you or they will need to give to end the contract

Please feel free to ask any other questions, to make sure you get the information you want before choosing an agency.

Remember you can always ask for help if you need it. If an agency tells you they cannot provide care for you and you are unable to find an alternative, please contact your usual worker or the Single Point of Access on 01472 256256 or for health direct payments contact the Continuing Healthcare Hub on 0300 330 2990.

Useful contact

Care Quality Commission – National Customer Services Centre 0300 061 6161 or CQC.

Page last updated: 06 Oct 2023