Pre-payment cards or direct payments?

Hull City Council allows residents to use direct payments to monitor funding from adult social care. This is called a ‘personal budget’ and can be applied for by anyone aged over 18 who is eligible for social care support. If you think you need help from adult social care, you can contact Hull City Council on 01482 300 300.

East Riding of Yorkshire Council allows residents to use pre-paid cards to receive and manage their Cash Personal Budget. The card is run like a normal debit card and uses ‘allpay’ to ar- range payment for goods and services linked to care. If you are interested in the scheme, you can contact the Direct Payment Support Team at the Council on 0330 808 0102.

HOWEVER there has recently been some criticism of the pre-paid card payment systems.

Research, carried out via Freedom of Information (FOI) requests by the Independent Living Strategy Group (ILSG), a network of disability organisations and their allies, found almost half of local authorities in England used the cards. Instead of making direct payments into service users’ bank accounts, councils load up the cards with funds, are able to monitor them – at an individual transaction level – and in many cases choose to restrict their use.

Restrictions—what is wrong with pre-paid cards?

While nearly all councils using prepayment cards said they considered them direct payments, roughly a third prohibited service users from directly withdrawing cash, as they would be able to with a regular bank account. The vast majority of authorities placed some other kind of restriction on how funds were spent, though the re- search found considerable geographical variance, creating a postcode lottery. Councils frequently imposed blanket bans – including blocking cards at certain establishments – around things such as food, alcohol, and dating and escort services.

The report said:

“Most common was a stipulation that the funds must be used as described in the individual care and support plan and to meet assessed eligible needs.”

Guidance—what does this mean?

Under the Care Act 2014, all people receiving long-term care and support are required to have control of their personal budget – including having agency over how funds are held and used to meet their desired outcomes.

The statutory guidance on the Care Act says prepaid cards “can be a good option for some people using direct payments, but must not be used to constrain choice or be only available for use with a restricted list of providers”.

Next steps—what does this mean for Councils?

In a series of recommendations, the ILSG advised councils to offer payment cards only as one of a number of options, to avoid blanket restrictions on their use and, when considering individu- al restrictions, to evaluate whether they represent a deprivation of liberty. It also called for “open and transparent” policies around monitoring accounts, recommending that access be restricted to single named individuals.

Margaret Willcox, the president of the Association of Directors of Adult Social Services (ADASS), which the ILSG told Community Care had engaged positively around the report rec- ommendations, said she was “grateful” that prepayment card practice had been investigated.

“Managing the balance between our duty to protect the people we serve and resources we manage alongside the maximising of choice and control is ever challenging, but the report recommendations provide a good test for us,” she said.