What is the difference between an Individual Service Fund and a Direct Payment?
Christopher Watson FRSA
Founder | Self Directed Futures | Chair | SDS Network England | Co-Chair | LDA Commissioners Network | Co-Founder | Gradually Fading Support Ltd | FRSA
In England, the approach to funding and organising personal care and support services for citizens with disabilities, as outlined in the Care Act, emphasises providing people with more choice and control via the use of Personal Budgets. The two primary mechanisms to deliver a personal budget are Direct Payments and Individual Service Funds (ISFs). Both options aim to empower citizens by enabling direct involvement in the day to day management of their care, but the two options do differ slightly in their administration and overall flexibility. Here’s a bit more of a detailed comparison:
Direct Payments - Definition and Purpose:
Direct Payments are sums of money paid directly to individuals by local authorities. They are intended for individuals assessed as needing help from social services under the Care Act/Mental Health Act, allowing them to purchase their care and support services directly.
Key Features:
Autonomy: Individuals have complete control over their funding to arrange and pay for their own care services.
Flexibility: Citizens can choose their service providers and how their care is delivered, offering the freedom to tailor services to specific goals and patterns of life.
Responsibility: Recipients manage the budget, pay provider invoices (if support provided via a care organisation) or the payroll for any persona assistant staff that they may employ, including fulfilling employer's legal responsibilities (maternity, sickness, redundancy etc).
Eligibility: Available to anyone with assessed needs under the Care Act 2014 or Mental Health Act 2007 who meets the criteria for managing their budget (or having a suitable person tp do so on their behalf) as set out in The Care and Support (Direct Payments) Regulations 2014
Benefits:
Empowers personal budget holders by giving people full personal choice and control over the care they receive and how it is delivered, encourages tailored care and support solutions that fit individual lifestyles and preferences.
Challenges:
Management burden: Direct Payment holders generally handle all of the main administrative tasks, such as hiring staff, managing budgets, and ensuring legal compliance (sometimes with support from a third party organisation - often called a managed account).
Financial oversight: Direct Payment holders need to account for their spending and any contributions towards the cost of their care, and manage their budgets effectively.
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Individual Service Funds (ISFs)- Definition and Purpose:
ISFs are a way of managing the funding for a person’s care where the control remains with the individual, but the money is held and managed on their behalf by a service provider (who is commissioned and contracted by the local authority).
Key Features:
Managed Funds: The care funds are held and managed by a service provider, but the individual directs how they are used (based on conversations around what matters to them).
Simplicity: Reduces the administrative burden on the individual, as the provider manages payments to staff, other providers and organisations and also covers the legal responsibilities of being an employer (where applicable).
Flexibility and Control: While the funds are managed by a provider, the individual still directs the type of care and how it is delivered (this is done alongside the provider who takes responsibility for any decisions around use of the budget).
Eligibility: Like Direct Payments, ISFs are available to those assessed by local authorities as needing support via an allocated personal budget.
Benefits:
Challenges:
Limited to local service providers who offer ISF arrangements, which might restrict choice when compared to Direct Payments.
Potential for less transparency in how funds are managed compared to directly managing the budget (although this can be offset by using third party holding account systems such as ISF Wallet). Decisions around the use of budget are made jointly with the ISF Service Provider and so are essentially more democratic, meaning the person doesn't have absolute control of use of their budget.
Conclusion
The choice between Direct Payments and Individual Service Funds depends largely on a persons preferences for control of their budget set alongside the local availability of ISF Service Providers. Direct Payments offer maximum control and customisation of care and support arrangements, suitable for those willing and able to manage their own affairs. In contrast, ISFs provide a more balanced approach where individuals can maintain control over their care and support decisions without as much of a burden around the financial management, which is ideal for those who prefer less direct involvement in administrative duties. Both options support the ethos of personalisation in social care, ensuring that support can be tailored to help people lead gloriously ordinary lives!.
Owner of Care and Health Law
10 个月I cannot leave this - even when on holiday - without saying that the fundamental difference is the contractual transparency or lack of it for an ISF set up. The council or ICB is getting free care planning from the person/proxy; the provider is getting free recruitment decision making support and often rota-ing from them too. The relative on the other hand is not the actual Principal that a true PHB or DP obliges them to be, for a person lacking in capacity to have a direct funding right, in their own name. The typical ISF should be called out for what it really is - outsourced and (free) care planning and delegated commissioning by a funder - whether that provider is commissioned or grant funded - but still a conventional arrangement for service provision where the decision maker on budgetary flexibility is still the funder and where the provider is not really working “on behalf of” the relative or the underlying person drawing on services at all - but is contracted to the funder in the normal way and accountable to it, not the person supposedly being given control at all. I do not gainsay the intent but simply decry the lack of contractual awareness for stakeholders about who is obliged to whom, and for what, in such deals
Lived Experience of Autism & Expert by Experience
10 个月Whist I am in support of different means of independence where is the Freedom Choice and Independence within Adult Social Care. Whilst an ISF maybe ideal for some out there it isn't adaptable for my needs. I think we have to not push an ISF down someone's throat without looking at other systems, in some areas it may simply not be offered and therefore a direct payment maybe the only solution. However the next best thing would be true full personalisation then we would have full Choice, Control and independence.
Lived Experience of Autism & Expert by Experience
11 个月I am fighting for service for Autism as well and oh the excuses and breaches of the Care Act it is disgraceful.
Lived Experience of Autism & Expert by Experience
11 个月Speaking as a recipient of a direct payment the whole system has got to change by bringing in full Personalisation meaning that allowing us to get on with it. Because I have to deal with an agency who makes excuses but I have the back up of a london borough. Having looked into an ISF it's no good for me.
CEO Croydon Mencap
11 个月The mechanism we settled on with a family is: they receive the direct payment (and had for years) and then paid the entire amount to us on a monthly basis. Thiis is held for them and we work together in the ways agreed in our partnership ageeement. It’s been a wonderful, meaningful albeit tough and confronting experience!