CQC Quality Statements

Theme 1 – Working with People: Assessing needs

We statement

We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

What people expect

I have care and support that is coordinated, and everyone works well together and with me.

I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and goals.

1. Introduction

Direct payments are a key part of the personalisation agenda, which includes information and advice, prevention and early intervention, community capacity building, improved use of universal services, and personalising the formal support people need and providing person centred care.

The Mental Capacity Act 2005 (MCA) and personalisation hold the same underlying values. The MCA states that a person should make their own decisions, but where this is not possible because they lack capacity, they should be involved as much as possible in decisions which affect them.

The ethos of personalisation also underpins the Care Act; that care and support services work together and with the adult and their carers, to promote wellbeing and independence (see the chapters on Promoting Wellbeing and Preventing, Reducing or Delaying Needs).

Direct Payments are cash payments, made instead of directly receiving social care services, to people who have been assessed as needing such intervention. They can be made to disabled people aged 16 or over, to people with parental responsibility for disabled children, and to carers aged 16 or over for carer services.

A nominated person is anyone who agrees to manage a direct payment on behalf of the person with care needs. An authorised person is someone who agrees to manage a direct payment for a person who lacks capacity according to the Mental Capacity Act 2005.

2. Responsibilities of Nominated and Authorised Persons

The nominated or authorised person must be available and willing to manage the direct payments on the adult’s behalf. They can be:

  • a carer, relative or friend;
  • appointed by the Court of Protection;
  • appointed under a Lasting Power of Attorney, who has health, welfare or finance decision-making powers;
  • accountancy support only;
  • third party management.

2.1 Authorised person

The authorised person must conform to the requirements of the Mental Capacity Act 2005; that an act done, or decision made, for or on behalf of a person who lacks capacity must be done, or made, in his or her best interests. The eligible adult should be asked who they want to manage their direct payments.

The authorised person who receives the direct payments on behalf of the adult must:

  • act in the best interests of the adult;
  • make sure the adult has as much input as possible in decisions which affect them;
  • inform the relevant adult social care team as soon as possible if the adult becomes able to make their own decisions, as a result of regaining capacity.

3. Application Process

Anyone who wants to be considered as a nominated or authorised person should contact the local Adult Social Care service in the area in which the eligible adult is ordinarily resident (see Ordinary Residence chapter), to discuss their application.

For more information see Personal Bugets and Direct Payments (NHS).

4. Further Reading

4.1 Relevant chapters


Risk Assessment

Direct Payments

Was this helpful?
Thanks for your feedback!
Reading Confirmation
  • This form allows staff to confirm they have read chapters in this APPP. This can be useful for newly employed staff as part of their induction, supervision, CPD and for team discussions for example.

    When you complete and submit the form, the confirmation will be emailed to you at the address provided.

  • Hidden