The short answer
- The payment must be sufficientThe statutory guidance in England says a direct payment must be an amount sufficient to meet the needs the council has a duty or power to meet.
- Ask for a review before you pay extraYou, a family member or a carer can ask the council to review the care and support plan. Bring evidence of what carers near your relative charge.
- The council can say no if it can meet the need more cheaplyA direct payment does not mean there is no limit. If the council can arrange care that achieves the same outcomes for less, it may decline to raise the budget, though the guidance says the decision should rest on outcomes and value for money, not cost alone.
- Paying extra is up to your councilThe guidance recognises that a person or their family may pay extra for care of their choice that costs more than the council would pay. How that works with a direct payment is for your council, so ask in writing before you agree a rate.
This page describes the rules in England under the Care Act 2014 and its statutory guidance. It is general information, not advice about your relative's case. PrimeCarers is an introductory platform, not a care agency or a CQC-registered provider.
Direct payments explains how a direct payment works from the start: asking for one, what it buys and the paperwork. This page picks up one problem within it: the carer you want, or the carer your relative already knows, charges more than the council has allowed for.
Enough to meet needs
A direct payment must be enough to meet the needs in the plan
The amount of a direct payment is not a figure the council can set as low as it likes. It comes from the personal budget in the care and support plan, and the statutory guidance sets out what that budget has to do.
Sufficient
Statutory guidance 12.25
Based on local costs
Statutory guidance 11.25
Explained to you
Statutory guidance 11.24-11.25
Including the costs of the route
Statutory guidance 12.27
All of these come from the Care and support statutory guidance, which councils in England must follow when they carry out their duties under the Care Act 2014. Paragraph numbers are given so you can quote them in a letter.
Where a gap comes from
Why a direct payment can fall short of what a carer charges
A gap between the direct payment and a carer's rate does not always mean the council has got it wrong. It helps to work out which of these is happening before you write to them.
| What is happening | What it usually means | |
|---|---|---|
| The hourly rate is set below local rates | The council's rate is lower than carers near your relative charge | Evidence of local rates is the basis of a review request |
| The hours in the plan are too few | The plan allows fewer hours than your relative needs | This is a needs question, so ask for a review of the plan itself |
| Costs of the route are missing | Recruitment or employer costs are not in the budget | Guidance 12.27 says such costs must be included where it is appropriate to meet needs that way |
| You want more than the assessed needs | Extra hours or extra help beyond what the plan covers | The council does not have to fund this, and your council's rules decide whether you can add your own money |
| A particular carer costs more than others who could meet the same needs | You prefer one carer, and others nearby charge less | The council can weigh outcomes and value for money, and may decline to pay the higher rate |
The hourly rate is set below local rates
- What is happening
- The council's rate is lower than carers near your relative charge
- What it usually means
- Evidence of local rates is the basis of a review request
The hours in the plan are too few
- What is happening
- The plan allows fewer hours than your relative needs
- What it usually means
- This is a needs question, so ask for a review of the plan itself
Costs of the route are missing
- What is happening
- Recruitment or employer costs are not in the budget
- What it usually means
- Guidance 12.27 says such costs must be included where it is appropriate to meet needs that way
You want more than the assessed needs
- What is happening
- Extra hours or extra help beyond what the plan covers
- What it usually means
- The council does not have to fund this, and your council's rules decide whether you can add your own money
A particular carer costs more than others who could meet the same needs
- What is happening
- You prefer one carer, and others nearby charge less
- What it usually means
- The council can weigh outcomes and value for money, and may decline to pay the higher rate
Every council sets its own direct payment rates. The council pages linked below show what a number of councils publish.
On PrimeCarers, carers set their own rates and show them on their profiles, and hourly visits cost £18 to £25 an hour with our fee included. That is useful evidence in itself: a search near your relative's postcode shows what carers nearby charge before you speak to anyone. Direct payment rates by council lists what councils publish about their own rates.
Asking for a review
Ask the council to review the plan, and show them what care costs locally
The statutory guidance describes a requested review: one that the person, their carer, a family member, an advocate or another interested party asks for. That is the route when the money does not cover the care in the plan.
- 1
Read the care and support plan again
Before you writeCheck the needs it lists, the hours it allows, and the hourly rate the personal budget assumes. Ask for the cost assumptions if they are not in it; the guidance says they should be shared with the person. - 2
Gather what carers near your relative charge
Dated evidenceScreenshots of profiles or quotes from several carers or agencies, with dates, showing the rate for the hours in the plan. Note any carer who quoted the council rate and could not start. - 3
Write to the council and ask for a review
In writingSay that the direct payment is not sufficient to meet the assessed needs at local rates, quote paragraphs 11.25 and 12.25 of the statutory guidance, attach your evidence, and ask for the budget to be reviewed. - 4
Keep the care going while you wait
Do not leave a gapIf your relative needs care now, talk to the council about how the needs will be met in the meantime, rather than going without. - 5
Ask for the outcome in writing
With reasonsIf the council keeps the amount the same, ask it to explain how the needs can be met for that amount, and which providers it has in mind.
The care needs assessment explains how the council assesses needs, and what to do if the answer is no.
If the council says no
What you can do if the council will not raise the payment
The guidance says a request for a direct payment does not mean there is no limit on the personal budget. If the council can arrange care that achieves the same outcomes for less, it can decline to pay more, though the guidance says decisions should rest on outcomes and value for money, not on cost alone. You still have several options, and a right to complain.
Options after a refusal
0 of 5 ticked
Within the council's process
Within your own choices
Paying extra yourself
When paying extra yourself may be possible, and what to check first
Some families decide to pay the difference themselves so that their relative can keep a carer they know, or have more help than the plan covers. The statutory guidance (paragraph 11.14) recognises that a person, or someone on their behalf, may pay extra to secure the care of their choice where it costs more than the council would pay, and says that extra is not part of the personal budget. How it works alongside a direct payment is for your council to set, so ask them before you decide.
Before you agree to pay more than the direct payment
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Ask the council, in writing
Think about the long term
If your relative's own money pays the extra and you manage it for them, paying for care as an attorney explains the duties that come with that. Care home top-up fees covers the separate rules for paying extra towards a care home, which are written into the Care Act regulations in a way that home care top-ups are not.
Scotland, Wales, NI
If your relative lives in Scotland, Wales or Northern Ireland
The Care Act 2014 and its statutory guidance apply in England. The other nations of the UK have their own laws and their own guidance on self-directed support and direct payments, so the paragraph numbers above do not apply there.
| Where your relative lives | Where to start on our site | |
|---|---|---|
| Scotland | Self-directed support, with four options for how the budget is used | Care funding in Scotland |
| Wales | Direct payments under Welsh law and guidance | Care funding in Wales |
| Northern Ireland | Direct payments through the health and social care trusts | Care funding in Northern Ireland |
Scotland
- Where your relative lives
- Self-directed support, with four options for how the budget is used
- Where to start on our site
- Care funding in Scotland
Wales
- Where your relative lives
- Direct payments under Welsh law and guidance
- Where to start on our site
- Care funding in Wales
Northern Ireland
- Where your relative lives
- Direct payments through the health and social care trusts
- Where to start on our site
- Care funding in Northern Ireland
The same practical steps still help everywhere: read the plan, gather dated evidence of local rates, ask for a review in writing, and use the complaints route if needed.
Care funding in Scotland, care funding in Wales and care funding in Northern Ireland explain how each nation pays for care at home.
Questions
Questions families ask about direct payments that do not cover the carer
The statutory guidance in England (paragraph 11.14) recognises that a person, or someone on their behalf, may pay extra to get the care of their choice where it costs more than the council would pay, and that this extra is not part of the personal budget. How that works with a direct payment is set by your council, so ask its direct payments team in writing before you agree a rate with a carer. If the payment does not cover the assessed needs at local rates, ask for a review first.
In England the statutory guidance says a direct payment must be sufficient to meet assessed needs, and that local market costs should be considered when the budget is set. Gather dated evidence of what carers near your relative charge and ask the council in writing to review the budget. Direct payments explains the rest of the process.
Yes, in some cases. The guidance says a direct payment does not mean there is no limit, and a council can consider whether it could meet the same needs for less. It should explain its reasons and work with you on how the needs will be met.
The statutory guidance describes a requested review that the person, their carer, a family member, an advocate or another interested party can ask for, as well as planned reviews and reviews after a change such as a fall or a hospital stay.
Usually, yes. A direct payment can pay a self-employed carer as well as an agency or an employed personal assistant, on the council's conditions. Check with your council's direct payments team before you start, as rules differ.
That is your decision, but tell the council about the gap in writing first, and keep a record of what you pay. If the council later agrees the budget was not sufficient, your letter shows when you raised it.
Use the council's complaints procedure first. If that does not resolve it, the Local Government and Social Care Ombudsman can look at complaints about adult social care in England.