HIGHLIGHT

How are 'indirect payments' for people who lack capacity working?

Confusion remains over assessments and some aspects of best interests decision-making processes, according to findings from an SSCR-funded study carried out by the Mental Health Foundation.

The study aimed to explore how direct payments (DPs) are operating for people who lack capacity to consent (termed 'indirect payments') and are living with learning disabilities or dementia.

It found that - for the purposes of receiving indirect payments - identifying a suitable person to act on behalf of the person who lacked capacity to consent was usually done informally, often because they were a family member and already involved in managing their relative's services.

People in the study had chosen indirect payments for several reasons. A suitable person had often chosen an indirect payment to avoid inadequate alternative services and/or to ensure meaningful activity for the disabled person. 

There were differences in processes between people with learning disabilities and those living with dementia. The latter were often 'given' a plan which assumed minimum care needs and was not aspirational in nature. It was more common for people with learning disabilities to have some form of person-centred planning.

The study also found limited on-going support for suitable people, and lack of clarity among practitioners on the application of the Mental Capacity Act (2005). 
  
The study recommends more information, training and support to help suitable people become fully engaged in the whole DP process, as well as more support and training for practitioners. It also suggests some of the person-centred practices common among people with learning disabilities could be adopted for people with dementia.   
  
View the full summary findings