What are Direct Payments for care at home?

Direct Payments allow people who have been assessed as needing care to receive funding directly from their local council, giving them choice and control over how care at home is arranged.

Can Direct Payments be used for home care?

Yes. Direct Payments can be used to arrange visiting care, respite care or live-in care at home, including employing carers directly or working with independent providers.

Why are some care models excluded from Direct Payments?

In practice, some councils interpret funding rules narrowly, which can exclude introductory or self-employed carer models even when they meet assessed needs and deliver consistent care.

Are introductory care services allowed under Direct Payments?

Introductory care services are not prohibited by national guidance, but acceptance can vary by local authority. Transparency, clear invoicing and safeguarding are usually key requirements.

Is home care cheaper than using a care agency?

Home care arranged through alternative models can be more cost-effective than traditional agencies, particularly where carers are paid fairly and continuity reduces churn and escalation.

Where can families get help understanding Direct Payments?

Families can speak to their local council, advocacy services, or specialist home care advisers to understand how Direct Payments can be used to support care at home.

Direct Payments, Introductory Care & Fair Access: What Families Need to Know

Direct Payments are meant to give families choice and control over care at home — but many discover that not all care models are treated equally. This guide explains how Direct Payments work, why some families face barriers, and how to make funding support the care that actually works.

When families first encounter the adult social care system, many assume the options are fixed: a council-arranged care agency, a care home, or nothing at all.

In reality, Direct Payments were created to offer something very different - choice, flexibility and control over how care at home is arranged. Yet across England, families using Direct Payments increasingly discover that not all home care models are treated equally, even when they deliver strong outcomes, continuity and fairer pay for carers.

This creates confusion and unnecessary barriers, at exactly the moment families are trying to make the right decision.

What are Direct Payments meant to do?

Direct Payments allow people who have been assessed as needing care to receive funding directly, rather than having care arranged on their behalf by the local authority.

The purpose is clear:

To give people choice over who provides their home care
To support personalised care at home, not one-size-fits-all services
To enable flexible support shaped around routines, dignity and wellbeing

In practice, Direct Payments can be used to:

Employ carers directly
Work with independent providers
Arrange visiting care, respite care or live-in care at home

👉 You can read more in our guide: Direct Payments & Funding Care at Home

The reality families are facing

Despite the intention behind Direct Payments, many families find that introductory care models and self-employed carers are treated differently to traditional care agencies, even when:

The care meets assessed needs
The person receiving care is happy and stable
Carers are paid significantly more than agency rates
The overall cost is often lower than agency provision

This creates a paradox.

Families may be supported to use care agencies that:

Charge £30–£35+ per hour
Pay carers close to minimum wage
Rely on rotating staff and short visits

Yet face restrictions when choosing models that:

Offer consistent, one-to-one care
Pay carers fairly and transparently
Reduce churn, missed visits and escalation

From a family perspective, this feels inconsistent and hard to justify.

Why this matters for people arranging care at home

Most families using Direct Payments are not trying to bypass the system. They are trying to make care work in real life.

Like you, they are asking:

How do I know when my parent needs care at home?
Can we start with just a few hours of help?
Is live-in care an alternative to a care home?

Introductory care models exist because, from speaking to hundreds of familes ourselves, we know many families want:

Continuity rather than constant change
A familiar face, not a rota
Clear pricing and genuine choice

When these options are excluded in practice, families can be pushed towards care that is less personalised, more expensive and harder to sustain.

Transparency matters.

Councils are right to require:

Clear invoicing
Safeguarding and accountability
Proper use of public funding

But transparency should not mean excluding entire care models.

Introductory home care services typically provide:

Carer vetting and DBS checks
Ongoing coordination and support
Backup planning when needs change
Administration families would otherwise manage alone

These services often reduce pressure on councils, hospitals and discharge teams, particularly when care is stable and preventative.

The wider funding context

This issue sits within a broader challenge facing home care in the UK.

Across the sector, there is growing recognition that:

The true cost of good home care has risen
Funding structures have not kept pace
Providers of all types are operating under pressure

Recent industry analysis highlights that while better pay for carers is essential, funding mechanisms often fail to reflect the full operational reality of delivering safe, consistent care - including recruitment, continuity planning and crisis cover.

👉 Further reading: Home Care Insight – Care at Home Pay Progress

For families using Direct Payments, this gap often surfaces as confusion about what can and cannot be funded, even when the care arrangement itself is working well.

A better conversation for 2026

As demand for home care continues to grow, and more families seek alternatives to traditional agencies, Direct Payments must keep pace with real-world care needs. They were designed to empower people, not limit them to one delivery model.

The question for the next phase of social care is not whether families should have choice, but how the system can support fair access to care that is consistent, sustainable and that best fits their needs. This conversation matters for families, carers and local authorities alike.
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👉 You can read more about introductory agencies in our guides to better understand how Gladys can support you and what "Intro Agency" status means for you and your family.
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Danielle Chatterton

Feb 18, 2026

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6 min read