Hi all, I’m at the point where I need a carer. An hour a day would improve my life no end. I want to go down the Direct Payments route I think but the tax and national insurance element seems daunting. My question really is, how easy is it to employ a carer through this route? Please share your experiences. Thanks Jen xx

I might have been unlucky but I had carers to look after my girlfriend who had dementia. I have PPMS and found it less stressful getting rid of the so called carers and struggling on doing it myself. Can’t remember how we got the carers but I think it was something she qualified for.

Not sure what local authority you are in but some organisations specialise in it including payroll , choosing a PA etc. Any budget should accommodate start up and nsmaybe some maintenance costs etc eg pvg or insurances. First stop would be contact with SW for assessment and they should explain options and set your LA context

Hi Jen, I`m your Direct Payments/carers expert!!!

I`ve used this system for 9 years.

First you need a care assessment from Social Services. This will be done by a Social Worker. They will assess all your needs and come up with how many hours they think you need.

Then you have a financial assessment, to determine if you need or are able to make a contribution. I pay £40 a week towards the cost.

My authority does not allow us to use self employed carers. They used to but no more.

I found my own carers. The one Ive had longest (9 years), does 16 hours, plus 2 sleepovers...this allows my hard pressed hubby some me time and a good nights sleep. My budget is £12.24 per hour and the carer gets £9.07 per hour. The difference is used for holiday pay, sick pay, employer`s liability insurance and my Payroll fees.

I have a 2nd carer who does 11 hours a week.

The Payroll firm holds my budget and pays my carers, after taking tax and insurance and pension amounts.

All I have to do is sign their timesheets, email them to Payroll and the wages get paid into their bank accounts.

I keep a record for myself what hours, holidays and sick days they`ve had.

Payroll do their contracts.

It runs well about 99% of the time.

I have used care agencies who charge a lot more than £9.07 an hour and the council pay £16.74 an hour. If they charge more, I paid the difference. I dont like using agencies, as too many different carers came .

The things they do for me are;

getting me up, showered, dressed and put to bed later in the day

taking me out

checking I have taken my medication

shopping for me or with me

light housework and cooking.

If you would like any more info, please ask and I`ll try to help.

There is usually a long waiting list to get assessed.



Thank you, this is super helpful. My LA (East Devon) will only provide care if you hit 2 out of 5 of their scoring criteria. Unfortunately, having MS to the point where your legs don’t work after 8pm and you can’t manage your housework is not one of these parameters. Even though they know that my home is not suitable because it hasn’t got wheelchair access, and therefore I have to struggle around on my legs which have limited use, not to mention the amount of falls I have every day is not good enough to get a carer. I don’t quite know what to do at this point

@ tingley, really hope you get something sorted as it sounds like you need the help.

@ Boudica, excellent explanation, it does sound a bit daunting to arrange but I guess once everything is up and running a good carer is a godsend.

Maybe explain that the fluctuations affect how you’d score in any given day and in your worst days you cant do x or y. Housework won’t be seen as critical but otherwise daily supports might

Wife has just been turned down for carers because she’s something like 75p over the weekly £128 limit, she’s already drastically cut her working hours to care for me.

The amount of cares allowance, ( I think is £67 ) comes nowhere near covering the cost in loss of earnings to try and get within the £128 max allowance.

I’m waiting for my assessment now but I’m not hopeful. My other option is pay a housekeeper to come in every day, but I live on benefits and I don’t think I can afford it. Excuse my language here… [Edited] THE TORIES.

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A financial assessment will happen after a care assessment.

I pay £40 a week towards my care and I have no savings. We did fight it and got it reduced.


I am looking for advice on next steps for supporting someone with MS.
My sister in law has PPMS. This year has been hell for her and her husband as she has been in and out of hospital first with various bouts ofPneumonia and other illnesses.
Her husband is exhausted as the lion share of care falls to him.
I am desperate to help with out interfering. I know the loss of dignity is really important to her and she doesn’t want ‘carers’ but she is having frequent falls and struggling to get up in the morning.
I would love to hear your advice. Practical or emotional support that I can share with them.