Hampshire County Council
Best Value Review Panel (Social Services)
19th December 2000
Outcome Report of The Receivership Unit Best Value Review
Report of the Director of Social Services
Appendix 2 of this report is not for Publication by Virtue of
Paragraphs 7 and 8, Part I of Schedule 12A Local Government Act 1972
Contact: Project Leader: Graham Collingridge Tel: 01962
847277
Project Manager: Janet Packman Tel: 01962
846257
1 SUMMARY
1.1 The Receivership Unit enables the Social Services Department
to manage a person's financial affairs when the Court of
Protection gives the Director of Social Services powers to act
as a Receiver for people with mental disorder. The powers are
exercisable when the Court is satisfied that "a person is
incapable, by reason of mental disorder, of managing and
administering his property and affairs". Mental disorder has
a wide definition that can include people with a learning
disability and people with a head injury. There is no
statutory duty for the Social Services Department to act as
Receiver but a majority of local authorities consider it
essential to carry out this role in a limited number of cases.
It is a service of last resort, when no other suitable person
can be found to undertake the role.
1.2 The Receivership Unit:
i) Acts as Receiver and ensures all client affairs are in
good order
ii) Advises area based staff
iii) Delivers training (related to ii)
iv) Ensures all clients are visited periodically
The Receivership Unit in Hampshire is located at Social
Services Headquarters. The Receivership Unit Manager reports
to the Commissioning Manager (Mental Health).
1.3 The unit currently carries about 300 cases. The ratio of
cases per full time receivership officers is 92, although the
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2001/02/07
recommended caseload from a review by Professional Services in
1995 was 50.
1.4 The 2000/01 budget for the Unit was £105 400. It receives
income from Portsmouth and Southampton Cities, and statutory
contributions from patients' accounts. The Receivership Unit
manages approximately £8 million patient funds.
1.5 The key objectives for the Best Value review of the
Receivership Unit were:
i) To analyse the key roles of the receivership unit.
ii) To identify the most appropriate management and
reporting arrangements.
iii) To review the financial and reporting systems.
iv) To review the cost-effectiveness of the provision of
services to the Cities.
v) To review the operation of the electronic banking
system.
vi) To develop standards and key performance indicators for
the Unit.
vii) To compare the Units performance with that of other
agencies.
viii) To consult with stakeholders to identify how
improvements to the service can be achieved.
1.6 The Four Cs
1.6.1 Compare
The key findings were:
* Hampshire's Unit is highly regarded by other authorities
and the Public Trust Office.
* The statutory fee received by the Receivership Unit
(£205 p.a.) is twelve percent of the statutory fee
received by the Public Trust Office when it carries out
the function (£1750 p.a.).
* Virtually all authorities surveyed provided a service in
some form.
* There is no preferred model for delivering a
receivership service.
* Many authorities combine the functions of receiver and
appointee in the same administrative unit.
* Hampshire's Unit has high caseload to staff ratio
(highest of those responding).
1.6.2 Consult
Consultation was undertaken mainly by questionnaire, although
service users were visited and a visit was made to a carers
group. There is a high level of satisfaction with the service
from both users and professionals. Receivership Unit staff
shared the view that they provided an effective and valued
service, but were more critical than others, particularly of
the poor systems and high workloads.
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1.6.3 Challenge
There was a unanimous view that the local authority should
continue to provide the service as a last resort. This would
include situations where there is no other suitable relative,
or where there are concerns about financial abuse or
exploitation. Neither the private or voluntary sector saw
themselves as an alternative provider, although both saw a
role for themselves in providing information about mental
incapacity and assisting in some circumstances. Other issues
from the challenge group were:
* Concern about the increasing demand for appointeeship
and the lack of capacity in the Department to meet this
need in appropriate circumstances.
* Demand for more visits from Receivership Unit staff to
area offices for advice and training events which could
increase the quality of service and reduce unnecessary
referrals.
* Low relative staffing levels in Hampshire.
* There is an opportunity for the Receivership Unit to
increase its business from other authorities.
* A need to improve publicity.
1.6.4 Compete
In addition to the views from the Challenge Group there has
been consideration about the most appropriate management
arrangements and whether the Unit should become a free
standing business unit. The review has concluded that
consideration of this needs to await the establishment of
business processes to deliver key management information and
enable a baseline assessment of performance. The unit also
needs a greater input from managers with appropriate financial
skills to ensure accountability.
1.7 Other considerations in Best Value
The Receivership Unit makes a contribution to promoting
community safety through its role in protection and crime
reduction. It also make a contribution to all five components
of the County Council's corporate objectives. There is
considerable scope for improving the quality and efficiency of
the service through the greater use of information technology.
1.8 Recommendations
The review has made eight recommendations:
1. To retain the current management arrangements for the
time being except for the introduction of additional
financial oversight. Management arrangements should
then be examined with a view to the Receivership Unit
becoming a business unit.
2. A range of measures to improve the financial and
management information reporting systems.
3. Establish the cost effectiveness of provision to the
Cities through the accurate time recording of work.
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2001/02/07
4. Continue to develop the Unit's business through renewal
of the contracts with the Cities, and at a later date to
explore other opportunities.
5. A range of key performance indicators has been proposed.
6. Measures to improve the publicity of the unit using
leaflets and information in electronic form.
7. The County Council should review its policy on
Appointeeship.
8. Management of Human and Capital Resources would be
improved through the implementation of staff performance
reviews, one additional receivership officer, and
additional office accommodation.
2 THE SERVICE UNDER REVIEW
2.1 The Receivership Unit enables the Social Services Department
to carry out its duties when the Court of Protection appoints
the Director of Social Services as a Receiver for people with
mental disorder. In most cases a Receiver is related to a
patient, but in certain cases the Court of Protection may
consider it to be in the patient's best interests for another
person to be appointed and this may include the Director of
Social Services. There is no statutory duty for the Social
Services Department to act as Receiver but a majority of local
authorities consider it essential to carry out this role in a
limited number of cases. The advantage of this is that there
is a charge payable for the service. Not doing it might
otherwise leave a highly vulnerable group without protection,
or the function could fall to care managers. This would be a
hidden cost to the Department, and if carried out without due
legal authority could place the Department at some risk.
2.2 The duties and powers of a Receiver are derived from Part VII
(Section 93 to 113) of the Mental Health Act 1983 and are
granted to a Receiver by the Court of Protection. The powers
are exercisable when the Court is satisfied, after considering
medical evidence, that "a person is incapable, by reason of
mental disorder, of managing and administering his property
and affairs". This is a broad definition that could cover
people with a learning disability, mental health problems or
mental impairment due to head injury, those who have suffered
a stroke, and older people who are no longer able to manage
their affairs.
2.3 The Receivership Unit in Hampshire is located at Social
Services Headquarters in Trafalgar House in Winchester. The
Receivership Unit Manager reports to the Mental Health
Commissioning Manager. The role of the Receivership Unit is
to:
4
i) Act as Receiver and ensure all client affairs are in good
order.
ii) Advise area based staff on the best means of managing
the affairs of someone with mental incapacity
(Receivership, Enduring Power of Attorney,
Appointeeship).
iii) Undertake training (related to ii).
iv) Maximise client input wherever possible and ensure all
clients are visited.
The Unit has a contract with Portsmouth and Southampton Cities
to provide a service on their behalf, and also receives income
from the Public Trust Office for administering patient's
affairs.
The Receivership Unit is staffed by:
* Receivership Manager (full-time)
* Receivership Officers (2.25 whole time equivalent)
* Administrative Support (1.7 whole time equivalent)
2.4 Activity Data
1.3.1 Referrals to the Receivership Unit
Note:
The distribution of cases between client groups is
approximately 70% older people; 20% learning disability; 10%
adults with a mental illness
Comment:
i) There is a trend suggesting an increase in the number of
referrals.
ii) There is a trend indicating an increase in the number of
new Receivership Orders.
iii) The percentage of referrals or new Receivership orders
per local authority area is an indicator of the relative
amount of resource used and has implications for
charging for the service.
iv) A lower percentage of the referrals that result in
receivership orders could either be an indication of
inappropriate referrals, or of successful diversion and
cannot on its own indicate efficiency. The impression
of Receivership officers is that Portsmouth referrals
have a higher incidence of no known relatives, often
have houses to sell and no liquid capital in comparison
with Southampton or Hampshire.
v) The ratio of cases/wte Receivership officer is 92
(actual no. of cases as at 27 November 2000 was 292).
The recommended caseload from a previous review by
Professional Services was 50.
2.4.2 Budget
The Receivership Unit has a budget of £105,400 for 2000-01.
It received income from statutory client contributions and
from contracts with Portsmouth and Southampton City Councils.
Details are not for publication by virtue of Paragraphs 7 and
8, Part I of Schedule 12A Local Government Act 1972. They are
contained in a confidential Appendix 2.
2.4.3 It is estimated that the Receivership Unit manages
approximately £8 million patient funds.
1.4 Appointeeship
Although Appointeeship is outside the scope of the review it
is important to acknowledge the Department's role as this was
raised as a key concern by many of those consulted. The role
of an Appointee is to manage the various Social Security
Benefits received by clients who, through mental incapacity
are unable to manage their financial affairs. The Benefits
Agency will seek to appoint a person to act as an Appointee.
This person will usually be a relative or other interested
person but can include the Director of Social Services. As
with receivership there is no statutory duty to undertake this
role. In some local authorities the Receivership Unit
undertakes the role of Appointee. In Hampshire the Area
Finance Teams undertake the role within the seven area offices
of the social services department.
1.5 County Treasurer's Review of Appointeeship
Increasingly the Social Services Department is being asked to
undertake the role of Appointeeship. The demand is likely to
increase further now that the threshold for eligibility for
Receivership has been increased by the Public Trust Office,
increasing the need for appointeeship. The County Treasurer
reviewed this function in 1999. Three options were identified
for the Department:
i) Refuse to act as Appointee, insisting that an
alternative is found.
ii) Continue with the existing arrangement.
iii) Centralise the process thereby removing the
responsibility from area offices.
The Department decided to continue with the existing
arrangements. Refusing to act would place too many vulnerable
people at risk, and centralising the service had resource
implications (and may not be practicable for what is
essentially a local service). The current Best Value review
suggests that this position needs to be reviewed in the light
of likely increased demand and the limited capacity of areas
to meet this within available resources.
3 THE REVIEW PROCESS
3.1.1 The key objectives for the review of the Receivership Unit
were:
i) To analyse the key roles of the receivership unit in
relation to managing client's affairs and the
relationship with other roles e.g. appointeeships.
ii) To identify the most appropriate management and
reporting arrangements for the Unit in the light of the
nature of the work undertaken.
iii) To review the financial and reporting systems currently
in operation and make recommendations to ensure
effective and efficient business processes.
iv) To review the cost-effectiveness of the provision of
services to the Cities.
v) To undertake a brief post-implementation review of the
operation of the electronic banking system.
vi) To develop standards and key performance indicators for
the Unit.
vii) To evaluate the effectiveness of the Receivership Unit
by comparing with the delivery of this role and function
with other agencies.
viii) To consult with stakeholders to identify how
improvements to the service can be achieved.
2.1.2 Objectives (i-vi) were being addressed by Professional
Consultancy from the County Treasurer's Department, and would
be developed by the Best Value Review. Objectives 7 and 8
were the additional components of comparison and consultation,
which was the focus of the Best Value Team.
3.1.3 The Review team included a service user from the National
Schizophrenia Fellowship and a representative from the Public
Trust Office.
3.2 The County Treasurers Review
This was completed in May 2000 and the detailed findings are
contained in a separate report. They are summarised below.
3.2.1 Key roles of the Receivership unit
The key roles are: acting as receiver (obtaining orders),
administration of patients' affairs, advisory, and training.
The key findings were that the unit works most closely with
care managers. The current level of input from corporate
finance functions is small given the level of funds for which
the unit is responsible. The implications for the management
of the unit and consideration of business unit status are
dealt with in Section 3.7.1.
3.2.2 Financial and Reporting Systems
The current systems are inadequate but can be improved. This
would involve the provision of four new PCs which link to
IT2000 and Microsoft Office. This would give the office
access to software packages that would provide an adequate
framework for effective monitoring and reporting. At the date
of this report the construction of a new database is virtually
complete, to be ready for operation from January 2001.
2.1.3 Cost effectiveness of provision to the Cities
An accurate judgement of this requires accurate and
comprehensive records of activity and service provided to the
Cities: these are not currently being maintained. The unit
needs to record time spent so that an accurate cost of
providing the service can be obtained. Following this
report, a normal time recording system has been instituted and
should become an electronic system in 2001.
3.2.4 Post implementation review of electronic banking
The Royline System with the Royal Bank of Scotland was
introduced in November 1998. There are no significant
problems with the operation of the system. However staff have
continued to record transactions in a manual ledger resulting
in a duplication of effort, and the absence of performance
indicators and management information prevents comparisons
between the electronic banking and previous manual systems.
(The manual ledger was discontinued in May 2000).
3.2.5 Feasibility of producing key performance indicators
This work continues: a number of possible indicators are
proposed in the action plan. The collection of the information
and the setting of targets needs to be related to the
implementation of the new management information systems and
to other findings from the Best Value Review.
2.1.4 The Four Cs
The review of the Receivership Unit was undertaken within the
context of the Best Value Four C's - Compare; Consult;
Challenge; Compete. It used the EFQM model to evaluate the
findings of the review.
3.4 Compare
3.4.1 Local Authority Questionnaire
A questionnaire was sent to a number of local authorities of a
similar size to Hampshire to ascertain how they provided their
Receivership service. Some smaller authorities were also
contacted to see if there was any difference in provision.
Authorities were asked about management arrangements, staffing
levels, local performance indicators, whether there was a
service specification, if the service had been reviewed and
when it was subject to a best value review. There was a good
response to the request: 20 questionnaires were sent out and
13 were returned. The results are found in Appendix 1.
3.4.2 The main conclusions from the comparison are:
i) The Receivership Unit receives a fee of £205 per year
for each receivership case plus a nominal amount for
work done prior to the making of an order. This fee
applies from September 2000 (there was a banding system
related to the amount of a patient's capital prior to
this). This is in comparison with the Public Trust
Office (PTO) whose fees are £1750 per annum for the
client when they undertake the Receivership function
themselves i.e. the fee the Receivership Unit is allowed
to receive is twelve percent of that of the PTO.
ii) There is no uniformly preferred model for managing
Receiverships. A wide variety of arrangements making
direct comparison difficult, but they include the
following:
* Most authorities consider it essential to undertake
the Receivership role. Only one of those replying
didn't carry out the function, and one authority used
a private firm of solicitors.
* The function is normally carried out by admin/finance
teams.
* Some authorities have a specialist Receivership Unit.
* Many authorities combine operational arrangements for
Appointeeship and Receivership.
* Some authorities gave an area based response (which
may include the appointeeship function), others
provide a centrally managed service.
iii) There are no recognised performance indicators for the
service.
iv) Hampshire staff carry a high caseload (92 per whole time
equivalent), with a range of 3 to 80 amongst comparator
authorities.
v) Only one authority had a service specification.
vi) Only one authority was undertaking a best value review
of Receiverships specifically, and another authority is
preparing to undertake a review in the near future.
vii) Hampshire, Portsmouth and Southampton appear to have the
highest cases per 100 000 population of all authorities
surveyed. Hampshire's rate is at the upper end of the
range of comparator authorities (excluding the Cities),
at 21.45. The rates for both Cities are particularly
high (Portsmouth 43.5; Southampton 31.4). An element of
caution must accompany these figures whose accuracy has
not been verified. As far as can be ascertained there
is no standardised comparative data available
nationally.
3.4.3 Conclusion
This comparison exercise has identified the variety of
arrangements and it is not possible to make objective
comparisons using quantitative data. The current review has
generated considerable interest and has encouraged closer
liaison between Hampshire and other authorities - notably the
City and County of Swansea, Wiltshire County Council and
Reading Borough Council, the latter two sending
representatives to the Challenge Day. It would appear that
Hampshire's Receivership Unit is regarded as a leader in its
field from which other authorities wish to learn. This view
is supported by the invitation from the Lord Chancellor's
Department for Hampshire to participate in the current
national review of the Public Trust Office.
3.5 Consultation
3.5.1 Consultation was undertaken with a range of users and
stakeholders via interview and questionnaires. The
questionnaires used for all groups other than the clients were
based on the EFQM Excellence Model. The main conclusion from
the exercise is that there is a high level of satisfaction
with the service from both users and professionals, who find
the service to be efficient and the staff knowledgeable and
helpful. Receivership Unit staff shared the view that they
provided an effective and valued service; they feel supported
by their manager and have good partnership arrangements with
most of their customers. The summary of responses below
describes a number of minor service improvements. Receivership
Unit staff's criticisms focused on poor systems and
difficulties managing demand.
3.5.2 Clients
A representative of the National Schizophrenia Fellowship
undertook a survey of twelve people in receipt of the
Receivership service. The sample had to be small given the
need for a personal and therefore time consuming interview.
It had been intended that a questionnaire would be completed
in discussion with the client but this proved impossible. The
interviewer found that the best method of conducting the
interview was a general discussion about the client's affairs,
wishes etc. with the client accompanied by someone they knew
well and how the Receivership Unit dealt with these.
The survey found a high degree of client satisfaction with the
service provided by the receivership service from all those
surveyed. Minor criticisms included a desire for more regular
financial statements, that the financial float held by the
residential home was too low, and one delay in receiving
payment a few years ago when the Receiver was on sick leave.
2.4.3 Carers
The
Receivership Unit Manager visited an Altzheimers Society
Group, run for carers, to consult on the work of the
Receivership Unit. The main findings were:
i) The group was concerned about the lack of a similar
service in neighbouring local authorities.
ii) Most carers were unaware of the work of the Receivership
Unit.
iii) Carers needed a range of advice and information about
the work of:
- the Public Trust Office
- acting as a receiver
- other social services issues, e.g. charging for
residential care
3.5.4 Other Departments within Hampshire County Council
Views were sought from the Chief Executives Department - Legal
Section; County Treasurer's Department - Pensions, Assessments
Section; Business, Property & Regulatory Services - Estates
Section.
On the whole the responses were positive, and indicated that:
* A speedy service was received from the Receivership Unit
* Although there were some difficulties raised by the
Assessment Section of the County Treasurer's department
around processes, a meeting was subsequently held and
these issues clarified and resolved
* A brief guide to the Unit's work was suggested by the
Pensions Payroll Manager and this was also identified as
a need within the Challenge Group meeting
* Estates Practice identified a wish for properties to be
emptied before they are valued and for the approval of
the Court to be obtained to the sale in advance
* Estates Practice also requested that if feasible the
authority should use only one or two firms of solicitors
who could become familiar with the processes of the Court
and the need to keep Estates Practice fully informed of
progress.
3.5.5 Public Trust Office
The Public Trust Office spoke in positive terms regarding the
services received, the obvious interest and concern for
clients' welfare, and have indicated that they regard the
service as efficient and effective.
3.5.6 Health Personnel
Questionnaires were sent to Community Psychiatric Nurses, but
no responses were received. Although questionnaires were not
sent to General Practitioners or Consultant Psychiatrists it
is known that both these groups are not happy with the length
of time they have to wait for their fees to be paid. It is
intended that feedback forms will be sent out annually to
Consultants and General Practitioners to gain their views of
the service provided by the Receivership Unit.
3.5.7 Social Services Staff
Questionnaires were completed by members of social services
staff that included team managers, care managers, members of
the Best Value Steering Group, and the staff of the
Receivership Unit. 17 questionnaires were sent out and 11
people responded. Responses from care managers reported a
high level of satisfaction as follows:
* The staff with whom I have dealings are highly motivated
and effective
* Most of my clients who are customers of the unit have
varying degrees of dementia and there is often a
noticeable stabilisation of their condition when the
stress of financial management is removed from them.
Most comments from relatives are favourable.
* The unit is providing a service for vulnerable people
where no one else is prepared to do so. It fulfils a very
real need for a small group of vulnerable members of
society.
* Consistency of quality of service. Appreciated by those
who use it.
* There could be more general cascading of information
perhaps with an information sheet as updates tend to be
dependent on contact with the unit
* Client/family feedback is very important and the use of
"approval questionnaires" might be considered.
* Local surgeries would be helpful.
* In all cases I have received excellent and speedy support
from the unit. They have proved both sensitive and
adaptable to individual client needs. If a member of
staff within the unit is off sick or not available there
has always been someone else who will fill the gap and
provide the service. I have no complaints at all and feel
the unit is to be congratulated on its' work.
3.5.8 Receivership Unit Staff completed a separate questionnaire and
were generally positive about their work, which they believed
to be of good quality, valuable and rewarding. They felt they
were well supported by their manager and had good partnerships
with most of their customers. Their main concerns were:
* Inadequate systems, particularly IT.
* Lack of documented procedures.
* Too many demands to meet needs within current resources.
* Lack of resources is a consistent issue but exacerbated
during the period of the review because of long term
sickness of one member of staff, consequent use of
agency staff, and additional pressures brought about by
the time required to introduce new systems.
* The manager of the unit cannot attend adequately to
management tasks because he carries a caseload of up to
80 people.
3.5.9 Legal Profession
Several solicitors' offices were invited to the Challenge
Group. Two attended and responded in a feedback questionnaire
as follows:
* The unit communicates well with its partners and
customers.
* External customers receive the support they require.
* The unit is providing a service for vulnerable people
where no one else is prepared to do so. It fulfils a very
real need for a small group of vulnerable members of
society.
* The unit seems to work very much with team spirit and the
members appear to keep each other well informed and
motivated - especially under the high workloads with which
they consistently deal.
* The unit is keen to improve services where appropriate and
accept input from outside bodies.
* The Receivership Unit does not take its role lightly-
when I went on an Alzheimer's course in London earlier
this year, I was pleased to know that we have such a good
RU locally, having heard all sorts of stories about other
local authorities. The RU does take responsibility to act
in cases where it is needed.
3.6 Challenge
3.6.1 A half-day workshop was held on 25th August, for key
stakeholders from voluntary organisations, the legal
profession, banking, health, and managers of residential
units, other local authorities and elected Member
representation.
The main issues emerging from the challenge group included:
* The view that the local authority should continue to
provide the service. The service provides protection
for a range of highly vulnerable people at risk from
their own actions or the exploitation and financial
abuse from others. It also enables people to remain in
the community who would otherwise be living in a more
contained environment. Not providing the service would
reduce people's independence and could result in
additional costs in providing higher levels of care and
additional demands on other parts of the service e.g.
care managers and social services finance managers
* Concern about the increasing demand for appointeeship
and the lack of capacity in the Department to meet this
need in appropriate circumstances.
* More visits from Receivership Unit staff to area office
to provide advice and training could increase the
quality of service and reduce unnecessary referrals.
* Relative staffing levels are low in Hampshire's
Receivership Unit
* More publicity is needed in a range of venues about
planning for and managing the financial implications of
mental incapacity.
* There is a business opportunity for the Receivership
Unit to increase its business from other authorities.
3.6.2 Further details on these points are given below. The
Challenge Group considered two questions and the main issues
emerging from each question included:
i) Why provide the Receivership service the way that we do?
* The advantage of the local authority providing the
service:
- a single point of contact
- a whole package of care (including financial
protection) for clients with mental incapacity
- client can relate to one agency instead of, for
example, having to contact Benefits Agency,
Pension, legal profession etc.
- undertake the role in the client's best interest
(not for profit)
- consider most cost effective way of managing a
client's money
* The Social Services Department undertakes the role of
Appointee in a limited number of cases, this managed
within each of the seven area offices by the Area
Finance Manager. If the Department were to increase
this service, additional resources will be required.
It is unlikely that the Benefits Agency would
nominate a residential home manager as an appointee,
as they feel this would result in a conflict of
interest.
* Need for greater understanding by care managers of
financial issues. Potential for care managers to
develop a "seamless service".
ii) How might the service be provided in the future?
* Voluntary agencies that attended the challenge group
felt they were, on the whole, not resourced to
undertake the receivership role, and where they had
tried, had had to hand it back to the local
authority.
* It was acknowledged that care managers need ongoing
training about the receivership process.
* Local surgeries held in Social Services area offices
would be beneficial to staff, voluntary agencies, and
carers/potential clients. At present, resources
preclude this happening on a regular basis, but when
it has happened has been welcomed by those attending.
* A Help-line would be useful, and may prevent the
staff of the Receivership Unit having to answer
general questions about receivership, processes etc.
This would leave them free to concentrate on caseload
issues. At present lack of resources prevents the
setting up of a Helpline.
* It may be possible to use the services of CAB more:
this could be investigated.
* The receivership unit needs to raise its profile both
internally and externally. An information leaflet
will be produced, which the Royal Bank of Scotland
has agreed to fund.
* Economy of scale: the receivership unit could serve
other bordering Counties (a service is already
provided to the two unitary authorities).
* The full implications of the reform of the Public
Trust Office are not clear yet, but it is anticipated
that more cases will need to be dealt with by the
receivership unit, and there is expected to be
greater demand for local authorities to act as an
appointee.
* The Receivership Unit should continue to provide the
existing service.
3.6.3 The information received from the delegates about the
challenge event via feedback forms was positive, with the
majority saying that it helped them understand more about the
Receivership Role. The representatives from other local
authorities found it helpful to hear other points of view and
perspectives of the role of safeguarding vulnerable adults
finances, and one representative indicated he would be
thinking of undertaking a Best Value Review in his own
authority.
3.7 Compete
3.7.1 Review by County Treasurer
The review by Professional Services Section of the County
Treasurer's Department was conducted to provide
recommendations about the most appropriate management and
reporting arrangements for the Receivership function with the
possibility of moving towards a formal business unit status.
The unit needs a greater input from managers with appropriate
financial skills to ensure accountability. The review
proposed the following options:
* Assistant Director (Resources) -Social Services
* Head of Social Services Finance Unit
* Head of Revenue Services (County Treasurers)
In further discussions the additional option of Business and
Property Services was proposed, given the possibility of the
unit achieving business unit status. It was decided to delay
the decision on this until a number of improvements to the
service are implemented. These include improved financial and
activity information systems and the collection of several
months management information.
3.7.2 Wholesale externalisation e.g. with local solicitors
providing the service is unlikely to be a realistic option.
Many of the cases would not be regarded as providing
sufficient income for solicitors, the necessary competencies
to take on aspects of work with mental incapacity are often
not available (evidence from the Law Commission), and would
require a high degree of partnership with care managers.
A consideration of options will need to take account the
outcomes of some major national policy reviews.
3.7.3 Public Trust Office
"Making Changes - the Future of the Public Trust Office" is a
review being undertaken by the Lord Chancellors Office that
will have an effect on the provision of the Receivership
service. The Lord Chancellor has indicated that there will be
a radical overhaul of the Protection and Receivership
Functions of the Public Trust Office, which will include:
* Transfer of Trust business to the Official Solicitor's
Office as the Official Solicitor already provides a
trust service in the public sector.
* Transfer of the Court Funds Office to the Courts Service
because of the Court Funds Office's very close links
with the work of the Courts.
* Mental Health Services to form a new unit called Public
Guardianship Office. They say the Mental Health
Service will be "radically overhauled refocused and
redesigned".
* The Public Trust Office will cease to exist as a
separate executive agency from 1st April 2001.
* A new scheme will be developed to replace the existing
Public Trustee Receivership role. This will specify
that Receivership services should be provided in cases
where no suitable receiver can readily be identified.
Tenders will then be invited from private and voluntary
sector bodies to take on this work and the Lord
Chancellor has not ruled out the involvement of the
public sector.
3.7.4 The Making Changes review also proposes more local decision
making, greater powers for managers of funds and an increase
in the level of capital required before receivership can be
requested (to £16 000 from the present level of £10,000).
This could have implications for an increased demand for
Appointeeships and, in Hampshire, further demands on the
workload of Area Finance Officers. The time scale for these
changes is as follows:
* Summer 2000 - Redesign of Protection & Receivership
Division work
* Autumn 2000 - Protection and Receivership Divisions merge
in preparation for new office (Public Guardianship
Office)
* Autumn 2000- Accreditation criteria requirements
published.
* New Year 2001 - Tendering process.
* April 2001 - Accreditation Panel sits.
* By 2001 management of investments to private sector and
replace Honorary Investment Advisory Committee with
Strategic Investment Board to monitor performance.
* By April 2001 transfer of trust business to Official
Solicitor.
* April 2001 creation of the Public Guardianship Office.
3.7.5 Mental Incapacity Legislation
"Making Decisions" is proposing a number of recommendations
including those listed below, which, if implemented, could
affect the responsibilities and workload of the unit. There
is no indication of the legislative timetable for these
changes that include:
* Powers over the Person as well as the Purse (only the
purse currently) to be exercised by the New Court of
Protection over persons deemed to lack mental capacity.
* Continuing Power of Attorney to replace Enduring Power
of Attorney and to provide for welfare and health care
decisions as well as financial (only financial decisions
at present).
* Receivers to be replaced by managers who can take health
care and welfare decisions. The manager has power over
the incapable person's capital as well as income,
including major gifts of capital (present Receivership
powers restricted to income).
3.7.6 Conclusion
The changes to the Public Trust Office could result in
additional demand on local authorities to manage cases.
Legislative reform would also increase the responsibilities of
Receivers (known as managers in the reforms). However this
also provides an opportunity for the County Council to expand
its current operation if desired.
4 OTHER CONSIDERATIONS IN BEST VALUE
3.1 Community Safety
The contribution of the work of the Receivership Unit to the
Community Safety Strategy is largely through policy aim 5:
Community and Crime Reduction Measures, particularly personal
safety and protection of property. The Receivership Unit
contributes to promoting community safety by managing the
financial affairs of a vulnerable group of people who could
be, or have been, subject to financial abuse or exploitation.
Some users of the service have severe mental health problems
which place themselves or others at risk, and who may be
subject to other powers under the Mental Health Act 1983. In
these circumstances the Receivership Unit's input is part of a
package of measures that minimises risk and promotes
independent living.
4.2 Equalities
4.2.1 Service Use
Monitoring of service use will be made possible through the
introduction of a database but is not done currently.
4.2.2 Consultation
There has been no previous user consultation exercise prior to
the Best Value review. The current user survey pilot
demonstrated that the nature of the client group provides a
considerable challenge to user consultation. It is proposed
that user consultation would be most effectively and
systematically conducted through care managers during care
management reviews and reported to the unit. This would
require effective implementation of the requirement that care
managers review cases and that where the Department acts as
receiver the case remains allocated. With regard to carer
consultation, Receivership Unit staff conduct periodic visits
to carers groups e.g. Alzheimer's Society.
4.2.3 Information
There is currently no information for stakeholders/users: this
is being developed with Royline. This is addressed further in
Section 4 of this report.
4.2.4 Training
There is a demand for the Receivership Unit to provide
training and advice to area-based staff, but this has
significant resource implications. The Challenge Group
highlighted the need for training for legal and financial
services in the private sector.
4.2.5 The main contribution to promoting equalities is to provide a
service to people with a significant disability, which
promotes independent living.
4.3 Sustainability
T he Receivership Unit contributes to
this through the following aspects of the
Corporate Strategy:
4.3.1 Quality of life
The Receivership Unit reduces factors contributing to ill
health, including poverty, stress to self and others, and care
to the vulnerable. It is a service of last resort. There is
a need to promote information on strategies to plan for and
manage mental incapacity. This is recognised by government
as a complex area of social policy and has proved a challenge
to legislate for and to resource at national level.
4.3.2 Environment
Through facilitating the resale of vacant homes when people
need to enter some form of alternative care; this contributes
to community safety by preventing the properties falling into
disrepair.
4.3.3 Economic prosperity
The Receivership Unit provides a service to the cities and
there are opportunities for additional business through
expanding the business /promoting other agencies to take it
on. There are potential Business opportunities through
selling expertise/training to the private sector. The
Receivership Unit has partnerships with the private (banking)
and voluntary sector.
4.3.4 Strong communities
Themes as above - facilities/access to services for disabled
people.
3.2.5 Quality services
Is evidenced through the consultation exercise.
4.4 Electronic Government
4.4.1 Systems and processes
Arrangements are in hand to introduce a database, and the
electronic storage of records. The Receivership Unit uses
electronic banking with links to Royline (Royal Bank of
Scotland).
4.4.2 Information
More could be made available through Hantsnet, and also
through the provision of web links to national sites e.g.
Public Trust Office.
5 ESTIMATED COST OF REVIEW
Total 29,262 14,778
Review costs were significantly overestimated. The main difference
lies in the actual time spent by project team members in
undertaking tasks for the review. The costs of room
hire etc were also less than expected. Travel costs for an external
steering group members were higher than expected and this
needs to be taken into consideration when selecting
external membership for future reviews. The figures do not include:
* Administrative support time
* EFQM preparation training
For future reviews, administrative support time should be monitored.
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6 MEMBER INPUT
6.1 The Review was scrutinised by the Best Value Review Panel
(Social Services) at the scoping and progress stages.
Councillor Hutcheson was the identified Member for this review
and attended the Challenge Group. The review was referred for
final approval without the need for an informal workshop.
7 LESSONS LEARNED
The key lessons learned from this review have been:
* A Best value Review specifically for the Receivership
Unit has provided the momentum to engage in a range of
consultation processes and identified the need to
develop a new business plan with clear objectives and
measurable outcomes. However, it is a relatively small
service and it is suggested that a specific Best Value
Review will not be required in the future provided a
regular review of the business plan is conducted.
* The EFQM approach is a helpful aid to ensuring a
systematic and comprehensive review is conducted.
However, given the small size of the service a rigorous
application of the model including scoring against each
criteria is not appropriate.
* The preparatory work undertaken by Professional Services
(County Treasurers) greatly assisted the progress of the
review.
* Drafting the action plan according to the prescribed
format has been a significant challenge, particularly
with regard to identifying performance indicators and
targets.
* The involvement of a service user from the National
Schizophrenia Fellowship and a representative from the
Public Trust Office added considerable value to the
Review.
8 CONCLUSIONS
8.1 The EFQM Model was used as the basis of evaluating the
findings from the review, identifying strengths, weakness, and
areas for improvements against each of the nine domains of the
model. This section summarises the conclusions from the
Review:
i) The service provided by the Receivership Unit gives a
high level of customer and stakeholder satisfaction.
There is a need to review satisfaction more
systematically.
ii) The statutory fees for the service (£205 per person per
annum) are twelve per cent of the fees allowed to be
charged by the Public Trust Office (£1750 per person per
annum) when they act as receiver. Local authority
receivership units therefore provide good value for the
person subject to a receivership order.
iii) The Receivership Unit provides a service available to
all in need as a last resort regardless of resources, in
contrast with the private legal sector and the Public
Trust Office. Although it is not a statutory duty to
provide the service the County Council should continue
to provide it as a service of last resort. Failure to
provide the service would place a very vulnerable group
of people at risk. It could also result in costs to the
22
County Council through additional demands on the
resources of the Social Services Department, for which
it would not receive the annual fee from the Public
Trust Office.
iv) The service the unit provides should continue in its
current form and management arrangements whilst improved
business processes are introduced. These arrangements
are largely concerned with the introduction of
computerised systems for the collection and use of
management information. The feasibility of the
Receivership Unit becoming a business unit should then
be evaluated.
v) The systematic collection of management information is
essential to understand the costs of the service and to
inform charges made to other authorities.
vi) Consideration could be given to partial externalisation
of the service i.e. becoming a business unit once the
recommendations made by the County Treasurer have been
implemented.
vii) Once new business processes are introduced these could
offer opportunities for expansion, to attract business
from other authorities in addition to Portsmouth and
Southampton Cities.
viii) Comparison with other authorities is difficult
given the diverse range of approaches to service
delivery and the lack of agreed national standards and
performance indicators. Hampshire's Receivership Unit is
held in high regard by other authorities and the Public
Trust Office.
ix) Hampshire's Receivership Unit Staff carry high caseloads
in comparison with other authorities and there is a case
for increasing the establishment of the Unit. The
current financial circumstances would allow for this
although additional office space would be required.
Alternative office accommodation outside of Winchester
could be considered.
x) Information about the service provided by the
Receivership Unit for staff and customers is limited and
could be improved through provision of electronically
available information, leaflets and increased liaison
and visits to areas.
xi) Organisational changes in the Public Trust Office and
legislative changes concerning the management of mental
incapacity are likely to impact on the workload and
nature of demands made on the unit, and this needs to be
kept under review.
xii) There is a significant level of concern from a range of
stakeholders about the limited capacity of the
Department to act as appointee as a last resort. The
Department should review the range of options for
managing the demand for appointeeships and the impact on
the role of the Receivership Unit.
xiii) The Receivership Unit makes a contribution to
promoting community safety as a crime reducing measure.
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xiv) The Receivership Unit makes a contribution to
sustainable development through each of the five aspects
of the Corporate Strategy.
9 RECOMMENDATIONS
1. Role and management arrangements
To retain the Receivership Unit in its current form and
to review at a later date once the improvements to
business processes have been implemented.
2. Financial and Management Information Reporting Systems
These need to be improved in the following ways:
* Development of databases and electronic storage
systems
* Introduction of a systematic approach to user
satisfaction by obtaining information through the
process of care management reviews
* Development of a business plan with clear and
measurable outcomes and performance indicators
* Development of an office procedures manual for staff
3. Cost effectiveness of provision to the Cities
* Needs to be established by accurate time recording of
work
4. Business opportunities
* Renew the Service Level Agreements with the Cities of
Portsmouth and Southampton that expire in April 2001
* Further consideration of the viability of attracting
business from other local authorities
5. Key performance indicators to be considered should
include
* Customer satisfaction/complaints (patients, carers;
care managers; PTO).
* Time to make application to PTO after receipt of
paperwork.
* Cost of service.
* Income per client.
* Caseload per wte staff.
* Client visits.
* Training events delivered / and satisfaction with
training.
* Receivership Orders per head population.
* Staff satisfaction.
These will need to be developed to reflect the key
objectives of the Receivership Unit.
6. Publicity
* To develop a leaflet with information about the
Receivership Unit in partnership with the Royal Bank
of Scotland.
* Information about the Receivership Unit should be
placed on Hantsnet and should include links to
national websites concerned with information and
services for people with mental incapacity e.g.
Public Trust Office.
* Development of Helpline subject to resources.
* Liaise with other organisations to consider their
role in making information available and develop
partnerships to undertake this.
24
* Increase information for care management staff-
electronically
* Increase liaison visits to SSD staff subject to
resources
7. Appointeeship
* The County Council should review its policy on
appointeeship in the light of changes introduced by
the Public Trust Office and the level of local
concern.
* The policy review should consider:
i) The circumstances, if any, when the County Council
should act as appointee.
ii) The options for service delivery, including
an increased role for the Receivership Unit.
iii) Charging.
iv) Payment of interest to clients on money
held.
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8. Management of Human and Capital Resources
* Staff performance and development is reviewed
annually.
* An additional case officer is required to meet
recommended caseload ratios and to enable the
receivership unit manager to devote time to
management duties.
* Office accommodation requirements should ideally
include:
i) Alternative storage facilities for records.
ii) Receivership Unit manager to have dedicated
office space for staff supervision and
confidential meetings with customers .
iii) An interview room for Receivership staff to
interview clients and other customers
26
10 ACTION PLAN :
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