Archived decisions

Contact: Rea Mattocks (01962) 847200; [email protected]

1. Introductory Summary

1.1 This report updates the Committee on the specific concerns raised on Direct Payments and CRB checks at the Governance Committee on 26 October 2006.

1.2 The following issues are covered in the report:

· The immediate action taken by Adult Services in response to the Internal Audit Report recommendations;

· Details of the Project that has been initiated alongside the County Treasurers' Department to develop a streamlined and user friendly Direct Payment process that is fit for current and future purpose within statutory requirements by July 31 2007.

· The need to ensure that systematic procedures are in place for Criminal Records Bureau checks

2. Recommendations

2.1 That the Governance Committee notes the progress since October and that a further report be brought back to the Committee once the total review has been completed.

3. Background

3.1 In April 2003 it became a duty for councils to make Direct Payments (DP). DP are designed to empower people by providing them with the funding that meets their assessed level of care need. This enables them to have maximum choice and control in how their care needs are met, rather than purely receiving Council provided services. DP form an essential feature of independent living.

3.2 There are a range of drivers for the Adult Services Department in relation to DP:

· The 2005/06 Internal Audit Report on DP

· Growth in uptake of DP

· The anticipated introduction of individualised budgets

· The need for a streamlined and user friendly DP process for both staff and clients

3.3 In summary, since the last meeting of the Governance Committee, Adult Services has:

· Finalised the management response to the audit and implemented a number of key recommendations;

· Set up a project to carry out a total review of the scheme. The review has been commissioned by the Assistant Director (Performance and Business Management) and Head of Finance (Adult Services), led by the Head of Quality and Audit and the Strategic Commissioning Director and supported by County Treasurer's Consultancy. The Review will develop a new business process for Direct Payments which will address the key issues raised in the audit report for the longer term and also ensure that the scheme is `fit for purpose'. The outcomes of the project will be reported to both Adult Services and the County Treasurer;

· A Direct Payment Action plan has been completed which is being implemented alongside the total review. (Appendix 1) The Action Plan ensures that all the issues which require short term action, including those arising from the Direct Payments audit, are dealt with immediately. Issues requiring decision rather than just immediate action, will be taken to the Operational Management Team in February for ratification. Interim measures will, where necessary, be implemented whilst the Review is ongoing.

4. The Internal Audit Recommendations

4.1 The key recommendations of the Internal Audit report reflected concerns that the current procedures in relation to DP were not being adequately followed. Adult Service's aim is to ensure that the DP Project Review addresses these issues long term whilst at the same time dealing with immediate issues in the short term.

4.2 The key recommendations

4.2.1 Assessments are completed ensuring that the client is eligible to receive Direct Payments

Care Managers were reminded of this requirement in a systematic communication exercise in November and December 2006. This included the attendance by more than 100 Care Managers at Road Shows held at seven venues across the County. In addition to written information made available at these road shows, experts were available from operations, finance and systems teams to answer questions and provide on-the-spot advice. Care Managers will be receiving an update about changes to the Direct Payments Support Worker Service Contract. The update will detail the new level of service provision.

In addition, a new Direct Payments Support Worker Service Contract was successfully let in January 2007 and all relevant Care Managers have received updates on the new level of service provision, its implications for them and how to access the service.


A detailed action plan in respect of all the more technical and systems related issues arising from this overarching heading within the Internal Audit report is available separately. (Appendix 1) It is a 47 item action plan setting out the system or process problem, the solution, the officer(s) responsible and the delivery date.

Angela Watwood, Area Director North Hampshire and lead officer for Care Management Practice will ensure operational consistency within Direct Payments processes.

4.2.2 Direct Payments are used for the correct purposes

Under this overarching recommendation, there are 8 detailed recommendations, of which 7 have now been implemented in full:

Quarterly statements are date-stamped on receipt;

Systems to identify late returns have been strengthened;

A checking mechanism for quarterly statements has been implemented;

The recovery of excess balances has been reviewed and a work stream incorporated in the Direct Payments Review Project Plan;

Balances in excess of 8 weeks are being identified, Care Managers notified and where appropriate invoices issued for recovery;

Clients have been reminded of their obligations to maintain a documentary audit trail and Care Managers have been reminded of their responsibilities in this regard;

Care Managers have been reminded of the need to monitor client records and record-keeping and this requirement has been incorporated and strengthened in the Care Management Manual re-write.

The eighth detailed recommendation requires that Care Managers are reminded of the need to highlight to clients who receive a one off Direct Payment that they are required to return receipts to the value of that payment within eight weeks. The Area Director with the lead for Care Management Practice will remind Care Managers of this through email communication by the 6 April 2007.

5. DP Total Review Project

5.1 The aim of this Project is to develop a proposal for a streamlined and user friendly Direct Payment process that is fit for purpose within statutory requirements by 31 July 2007 which can then be recommended for agreement by the Executive Member for Adult Social Care after the appropriate consultation has taken place.

5.2 The intention is for the new DP process to be ready for implementation at the latest by 1 April 2008, subject to the scale of change required and its associated risks, particularly in respect of any system change requirements. Updates and risks will be reported back through the Modernisation Board which reports to Members.

5.3 The Project aims to deliver procedures and processes which ensure:

5.3.1 Systematic assessment, monitoring and review of care needs to ensure that resources are deployed effectively

This was also a key outcome from the Internal Audit report and whilst immediate action are being implemented, in the longer term we are seeking to ensure a robust and modernised process is developed as part of the total review. This topic will also form a key part of the re write of the Care Management Manual. Additional measures have been put in place across the County including employing specific Care Mangers to undertake reviews as well as ensuring Direct Payment reviews are given priority. The importance of the review process was highlighted during road shows which took place during December for Care Managers.

5.3.2 Reconfigured Care Manager roles, to enable them to concentrate on their key tasks, with appropriate administrative and financial support to be provided in areas such as data entry, checking of invoices and bank accounts

This will be a key part of the Project and will examine the roles and responsibilities of Care Managers, Finance and Administrative staff as well as the Support Worker Contract and identify who should do what and at what stage of the process the appropriate action should be carried out.

Part of the review will be to benchmark our current processes against those of other authorities. A key part of this will be to understand how the risks of more streamlined processes have been managed by other councils.

This will have resource implications for all of the staff groups within the process, which is why it will be important to streamline processes where possible, as well as any identifying potential skills gaps and or training needs.

5.3.3 Recognition that choice in assembly of care packages can make life more complex not only for County Council staff but also for the clients, notably dealing with Income Tax and National Insurance

The review will examine whether it is possible to ease the complexity of the current system by developing a more streamlined process.

In addition it will be imperative to ensure that the correct processes are in place which satisfy our requirement to maintain a duty of care for our clients. New guidance will be drafted as part of the review which meets DOH guidance and outlines how we will monitor clients spend. This will ensure that adequate arrangements are in place.

6. Need to ensure that systematic procedures are in place for Criminal Records Bureau checks

6.1 A new policy and procedure document on CRB checks for Hampshire County Council staff is currently being finalised and will be issued shortly.

6.2 Specifically as part of the departmental procedure for Direct Payments, published on Hantsweb, provision is made for the police checking of support workers employed directly by the Direct Payments user.

The procedure states:

i) An adult who is receiving a Direct Payment to meet their own needs is responsible for the arrangements and the services they receive.

ii) If as part of this they wish someone they are planning to employ as a Personal Assistant to have a Criminal Records Bureau (CRB) check then this is something the Department will support them with.

The check is not mandatory as the support worker might be a family member or friend.

This process is carried out by the Human Resources (HR) Resourcing Centre who will send the user a CRB form and a guidance booklet. The potential personal assistant (PA) completes the form and returns it registered post, along with original documents as required. The original documents are returned and the form sent off to CRB. The Resourcing Centre and the potential support worker get CRB certificates sent to them.

HR will then advise the DP user one of the following:

i) The CRB check is clear or we would have no issues appointing this person to a similar role.

or

ii) The CRB check is not clear and the DP user might like to invite the potential PA to share their CRB feedback.

Exceptionally there could be major concerns from the CRB response and HR would alert a strategic lead worker for Direct Payments who would liaise with the relevant operational workers using Adult Protection processes. Without making conditional offers of employment, a Direct Payments user can invite their potential PA to show them the return they are sent from CRB. Their willingness to share this could be taken into account in considering their appointment.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.