Report 41: Prevention in adult safeguarding - Emerging evidence
Haringey Council: Quality of Life Reviews for financial safeguarding
Haringey Council has involved the Association of Independent Visitors UK to help deliver a proactive approach to managing money on behalf of people who have lost mental capacity. Margaret Allen (Assistant Director, Safeguarding and Strategic Services) and Marcus Power (Finance Manager, Income, Safeguarding and Strategic Services) explain the scheme.
The London Borough of Haringey holds between four and five million pounds on behalf of around 70 to 80 people who have lost mental capacity. It's a large sum of money and a considerable responsibility.
For local authorities, this responsibility is longstanding. Typically, council finance officers carried out this role in a reactive way, settling essential financial matters only when bills appeared. Meanwhile, a person could have quite significant needs that would go unaddressed, despite the person having funds to meet these needs. Perhaps no one ever asked the person what they would like to spend their money on. Perhaps key care staff didn't know the person had their own funds.
Since summer 2010, Haringey Council has embarked on a new way of working systematically to ensure that the funds it manages when appointed as a Deputy by Order of the Court of Protection are used proactively in clients' best interests to promote their quality of life. Haringey Council now asks 'Independent Visitors' from the national Association of Independent Visitors (AIVUK) – all current and ex- Court of Protection Visitors who work with private clients, solicitors, Deputies and Attorneys to uphold and safeguard best interests – to make a visit to each person where Haringey Council is the appointed Deputy. By March 2011, the Independent Visitors had conducted these Quality of Life Reviews, as they are known, with about a quarter of Haringey Council's Deputyship caseload.
An Independent Visitor meets with a person in their own home and talks to them about their life, their friends and family, and what they like to do. They establish what the person would like to spend their money on and report this back to the Council's Finance Assessment Team, who decide how best to spend money for the person in accordance with their preferences and needs.
The team have a range of practical tools to help – software that enables them to manage people's Deputyship Account directly, and a corporate visa card that allows them to buy goods and services, often using the internet. Everyone has different interests and needs, but so far as a result of the Quality of Life Reviews, the Council has organised for money to be spent on a wide range of items – magazine subscriptions, DVDs, clothing and holidays to name a few.
The new procedures take more staff time but do not involve additional resources. Each visit from the Independent Visitors costs £150, but the person pays for this from their own funds.
What's worked wellOpen
The feedback so far – from care homes in particular – has been very positive. The following two examples give a snapshot of the outcomes possible from the new approach.
Mr W lives in supported housing. His mobility is becoming more limited and so, as a result of a Quality of Life Review, the Council helped Mr W purchase a motorised scooter so he can get around the local area.
Mr S lives in a care home. At his Quality of Life Review, he told the Independent Visitor that he would appreciate some male company and a weekly visit to the local pub. As a result, Mr S now self-funds a small additional care package, which involves a care worker taking Mr S out regularly.
The Finance Assessment Team met with care home staff to explain the aim of the scheme. Some staff can be resistant to the idea that the Council are spending money that belongs to residents.
Advice for othersOpen
The new approach stemmed from a number of influences:
- legislation – in particular, the Mental Capacity Act 2005's emphasis on best interests decisions
- policy – self-directed support and giving people control over the services they use
- best practice shared by other local authorities.
By taking this approach, the team can demonstrate that they have tried to act in a person's best interests. They can also show that they have tried to ensure that the person has as good a quality of life as they would expect had they not lost the capacity to make decisions for themselves.
The team at Haringey recommend being risk-aware rather than risk-averse. Strong governance procedures – specifically a written audit trail – prevent any errors or abuse of the system. The approach also means the Council is taking a preventative angle on safeguarding – by setting up open, clear systems for managing people's money, and by reaching out to people who may be isolated.
Haringey Council intend to roll out the scheme across their Deputyship caseload, taking into account the views of other advocates who may be working already with younger adults.
Marcus Power, email: firstname.lastname@example.org