SCIE Report 36: Enabling risk, ensuring safety: Self-directed support and personal budgets
'By focusing on working with staff and service users to prevent problems, direct payments staff report that there are now fewer problems to be resolved' (Rowlett & Deighton 2009)
Case study: Lincolnshire County Council
The literature search for the research in this report identified a case study showing how a local council used corporate risk management strategies to deliver improvements through the increased uptake of direct payments and personal budgets.
As part of its social care transformation process, Lincolnshire County Council used risk analysis and management as a tool to support the development of a simpler, more flexible approach to direct payments and personal budgets.
In analysing the existing processes, the authors found that problems were arising from inaccurate ideas about risk, which focused on protecting the organisation from financial fraud. Because of this, an unworkable audit system had been put in place.
Working within this complicated system took up a large amount of staff resources. This meant that staff could not focus on risk issues relating to individuals, such as safeguarding and ensuring that social care outcomes were met. In agreeing to remove the unnecessary and ineffective controls [senior decision makers] were actually reducing, not increasing, the authority's exposure to risk.
The organisational change evaluation showed that, by focusing on working with staff and people who use services to prevent problems:
- direct payments staff reported that there were now fewer problems to be resolved
- frontline staff identified a number of cases of potential misuse of funds as a result of having closer links with individuals.
This shows that building closer relationships instead of relying solely on paperwork checks does appear to be making it easier to identify and address misuse of funds.
The new system also incorporated other ways of identifying fraud:
- paid carers asking for finance checks for the service users who employ them
- new bank account checks have highlighted problems that have led to more detailed finance checks and identified areas of concern about specific direct payments, which can then be addressed and resolved.
The case study highlighted the importance of managing anxiety about risk and exploring views on risk in a corporate way, with all stakeholders. It also emphasised the need for support services which are capable of providing appropriate levels of support and negotiated risk management on a case-by-case basis. This allows individuals to use their direct payments most effectively to meet their chosen outcomes.
Finally, the new system was subject to an evaluation, which showed significantly improved performance in the take up and management of direct payments alongside cash savings.
After moving the priority from funding issues to ensuring safety and achievement of outcomes, the new process is still more effective at identifying and addressing misuse of funds than the original approach.
- For more practical resources and practice examples visit the Putting People First website.