Direct payments for social care: options for managing the cash

Direct payments for social care:options for managing the cash

How local authorities and financial institutions can make managing the finances easier for older people

Expert series

• Toinfluencethewaythatpaymentservicessupporttheimplementation oftheGovernment’spersonalisationpolicyinadultsocialcare,sothatthey meet the needs of older people

• Toshareknowledgeandexperiencethatenablethosedeliveringdirect paymentstoaccessthebestavailablepaymentsolutions

LocalGovernment,banks,buildingsocieties,creditunions,paymentserviceproviders,anddirectpaymentsupportservicesandadvisers

Direct payments for social care: options for managing the cash. How local authorities and financial institutions can make managing the finances easier for older people

June 2013

Thisdocument: • providesanintroductiontopersonalisation,personalbudgetsand directpayments • outlinesthedifferentpaymentsystemsusedtodeliverpersonalbudgets anddirectpayments • highlightsthepaymentandauditingfunctionsessentialtodeliver directpayments • drawsattentiontothebarriersolderpeoplecommonlyfacetoindependent useofpayments • shareslessonsfrompractice • suggestspossibleimprovementsandsolutions

HelenaPoldervaartandLucyMalenczuk

Forfurtherinformationortorequestcopiesofthisreport,contact: LucyMalenczuk,PolicyAdviser–FinancialServices,AgeUKTavisHouse, 1-6TavistockSquare,LondonWC1H9NA,[email protected]

www.ageuk.org.uk/professionalsthelinktotheexpertseriesreportpageis:www.ageuk.org.uk/professional-resources-home/knowledge-hub-evidence-statistics/expert-series/

AgeUKwouldliketothankthelocalAgeUKsthathavecontributedtothecontent of this report

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Contents 1 Contents 3

2 Introduction 4

2.1Summary 5

3 Overview of personalisation and direct payments 7

3.1The‘personalisationagenda’ 9

3.2Personalbudgetscanbespentonservicesandequipment agreed in a support plan 10

3.3Differenttypesofpersonalbudget 11

3.4Supportinsettingupandmanagingdirectpayments 12

3.5Recipientsofdirectpaymentsmightchoosetotopthemup 13

3.6Cashpayments 13

3.7Localauthoritymonitoringrequirements 13

4 How direct payments work – a range of payment systems are available 14

4.1 Whatfeaturesshouldadirectpaymentsaccountoffer? 15

4.2Bankaccounts 15

4.3Creditunions 16

4.4Useofpaidthirdparty 16

4.5Smalloneoffpaymentswithoutseparatebankaccount 16

4.6Vouchers 16

4.7Prepaidcards 17

4.8Whattheprepaidcardsystemscando 18

5 Money management - barriers and solutions 20

5.1 Fraudandfinancialabuse 26

5.2 PowerofAttorney 28

5.3 Useofset-off 29

6 Best practice: recommendations for local authorities andfinancialorganisations 30

7 Appendix 33

7.1 Legislativebackground 34

7.2 Templatelettertobanks,providedbyAgeUKtolocalauthorities 35

7.3 Furtherreadingandusefullinks 37

References 39

IntroductionTheGovernmentiscommittedtotheprincipleof‘personalised’services.Personalisation,asitisknown,isalreadyusedwidelyinsocialcareandtheCoalitionGovernmenthasexpresseditson-goingsupportfordevelopmentofpersonalisedapproachesandservices.Theobjectiveofpersonalisationistotailorcareandsupporttoanindividual’sparticularneedsandpreferences.Personalisationisabroadconceptand,whenfirstintroduced,adviceandguidancewasissuedtolocalauthoritiesindicatinghowitshouldbedelivered.Thisguidanceemphasisedtheimportanceofuniversalinformationandadviceservices,careandsupportplanning,makingbrokerageandadvocacysupportavailableaswellasdeliveringservicesin adifferentwaythroughofferingcashpaymentratherthancommissionedservices.1

Localauthoritiesarenowintheprocessoftransformingtheirdeliveryofalloftheseessentialelementsofcareandsupport.Theelementofdeliverywhichhasattractedthemostattention(perhapsbecauseitwasaccompaniedbyatake-uptargetforlocalauthorities),isthatofpersonalbudgetsanddirectpaymentsandforsomepeoplepersonalisationisnowcloselyassociatedwithindividualsreceivingcash topurchasetheirownsupport.Personalbudgetsingeneralanddirectpayments inparticular,arejustoneofthemechanismsforachievingthebestoutcomesforindividualswithinapersoncentredapproach.

Holdersofpersonalbudgetsareofferedarangeofchoicesastohowtheyreceivethefundingattachedtotheirpersonalbudget,includingtakingitasadirectpayment.Thefocusofthisreportisthoseolderpeoplewhochoosetotaketheirfundingasdirectpaymentsand,broadlyspeaking,controlthefundsthemselves.Thereportdealswithasmall,butimportant,aspectofpersonalisation–howpeoplereceive,manageandspendthemoney.

Weconsidertherealitiesforolderpeopleofmanagingtheirdirectpayments andhowtheprocesscouldbemadeeasierandmoreresponsivetotheirneeds. Welookatthe‘traditional’methodofmanagingdirectpayments,viabank accounts,andatnewermethodsusingprepaidcards.

Mostoftheproblemsdescribedinthisreportarenotnew,rathertheyaretheday todaydifficultieswhichmanyolderpeopleexperienceinmanagingtheirmoneyandpayingforthings.Solvingsomeoftheproblemshighlightedherewould solveon-goingdifficultiesolderpeoplehaveinrelationtoservicesfromfinancialinstitutions.Olderpeoplearegenerallygoodatmanagingtheirmoneybutcanbedefeatedbypracticalobstacles–thesystemmustworkwiththem,notagainstthem.Personalisationhasthepotentialtomakeareallypositiveimpactonthe livesofolderpeople.Thesebenefitsshouldnotbeunderminedbyobstaclesinmanagingthemoney,orbypressurisingolderpeopletoacceptdirectpayments iftheywouldpreferthemoneytobemanagedinsomeotherway.

Thisreporthasadualfunction:

• itprovidesanintroductiontotheGovernment’spersonalisationpolicyinadult socialcarefocusingonaspectsrelevanttobanksandotherpaymentservice providers;and,

• itprovidesanoverviewofsomeofthepaymentmethodsavailabletodeliver personalisation,focusingontheoptionsavailabletolocalauthoritiescommissioning paymentsandotherservicestohelprecipientsmanagetheirmoney.

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Direct payments for social care: options for managing the cash • June 2013

Thereportdrawsattentiontothebarriersolderpeoplecommonlyfaceinindependentuseofpayments,shareslessonsfrompracticeandsuggests possibleimprovementsandsolutions.Itisnotintendedtobecomprehensive, butrathertoenablefurther,moreeffectivedialoguebetweenthepayment serviceprovidersandthoseinvolvedindeliveringandusingdirectpayments.Thereportwaspreparedbyaninformalliteraturereviewofkeyaspectsofpersonalisation,areviewofrecentlessonslearntonhowolderpeopleuse paymentsystemsandexamplesofdifferentsolutionsemployedbyselected localAgeUKsandsupportservices.Thesewereanalysedtodevelopsomesuggestedbestpractice,drawnbothfromexistingpersonalisationsolutions andpracticedevelopedinotherworkonpaymentsservices.

2.1 Summary1. Older people face barriers accessing mainstream payment methods. The increased demand for direct payments accounts caused by the Government’s targets to increase take up could help drive solutions for all older people, not just direct payment recipients.

Manyolderpeoplereceivingdirectpaymentsarelivingwithdisabilitieswhich canmakeoperatingtraditionalpaymentssystemsmorechallenging.Inordertosupporttheaimofpersonalisationasanapproachwhichgivestheindividualreceivingcareandsupportchoiceandcontrol,paymentssystemsneedtobeinclusivelydesigned.Todate,thefinancialservicesindustryhasnotpaidsufficientattentiontoinclusivedesign.Forexample,ChipandPINcardtechnologyhasgenerallybeenconsideredasuccess,howevertherequirementtoremember andtypeinaPINcanactasabarriertoindependentuseofpayments.There aresomesignsofimprovement,forexampleinthepaymentsCouncil’srecentresearchonhowolderpeopleandthosewithdisabilitiesusepaymentsystems.2

Theincreaseindemandforaccessiblebankingfromusersofdirectpayments couldactasanincentiveformoreinclusiveservices.

2. There is some excellent practice and potential solutions available, but these are not always shared and so availability across the country is variable.

Somelocalauthoritieshavecommissionedprepaidcardswhichoffersignificantbenefitstobothauthoritiesandusers,whileothershavedevelopedinnovativerelationshipswithlocalcreditunions.Similarly,paymentsystemsprovidershavealreadydevelopedsolutionswhichcouldhelpolderpeopleovercomethebarrierstheycurrentlyface.Secondcardsandemergencycashcodesarealreadyinuse insomesituationsbutcouldbemorewidelyavailable.Moresupportisneeded tohelplocalauthoritiescommissionthebestavailableservicesfortheirclients.

3. There is a need for more accessible information about the different payment systems available and how they work for direct payment recipients.

Informationandadviceonmoneymanagementisavailable,butmaynotbe joined-upwithdirectpaymentsteamsinlocalauthorities.Localauthorities maybeabletoimprovethedeliveryofdirectpaymentsbyconnectingusers toexistingsourcesofsupport.

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4. Solutions often rely on internet access, yet many older people have either never used or do not have easy access to the internet.

Classesandsupportdesignedspecificallytohelpolderpeoplegetthebest outoftheinternetmaybeavailablelocallyandcouldmakeiteasierforusers tomanagedirectpayments.Supportworkersshouldnotmakeassumptions aboutolderclients’internetuse,orabouttheirwillingnessandabilitytolearn.Instead,workersshouldconsiderwhetherolderclientscouldstarttousesome ofthebenefitsoftheinternet,perhapswhilstretainingsomeotheroptionsasasafetynet.Forexample,manybankaccountsofferonline,branchandtelephoneaccess,soanolderusercouldtryusingonlinebankingforviewingstatementsregularly,whilstkeepingtheabilitytomakepaymentsinbranchoroverthe phone.Howeverforthistoworkwidelythedesignofonlinebankingsystems needstobeimproved,forexample,byensuringsecuritysystemsand procedureswhichareaccessibletoolderconsumers.

WhenHelen’sarthritisandanginagotworse,herdaughterrequesteda socialcareneedsassessment.Shewasfoundtoneedregularcareathometohelpwithhouseworkandpersonalcare.3

‘I’ve always prided myself on being independent and managing on my own, but when my health problems got worse I realised I needed help to stay living at home. After my assessment, the council arranged for a care worker to come round every morning to help me get up, washed, and dressed, and do a bit of cleaning.

This helped me a great deal, but I wished my care worker didn’t come so early every day – I could never have a lie-in. And having a different carer every day wasn’t ideal either.

I talked to my social worker and she explained about personal budgets. My daughter and I read up on it and I decided to go for a personal budget in the form of direct payments. I use them to employ a personal assistant, who really understands my needs and fits in well with me. I interviewed a few people before I chose her. She comes a bit later on Fridays so I can sleep in, and takes me to my local café for breakfast once a week.

The paperwork for direct payments sounded daunting, especially as my rheumatoid arthritis makes it difficult to write, but my daughter helps me fill in forms and I can file them myself. It isn’t hard to manage, and I know that my council has a direct payments support service to help me should I need more help.’

Personalisationcanprovidethebestpossible careandsupportneededfortheindividual and increase independence

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Overview of personalisation and direct payments

3ThissectionintroducestheGovernment’spersonalisationpolicy.Itsummariseskeyterminologyanddescribestheaimsofpersonalisation,thelegislativebackgroundand someofthewaysthatpersonalisationcanbedelivered. Italsolooksatsomeofthemainrequirementswhich willbeplacedonauserofdirectpayments.

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KeyterminologySocial care needsincludecareandsupporttoenableanindividualto managetheireverydaylivesandretaintheirindependence.Forexample, thiscouldbehelpgettingupinthemorningorwithcleaningandshopping, oropportunitiesforsocialinteractiontoimprovequalityoflife.

A support planisagreedbetweentheindividualandtheirlocalauthority. Itsetsouthowthepersonwantstoleadtheirlifeandhowthesupport neededtoachievethiswillbedelivered.Thesupportplanshouldbereviewedregularlyandamoreurgentreviewshouldbetriggerediftheperson’sneedschangesignificantly.

Thepersonal budgetsetsouthowmuchtheindividualwillbegivenbythe localauthoritytospendonservices,supportandactivitiestoachievetheoutcomesintheagreedsupportplan.Initiallyan‘indicativebudget’isagreed, butthismustbesufficienttomeetassessedandeligibleneeds:itmayneed tobechangedifitprovesinadequate.Thepersonalbudgetcanbedelivered asa‘directpayment’orcanbemanagedbythelocalauthority.

Direct payments arepersonalbudgetspaiddirectlytoanindividualservice user,forthemtospendonthesupportagreedinthesupportplan.Inthis contexttheterm‘directpayments’hasadifferentandspecificmeaningand doesnotincludeanyotherpaymentsmadedirectlyintoanaccount(e.g.DWPbenefitpaymentsmaysometimesalsobereferredtoas‘directpayments’ bysomefinancialinstitutions).Inthisreportdirectpaymentsrefersonlyto moneypaiddirectlytoanindividualserviceusertodeliverapersonalbudget.

Adirect payment agreementisacontractsignedbetweentherecipientandlocalauthoritysettingoutthetermsonwhichdirectpaymentsaremade.

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3.1 The ‘personalisation agenda’‘Personalisation means thinking about care and support services in an entirely different way. This means starting with the person as an individual with strengths, preferences and aspirations and putting them at the centre of the process of identifying their needs and making choices about how and when they are supported to live their lives. …Personalisation is about giving people much more choice and control over their lives.’

Theobjectiveofpersonalisationistotailorcareandsupporttoanindividual’sparticularneedsandpreferences.Forpeoplewhosecareandsupportisfunded bythelocalauthority,onewayofachievingthisisthroughpersonalbudgets.

Thisapproachisaboutmuchmorethanjustmoney.Itmeanschanging practicesothatperson-centredprinciplesareusedateverystageinthe processofarrangingcareandsupport,includingforthosepeoplewhoarenoteligibleforlocalauthoritycareservices.Mechanismsfordeliveryhavebeendevelopedtosupportthisagenda,includingtheuseofpersonalbudgetsand directpayments.Somuchattentionisfocusedonthesemechanismsthatthey canbecomealmostsynonymouswithpersonalisation,howeverthisreferstoamuchbroaderagenda.Personalisationisaboutgivingpeoplechoiceandcontrol:controlovertheresourcesavailableandchoiceabouthowsupportisprovided. Thisiscommonlyreferredtoas‘self-directedsupport.’

Section 3.3 setsoutthedifferentwaysinwhichpersonalbudgetscanbedelivered.Thisreportfocusesonpersonalbudgetsdeliveredasdirectpayments,whenanindividualhasthemoneyagreedintheirsupportplanpaiddirectlytothemandtheymanagethatmoneyandpurchaseservicesthemselves.Otheroptionsallowindividualstonominateotherstomanagepaymentsontheirbehalf,ortorequestthatthelocalauthoritycontinuetomanagethemoney,inaccordancewiththesupportplan.

Directpaymentsareoftenpresentedasofferingthegreatestdegreeofchoice andcontrol,becausethemoneyiscontrolleddirectlybytheindividual.Arange offactorsinfluencetheextenttowhichdirectpaymentsdoincreasethereal controlexperiencedbyanindividualreceivingthem.Researchhasidentifiedanumberofbarrierstotheuseofdirectpayments,includingawareness,availability ofinformationandadviceandtheattitudesandpracticeofcareprofessionals. Thisreportfocusesonsomeofthemostbasicissues–howeasyisitforuserstoreceive,manageandmakepayments?AgeUKhearsfromolderpeoplewho cannotmakebasicpaymenttransactionsorwhostruggletokeeptrackoftheirmoneybecauseofbankingsystemsthatexcludethem.Theseproblemsmust beaddressedfordirectpaymentstoworkforpeopleinlaterlife.

Section 5 ofthisreportlooksatthebarriersandsuggestssolutionsbased onlessonsfrompracticeandanalysisofexistingworkonpayments.

The amount spent on personal budgets in 2011-12 was £2.597 billion (14.8 per cent) of all spending on adult care and support services. 4

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3.2 Personal budgets can be spent on services and equipment agreed in a support planApersonalbudgetholdercandecidehowtheywanttospendtheirmoney,as longastheiragreedneedsaremetandthelocalauthorityhassignedofftheirplans.Forexample,theymayspenditonpayingsomeonetotakethemtotheshops,ortomakemealsforthem,orontransporttoaleisurecentre.MoredetailsonwhatcanbeincludedinasupportplancanbefoundintheDepartmentofHealthGuidanceondirectpaymentsandisaccessibleat:webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/SocialCare/Socialcarereform/Personalisation/Directpayments/DH_076522

Themoneyisoftenspentonservicessuchaspersonalcareandcanalsobeused tobuyequipmentsuchasaidstohelpthemmanageathome.Peoplearealso encouragedtospendtheirbudgetscreatively,forexample,choosingtogooutforlunchatalocalcaféwheretheycangetareasonablypricedmealandmeetfriends.

Researchsuggeststhatolderpeopletendtospendtheirmoneyon‘traditional’careservices,i.e.homehelps,daycentres,personalcarers,andtransport,asopposedtoleisure,educationorholidays.6 Theuseofhomehelpincreasessubstantiallyamongoldergroupswhentheymovetopersonalbudgets,butfurtherresearchisrequiredtounderstandwhetherthisisbecauseofolderpeople’spreferencesorifitisdrivenbythewaybudgetsaredeliveredortheamountsavailable.7

Personalbudgetscanalsobeusedtopayforoneoffitems,suchasequipment tomakeiteasierforsomeonetoliveathome,ifthisisagreedinasupportplan.

Atpresentpersonalbudgetscannotbeusedtopayforlongtermresidential care,althoughthisisunderreview.

Daughter of 86 year old with Parkinson’s

‘Seven years ago I came back to live with my mum and dad because my mum was getting worse with Parkinson’s disease and she needed some help. I had a full-time job, which I still have, so I needed care to help me. Having direct payments has enabled me to have a holiday, which I hadn’t had for five years, when I had to put her in a home. And when she came out she wasn’t well. So since then I haven’t wanted to put her in a home and so I’ve not gone away. The direct payments have enabled me to pay for carers to stay overnight and take care of her and they have been wonderful with her. When I came back she was as healthy as she was before I went away.’ 8

Personalisationcanbenefitboth theindividualandtheircarer

In England, 527,000 people had a personal budget at the end of March 2013. 5

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http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/SocialCare/Socialcarereform/Personalisation/Directpayments/DH_076522



3.3 DifferenttypesofpersonalbudgetPeoplecanreceivepersonalbudgetsinanumberofways.

• Direct paymentstoanaccountorpaymentcardheldandmanageddirectly bytheindividual(orbya‘suitableperson’whocanbeafamilymember althoughtheycan’tpaythemselvesfordoingit).Withtheincreasedcontrol comesincreasedresponsibilitiesandadministration.Dependingontheservices involved,therecipientmayneedtodealwithemployeepayrollissuesand willneedtobeabletoaccountforthewaypaymentshavebeenusedso thatthelocalauthoritycanseethattheyhavebeenspentonservicesagreed inthesupportplan.

• An account managed by the local authorityinlinewiththeindividual’swishes, alsoknownasa‘virtualbudget’or‘managedbudget’.

• An account held by a third party and managed in line with the preferences of the individual,forexampleheldbyaserviceproviderintheformofan individualservicefund(ISF).Theservicedirectlydeliveredbytheproviderhas tobepaidforoutofthepersonalbudget,butthebudgetcanalsobeusedto purchaseotherservicesandactivitiesthattheindividualwants.Thiscanbean attractiveoptionastheserviceusercancontrolhowfundsarespentwithout havingtheresponsibilityforemployeepayrollandbankingactivities.

• An account managed by a carer, friend or relative in the form of a user controlled trust.Trusteeshavecertainlegalresponsibilitiesbasedontrustlaw.

• A mixture of the above,forexamplereceivingadirectpaymenttocover thecostsofactivitiesoutsidethehome,butanISFtocoverthecostsof careathome.

No-onecanbeforcedtoacceptthedirectpaymentoptionofmanagingtheir personalbudget.9

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3.4 Support in setting up and managing direct paymentsEachlocalauthorityisresponsibleforprovidingsupportinsettinguppersonalbudgetsanddirectpayments.Researchshowsthatsupportservicesarecrucial inenablingolderpeopletousedirectpayments.10

Supportbrokerage‘involvestheassistancethatpeopleneedtoworkoutwhat theirchoiceswillbe,andthesupportrequiredtomakeithappen.’(Department ofHealth).Noteveryonereceivingdirectpaymentswillreceiveabrokerageserviceoranon-goingsupportserviceif,forexample,theyareinapositiontomanage everythingthemselvesortheyhavefamilyorfriendswhocanprovidesupport.

Somelocalauthoritieshaveextensiveinformationonline,includingtheformswhichhavetobefilledintorecordhowthemoneyisspent.11Othersputpracticallynothingonline.Thequalityoftheinformationalsovariesgreatly,fromsomeexcellentplainEnglishguides,tosomewhichrequiresignificantpriorknowledgetounderstand.AtthetimeofwritingitwasnotpossibletofindanynationallyagreedplainEnglishpublicinformationaboutpersonalbudgetsanddirectpayments.Localauthoritiesoftenhaveteamsworkingonfinancialinclusionissuesandwheretheseareconnectedtodirectpaymentsteamstheycanbeagooduseofresource.

‘Thedirectpaymentsteamhavebeenfullyalignedwiththefinancialinclusionteamensuringthatdirectpaymentsusersgetfullfinancialadvice,andwehavesetupfreebankingarrangementswithacreditunion.Allstaffinvolvedinassessmentandcaremanagementhavereceivedtraininginpersonalbudgets.Thistrainingisdeliveredbyauserofdirectpayments.’12

‘InPeterboroughdirectpaymentsaremanagedbyPeterboroughCouncilforVoluntaryService.Thisisaninvaluablesupportandinformationservicethatcontinuestoreassurepeopleastheytakeuppersonalbudgets.’13

‘When I started the direct payment I had to set up a special bank account, but that wasn’t any problem. Age UK Camden organised a payroll company to do my carer’s wages for me and also set up employer’s insurance. I wasn’t afraid of the paperwork because I have experience of bookkeeping. All I have to do is to write my carer a pay cheque once a month, pay any bills that come in and pay the tax to HMRC each quarter. In two years I have never had any problems either with HMRC or with Camden Council. It’s all very simple as long as you keep all the papers in the right place.’ 14

Voluntaryorganisationsoften playavitalrole

The level and type of support onoffervariesa great deal, from minimal to extensive, high quality support and information.

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3.5 Recipients of direct payments might choose to top them upAllthelocalauthoritiesandmoneymanagementsystemswelookedatallow theaccountorcardholdertotopuptheiraccountwiththeirownmoney.Thisis sothattheycanbuymoreorbetterservicesthanarefundedthroughtheir personalbudget.

3.6 Cash paymentsGenerally,localauthoritiesdonotallowcarerstobepaidincashbuttheywilloftenallowcashpaymentsofothercostssuchasstamps,travelfares,foodanddrink,thereforeaccountswhichallowreasonableaccesstocashmaybeimportant. Cashpaymentsaremuchmoredifficulttomonitor,hencethepreferenceforpaymentsthroughaccounttransfersorbycard,buttheymaybetheonlyfeasiblewaytopaysmallsumssuchastaxifares.

3.7 Local authority monitoring requirementsAlllocalauthoritiesrequiresomeevidenceofhowthemoneyhasbeenspent,butthelevelsofmonitoringvary,asdotheformsandsystems.Acommonrequirementistosubmitevidencequarterly.

Evidencerequiredalsovariesbutcaninclude:

• Bankstatements

• Invoicesandreceipts

• PAYErecordsandemployer’sinsurancecertificate

• Signedtimesheets(personalassistants)

• Monthlyincomeandexpenditureform

Recipientsofdirectpaymentsmaythereforehavesignificantadditionaladministrativeburdens:itisnotjustacaseofchoosingtheservicesthatsuitthembestandfindingouthowtopayforthem.Thepaymentmethodandavailability ofstatementsandotheraudittoolscanaffecthoweasyitisforrecipientstomanagetheadministration.

Inthecaseofsomeprepaidcardsandcreditunionaccounts,localauthorities canhaveaccesstotheaccountsandarethereforeabletomonitorthemonline,withouttheneedfortheindividualtosendthemstatements.

CamdenCouncilistryingtoreducetheburdenonitsusersandnowonlyasksthemtosendinafewrecentannotatedbankstatementsfromtimetotime.Usersdon’tneedtosendinpayrolldocumentsorinvoices,unlesssomethingseemswrong.

As of 2013, expenditure on direct payments has increased by 30 per cent since 2011. 15

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How direct payments work – a range of payment systems are available

4Thischapterfocusesondirectpaymentsandlooksspecificallyatthemethodsofpaymentthatareavailable,bothtotransfermoneyfromthelocalauthorityand fortherecipienttomanageandspendthemoney.

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4.1 What features should a directpaymentsaccountoffer?Oncesomebodyhasdecidedtoreceiveadirectpaymenttheyneedtothinkabouthowtheywanttomanagethemoney.Theoptionswillvarydependingonthearrangementsinthelocalauthority.Paymentswillusuallybemademonthly,andbecausetheyaremostcommonlyspentonregularservices,accountswouldnotnormallybeexpectedtobuilduplargereservesmonthbymonth.Insomecasesaccountsmayholdlargesums,eitherbecauseofthesizeoftheregulardirectpayment,orbecausetherecipienthasbeenawardedaoneoffamounttobuyequipment.Therecipientwillneedtobeabletomakebothregularandoneoffpaymentstoindividualsandtocompaniesandthesizeandfrequencyofthesepaymentswillvary.Therecipientwillalsoneedtomanagetheaccountandbeabletoaccounttothelocalauthorityforthewayinwhichthedirectpaymenthasbeenspent.Becausethedirectpaymentisusedtofundessentialcare,itisespeciallyimportantthatthepaymentsystemsusedarereliableandrobust.Contingencieswillsometimesneedtobefactoredintotheamountofthedirectpayment,forexampleinthecaseofemergencies.

4.2 Bank accountsMostlocalauthorities(butnotall)requiredirectpaymentstobeputintoanaccountwhichisonlyusedfordirectpaymentsandiscompletelyseparatefromrecipient’sotherincome.Thiswillusuallyrequiretherecipienttoopenanewbankaccount.

Somelocalauthoritiesacceptothertypesofaccounte.g.oneheldatabuildingsociety,PostOffice,NationalSavings,creditunion,butsomewillnotacceptbuildingsocietyaccountswithapassbook,forexample.17 Itisthereforeimportantthat usersfindtherightsortofaccount;thiswilldependontheirindividualneedsandmayalsovarydependingontheareatheylivein.Thereareusuallyanumberonofferatmostbanksandbuildingsocieties.Themostobviousaccountisastandardcurrentaccount,whichwillnotchargeaslongastheaccountisincredit.Dependingonthebankorbuildingsociety,theremaybeanumberoftheseavailable.

Mostmajorbanksoffera‘basicbankaccount’,whichcanseemattractiveasitwillnotallowtheusertogooverdrawn.Howeverthistypeofaccountmaynotbesuitableforadirectpaymentsaccount,asitdoesnotoffercheques,islikelytohaveconsiderablerestrictionsoncounteruseand,notprovidetelephoneorinternetservices.Thiswillusuallybetooinflexiblefordirectpayments.Ontheotherhand,itisunlikelythata‘packagedaccount’(onewhichincludesadditionalservices,suchastravelinsurance)willbeappropriatefordirectpaymentsastheseaccountschargeamonthlyfeeforthebundleofextraproductswhichwillusuallybeirrelevanttorecipientsofdirectpayments.

Somedirectpaymentrecipientshaveevenbeenadvisedthattheyneedabusinessbankingaccount,butthisshouldnotbenecessary.Differentaccounttitlesmayalsomakeitdifficultforrecipientsorthosesupportingthemtoeasilyrecognisethemost

There is a huge variation between local authority areas in the systems which are operated.

Less than 18 per cent of older people use internet banking to pay bills (under 5 per cent for over 75’s). 16

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appropriateaccountforanindividual.Advisersshouldencouragedirectpaymentsrecipientswhoplantouseabankaccounttoconsiderwhatfeatureswillbeimportantforthemandwherepossibletoshoparoundtofindtheaccountofferingthebestfit.Tabletwomaybehelpfulinthinkingofsomeoftheimportantfeaturesofanaccountfordirectpayments.

4.3 Credit unionsInsomeareaslocalauthoritieshaveworkedwithlocalcreditunionstocreateabespokeaccountforpeoplereceivingdirectpayments.Somecreditunionsare abletooffercurrentaccountswhichprovideverysimilarfacilitiestotraditional bankaccounts,includingdebitcardsandaccesstotheLINKnetworkofcashmachines.Thisisnotyetanationallyavailablesolution,becausecreditunions donotyethavenationwidecoverageandarenotallabletooffercurrentaccounttypefacilities.HowevertheGovernmenthaslaunchedacreditunionmodernisationprogrammeandasthisdevelopscreditunionsmaybecomebiggerplayersinthemarketfordirectpaymentssolutions.

4.4 Use of paid third partyAthirdparty,suchasindividualservicefunds(ISFs),orpayrollservicesoranaccountant,isanoption,butwillincreasethecostofdeliveringthepersonalbudget.

4.5 Smalloneoffpaymentswithout separate bank accountSomelocalauthoritiesoperatesmallpaymentsschemeswherepaymentswithinapre-agreedlimit(e.g.upto£500)canbegivendirecttoindividualsforsupportneeds.Adirectpaymentagreementisstillrequired,butthepersondoesnotneedaseparatebankaccountandmonitoringisdoneprincipallythroughthereviewprocess.Thiscanprovideastraightforwardwayforpeopletopurchaseequipment orone-offservices.

4.6 VouchersSomelocalauthoritiesusevoucherstomakedirectpayments,althoughthesecanbemorerestrictive,forexample,limitedtospecificpurchases,brandsoroutlets, andtendtounderminetheprinciplesofchoiceandcontrol.18

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4.7 Prepaid cardsSomelocalauthoritiesusespeciallycommissionedprepaidcards,ontowhichtheyloadthedirectpayment.Suchcardsdonotrequiretheusertohaveabankaccount,butsomerequiretheusertobeabletousesystemssimilartotelephoneorinternetbanking.Prepaidcardswillrepresentacosttolocalauthorities,butsomeauthoritieswhohaveusedthemsofarbelievethattheydeliversavingsoverall,especially wheretheyalloweasiermonitoring.ArecentreportbythethinktankDemosintouseofprepaidcardsforbenefitdeliveryincludesusefuldetailontypicalcostsandexamplesofwherelocalauthoritieshavefoundsavings.19

‘After many years of helping people to open bank accounts and dealing with all the problems of this, this is a great improvement for us and saves a lot of time in the set-up procedure.

I was initially sceptical that this scheme would work; knowing that not many of our users have internet access and a lot might have problems with phone banking. However it has proved much more user-friendly than I had anticipated. There have been cases of financial abuse, usually where family members have been using the cards on behalf of older people, but these have been swiftly picked up and stopped.’ 20

AgeUKCamden’sexperience of prepaid cards

Prepaid cards are relatively new and schemes vary significantlyinthe functions and supportoffered.

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4.8 What the prepaid card systems can doPrepaidcardsofferdifferentfunctions,dependingonthearrangementmadebetweenthelocalauthorityandthecardprovider.Thetablebelowcomparesaselectionoftheprepaidcardscurrentlyinusewiththefeaturesofastandardbankcurrentaccount.Thefollowingchapterconsiderstheusabilityofdifferentfunctions.

Tableone,below,includesasmallselectionoftheprepaidcardscurrentlyused bylocalauthoritiesforthepurposeofillustratinghowthefeaturesofthesevary.Manymoreprepaidcardsarecurrentlyavailable.

Insummary,prepaidcardscanoffermostofthefunctionsofastandardbankaccount,themaindifferencesbeingbranchaccess,whichisoftenparticularly valuedbyolderpeople,chequesandoverdraftfacility.Howevernoneofthe prepaidcardsoffereverythingthatastandardcurrentaccountdoes.

Receivingpayments

Makingpayments

Secondcardavailable1

Face to face payments

Directdebits

Standingorders

Online payments

Telephonepayments using card

Telephonepaymentsvia banktransferdirect to payeeaccount

Table one: Examples of features of prepaid cards

Canaddownmoneyto account

Cash withdrawal

4

notusually

4 Chip& signatureavailable,payeeneedscard

reader

4

4

4

4

4 whereMastercardaccepted

4

onto the cardonly

4 if agreed

4

4 Chip&PIN,payeeneeds card reader

unknown

unknown

4 if agreed

4 bypostusing giroslip,online,

telephone,inbank

4

4 Chip&PIN,payeeneeds card reader

8

onto the cardonly

4 if agreed and onlyatcardissuerbankorATMswith

Visasymbol

4 4

4 4 4 4

4 4 4 4

4 4 4 4

Functions Bank Accounts

Camden Card

Enfield E-Card

Kent Card

18


Directdebits

Cannot overdraw

4

8

8 8

Keeping track

Paper statements

Telephone account information e.gbalanceOnline statements

Accountcan bemonitoreddirectlybylocalauthority

8

4 44

4 on some accounts

4 44

4 44 unknown

4 4 44

8 4 – 4 onlineandvia dataprovided

bybank

1 Secondcardscanbealifelineforaccountholderswhocannotalwaysgetouttoaccesscashthemselvesbutwhohavearegular carerwhocanbenamedonasecondcardlinkedtotheaccount.

Table one: Examples of features of prepaid cards

Functions Bank Accounts

Camden Card

Enfield E-Card

Kent Card

19


Money management - barriers and solutions5Thissectionappliesresearchonhowolderpeoplemanagetheirmoneyandinteractwithpaymentsystemstothedirectpaymentscontext.Itoffersasnapshotofsomeoftheconstraintswithinwhicholderpeoplemaybeoperatingandconsidershowwellexistingsystemsenablethemtomakepaymentsindependentlyandsafely.Italsoincludessuggestionsonstepspaymentserviceproviders,localauthoritiesandthosewhosupportdirectpaymentrecipientscantaketomakesystemsworkmoreeffectivelyforolderpeoplereceivingdirectpayments.Thechapteralsolooks atsecurityandrisksaroundfinancialabuse. 20


Olderpeopleinreceiptofsocialcarewhichisfundedbytheirlocalauthority mayalreadybelivingwitharangeofphysical,sensoryand/orcognitivedifficulties. Thesystemsusedtodeliverdirectpaymentsshouldtakeaccountofthosedifficultiesandnotaddtothem.

Olderpeopletendtohaverelativelygooddailymoneymanagementskills,howeversomecannotmakethemostoftheirmoneybecausetheyfinditdifficulttoaccessfinancialservicesorlackfinancialcapability.Othersmayneedhelpadjustingtochangesintheexternalworldorintheirownlives.

Researchhashighlightedbarriersexperiencedbysomeolderpeople.Thesebarrierscanbepermanent,forexamplesomeonewithalongtermconditionwhoispermanentlyhousebound,orcouldbetemporary,forexampleadirectpaymentrecipientmayhaveawell-establishedroutineofgoingtothebankbranchonceaweek,thatcouldeasilybedisruptedbybadweatherorsuddenillness.

Thissectionsetsoutsomeofthecommonchallengeswhichcaneffecttheease withwhichdirectpaymentscanbemanaged.

“People in later life have a lot to adjust to as their health declines and they acquire disabilities. …I do not think it will be laziness/preference that will get them to pay someone else to help out with the responsibilities involved in direct payments: it is more likely that they feel overwhelmed with all they have to cope with.” 23

“It is usually carers and or family who are managing the direct payments. Some younger disabled service users (aged under 70) are managing their direct payments but have usually had help and support in doing so initially.” 24

Over a quarter of people over 65 have difficulties with eyesight. 21

Almost a quarter of people aged 75+ report difficulty walking 100 yards. 22

21


Tabletwolooksatsomeofthemainchallenges,andpossiblesolutionsformoneymanagementanddirectpayments.

Choosing the right account for direct payments

Opening the account

•Gettinginformation,especiallyifnotonline

•Limitedchoiceofbankbranches,especiallyifrestrictedmobilityor in a rural area

•Knowingwhat kind of account is needed (some direct paymentrecipientshavebeenwrongly toldthattheyneedapaidfor,orevenabusinessaccount)

•Havingtherightidentification

•Completingforms

•Ensuring the account is flagged as a direct paymentsaccount

•Makesurerecipientknows what features theywillneed e.g.internetaccess,paperstatements, abranchnearby

•Help recipients to access information and application forms

•Help recipients thinkaboutwhethertheymightbeableto use internet or telephonebanking

•Encourage applicants tofindoutwhatidentificationis requiredbefore goingtothebranch tosaveuselesstrips

•Knowwhatidentificationisacceptable

•Makesurethatclientsknow their account shouldbeclearlymarked as a direct paymentsaccount

•Provideclientswithatemplateletter,whosewordinghasbeenagreedwiththeBritishBankersAssociation.(SeeAppendixA)

•Makesurethat thebankhasacknowledged that the account is a direct paymentsaccount

•Makesurestaffhave a good understanding of the account requirements of directpaymentrecipientsandabilitytoadviseandassistappropriately

•Makesurepoliciesallowan appropriate range ofidentificationtobeaccepted and that staff are aware of how to support customers without it

•Makesuredirectpaymentsnamingconventionisavailableand well used

Table two: Challenges and solutions

Activity Challenges Solutions

Local authority/ support services

Financial organisations

22


Making payments by card

Using telephone banking

•Difficulttohear

•Difficulttounderstandandbeunderstood

•Difficulttopress buttonsonphone

•Mistrustandlackofaudit trail

•Timeconsumingandpotentiallyexpensive

•Passwordscanbedifficulttoremember

•Automatedsystem vary,therecanbeproblemsiftherearelots of options or too little time to respond

•Makesurerecipienthas a phone with amplificationand bigbuttonsandanyother appropriate assistiveaids

•Ensure that for users whofindtalkingon thephonedifficultafacilityexiststoauthorise someone else to speak on their behalfaswiththeCamdencard

•Encourage users to keepnotestoprovide a record of telephone conversations

•Informusersofalternativestoexpensivephonelines

•Considerimpactofsecurityarrangementswhencommissioning,forexample,theCamdencardusersneedaPINnumber iftheyusethecardonline,butforphonecallstheyonlyneedtheircardnumber and the answer to a securityquestion

•Bothremembering andusingPINnumbers canbedifficult

•Youneedtobepresentto use the card for high street shopping oraccessingcash,difficultforthosewithmobilityissues

•Providermaynot havecardpayment facilities(especiallysmallproviders)

•Remindclientsthatbankswillprovide ChipandSignaturecards to people who havedifficultywith ChipandPIN

•Thinkaboutwhethernewsystems,suchasemergencycashnumbersorsecondcardsareavailable

•Designnewsystemstobeusablebythebroadestpossiblerangeofcustomers(firmsmayfindtheBritishStandardsInstitutestandardonvulnerablecustomers useful) 25

•Makesurethatsystemdoesnotrelysolelyoncardpaymentswhichwillexcludemanysmallerserviceproviders

•Reviewtelephonesystemstoensuretheyareaccessibletooldercustomers;researchonwhat older customers want from telephone linesisavailable.Keyissues include staff trainingandnumberofautomated options 26

•Reviewthesecurityneeded to access telephonebankingand the guidelines providedtocustomers,forexample,isitreasonableto expectcustomerstomemorise all of the passwordsrequired?




23


Using online banking

•Haveneverused the internet

•Lack of internet at home

•Lackoftrust–security,reliability,audittrail

•Maynotbeabletoafford computer and broadbandconnection

•Considertraining aimedspecificallyatolderpeople.Forinformation on training availablefromAgeUKseeAppendix7.3

•Thinkaboutwhetherthemoneysavingand communications benefitsofacomputermake it worthwhile foryourclient,butrememberthe cost of equipment andbroadband

•Considerencouragingyourclientstogetanaccount which allows internetaccess,butwhich also has other typesofaccesssothere’sabackup and time to get used toitgradually

•Reviewonlinebankingsystemsandcheckavailability

•Considerdevelopinglearning aids for those new to internet banking,forexample,theabilitytouseademonstrationsystembeforesigningup

•Considerwhatsupportcouldbemadeavailabletolessconfidentonlinebankingusers

•Reviewthesecurityrequired to access onlinebankingandguidelinesgiventocustomers,isitreasonabletoexpectcustomers to memorise thepasswordsrequired?

Access to cash

•Difficulttogetifyoucan’tgetoutofthehouseyourself

•Needtobeableto useaPINandto useanATM

•SomeATMsaredifficulttousebecauseofsecurityandphysicalbarriersduetolocation

•Somebanksrequirehigh minimum amounts for counter cash withdrawals

•Encourageyourclientstothinkaboutsafewaystoaccesscash,e.g.transferringmoneyto someone who can accesscash?(maybebetterthanhanding outthecardandPIN)

•Encourage clients to askthebankaboutpolicyoncashwithdrawalsbeforeopening account and consider switching to one that makes cash access easier

•ProvidemoreATMssuitableforpeople withvisualand other impairments

•Removeanylower limitsonsizeofcountercash withdrawals




24


When help is needed

•Whenassistanceisneeded to access (e.g.someonewhois hard of hearing maywanthelptousetelephonebanking)–thismaynotbepossiblebecauseofsecurityproceduresorif mandates are not recordedclearly

•Thinkaboutwhethertherearepaymentmethods that allow independent use

•Considersettingup abankmandateif a recipient has a regular carer

•Thinkaboutthesafestwaytogethelpe.g.isitbettertousedifferentpeople to check statements instead of relyingononeperson?

•Considerrequiringthe option of a second,linkedcardtobeavailabletoanominated carer when commissioning

Keeping track

•Easyiftelephoneandonlinebankingarefeasible,otherwiserelyongettingtoabranchor paper statements

•Paper statements not alwayseasytoread

•Encourage clients to check what the bank’spolicyonpaperstatementsisbeforeopeninganaccount, or consider switching

•Encourage clients to thinkaboutusingATMsto get mini-statements

•Encourage clients to keep up-to-date records

•Encourage clients toaskthebankwhat other formats statements can come in,banksmustmakereasonableadaptationsand should offer larger print and other formats

•Providemonthlypaperstatements on demand and ensure statements inalternativeformats aresentpromptly

•Publiciseandimproveinformation on alternativeformats

•Makestatements and letters as easy-to-readas possiblee.g.checkcompatibilityofonlinestatements with screen reading software and test impact of colour contrasts on paper statements

•Canlocalauthoritiesbegivenaccesstoviewaccountsandstatements to make monitoringeasier?

•Improveaccessfor bankcustomers with impairments anddisabilities

•Makeiteasyfor people to take out mandates,beissuedwithsecondcardsetc.




25


AlocalAgeUKexperience“Very few of them want to open a bank account - most are already reliant on carers or family managing their money. Families and carers are sometimes attracted by the [direct payments] scheme.” 27

An older man had a stroke and so was unable to use telephone banking. He obtained a mandate2 for his wife however on several occasions the bank ‘lost’ it. This caused great distress to the couple, the visit to the bank had not been easy and the loss left the couple unable to check balances or make payments. In addition, they both were made to feel very undignified, as the gentleman was forced to struggle to communicate passwords to telephone staff who could not understand him due to his speech impairment.

5.1 FraudandfinancialabuseTheAuditCommissionreportsthatin2011/12theaveragevalueofeachcaseofdetectedsocialcarefraud,includingthoseinvolvingpersonalbudgets,was£18,000,morethaneighttimestheaveragevalueofeachdetectedbenefitfraudcase. TheCommissionnotesthatsocialcarefraudarisingfrompersonalbudgetsisnoteasytodetectorprove,butisagrowingrisk.Fraudstersarebecomingincreasinglyawareoftheopportunitiesandtheabilitytoaccessfundsthroughdirectpayments islikelytomakefraudmoreattractive.29Everysystemis,ofcourse,opentoabuse -ourmainfocushereiswherethepersonreceivingcarecontrolstheirdirectpaymentsorhasthemmanagedbyafamilymemberorfriend.

Safeguardingpractitionersandlocalauthorityfinancedepartmentsprovide thefollowingexamplesofmisuseofdirectpayments:

• Personcontrollingthedirectpaymentaccountnotusingthemoneyto payforthecareofthevulnerableadult.

• Familymembergainingaccesstothedirectpaymentsaccountand misappropriatingthemoneysothatcarecostscouldnotbepaid.

• Personcontrollingthedirectpaymentsaccountengaginginfalseaccounting throughtheforgeryofaccountingrecordsorpayslips,toallowmoneyto bemisappropriated.

• Careworkerclaimingmoneyfortimetheyhadnotworked.

• Careworker,familyorfriendspendingavulnerableadult’sbudget inappropriately.30

2 Banksoffermandatesindifferentforms.Someareusedjusttoallowanaccountholdertoappointanotherpersontoaccesscash, otherscanbeusedtoinformthebankthatanotherpersonmayreceiveinformationabouttheaccountorhelptheaccount holdermanagetheaccount.

Ease of remembering a PIN falls with age and disability. Whereas nine out of ten people aged 25 – 34 find it very easy to remember, this falls to around three quarters of people aged 65+ or those people with a disability. 28

26


ActiononElderAbusestates“Intheexperienceofourhelpline,mostfinancialabuseisperpetratedbyfamilymembers,oftensonsanddaughters,whowilloftenseek tojustifytheiractionse.g.byclaimingthattheyaretakingtheirinheritance ‘abitearly’.”31

CroydonhasnowintroducedawarenesstrainingaswellassupportfromtheCouncil’sauditteam.Aspartofthis,staffareencouragedtomakeclosechecksonthededicatedbankaccountswithwhichusersmanagetheirdirectpayments.DavidHogan,investigationsmanageratCroydonCouncil,saidthatinthepasttheytendedonlytogivethemacursoryglance.

‘They need to go through these line by line and ask, “Is this telling me something I didn’t know about the service user?” It’s getting them to focus on the detail.’ 32

In2011,CroydonCouncilsuccessfullyprosecutedanelderlywoman’ssonforkeepingover£12,000intendedtopaycarers

EnfieldCouncilissuesaprepaidcardknownastheE-CardandtheirHeadofSafeguardingAdultssaysthatmakesitrelativelyeasytospotirregularities,but thatitisjustasimportantthatstaffarefinanciallyawareandhaveregularface tofaceconversationswithclients,especiallyiftheyareisolatedorvulnerable.33

Brunel University has developed a free tool to help social care, health and banking professionals spot financial abuse. More information can be found at: www.elderfinancialabuse.co.uk

AgeUK’sinformationguide‘MoneyMatters’providestipsonkeepingyourmoneysafe,includingadviceonhowtokeepyourPINsafe,monitoringyouraccounttomakesurethatyoupickupanysuspiciousactivityquicklyandwhattodoifsomethingseemswrong.

www.ageuk.org.uk/Documents/EN-GB/Information-guides/AgeUKIG20_Money_matters_inf.pdf?dtrk=true

Thereareoccasionswhentheindividualcanonlydrawoutcash,forexample,bygivingsomeoneelsetheirPINnumberbecausetheyarenotphysicallyabletogettoabankorshop.Researchconductedin2011foundthatalmostone-fifthofpeopleaged65andoverregularlyusedsomeoneelsetoaccesstheirdaytodayspendingmoney.34EvenrememberingthePINcanbenear-impossibleforsomeusers.Thesameresearchfoundthataroundaquarterofpeopleaged65oroverorlivingwith adisabilitydidnotfinditveryeasytoremembertheirPIN.Itisevenmoredifficult torememberthelongerpasswordsrequiredforonlineandtelephonebanking.

“My bank will not give me monthly statements on my direct payment account because there is not enough turnover of money in the account – I therefore have to wait for the quarterly statements to check on the money that has gone out.”

27


http://www.elderfinancialabuse.co.uk

http://www.ageuk.org.uk/Documents/EN-GB/Information-guides/AgeUKIG20_Money_matters_inf.pdf?dtrk=true

http://www.ageuk.org.uk/Documents/EN-GB/Information-guides/AgeUKIG20_Money_matters_inf.pdf?dtrk=true

5.2 Power of AttorneyAPowerofAttorneyisanoptionforpeoplewhohavearegularandtrustedpersontosupportthem.Powerscanbeestablishedsotheyoperatewhenthedonorstillhasfullmentalcapacity,butneedssomeoneelsetohelpaccessbanking.TheadvantageofaPowerofAttorneyisthatitallowsthepersonholdingthepowertotakealldecisionsandgiveinstructionsinrelationtothefinancialaffairsofthedonor.Howeverthiscanalsobeadisadvantageasitmaygivetheattorneymorepowerthanthedonorreallywantstogiveaway.Theattorneyisrequiredtoactinthebestinterestsofthedonoratalltimesandtherearelegalsanctionsavailablewheretheattorneydoesnotactinthisway.Althoughthedonorisentitledtocontinuetomakedecisionsabouttheiraffairsforaslongastheyhavecapacitytodoso,somepeopleexperiencedifficultiesbecausebanksystemsarenotalwayssetuptoallowtwopeopletomakedecisionsonasingleaccount.AnotheradvantageofaPowerofAttorneyisthatitisaformalprocesswithsomesafeguardsduringthesetupprocess.Howevernooneelsemonitorsitduringuse,sosimilarsafeguarding issuesexistaswithothermethodsusedtogivesomeoneelseaccesstotherecipient’saccount.

Hisson,James,heldapowerofattorneywhichwasbeingusedtoensurehisfatherhadsufficientmoneyandallbillpaymentswerebeingmade.Thebuildingsocietyhadnoconcernsovertheaccountandnounusualtransactionshadbeennoted.

Davidwasapproachedbyhisgrandson,Tom,whoclaimedthatJameshadbeenmisusinghisPowerofAttorneyandstolensomemoneyfromDavid.Beingblind,Davidcouldnotseehisbankstatementstocheckifthiswastrue,butTomwassopersistentandconvincingthatDavidrevokedthepowerofattorneyfromJamesandawardedittoTom.Tomhasnowhadover£35,000transferredfromDavid’saccountintohisown,ofwhichDavidwasunawareasTomliedaboutwhathewassigning.

Davidis98.Hehasfullmentalcapabilitybut isblind,hardofhearingandishousebound.

One in three people over 65 will die with a form of dementia. 35

28


5.3Useofset-offSet-offisarulethatallowsabankorbuildingsocietytousemoneyfromacustomer’saccounttopayamountsowinginanotheraccountheldby thatcustomer.

In2010AgeUKraisedconcernswiththeFinancialServicesAuthorityabout set-off.TheseconcernswereinitiallyhighlightedbytheAgeUKSupportBrokerageProvider’sNetwork.Itcouldmeanthatapersonholdingabankaccountfortheirdirectpaymentscanfinditbeingdrawnonbytheirbanktopayoffanoverdraftonaseparateaccounttheyhavewiththesamebank.FollowingaFinancialServicesAuthorityconsultationitwasclarifiedthatset-offcannotbeusedinthesesituations.

Astherulesprotectingusersfromset-offonlyapplyifthebank‘knowsorreasonablyoughttoknow’thattheaccountholdsdirectpaymentsitisimportantthattheuserensuresthatthebankisawarethattheaccountistobeusedfordirectpaymentsandthatthebankacknowledgesthis.

AnecdotalevidencefromAgeUKstaffworkingondirectpaymentsisthatnot alllocalauthoritiesrequiredirectpaymentsbankaccountstobenamedassuch andnotallbanksput‘directpayments’intotheaccountname,despitebeingrequestedtodoso.Someadviceagenciesadviseclientstosetuptheirdirectpaymentsaccountwithabankwithwhichtheyholdnootheraccounts.

29


Best practice: recommendations for local authorities and financialorganisations

6Thissectionbringstogetherrecommendationsforadoptingexistingbestpracticeandsuggestionsfornewdevelopmentswhichcouldremovebarriers.Forbothlocalauthoritiesandfinancialorganisations,akeythemeisawarenessofwhatolderpeopleneed.

30


Local authorities• Do not put pressure on people to accept or directly manage direct payments if they are unwilling to do so.Instead,clarifythefullrangeofoptionsfor managingpersonalbudgets,andensurethattheotheroptionsavailablegive peopleasmuchchoiceandcontrolastheywant.

• Recognise the relationship between financial inclusion initiatives and direct payments.Considerjoining-updirectpaymentsandfinancialinclusion teamsashasbeendoneinPeterborough.(Seesection3.4)

• Review the options available to users in your local area (e.g. bank accounts, credit union accounts, prepaid cards. Avarietyofoptionsmaybeneededto meettheneedsofdifferentusers.(Seesection4).

• Review the information you provide to users about different types of account, their advantages and disadvantages and common pitfalls of use for direct payments. Beawareofexistingsourcesofinformationwhichcould supportuserse.g.AgeUK,MoneyAdviceService.Suggestedresourcesand linksareincludedinAppendixB.

• Encourage users to think not just of their current needs, but also of contingencies. Forexample,howwilltheymanagetheirdirectpaymentsif theycannotgetoutofthehousebecauseoftemporaryillnessorbadweather.

• When commissioning services, be aware of what is possible and of how users operate systems in practice. (Seesections4&5).

• When appropriate, encourage users to try out online services.Classesand supportareincreasinglyavailableandlinksareincludedinAppendixB,but rememberthatcostsmaybeprohibitiveforsomeclients.

• Make sure that staff managing direct payments are trained to identify signs of financial abuse.FreetraininghasbeendevelopedbyBrunel University(contactsincludedinAppendixB).Otherorganisationsprovide trainingtohelpolderpeopletalkaboutabuse.Consideraddingthistofinancial inclusionprogrammes.

• When providing safety tips to users make sure they are practical. Thinkofthebarriersdescribedinsection5andconsiderwhatthebestways tomanagetheseare.

31


Financial organisations• Make sure that frontline staff know how to handle direct payments, especiallythattheyknowwhatkindsofaccountsaresuitableandhowto appropriatelynameorflaganaccount.Staffmayneedtoberemindedwhat directpaymentsinthiscontextmeansothattheyunderstandthedistinction betweentheseandotherregularpaymentsintoanaccount.

• Make sure that there is a naming convention for direct payments accounts so that they can be easily identified and inappropriate set-off can be avoided.

• Design new services to take account of the needs of direct payments users. TheEqualityAct2010requiresthatreasonablestepsshouldbetakentoensure equalityofaccesstoservicesforpeoplewithdisabilities.Lookatthebarriers describedinsection3andconsiderhowyourcurrentofferingcouldbemade moreaccessible,forexample:

- Howcantheaccountholdersafelydelegateauthorityonapermanentor temporarybasis–canasecondcardfunctionbeaddedtoanaccount?

- Howaccessibleareyourbranches,ATMsandotherinfrastructure?

- Couldyoursecurityproceduresbemademoreusable?Howpracticalare theyforcustomerswithsight,hearingandcognitiveimpairments?

- Istheguidanceyouprovideonsafetypracticalandreasonable?Forexample, guidancecommonlyrequiresthatcustomersdonotwritetheirpasswords downatall,morepracticalguidancemaybetoprovidecustomerswith adviceonhowtorecordpasswordssafely,ortodevelopprocedureswhich donotrequirecustomerstoremembermultiple,complexpasswords.

- Doyourstaffknowhowtoworkwitholdercustomerslivingwithadisability? Trainingisavailabletohelpstaffunderstandhowtheycansensitivelyand usefullyservecustomers.

- Docustomersandstaffknowaboutalltheservicesyoualreadyoffer? Forexamplehowwouldanewcustomerknowthatlargeprintstatements orChipandSignaturecardsareavailable?

• Make sure your staff are trained to identify and appropriately deal with signs of financial abuse.FreetraininghasbeendevelopedbyBrunelUniversity, linksareincludedintheAppendix.

32


Appendix7

33


7.1 Legislative backgroundDirectpaymentswereintroducedundertheCommunityCare(DirectPayments) Act1996.FormoreinformationonthehistoryandlegalbasisfordirectpaymentsseePersonalisationinPractice:LessonsfromexperienceAgeUK,2010at:

www.ageuk.org.uk/documents/en-gb/for-professionals/care/personalisation_in_practice-lessons_from_experience.pdf?dtrk=true

Thecommitmenttomainstreampersonalbudgetswassetoutinthe‘PuttingPeopleFirst’concordatissuedattheendof2007.36Thiscommitmentwasre-iteratedandextendedbythecurrentGovernmentinits‘Coalition–ourprogrammeforGovernment’publication.37

ThereisastrongdrivefromcentralGovernmenttoextendthereachofpersonalbudgetsanddirectpayments,in2010theGovernmentsetatargetthateveryonereceivingon-goingcareandsupportwoulddosobypersonalbudgets,with theaimofmakingpersonalbudgetsthenormbyApril2013foreveryonewho receiveson-goingcareandsupport,althoughthiswasreducedto70%in2012.38

TheGovernmenthasalsoexpressedapreferencethatmostpersonalbudgets aredeliveredasdirectpayments.

ThenumberofpeoplereceivingpersonalbudgetsatMarch2012was527,000 (up40percentfromthepreviousyear).Ofthese,139,000receivedadirectpayment (anincreaseof11percentfrom2011).39 Onestudyhasfoundthatolderpeople aremorelikelythanothergroupsofpersonalbudgetholderstohavetheirsmanagedbytheirlocalcouncil,butalargenumberdoreceivethemoneydirectintotheirownbankaccount,whichtheymanagethemselves.40Therecanbeaperceptionthatdirectpaymentsarenotforolderpeople,howeverresearchshowsthattheycanworkwellforsome.Infact,recentanalysisbytheCentreforDisabilityResearchhassuggestedthatolderpeoplereceivingdirectpaymentsreportmorepositiveoutcomesacrosssomedomainsthanthosewhosepersonalbudgetsweredeliveredbyothermechanisms,41 althoughthestudythiswasbasedonisnotnationallyrepresentative.Thereiscurrentlysignificantvariationoftakeupofdirectpaymentsbyolderpeopleacrossdifferentlocalauthorities.42Assumptionsaboutwhetherolderpeoplewantdirectpaymentsorcanmanagetheadministration maybeslowingtakeup.However,asthisreportshows,therearewaystoaddresssomeoftheconcernsolderpeoplemayhavearoundmoneymanagementwhichcouldopenupdirectpaymentstomoreolderusers.

TheCarersandDisabledChildrenAct2000extendstherighttoreceiveadirectpaymenttosomeoneprovidingassistancewithcare.Itgiveslocalauthorities powerstoofferassistancetoanyonewhoprovidesregularandsubstantialcaretosomeonewhomightneedcommunitycareservices.Thetypesofhelpthatcanbegivenarewide-ranging.Forexample,ifthepersoncaredforrefusestoaccepthelpfromanyonebutarelative,thelocalauthoritycanfundhelpwithhouseworkfor therelative(throughadirectpayment)sothattheyhavetimetocareforthem. Thecarerdoesnotneedtoliveinthesamehouseholdasthepersoncaredfor, andtheydonotneedtobeactuallyreceiving,ortohavebeenassessedas needing,acommunitycareservice.

34


http://www.ageuk.org.uk/documents/en-gb/for-professionals/care/personalisation_in_practice-lessons_from_experience.pdf?dtrk=true

http://www.ageuk.org.uk/documents/en-gb/for-professionals/care/personalisation_in_practice-lessons_from_experience.pdf?dtrk=true

AtpresentpersonalbudgetsareonlyavailableforsocialcarebutinOctober2011,theSecretaryofStateforHealthannouncedthat,subjecttotheevaluationoftrials,byApril2014everyoneinreceiptofNHSContinuingHealthcarewillhavearighttoaskforapersonalhealthbudget,includingadirectpayment.Thiswillformpartofabroaderrolloutofpersonalhealthbudgetstopeoplewithlongtermhealthconditions.Attheheartofapersonalhealthbudgetisacareplanwhichsetsout theindividual’shealth(andsocialcare)needsandincludesthedesiredoutcomes, theamountofmoneyinthebudgetandhowthiswillbespent.43

IfpersonalbudgetsaretodeveloponthescaleenvisagedbytheGovernmentthiscouldconsiderablyincreasethemarketfordeliverymechanismsandsupport.

7.2 Template letter to banks, provided by Age UK to local authoritiesDearSir/Madam

Youhaverecentlybeenapproachedby[insertnameofdirectpaymentrecipient]whowantstoopenaneworsecondbankaccount.

Theyneedtodosobecausetheyhavedecidedtohaveadirectpaymentfrom [insertnameofcouncil].Adirectpaymentgivesindividualsmoneyinsteadof socialcareservices.TheCouncilgivestheindividualthemoneysothattheycanarrangetheirownservices.

Aseparatebankaccountisessentialasthemoneyneedstobeusedforaparticularpurposeandinformationgiventothecouncilforauditpurposes.Itisnottoberegardedasincome.Pleaseseetheattachedsheetformoreinformationon directpayments.

TheBritishBankersAssociationhaveagreedthatthisletterbeusedasevidence ofcapacity,followingourassessmentof[insertnameofdirectpaymentrecipient] foradirectpayment.

The[insertnameofcouncil]onlyprovidesservicestopeoplelivingwithinitsboundariesandsocanalsoconfirmtheaddressof[insertnameofdirect paymentrecipient]is[insertaddress].

Ifyouhaveanyqueriesaboutthecontentsofthisletter,pleasecontact

[insertnameandcontactdetailsofrelevantpersonincouncil/supportservice]

Yoursfaithfully,

[Leadincouncilfordirectpayments]

cc.[insertnameofdirectpaymentrecipient]

35


Informationondirectpayments[canbeamendedtoreflectanylocalfocus]Directpaymentsgiveindividualsmoneyinsteadofsocialcareservices.TheCouncilgivestheindividualthemoneysothattheycanarrangetheirownservices.Thelawsaysthatcouncilsmustofferthisasanoptionfordisabledpeopleiftheymeetthequalifyingcriteria.

ThesedirectpaymentsarenotabenefitandaredifferentfromtheDepartmentofWorkandPensions‘directpayment’whichisameansofpayingeitherbenefitsor apensiondirectlyintoanindividual’sbankaccount.

Directpaymentsaremadebythecounciltotheindividualtopurchasetheirownservices.Theyarenotaformofincomeandshouldnotberegardedassuch.

Thecouncil’sdirectpaymentrecipientsneedtohaveaseparatebankaccountto paytheirdirectpaymentinto.Thisaccountmustbeseparatefromtheirexistingcurrentaccountforthecouncil’sauditingpurposes.

Thedirectpaymentrecipientmayneedsupporttomanagetheirmoneyandfor thisreasonwanttoopenajointaccountwithanominatedperson.Theywillneed achequebookforthisnewaccountsotheycanpayfortheircareservices.

Somepeoplehavenopreviousbankinghistoryorutilitybillsintheirname. TheymaychoosetogiveyouIDintheformofaCitizenCard.Somepeoplemayhavecapacitytomanagetheirbankaccount,buthaveaphysicaldisabilityandconsequentlyneedasignaturestamp.

Manydisabledpeoplehavelowincomesandsomemayhaveapoorcreditrating.However,anaccountfordirectpaymentscannotbeusedforpersonalexpenditureandwillhaveaguaranteedincomeeverymonthfromthelocalauthorityinvolved.

TheEqualityActrequiresyoutomakereasonableadjustmentsfordisabled people,andtotreatdisabledpeopleequallyandfairlyregardingaccesstogoods andservices.

TheBritishBankers’AssociationhasagreedwiththeDepartmentofHealthandtheAssociationofdirectorsofSocialServicesthatthestandardletterattachedbeacceptedasaformofevidenceofcapacity.Councilsmustonlymakeadirectpaymentwheresomeonehasconsentedtohaveadirectpaymentandisable tomanageone,withorwithoutassistance.Ascouncilscanonlyprovideservices toresidentsintheircouncilarea,thecouncilisalsoabletoconfirmtheaddressof thedirectpaymentrecipient.Thereforethelettercanalsobeusedasproofof thatindividual’saddress.

MoreinformationisavailablefromtheDepartmentofHealthwww.dh.gov.uk ortheBritishBankers’Associationwww.bba.org.uk

Ifyouwouldlikeanyfurtherinformation,pleasecontact[insertlocal contactinformation]

36


http://www.dh.gov.uk

http://www.bba.org.uk

7.3 Further reading and useful linksAgeUKhasarangeofusefulguidesforolderpeopleandthoseworkingwiththem.Thosethatcovertheissuesaddressedinthisreportare:

• ‘ManagingYourMoney’

• ‘MoneyMatters’

• ‘PowerofAttorney’

• ‘PersonalBudgets’

• Factsheet24,Self-directed support: direct payments and personal budgets

Afulllistofguidesandfactsheetscanbefoundhere: www.ageuk.org.uk/publications/age-uk-information-guides-and-factsheets/

Guidescanalsobeorderedinhardcopybycalling:08001696565

ThereisarangeofinformationandresourcesavailablefromAgeUKonpersonalisationwhichcanbefoundhere: www.ageuk.org.uk/professional-resources-home/services-and-practice/care-and-support/personalisation-hub/

The Way We Pay - payment systems and financial inclusion,AgeUK,2011.Thisreportpresentsnewresearchonhowolderpeopleusepaymentsystemsinrealityandcomparesapproachesinothercountries.Itwillbeofinteresttothosewhowanttolearnmoreaboutthebarriersfacedbyolderpeopleusingpaymentsystemsaswellasexploringpossiblesolutions.

www.ageuk.org.uk/Documents/EN-GB/For-professionals/Consumer-issues/the_way_we_pay_research_report.pdf?dtrk=true

GuidetouseofprepaidcardsinlocalGovernment,includingexamplesof documentsalreadyproducedbylocalauthoritiesusingprepaidcardsfordeliveringdirectpayments.

www.mastercard.com/uk/business/en/prepaid/commercial/guidance.html

British Standards Institute BSI 18477.Thisrecentlyproducedstandardiswrittento helpfirmsprovidingservicestovulnerablecustomersunderstandgoodpractice andinclusivedesignandhowthesecanhelpawiderangeofclients.

www.bsigroup.com/Documents/consumer-resources/BSI-Consumer-Brochure-Inclusive-Services-UK-EN.pdf

37


http://www.ageuk.org.uk/publications/age-uk-information-guides-and-factsheets/

http://www.ageuk.org.uk/professional-resources-home/services-and-practice/care-and-support/personalisation-hub/

http://www.ageuk.org.uk/professional-resources-home/services-and-practice/care-and-support/personalisation-hub/

http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Consumer-issues/the_way_we_pay_research_report.pdf?dtrk=true

http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Consumer-issues/the_way_we_pay_research_report.pdf?dtrk=true

http://www.mastercard.com/uk/business/en/prepaid/commercial/guidance.html

http://www.bsigroup.com/Documents/consumer-resources/BSI-Consumer-Brochure-Inclusive-Services-UK-EN.pdf

http://www.bsigroup.com/Documents/consumer-resources/BSI-Consumer-Brochure-Inclusive-Services-UK-EN.pdf

Your call is valuable to us: understanding what older people want from call centres,AgeUK,2012.Thisexpertseriesreportincludesaliteraturereviewandnew researchonthebarriersolderpeoplecanfacewhenusingcallcentres,along withsuggestionsonhowtodesignaccessibletelephoneservices.

www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/Expert%20Series-Advice%20Line%20Report.pdf?dtrk=true

Financial Services Authority Know Your Rights Guide,auserfriendlyguidetoyourdaytodaybankingrights,includingquestionsonuseofset-off.

www.fsa.gov.uk/pubs/consumer_info/know_your_rights_guide.pdf

BBA BCOBS Industry Guidance–thisguidanceisaimedatbanks,butcanbeuseful foradvocateswhowantmoreindepthinformationabouthowbanksshouldtreattheircurrentaccountcustomers.

www.bba.org.uk/media/article/industry-guidance-for-fsa-banking-conduct-of-business-sourcebook

Findaclasstohelpyougetonlineanduseonlinebanking.

www.ageuk.org.uk/work-and-learning/technology-and-internet/learn-about-technology/computer-training-courses/

orbycallingAgeUKon:08001696565

MoneyAdviceServicehasafreerangeofguides,onlinetoolsandprovidesface tofaceandtelephoneadviceforindividualstohelpthembudgetandmanage theirmoney.

www.moneyadviceservice.org.uk/?&gclid=CMv5uM-5m7ICFcqe7Qod0FIAeA

orcall:03005005000

BrunelUniversityhasdevelopedafreetooltohelpsocialcare,healthandbankingprofessionalsspotfinancialabuse.

www.elderfinancialabuse.co.uk/

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http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/Expert%20Series-Advice%20Line%20Report.pdf?dtrk=true


http://www.fsa.gov.uk/pubs/consumer_info/know_your_rights_guide.pdf

http://www.bba.org.uk/media/article/industry-guidance-for-fsa-banking-conduct-of-business-sourcebook

http://www.bba.org.uk/media/article/industry-guidance-for-fsa-banking-conduct-of-business-sourcebook

http://www.ageuk.org.uk/work-and-learning/technology-and-internet/learn-about-technology/computer-training-courses/

http://www.ageuk.org.uk/work-and-learning/technology-and-internet/learn-about-technology/computer-training-courses/

http://www.moneyadviceservice.org.uk/?&gclid=CMv5uM-5m7ICFcqe7Qod0FIAeA

http://www.elderfinancialabuse.co.uk/

References1 Guidanceondirectpayments,DepartmentofHealth2009,

updated2010: http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_121131.pdf

2 Consumerresearchwith‘olderold’consumersandthoselivingwithcognitive,physical&sensorydisabilities,PaymentsCouncil,2012: www.paymentscouncil.org.uk/current_projects/research_with_disabled_consumers_and_people_aged_over_80/

3 Factsheet24,AgeUK: www.ageuk.org.uk/publications/age-uk-information-guides-and-factsheets/

4 ADASSPersonalBudgetsSurvey,March2012: www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=9298

5 CommunityCareStatistics,SocialServicesActivity-England,2011-12,provisionalreleasepublicationdate:12September2012

6 PersonalBest,Demos,2010

7 ibid

8 From‘Yourcare,yourchoice’filmforAgeConcernEngland,2006

9 Factsheet24,AgeUk: www.ageuk.org.uk/publications/age-uk-information-guides-and-factsheets/

10 ThinkLocalActPersonal,ImprovingPersonalBudgetsforOlderPeople,PhaseOneReport,2013: www.thinklocalactpersonal.org.uk/Browse/SDSandpersonalbudgets/Self-directed_Support_Forum/Latest_Self-directed_Support_Forum_Products/?parent=9425&child=9436

11 BirminghamCouncil: www.birmingham.gov.uk/cs/Satellite?c=Page&childpagename=Adults-and-Communities-General%2FPageLayout&cid=1223345032096&pagename=BCC%2FCommon%2FWrapper%2FWrapper

12 ADASSPersonalisationSurveyOctober2011p6 www.adass.org.uk/index.php?option=com_content&view=article&id=285&Itemid=190

13 JuliaFlack,AdvocacyWorker,AgeUKPeterborough

14 AgeUK,YourCare,YourChoice,Makingdirectpaymentsworkforyou,DVD

15 ibid

16 Ofcom(2010)DigitalParticipationConsortiumTechTrackerQ1 2010

17 camdencarechoices.camden.gov.uk/managing-your-direct-payments.aspx

18 Factsheet24,AgeUK: www.ageuk.org.uk/publications/age-uk-information-guides-and-factsheets/

19 Demos,ThePowerofPrepaid,2012

20 WalterMiddleton,directpaymentsManager,AgeUKCamden

21 OfficeforNationalStatistics(2001)General HouseholdSurvey

22 EnglishLongitudinalStudyofAging(2006)Wave2

23 MaryCox,SafeguardingAdvisor,AgeUK


25 BritishStandardsInstitutestandard18477: shop.bsigroup.com/en/ProductDetail/?pid=000000000030213909

26 AgeUK,2012,Yourcallisvaluabletous:understanding whatolderpeoplewantfromcallcentres: www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/Expert%20Series-Advice%20Line%20Report.pdf?dtrk=true


28 TheWaywePay,AgeUK2011

29 ProtectingthePublicPurse,AuditCommission. November2012: www.audit-commission.gov.uk/fraud/protecting-the-public-purse/Pages/protecting-the-public-purse-2012.aspx#downloads

30 FromSCIEReport‘FinancialCrimeagainstVulnerable Adults.’November2011

31 www.elderabuse.org.uk/Mainpages/Abuse/abuse.html

32 TheGuardian,SocialCareSection.18January2012

33 TheGuardian,SocialCareSection,18January2012 www.guardian.co.uk/society/2012/jan/18/social-care-fraud-personal-budgets?INTCMP=SRCH

34 TheWayWePay:PaymentSystemsandFinancialInclusion,AgeUK,2011

35 DementiaUK,TheAlzheimer’sSociety,2007.(Adapted fromAlzheimerSocietyNewsrelease19January2009)

36 webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081118

37 www.cabinetoffice.gov.uk/media/409088/pfg_coalition.pdf

38 ‘AVisionforSocialCare:CapableCommunitiesand ActiveCitizens’(DeptHeath)November2010: www.communitycare.co.uk/articles/26/10/2012/118640/lamb-scraps-100-personal-budgets-target.htm

39 CommunityCareStatistics,SocialServicesActivity -England,2011-12,provisionalreleasepublicationdate: 12September2012

40 CentreforDisabilityResearch,OlderPeopleandpersonalbudgets:Are-analysisofdatafromtheNationalPersonalBudgetSurvey2011,2012: www.thinklocalactpersonal.org.uk/_library/PersonalBudgets/CfDRNationalPersonalBudgetSurveyOlderPeopleReanalysis August2012v22.pdf

41 CentreforDisabilityResearch,OlderPeopleandpersonalbudgets:Are-analysisofdatafromtheNationalPersonalBudgetSurvey2011,2012: www.thinklocalactpersonal.org.uk/_library/PersonalBudgets/CfDRNationalPersonalBudgetSurveyOlderPeopleReanalysis August2012v22.pdf

42 ThinkLocalActPersonal,ImprovingPersonalBudgetsforOlderPeople,PhaseOneReport,2013: www.thinklocalactpersonal.org.uk/Browse/SDSandpersonalbudgets/Self-directed_Support_Forum/Latest_Self-directed_Support_Forum_Products/?parent=9425&child=9436

43 www.dh.gov.uk/health/2012/02/personal-health-budgets-and-nhs-continuing-healthcare/ Update1February

39


http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_121131.pdf




http://www.paymentscouncil.org.uk/current_projects/research_with_disabled_consumers_and_people_aged_over_80/

http://www.paymentscouncil.org.uk/current_projects/research_with_disabled_consumers_and_people_aged_over_80/



http://www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=9298

http://www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=9298



http://www.thinklocalactpersonal.org.uk/Browse/SDSandpersonalbudgets/Self-directed_Support_Forum/Latest_Self-directed_Support_Forum_Products/?parent=9425&child=9436




http://www.birmingham.gov.uk/cs/Satellite?c=Page&childpagename=Adults-and-Communities-General%2FPageLayout&cid=1223345032096&pagename=BCC%2FCommon%2FWrapper%2FWrapper




http://www.adass.org.uk/index.php?option=com_content&view=article&id=285&Itemid=190

http://www.adass.org.uk/index.php?option=com_content&view=article&id=285&Itemid=190

http://camdencarechoices.camden.gov.uk/managing-your-direct-payments.aspx

http://camdencarechoices.camden.gov.uk/managing-your-direct-payments.aspx



http://shop.bsigroup.com/en/ProductDetail/?pid=000000000030213909

http://shop.bsigroup.com/en/ProductDetail/?pid=000000000030213909




http://www.audit-commission.gov.uk/fraud/protecting-the-public-purse/Pages/protecting-the-public-purse-2012.aspx#downloads



http://www.guardian.co.uk/society/2012/jan/18/social-care-fraud-personal-budgets?INTCMP=SRCH

http://www.guardian.co.uk/society/2012/jan/18/social-care-fraud-personal-budgets?INTCMP=SRCH

http://www.cabinetoffice.gov.uk/media/409088/pfg_coalition.pdf

http://www.thinklocalactpersonal.org.uk/_library/PersonalBudgets/CfDRNationalPersonalBudgetSurveyOlderPeopleReanalysisAugust2012v22.pdf

http://www.thinklocalactpersonal.org.uk/_library/PersonalBudgets/CfDRNationalPersonalBudgetSurveyOlderPeopleReanalysis August2012v22.pdf







http://www.dh.gov.uk/health/2012/02/personal-health-budgets-and-nhs-continuing-healthcare/

http://www.dh.gov.uk/health/2012/02/personal-health-budgets-and-nhs-continuing-healthcare/

TheAgeUKexpertseriesisforpeople influencing,designing,commissioning anddeliveringservicesforlaterlife. Thereportspresentevidence,lessons fromexperienceandpracticalsolutions.

TavisHouse1–6TavistockSquareLondonWC1H9NA0800 169 80 80www.ageuk.org.uk

Published in June 2013

AgeUKisacharitablecompanylimitedbyguaranteeandregisteredinEnglandandWales(registeredcharitynumber1128267andregisteredcompany number6825798).TheregisteredaddressisTavisHouse,1–6TavistockSquare,LondonWC1H9NA.AgeUKanditssubsidiarycompaniesandcharities formtheAgeUKGroup,dedicatedtoimprovinglaterlife.ID20093406/13

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