After dealing with a few similar safeguarding cases recently I am increasingly frustrated that my council does not have anything in place to keep track of who is employing who regarding direct payments and personal assistants.
I am all for people having the choice to employ who they wish to provide their care, but why does this remove all responsibility from us to ensure that person is safe. I understand that it is the responsibility of the service user to do the relevant checks, but just because someone doesn't have a criminal record does not mean they are not capable of criminal acts. I don't see why councils don't insist on keeping a record of personal assistants just so they know where to look if anything goes wrong.
I have dealt with two cases recently where a Personal Assistant has been accused of abuse of varying degrees. I know that both these PAs supply care services to other people, but have no way of finding out whose these people are.
Does any council have a system in place for keeping track of personal assistants? I would love to know so I can put a case forward to my own council as to why we should have basic information about a service users personal assistant.
If the person is in receipt of an Individual Budget, there's nothing to stop the SW / Care Manager asking for contact details for the PA, so they can offer support such as manual handling information / training or procedures in the case of a 'no reply'... of course they can refuse, but you really should be working together to make sure the arrangement is stable & safe.
I would try to get this information into the Support Plan, so that you can check & update at each review.
As a Personal Assistant employer of 17 years working as a Personal Budget Coordinator I do have a problem with authorities having "too much information"!
I completely understand the need to safeguard people, and having details of people's personal assistants might seem to be some way to go about this, however abuse goes on by workers from registered agencies and in Care homes, as well as by informal care providers. Just and just having workers details is no guarentee of safeguarding a service user and, in my opinion, defeats the object of allowing the person to take responibility for organising their own care and support.
In terms of offering support/ training etc - this should go directly through the employer. Local Authorities can't have it both ways -being happy to have the Disabled Person being an employer, employing legally and assuming full responsibility if things go wrong on the one hand, but then feel that they cannot trust the disabled person not to pass on beneficial infomation/ training to their workers or deal with potential abuse.
Working in the field I know that the majority of people are tempted by the flexibility of employing their own worker, and the autonomy - but people in general don't fully know that they will need to become a hr specialist, employment law expert, business man and accountant!
Support must by provided to the PA employer, to enable them to employ well and minimize risk - decent training and ongoing support for the PA employer's themselves is far more efficient at helping people take responsibility for their own assistance/safety, especially in the long-run.
The Local Authority that provides my Direct Payment have already overstepped the mark when the in-house payroll and support service (a conflict of interests in my opinions) started contacting privately employed Personal Assistants directly, using details that had been provided for payroll purposes only, to offer additional work.
Several of my friends who employ PAs suddenly had PAs cancelling work with them in favour of better paid cover work for someone else, or even said that they had been contacted by individuals looking for PAs - meaning that the Council had passed on private details. This obviously drastically affects the relationship the original employer has with their employee, and the PAs were under the impression that their employers had passed on the worker private details. For the above reason I would not suggest to any of my clients that employee's details are put on the Support Plan, or indeed given out to anyone!
A decent quality training course for people wishing to undertake employing a PA and the provision of good quality, on-going, independent, support services to the PA employers themselves is the only way to go!
Yes thats fine to do
The point I was trying to make is that there is no way of recording this information centrally, to be used effectively in the event of a safeguarding. If that PA abuses their client in some way we have no way of quickly/ easily finding out if they work with other vulnerable people and if so who those people are! We can record information about PAs on individual records but would have no way of contacting any other service users if they may be at risk from that PA without going through the records of every person on a direct payment or relying on word of mouth.
As a Family Carer operating a budget on behalf of my brother for the past 4 years I have acted as Employer so have the answers you ask for.
Under employment law where working with vulnerable children and adults there is an obligation on the employer to check
(a) the POVA list where appropriate (usually via the local direct support service or social care department)
and (b) desirable but not mandatory to do an enhanced CRB check.
If you recruit through the Job Centre you have to complete a form guarateeing that you will do the enahnced CRB check in order to post vacancies on their site.
As an employer you can be held liable if you fail to check the people you employ - this also goes as far as making it a criminal offence if you fail to check if they are eligible to work in the United Kingdom. You can be fined £10k per payment and up to 2 years in jail for employing someone not eligible to work.
Once my PAs are checked they have to provide me with copies of their birth certificates and driving licenses. It is a sackable offence to not do so on a regular basis so that I can confirm that they have not incurred points on their licenses and that they also give me a copy of their insurance forms to ensure they are insured to drive on the roads.
Social workers should be directing new entrants to DP to their local support service who should be able to assist in there start up and if necessary continued management through third party schemes. The support service can do the checks for individual and make sure that the service is being carried out by people NOT calssed as a risk to the individual.
Does that help?
I am a PA and have worked in 2 different LA's.
My own experience of Social workers in this context unfortunately is quite danming.
I worked with one client who was being abused by 2 'friends' who would stay at the clients address and steal their money. When I bought this up to the LA Social worker they explained they were aware but would do nothing about it. I made 17 complaints (all supposedly logged) and still nothing was done.
I called for CPAs and when they were done again were told nothing could be done.
PA's often work for a Care Provider and LAs should have the details of these, under legislation if a Care Provider has done their own checks the PA should be ok (I know some people slip through the net). LA's should have the Care Providers details and at the point of safe gaurding should then be able to talk to the Care Providers about the PA in question.
Although I'm wondering about if the shoe is on the other foot how do PA's complain about safe gaurding from the LA's.
Us 'little PA's' never seem to have any voice or are ignored due to our role.
I won't mention Data Protection issues regarding clients passing on workers details to be held on a central database that belongs to an organisation that the PA has no contractual relationship with. The administration of such a database would require a small army of people just by itself.
LA's don't keep registers of care workers employed by agencies.
The ability for clients to be employers of their own PA's is a part of personalisation that is fundamental. Sadly little thought was given as to how this would work in practice when you are talking about 1000's of unregulated PA's being employed, the development of 'ghost dom care agencies', safeguarding and other such issues.
With regards to the issue about the client being abused by 'friends' - unless the client is willing to co-operate with any action taken then it is a no win situation (have come across it quite recently). Unfortunately the Law does not allow LA's to employ a couple of heavies to go have a 'quite chat' with 'friends' in such circumstances.
Khitan: I won't mention Data Protection issues regarding clients passing on workers details to be held on a central database that belongs to an organisation that the PA has no contractual relationship with. The administration of such a database would require a small army of people just by itself. LA's don't keep registers of care workers employed by agencies. The ability for clients to be employers of their own PA's is a part of personalisation that is fundamental. Sadly little thought was given as to how this would work in practice when you are talking about 1000's of unregulated PA's being employed, the development of 'ghost dom care agencies', safeguarding and other such issues. With regards to the issue about the client being abused by 'friends' - unless the client is willing to co-operate with any action taken then it is a no win situation (have come across it quite recently). Unfortunately the Law does not allow LA's to employ a couple of heavies to go have a 'quite chat' with 'friends' in such circumstances.
Issues of who a *PA* works for may well fall under some dark corner of the Data Protection Act but there is one sure thing, *we* (substitute whomsoever you wish here, LA, CQC, Care Provider...etc) should damn well know which client has a PA - and that means ALL publicly funded clients (issues become more tenuous for a privately funded client) ...it is, after all, Public monies being spent. From an HMRC position, they should damn well be told about who is earning money, being paid and make sure they are completeing a suitable tax return to establish their tax position. In addition, that PA should be insured for Public Liability at the very least and that should also be a matter for verification.
This is not about LA's *knowing* the names of care workers employed by agencies - the agencies have that information and have already been through a whole sequence of checks and balances before employing said care worker - it's about a whole raft of unregulated activity which is being carried out for the older, vulnerable sector of our society whom often need additional protection, over and above that which they are able to implement themselves.
This is much simpler than it may seem but...... and here's the big but, most LA's are not concerned with tracking or monitoring just how an allocated PB is being spent. There appears to be an ethos of hand wiping after the money is transferred to the client and it is going to bring more and more abuses to the fore as unscupulous operatots move into this largely unregulated area of PA/Advocates.
I take issue however with your assertion that safeguarding and/or abuse prevention can only prevail with the co-operation of a client. That is clearly not so for numbers of reasons and whilst it is preferable to have a client *onside* abuse can be confronted and prosecuted without such help and assistance. Indeed, in many cases, the client who suffers from short term memory loss and/or Dementia not only will not be able to identify much of the problem but are, in fact, the very people that have to be protected from abuse.
Evidence of financial abuse can come from many quarters and can be identified under the right circumstances and/or the process of *setting up* a situation that allows for independent evidence to be gained. When one talks of friends - friends who steal from 'their' friends - one doesn't really need to go far to establish the true value and intent of such a relationship. With families it is remarkably harder than with friends but... this has to be stopped. No ifs and buts ...it's theft, it's criminal, it is prosecutable and it is abuse of a vulnerable person.
As you say, great idea Pa's but it all got lost in translation. The whole system is slipping into mindnumbing inequalities as La's and care providers are bound by strict legislation and compliance whilst public money is handed out to vulnerable people, some who have little idea over what they are doing from moment to moment, to be spent with any non regulated provision as they wish. Nonsensical.
pj
So what is the solution? A PA register with basic contact details and who they provide services for so that in the event of an emergency/safeguarding/issue we know who to speak to?
In my LA at the moment unless the information is volunteered there is no prerequisite to find out any basic information about a PA. I feel there needs to be change in the way we view these relationships - we wouldn't expect a care agency to employ someone without information about who they actually are, so why do we think it is okay to let service users employ what are potentially complete strangers without the same information?
I am completely behind the idea of people having the choice in who they employ, i think it is one of the most progressive things to have happened in social work in a very long time. My issue is that much like elements of the mental capacity act, it seems that some people see it as an opportunity to discharge their safeguarding responsibilities and that isn't okay. People should be afforded choice and responsibility without having to forfeit their right to protection.
The issue about safeguarding and PA's is one many a social worker hasfound a massive source of fustration. As for responsibility for checks - I would have thought that the responsibility is joint a several between the service user or his/her agent and the local authority. The SU as they will be the employer of the PA, th LA as they will ultimately be providing public funds to pay for the support and in the same way that the LA has to satisfy itself that services funded via DP's are legal, they also have a responsibilty to ensure that are not being put at risk due to those services.
A list of PA's (along with a list of care workers or providers) should be made available to any prospective PB client. That list should be derived from a central register - much in the same way that CQC has a list of every care provider across England because the care provider has to be registered with CQC) . It really does follow that there has to be aregister for individuals that provide PA services and/or individua care provision.
The way this nonsensical situation is at the moment is that LA's, homes and dom care agencies/providers ALL have to be registered and comply with legislation. A PB can *hire* anyone at all - next door neighbours cousins daughter! - without any checks on that person, or for that person to have been cleared of a criminal history of abuse (..and more). Further, those unregulated people need have absolutely no training in manual handling, food & hygiene, medication practice, dementia awareness and so on.... it is farcical.
Before we all get carried away with this great new world of PB's - cycnically, in my view, brought about because of unrelenting pressure from support groups such as the Carers Association and seized upon as a way of cutting Social Care spend (it is becoming more apparent as to the underlying ethos in this as LA's raise the threshold bar, create complicated application systems, sometimes by telephone assessment!, and reduce the funding thereby to and end SU). Levels of funding in many cases are down to no choice, or very little choice, of spend as the funding award barely covers basic human and personal needs and requirements to survive with some modicum of dignity.
It is quite clear and obvious to anyone who is involved and working in this field that abuses are going to rise (possibly substantially) if no checks and balances are made upon those swathes of people who will come into contact with the older vulnerable groups of PB holders and are completely unregulated.
This is not about removing choices, there are many aspects of being funded and the money being spent that do not bring heightened concerns for abuse worries. Buying things, for example, tickets, outings, shopping, visits and trips and a whole lot more but if we are going to allow vulnerable people to have money for personal care we are going to have to ensure that care and any assistance in buying that care is provided by people on regulated lists. It is impossible for an individual - let alone a vulnerable adult - to ensure the people they are *hiring* are fit for the purpose, so to speak, (an individual, for example, cannot apply for a [enhanced or otherwise] CRB check) and it falls on a wider management structure to ensure that people who get up close and personal are *vetted* or *regulated* before they work with vulnerable people.
I think there is a growing problem with the "or his/her agent" which we probably would accept implies a PA or Broker hired for the purpose, so to speak. (Not so much, say, legal representative or parent for example)
There is no system for checking the suitability of the said PA under these circumstances - in the same way (and perhaps even more serious) that there is no checks on the suitability of a care worker employed directly under a PB scheme who did not come from some regulated agancy.
Clearly, the fact that money transfers from the LA to a SU cannot surely devoid the responsibility of following the money trail through to its destination as it is still public money. We cannot accept that the SU is the *end* destination of the money...that is clearly nonsensical. As you mention, there is a minimum of responsibility at least, to ensure funds are not being used 'illegally' and/or the services bought do not pose a risk to the SU.
Clearly, it is difficult to envisage a system that does not have control checks and balances - complete freedom of choice, is, as we all know anyway, an illusion.
Sorry...got carried away.
Yes. A PA register at the very least. Consultable by the Public and by social care professsionals......Along with a care worker register..... ;0)
PJ
I'm thinking things may change as soon as someone with a PA and a Personal Budget from the Local Authority is seriously abused and it becomes kown in the media that public money was used to fund this abusive person. Of course most PAs are honest and committed, but service users are potentially vulnerable in these situations, just as they are when receiving care through an agency commissioned by the LA or directly from carers employed by the LA. This was an issue raised when personalisation and Personal Budgets were first discussed but tended to be dismissed as social workers not wanting their service users to attain so much independence or resisting change and thus putting the frighteners on. Some disabled people were vociferous that they would employ PAs with criminal records if they wanted to, but many of them were very well placed to look after themselves if things looked like going wrong. I heard today about a woman with no speech who is frightened of her PA who is very domineering and seems to work as she likes and when she likes. She has confided her fear in a social care worker but at review (with the PA in the room) communicated that she was happy with her. My view is that, whether it looks patronising or over-protective or not, the LA awarding the Personal Budget should insist anyone employed with that money is CRB checked (far from an absolute guarantee of safety but something), and that we should look (yet again) at registration for social care workers in all settings as we have for social workers.
It's such a sad indictment that we *may* be waiting for something serious to happen to draw attention to the gaping hole in this area. :0(
The whole personalisation issue has been forced and thrust into our lives under the mantra of personal choice - which is difficult to argue with at many levels as a notion or ethos.
In reality, as many of us know about and have experienced, it was all a con trick for the most part and the reality of personal choice certainly is NOT available to all PB holders. Clearly, it works for some sections of social care - albeit there are still concerns of unregulated provision - but for the older vulnerable sector it just is, in its current form, unthinkable and unworkable for the vast majority.
However, LA's are under central government targets and have also seen the obvious possibilites to reduce their social care budgets by, mistakenly I believe, thinking they just award a PB and are then free of any responsibility from thereon in. Cutting out in house provision has, and is, reducing care provision costs as is reducing qualified care managers and other support staff whilst hiring untrained staff to undertake telephone assessments. Closing day centres reduces choices for PB holders and it is difficult to see how other support services can start up and flourish in an environment of not knowing where the income is to come from, in what volume and when.
By the way, your recounting of the person you spoke about is so clearly abuse it's not even worth discussing whether it is or not. (I know you're not :0))
Fear of someone else (in the case you mention, clearly, fear comes to the fore having explained the position when the person concerned was not there but being afraid to express that in front of the person concerned comes from emotional abuse. Pure and simple.) is often clearly visible by a third party and I'm sad that this person should have to experience such behaviour.
I also agree that registers and CRB checks are not infalliable and not the full story either but.......at the moment we have next to nothing in the way of safeguarding PB SU's.
I agree with you wholeheartedly that the money being spent under any guise that we choose to call it, Personal Budget, Direct Payment etc., is still public money and deserves to be accounted for correctly and I think we have to get over this mind wrenching contradiction between freedoms and free choice and the need to protect people who cannot protect themselves. Having a system that does not take that into account is plain daft, in my view.
Maybe these senior managers and politicians need to be visiting the increasing numbers of dementia sufferers countrywide to see just how vulnerable they can be and how the PB system, as it is, provides no security for that vulnerability.
I know Skills for Care were looking into starting a data base with personal assistant details, not sure how far they have got with this.
Trisha1: I know Skills for Care were looking into starting a data base with personal assistant details, not sure how far they have got with this.
With the whole system in a very near freefall there is no such database. I doubt there ever will be. The whole system is a disgrace from start to finish for the older vulnerable groups who are just not best served by this approach. On top of the cuts, obvious and clandestine, personalisation is nothing but a money saving exercise for older vulnerable adults. I know of not one person in such a group [I have experience of over 600....] that has been funded either at the same level as previously, or higher. In every case, the funding is below (...often, well below) the previous system.
The relativity of this to this thread is that if we did not insist on pushing through these completely inapproariate schemes we wouldn't need PA's...!!
Have been reading with interest. Would driving a vulnerable adult/s without a driving license be seen as abuse? Obviously I know you should check license. Well I have certainly learnt from that!! This person hadn't even passed her test. Just always had had a provisional. How would this stand up in court, especially if the person had drove a bit unusually on the motorway? Should this person be charged? Is it possible even after 17 months. Police removed her for other things, but she was never cautioned just sent on her merry way. She was not sacked after finding out, so guess it would be pretty difficult to get a conviction? And at the most I guess (for the driving) she would get 3 points off her license.