Picking up the tab for service users

Social workers are often faced with a dilemma over whether to use their own money to help clients. Andrew Mickel asks if this brings their professionalism in to question

Social workers are often regarded as altruistic. But it seems that the desire to help clients sometimes leads them to put their hands in their own pockets.

Rebecca* works in an older people’s mental health team and has had to spend her own money on clients, often because benefits haven’t gone through. “It is common for me and my colleagues to spend between £10 and £30 two or three times a year,” she says. “You go to somebody’s house and there’s no food or money there. You don’t feel that you can leave with absolutely nothing in their house, so I have been across the road to get some milk, cereal, bread, and then sort the problem out in the morning.”

On another occasion an elderly woman’s son who was her main carer was hospitalised, and none of her other carers could get in her house. “It cost me £40 because I needed to get keys cut for the carers,” Rebecca says. “I’ve spoken to the manager and he’s offered to pay the money out of his own pocket.”

The public sector union Unison says it has no record of its social worker members paying out for clients but Ruth Cartwright (pictured), professional officer for England at the British Association of Social Workers, says: “Most social workers have probably done it, or felt inclined to do it, during their career.”

Taboo subject

So why is this common practice something of a taboo subject? There are several reasons. The sums spent are often individually small. It can be difficult to determine what constitutes an altruistic act, and what could be perceived as threatening a professional working relationship with a service user, so staff consider it is best not to mention it. But perhaps most importantly the already difficult task of gaining access to state cash for clients has recently been made even harder.

For those working with children, obtaining money appears straightforward. Section 17 of the Children Act 1989 provides for “assistance in kind or, in exceptional circumstances, in cash”. But, Sharon*, who used to work in a child protection team says this is very bureaucratic. “There are three or four pages of forms and it needs lots of signatures. It should be made easier.”

For those working with adults who need immediate cash there are no funds available from local authorities. Outside of working hours, the Department for Work and Pensions has an emergency service that is supposed to be able to provide cash if something goes wrong with a user’s benefits (the money is subtracted from subsequent payments). But a few months ago that service was restricted to weekend daytimes only, and it involves going through a call centre, and a visit by a local emergency officer.

It is also possible to make a crisis loan application during working hours. But Gary Vaux, head of money advice at Hertfordshire Council, says: “This system is in crisis because so many people are waiting for their benefits claims to be processed.” He adds that it can take a day to be processed, and is not immediate enough to help deal with emergency situations.

The increase in crisis loan applications arguably points to an increased need for an out-of-hours emergency service, although it should be noted that the service was cut partly because of falling use. Ken Brennan, manager of the Hertfordshire emergency duty team, says that when emergencies do happen cash is needed from somewhere. “It shouldn’t be social services who sustain people,” he says. “It should be the DWP.”

In the absence of proper systems, alternative, less formal, arrangements have evolved. Cartwright says that when she worked in a hospital social work team, in-house fundraising created a charity fund to help out users in need of essentials. “It was run by one of the admin staff. There are plenty of funds like this around, and then there’s also creative accounting by the first-line manager.”

Introducing such funds defends the profession from questions about transparency. For those without access to money from these sources Cartwright says that social workers should contact their managers before buying anything. But she also acknowledges that this isn’t always possible.

Official guidance

What little official guidance there is on maintaining professionalism is wide open to interpretation. The GSCC code of practice states social workers should “[promote] the independence of service users whilst protecting them from harm”, which would suggest that ensuring that users have what they need is the priority. It goes on to state that this should be while “upholding public confidence in social care guidance”, suggesting that a rigorous form of professionalism should take precedence.

The GSCC wouldn’t be drawn on specific scenarios, but its concern is focused on those social workers who overstep professional boundaries. Robin Weekes, its head of conduct, says: “Practitioners are sometimes required to exercise their judgment in difficult circumstances. Most social workers will act in the best interests of people who use services, but it is our duty as regulator to investigate if someone was going beyond the boundaries of their role.”

Former social worker Bob Holman (pictured), best known for his work as a neighbourhood worker in Glasgow’s Easterhouse estate, says: “I never gave money out of my own pocket because there was a strong emphasis on being professional.”

Sharon has also concluded that social workers shouldn’t spend their own money, but for different reasons. “At the time I thought this was really endearing, this was what social work was about,” she says. “But now I very much question it. Who am I to dictate someone’s needs? Would I be prepared to buy drugs, fags or porn for somebody? Someone’s physical need for drugs could be just the same as food and it’s not a decision for me to make.”

But such ethical dilemmas seem trivial when faced with an elderly client who has no food in the cupboard. As for the question of whether it leaves a service user feeling they “owe” a social worker, many professionals don’t let users know they have paid for things out of their own pockets, instead pretending they can claim back the money later.

What seems inevitable is that with the reduction of out-of-hours services more professionals are going to be faced with situations that need immediate financial help that won’t be there.

The regulatory standpoint should be clarified in the GSCC’s forthcoming guidelines on professional boundaries. But Holman says that meeting professional standards shouldn’t be used as an excuse to keep a distance from people in need. “I’m a member of a society where there are people who are unnecessarily poor through no fault of their own. I therefore do have some duty towards helping people who have desperate need.”

* Names have been changed

Your views on paying for clients

Social workers’ attitudes towards putting their hands in their pockets for clients from www.communitycare.co.uk/carespace

● Lins: “I had a case that involved a young woman who was moving into her own flatI could see they were struggling to buy basic items. I had known her since she was 12 years old. I took her to Ikea and bought her curtains. I probably shouldn’t have but I wanted to show her practical support and not just lip service. I did inform my manager, just to cover my back.”

● Rosierosierosie: “Yes, I have put my hand in my pocket for clients and I would again. I always make sure a client knows that it is money I claim back though (even when I don’t), so it doesn’t become a personal thing – I think that would be dubious practice.”

● Lizzer: “On my first placement I used to meet two girls and buy them a hot chocolate. One day my manager questioned me on it and said in the future I should get receipts and claim the money back. I do understand the rationale behind it, but it sort of took a bit of the humanity away having to turn it into paperwork.”

● CB: “I have bought basic foodstuffs for some people when they are discharged from hospital and have no money and no food. We don’t have any access to any petty cash and although I know I shouldn’t”

Have your say on this issue

This article was published in the 13 November 2008 issue of Community Care under the headline ‘Who’s picking up the tab?’