Personal budgets protocol

Emotional abuse

Personalisation and the transformation of adult social care promotes independence and gives people who use services more choice and control over the way their support is provided.

Self directed support

Self directed support is a change to the way people with ongoing social care needs are supported. There is a focus on increasing people's independence and their promoting inclusion in their community. Every person receiving support should have as much choice and control as possible over how this is provided.

Personal budgets

A personal budget is the name for money allocated to individuals, who are eligible, to pay for ways to meet their social care needs. Where there is more than one funding source, such as Supporting People or Independent Living Fund monies, these can be added to the personal budget and called an individual budget. A personal budget may be managed by councils or by another organisation. People choosing to manage their own personal budget will usually be paid via a Direct Payment.

Adult safeguarding

Adult safeguarding is the multi-agency process used to investigate allegations of abuse or harm in respect of vulnerable adults (see policy and procedure for definitions of vulnerability). Abuse or harm occurs in all areas of people's lives and in services they receive and takes many forms:

Physical abuse
Financial abuse
Neglect
Sexual abuse
Emotional or psychological abuse
Discriminatory abuse
Institutional abuse

Adult safeguarding is therefore about working with vulnerable adults to stop abuse or harm occurring; to assist individuals to be safe from abuse or harm in the future and to work with services to prevent abuse or harm occurring in the first place.

Aims of this protocol

The main aim of this protocol is related to the prevention of abuse or harm by ensuring all reasonable steps have been taken to minimise the risk of abuse for people who are self directing their own support. Particular attention needs to be given to those people who may be vulnerable to abuse or harm and who lack the capacity to make decisions related to these matters and need someone to assist or make decisions on their behalf.

To recognise that abuse and harm can occur with personal budgetary arrangements
To recognise that self directed support has similar safeguarding risks as other forms of support
To identify particular adult safeguarding issues that may arise for the increasing number of people who will be taking a responsibility for arranging their own support e.g. financial abuse, neglect, poor quality of support
To clarify the risk management processes needed to deal with the above situations
To clarify the training needed to support this protocol

Key issues

Self directed support is potentially an effective and established way of enabling people to take control of decisions about how their needs are met.

Experience and learning from the implementation of existing safeguarding policies can be used to manage or resolve the risk of abuse during the transformation process in public services. At the heart of this transformation is the need to recognise that, for the most part, organisations and professionals do not need to make decisions for people. Individuals should be able to make real and informed choices some of which will include risks of harm and abuse.

People need to be aware of any potential for abuse or harm that may occur in the arrangements they are making. All types of abuse are possible but any concerns about the potential misuse or stealing of the money provided through a direct payment should be highlighted.

An evaluation of risk is central to any assessment: simply put, a risk assessment is a careful examination of what could cause harm to people. Risk management and risk enablement is part of the person centred support planning process.

Support Plans should record all risks associated with identified needs and any other safeguarding issues identified in assessments. There will be specific reference to how the personal budget will be spent to meet needs and outcomes.

Consideration needs to be given to what support is offered to people providing the support, including Personal Assistants (PA) who have become the subject of safeguarding allegations and may be suspended or disciplined by their employer.

Direct payment recipients who become employers need to understand their responsibilities to inform the Independent Safeguarding Authority (ISA) of any staff they dismiss following an adult safeguarding investigation to ensure that consideration is given to whether the PA is suitable to continue working in the area of health and social care.

Approval for a direct payment may be refused if there are serious safeguarding issues or any previous incidents related to financial abuse that cannot be resolved or appropriately managed. Capacity is a key issue but many people with limited capacity will be supported to manage a direct payment especially where the carer or a trust circle oversees the Personal Budget. If there is financial abuse by a carer/relative moves must be made to remove the risk. Actions by the person using a direct payment that are deemed to be fraudulent will result in the termination of the arrangements until such time as work has been carried out to reduce or remove the identified risk.

Vulnerable adults need someone they can ‘trust' and talk to when they feel they are being abused. This may be a relative, a friend or a member of staff (health or social care). An adult safeguarding leaflet should be given to all individuals receiving a direct payment.

Good prevention of abuse or harm starts with awareness and moves on to good recruitment and employment practices. These can include the scrutiny of potential PAs criminal background (Criminal Records Bureau checking - Independent Safeguarding Authority checking); examination of previous employment history; the checking of qualifications; close examination of references, etc. Information on these procedures should be made available to all people considering arranging their own care.

The assessment, support planning, monitoring and review process must continue to address any issues about individuals' capacity to manage a direct payment and appropriate arrangements to assist put in place. Where a person does not have capacity, a carer/relative can act on the person's behalf unless there are concerns about what is in the individual's best interests.

Finance Officers employed to check and support users of direct payments need to be made aware of safeguarding issues.

As part of any review of self directed support arrangements there should always be consideration of safeguarding issues and procedures.

Supporting people with direct payments

SUGGEST are a user led group offering advocacy and support to people who use direct payments. Staff and members of SUGGEST must ensure they are aware of safeguarding issues and routes to reporting concerns.

SUGGEST monitoring forms should have a tick box where people using a direct payment can ask to discuss concerns. SUGGEST have a representative seat the Adult Safeguarding Board Implementation Group.

Training issues

Safeguarding is concerned with assisting people to make themselves safe(r), so individuals need good quality information related to how to make referrals about abuse situations.

Individuals should be given clear information about situations when/where authorities enter adult safeguarding processes. This could be enhanced by offering training regarding safeguarding and staying safe.

All training in respect of personalisation and self directed support must include elements of adult safeguarding and risk management.

People using self directed support need to be aware of the processes for expressing concerns or reporting abuse or harm about the support services they engage with.

Staff involved in assessments, support planning, monitoring, reviewing and supporting people using direct payments must have received training in basic awareness of adult safeguarding. This would include any people providing peer support via the local user-led organisation.

Training should be made available to PAs employed to support individuals under a direct payment.