Adults, Health and Housing DPEG – ‘Policy Co-Production’ Session 2

Adults, Health and Housing Agenda Introductions. Purpose of Today. Potential Misuse of Direct Payments. Suspension of Direct Payments. Discontinuing Direct Payments.

Adults, Health and Housing Welcomes, Introductions & Housekeeping Ian Kennard :| Direct Payments & Personal Budgets| ikennard@thurrock.gov.uk Ian Evans :| Director of Thurrock Coalition | ian@thurrockcoalition.co.uk

Adults, Health and Housing Purpose of Today? ‘To discuss and capture the thoughts of all on key elements or themes of Direct Payment policy so that we can co-produce a new, more appropriate document to improve the Direct Payment experience.’ In order to do this we must be: Open and honest. Listen and be respectful. Give each person the opportunity to express their views and opinions.

Adults, Health and Housing ‘Potential Misuse of Direct Payments’ Question: What does misuse mean?: Verb (Misuse) – To use something in the wrong way or for the wrong purpose ‘he was found guilty of misusing public funds’ In Session 1 We Defined Misuse As: Direct Payment monies that are used on things that are not legal or compliant. Direct Payment monies that are used on services or items that do not meet the individuals outcomes.

Adults, Health and Housing ‘Potential Misuse of Direct Payments’  Potential misuse of Direct Payment is defined within policy when: “the spending does not appear to correspond with the agreed outcomes between the service user and Thurrock Council”. The policy then states the following actions need to occur: A Letter stating what the concerns are and giving 14 days for information to be supplied. If the concerns remain or are not addressed after 14 days or there is no response this will be escalated to a Care Professional to discuss the matter with the service user/nominee/suitable person within 4 weeks. If after review the expenditure is deemed appropriate, no further action is required. A letter will then be sent confirming the outcome. If the spending is deemed inappropriate a decision is made to suspend or stop the Direct Payment a letter will be sent to offer of a Reablement or alternative service until other options are explored.

Adults, Health and Housing ‘Potential Misuse of Direct Payments’ In groups can you discuss the following: Is the definition of potential misuse appropriate given the discussions in session 1? If not how should it be changed? Are the actions defined within the policy after concerns of potential misuse are raised: Appropriate? Timely? Proportionate? How would you change this process if at all?

Adults, Health and Housing ‘Suspension of Direct Payments’ Currently your Direct Payment may be suspended if either of the following situations cannot be resolved: There is evidence that the Direct Payment is not being used appropriately. If your Direct Payment returns have not been submitted. Should these situations not be resolved then: The Direct Payment will be suspended pending a care review. Alternative ‘commissioned’ care will be put in place to meet the eligible need.

Adults, Health and Housing ‘Suspension of Direct Payments’ In groups can you discuss and respond to the following: Do you feel the reasoning for suspending a Direct Payment package is appropriate? If not why and how could this be made clearer? Do you feel the care review and replacement care options are appropriate or is there a better way? What risks or issues will the Direct Payment User face and how can these be managed? What types of restrictions do you feel the Authority should consider (if any) to enable suspensions to be lifted?

Adults, Health and Housing ‘Discontinuing Direct Payments’ Paraphrasing the current policy: Discontinuing a Direct Payment should be the last resort and taken when there are clear breaches of the Direct Payment have taken place. As a result of this the Authority would: Provide 4 weeks notice. Recover un-used monies. Transfer care to alternative delivery method – i.e. spot commissioned care. Undertake any relevant risk assessments. Meet any contractual responsibilities i.e. redundancy payments. Take punitive action to recover misused monies if appropriate. But currently there is no specific provision within the policy about how a person could potentially access Direct Payments again.

Adults, Health and Housing ‘Discontinuing Direct Payments’ In groups can you discuss and answer the following: Do you think the steps the Authority takes are appropriate? If not why not? What additional steps or actions should the Authority take when ceasing a Direct Payment? How should a person (if at all) be allowed to receive a Direct Payment again? Should reasonable restrictions be put in place? If so what types?