Agenda item

The Director of Adult Social Care and Health Integration presented a report, the purpose of which was to set out the findings of a recently finalised investigation by the Council’s Internal Audit service, Veritau, into the arrangements for Direct Payments, and to describe the management action plan in response to the audit recommendations.

By way of background, it was explained that Direct Payments were local health and social care payments for people who had been assessed as requiring support from social services, and who would prefer to arrange and pay for their own care and support rather than to receive services directly from the Local Authority.  The aim of direct payments was to allow the service user greater choice and control through the flexibility of being able to purchase their own care package.  The Care Act (2014) mandated direct payments for the first time in April 2015.

The Council’s Direct Payments guidance defined Direct Payments and under what conditions Direct Payments could be made.  In the year 2023/24, £9,690,242.40 was paid to adults and carers and £318,735.83 was paid to children.  At the start of the audit, there were 832 active customers currently in receipt of Direct Payments; 555 adults on a managed account, and 217 adults who had their Direct Payment made directly into their account.  There were also 59 children who received Direct Payments.

The audit activity focused on the period December 2022 to December 2023, which was undertaken following a request by management within Adult Social Care for Internal Audit to assess arrangements for Direct Payments.

The Committee heard that although the audit determined that there were effective processes in place for some elements of the process, there were four findings that required early resolve by management as collectively they had produced a finding of Limited Assurance.  These four findings, together with actions that would be taken to deliver the recommendations, were outlined as follows:

·        Recommendation One:  Annual review of direct payment provision by Social Care staff.

Action: Plans were in place to utilise temporary staff, funded by Flexible Use of Capital Receipts, with the intention of eradicating the backlog.  A further plan had been agreed in the actions to facilitate future compliance with timescales along with further dip sampling to provide assurance of compliance for management.  It was anticipated that full implementation would be achieved by the end of May 2025.

·        Recommendation Two: Monitoring of direct payment spend by the Adult Social Care Finance Team. 

Action:  Recommendation had been fully implemented and signed off as complete by Veritau on 5 December 2024.    

·        Recommendation Three: The Council did not record the prevalence of family members employed as personal assistants.

Action: Implemented - pending audit sign off.

·        Recommendation Four: Direct Payment applicants were not informed of the legal requirements relating to misspending Direct Payment funds.

Action: Implemented - pending audit sign off.

During discussion, several points were raised, as follows:

·        A Member referred to recommendation one and queried the reasons as to why reviews were not being carried out already, and what financial implications the employment of additional staff would have on the existing budget.  In response, it was explained that the combination of high demand and staff vacancies had resulted in delays in reviewing, which was a common issue for Local Authorities.  The audit review had identified this, and resources would be targeted accordingly.  There was an urgency to complete this work; monies would be derived from capital funding.

·        A Member queried whether there was a minimum number of hours required for the appointment of personal assistants.  In response, it was confirmed that there was no minimum, but it may have been difficult to appoint an assistant for a lower number of hours.

·        In response to a query regarding national benchmarking around this issue, it was explained that further consideration would need to be given as to how this could be best achieved.  It was possible that some regional data could be acquired, but there was no public benchmark.  The Council’s position was not unusual, and the Director was comfortable with how teams currently operated within the department.  It was acknowledged that a plan was needed to ensure that progress was sustained once temporary staff had left the authority.

·        A Member referred to family members employed as personal assistants.  Consideration was given to possible changes in circumstances that could arise, and the legal implications of this.  In response, it was explained that a Direct Payment policy could not be set-up for two living in the same household, though it was acknowledged that financial abuse could happen.  It was highlighted that, from the perspective of officers in the Local Authority, an empathetic but legally compliant approach was always taken when providing support.  A short discussion ensued in relation to informal carers and the vital support that they provided to their family members and friends.  Consideration was given to the rights of carers in providing this support.

NOTED