Office of the Public Guardian APAD AGM

1. Office of the Public GuardianAPAD AGM Martin John, Public Guardian and Chief Executive

2. OPG - A reminder • Registering Lasting & Enduring Powers of Attorney • Supervising Court-appointed Deputies and people acting as attorneys under registered LPAs/EPAs. • Regulate and investigate Deputies and registered attorneys, working with relevant organisations to protect vulnerable adults • NOT the Court of Protection

3. Vision & Mission • To encourage everyone to prepare for a possible lack • of mental capacity and to empower and safeguard • those who lack mental capacity now To improve awareness and knowledge of the OPG and the services it provides in order to improve the preparedness of everyone for a possible future lack of mental capacity.

4. Vision & Mission To continue to improve the service provided to Deputies and Attorneys, and those applying for such roles, in order that decisions concerning people who lack capacity are made optimally and quickly. To create a proficient and motivated workforce equipped with the skills to carry out their roles effectively. To engage effectively with a range of supporting organisations in order to improve the effectiveness of the Mental Capacity Act 2005 and engagement with the OPG.

5. Supervision • Deputies appointed financial year 2009/10 = 11,500 • Total active Deputy orders: 32,800 • Local authority as the Deputy: 8,000 (24%)

6. Supervision • Level 1 : deputy is assigned a caseworker to provide • guidance and to provide close supervision £800 (520 • cases) (2%) • Level 2A: deputy is assigned a caseworker to provide • intermediate supervision £350 (6,000 cases) (18%) • Level 2: guidance provided via Contact Centre; required to • submit annual report £175 (20,600 cases) (63%) • Level 3: Contact only when necessary no cost (5,700 • cases) (17%)

7. Visits to local authorities • OPG carried out 250+ visits to Local Authorities over the last two years • Between 1 and 6 client reviews in each visit • 90% reported the LA between average and excellent • 10% (13 authorities) marked for repeat visit or referred to OPG Investigations team

8. Excellent authorities • Training and understanding of MCA was evident and applied in practice • Client files were well maintained and documented, with regular file reviews • Evidence of pro-active management of property, funds and investments • Pro-active contact with clients, either directly with Deputy or via Social Workers or key workers • Clear policies and strategies

9. Poorer performing authorities • Lack of direct contact between Deputies and clients • Lack of pro-active identification of clients’ needs – “we just pay the bills” • Poor links with social work staff: Deputyship section isolated

10. Poorer performing authorities • Cases inappropriately managed through appointeeship • Staff doing their best but hampered by: Systems-related problems: lack of internal review/management controls; Documentation or care plans not evident Overarching strategies/policies not clear: criteria for accepting cases, handling property, investment strategies

11. Investigations into Local Authorities • Deputy was completely reliant on care staff reporting on client’s needs. There were no systems in place for finding out clients’ views or needs or for ascertaining whether their needs were being met.

12. Investigations into Local Authorities 2. Multiple concerns not only about compliance with the requirements of the MCA and the Code, but also financial failings including a failure to seek remission of fees, or to claim remuneration for the Deputy, and a failure to monitor personal allowance spending.

13. Taking action • Serious problems warrant discussion with senior LA officers; staff will also audit files • Otherwise, problems are drawn to the Deputy’s attention; follow-up reviews are scheduled • Increasingly we will segment LA, professional, panel and lay Deputies

14. Taking action • Visit ratings according to findings will help determine frequency of future visits • Increasing OPG feedback – including to those performing well • Building feedback into good practice guidance

15. A second reminder : Safeguarding Protocol • …set out a joined-up approach across the various agencies involved in responding to concerns about abuse. • …enable the OPG and local authorities to work more effectively together to help prevent and respond to abuse, by sharing information and following principles laid down in the guidelines.

16. Reminder #3 • To improve awareness and knowledge of the OPG and the services it provides in order to improve the preparedness of everyone for a possible future lack of mental capacity • Don’t just think “Deputyship” • Significance of planning ahead – encouraging people to think about making LPA • Need to ensure registration of EPA at the right time

17. Office of the Public GuardianAPAD AGM Martin John, Public Guardian and Chief Executive

18. CONTENTIOUS PROPERTY & AFFAIRS APPLICATIONS- A BARRISTER’S VIEW by DAVID REES www.5sblaw.com

19. Nothing about us Without us –Safeguarding, Risk and Choice Daniel Blake Policy Development Manager Action on Elder Abuse

20. Context Review of No Secrets Creation of Care Quality Commission Transformation of social care – Personalisation Agenda Mental Capacity Act – DoLS Disability Hate Crime High media interest – Panorama, Coventry case etc Economic Crime a priority for criminal justice agencies Continued government focus on “Dignity in Care”

21. New Context? Scaling back of regulation – the end of CQC? Conservative – Better Regulation Document No registration of social care workforce. ISA provides “safety net” albeit greatly reduced No safeguarding legislation. Rapid expansion of a “cash for care” model of personalisation. What can we reasonably defend as a position whilst accepting the inevitable? Opportunities?

22. UK Study of Abuse and Neglect of Older People - 2007 In 2004, there were 8,587,000 people aged 66 years and over in the UK. Extrapolating the prevalence percentages suggests: • 105,000+ were facing neglect • 86,500 were facing financial abuse • 58,600+ were facing psychological abuse • 62,400 were facing physical abuse • 42,500 were facing sexual abuse

23. Helpline Statistics: Financial offences Analysis of calls relating to financial offences 14/06/07 -31/05/09 886 calls £9,573,996 was reported stolen, coerced or defrauded from older people 165 houses were sold or taken without consent The total monetary value involved is estimated to be £50,000,000 57% of victims were aged 80+ 62% of victims were women 14% of callers highlighted misuse of PA/EPA/LPA 10% callers alleged that benefits were regularly being stolen

24. Regulation = Protection? Full implementation of MCA has been positive Unregistered EPA a major problem – loophole for abusers! Does the cost and bureaucracy of LPA put of those in greatest need? We need to spot the warning signs earlier Recognise we are in the most cases dealing with motivated perpetrators

25. Striking the Balance • The Putting People First Concordat: “We will always fulfill our responsibility to provide care and protection for those who through their illness or disability are genuinely unable to express needs and wants or exercise control.” • There should be a clear model for risk assessments for care recipients and those others acting in their best interests • Current government approach “assumes that every ‘citizen’ starts with an ability to exercise choice and control and that the ‘risks’ involved are simple ones. Effectively, it ignores the experiences of abuse articulated through domestic violence, through regulation, through adult protection and through the experiences of the AEA helpline

26. Personalisation and Safeguarding Right to give people a greater say and control over the nature and quality of care they receive. This applies to Care homes and Hospitals as much as Individualised Budgets. The right to choice is not in conflict with the right to protection. Lack of portability of IB’s – an increased risk Safeguarding needs to address the very real concerns of disabled people. Nothing about us without us. Informed decision making is about information, risk assessment and risk management However safeguarding does sometimes require tough decisions which could include over riding the wishes of an adult with consent based on an assessment of risk and potential harm

27. Regulation? • A domiciliary care worker provided through a registered agency has to have the following: • CRB and PoVA check (ISA registration) • NVQ training • Supervision • The same individual working under “cash for care” does not need to. • What is the difference? Why were the above introduced in the first place?

28. It is essential that health and social services review the implications of acceding to peoples “choice” if the latter is not to be construed as abandonment Serious Case Review into the murder of Steven Hoskins

29. Contacts AEA 0208 835 9280 www.elderabuse.org.uk Elder Abuse response line 08088088141