Agenda item

To consider a report of the Strategic Director of Children, Families and Adults (to follow).

Martin Middleton, Direct Payments Project Manager, attended to provide an update on the status and progress of the Council’s prepaid social care card product – known as the Empower Card. It was reported that as of March 2012, there were approximately 2000 Empower cards in existence (not all active) holding in the region of £2.5m in prepaid social care funding (including client contributions). Martin explained that such a rapid take up of the process in its formative period had created a number of issues, both with the product itself and the associated processes. As a result the Council had approved a three month ‘pause’ in the roll out of the Empower Card in November 2011 as part of a post-implementation review.

Martin described that the review was under way and that the service had collated and analysed issues from a variety of sources including service users, carers, the third sector and internal departments among others. Initial analysis of these responses had suggested that on balance most people were happy with the card and liked the concept. Having said this, Martin also outlined that a number of areas for improvement had emerged, mainly as a result of getting the existing infrastructure and established mechanisms to adapt to the new ways of working. Martin asserted that these issues did not originate from any single source and many pre-dated the Empower card. As a result of these findings, it was described how task teams had been put in place to undertake a detailed review on all the 3000 or so Empower and Direct Payment accounts on the Council’s books. Internal administrative processes had been reviewed and improved and training for all relevant staff on the revised processes was planned for April 2012. Martin also noted that work was ongoing to identify whether any alternative products were on the market which could better meet the needs of Cheshire East residents.

Lisa Quinn, Director of Finance and Business Services, attending as a member of the Strategic Empower Steering Group added that the Empower ‘pause’ was part of a wider review of client social care finance. She also reasserted that the ‘pause’ had been a useful mechanism to review what had been going well with the Empower card and where there was need for improvement. As this had yet to be completed she described how the Steering Group had asked for the ‘pause’ to be extended indefinitely until the Council was confident that all the issues had been fully rectified.

It was described how the Committee had been recently informed that there was occasionally money in service users’ Empower accounts that was not being used and was therefore sitting idle. It was queried what could be done to retrieve this money. Martin explained that if identifiable unused money was sat in client’s accounts, it was moved to the Council’s holding account with Citibank and from here to the Council’s budget. He reported that Citibank had recently cleared £500k to be transferred back to the Council from its holding account. Martin continued to explain however that there was often a need to carry out detailed reviews on large balances above the agreed care plan package and to not assume that the money was simply unused. For instance, service users could be back loading their funds for respite care at the end of the year or they could be involved in a dispute with a provider that they hadn’t paid for a service already received. It was noted therefore that there was potential for more than £500k that could be retrieved but that this would require further work. 

It was questioned whether the service had any idea in terms of an end date for the ‘pause’ period. Martin reported that there were a number of variables which impacted on the ‘pause’ period being ended. An example of such a variable was waiting for information from care providers which was outside of the Council’s control. Providing an approximate date, it was estimated that the ‘pause’ would come to an end in December 2012.

With regards to the survey results, attention was drawn to the fact that only 65% of those asked understood and endorsed the Empower product. This suggested that nearly a third of those surveyed had some element of disconnect with the package. It was stated that this was a concern as a paucity of information could undermine the whole concept and consequently, it was queried whether any further work was being done to uncover the reasons behind this. Martin acknowledged that this was an issue and that the service was going back and looking at the survey responses in detail to identify recurrent themes. He also noted that work was ongoing to improve the customer feedback and resolution process.

Reference was made to the fact that those service users with Direct Payments could not purchase Council services. It was queried therefore whether any attempts had been made to lobby central government or the LGA over this issue. Jacqui Evans, Head of Local Delivery/Independent Living Services, confirmed that questions had been asked of the Association of Directors of Adult Social Services and the LGA and that they were awaiting a response. Martin also noted that service users could have a hybrid package in which they received both services from the Council and had a card for other services.

Barrie Towse, LINk Chair, noted that the LINk had played a significant part in bringing this issue forward and she stated that she was grateful for the ‘pause’. Barrie explained that the LINk had been concerned that service users were having choice taken away by being given the Empower Card as their only Direct Payment option. She confirmed that this had now been clarified and was no longer a concern. Overall, Barrie reported that the LINk believed the Empower Card was a good product but they were now worried that the longer the ‘pause’ continued for the bigger the step backwards the personalisation agenda would take.

In terms of the audit of the Empower Card it was queried who carried this out and whether the Council could retrieve money that had been misspent. Martin confirmed that the Empower Card had made auditing the Direct Payment process much easier as it provided almost automatic electronic intelligence on purchases. He explained that a team within the client finance unit were tasked to carry out the process of audit and if an inappropriate purchase was identified this would then lead to a conversation with the client and their social worker. This conversation could then lead to an adjustment in the care package if it was determined that money had been spent on unnecessary goods/services.

RESOLVED –

a)    That the Committee note the progress of the review and the extension of the Empower ‘pause’ until all Empower card customer accounts had been audited and customers given a care review.

b)    That the Committee acknowledge the pressure that the review is putting on officers.

c)    That the Committee endorse the Council’s continued exploration and evaluation of the current pre-paid card produce against alternative options available in the market.

d)    That the Committee receive an update report once the review is completed and that this include all the relevant financial information and implications.