Access For All The Importance Of Inclusive Services

Access For All The Importance Of Inclusive Services

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Access for all
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The importance of inclusive services
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Contents
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Page 2 Executive summary
Page 3 Section 1 – Introduction
Page 5 Section 2 – The case for inclusive access
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The moral case
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The legal case
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The business case
Page 14 Section 3 – Identifying vulnerability and ensuring inclusive
services
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BSI Standard 18477: Fair, flexible services for all
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Behavioural triggers
Page 21 Section 4 – Good practice
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Choice of access method for service users and customers
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A preventative approach
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Proactive approach to identifying vulnerability
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Appropriate support targeted to the user’s needs
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An enabling approach to service users and customers
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Willingness to help resolve problems
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Accurate recording of personal information, establishing follow-up
procedures
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and early investigation of non-compliance
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Respect for and trust in intermediaries/advocates
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Appropriate data-sharing to improve customer service
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Engaging one agency to coordinate access for very vulnerable
people
Page 29 Section 5 – Conclusion and recommendations
Executive summary
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The internet revolution means that products and services are
increasingly offered to, and used by, the public online. Yet there are
seven million UK households without internet access, and there will
always be people who need to access goods and services through other
channels – particularly face-to-face support.
There are sound moral, legal and business reasons why providers should
make sure that their services and products are equally available to
all users and potential users.
Morally, a civilised society should ensure that no one is
disadvantaged by barriers which prevent them from accessing services
available to the general public.
Legally, the Equality Act 2010, and the Consumer Protection from
Unfair Trading Regulations 2008 (CPRs) require certain duties from
providers, who are breaking the law if they do not comply.
In business terms, inclusive provision increases the potential market
for goods and services, improves customer satisfaction and ultimately
reduces the cost. Many organisations are beginning to address the
issue of how to provide inclusive access to goods and services. A
common starting point is to list potential risk factors – such as a
medical condition, or personal circumstances – which might lead to
disadvantage or vulnerability. Other organisations recognise that
vulnerability can be a dynamic and changing state, which may be caused
by the failure of systems and procedures to accommodate the needs of
all individuals. We suggest that vulnerability should be identified
through understanding risk factors, awareness of behavioural triggers,
and a recognition of the potential barriers caused by existing
systems.
Providers should be alert to signs of vulnerability, which may
include: explicit disclosure of problems; obvious signs or information
when the user engages with the provider; hidden signs which may need
time and encouragement to discover; and changes in behaviour over
time.
In this report, Citizens Advice advocates a proactive and anticipatory
approach, in which equality and inclusivity are integral to the design
of service provision; where systems are in place to identify
vulnerable users; and where follow-up procedures are robustly applied
to give the best service to the individual. These processes must be
fully understood and implemented by all staff from the executive to
the frontline.
SECTION ONE
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Introduction
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Modern technology has revolutionised the way we communicate, and is
increasingly changing the ways that providers offer products and
services. Web and internet services enable millions of consumers to
access goods and services at their own convenience, and at minimal
cost. Generally speaking, online services are efficient and
cost-effective for both users and providers, and we have seen most
organisations developing facilities for internet access over recent
years.
The Government is deliberately promoting use of the internet, and its
‘Race Online’ initiative aims to help over 1.5 million more people
online by 2012.1 Government is also designing more systems on the
basis of online access – for example, administration of the new
welfare benefit, universal credit, will adopt a ‘digital first’
principle2, and will rely on most claimants providing information and
changes of circumstances online.
There are, however, seven million households currently without
internet access, and nine million adults in the UK have never accessed
the internet.3 There will always be a number of people who will – for
very good reasons – be better served by other means of access –
sometimes by telephone, and often through talking face-to-face to
someone who will help them access whatever service or product they
need, or resolve the problem they face.
An elderly man came to a Surrey CAB for help completing application
forms for pension credit and housing benefit and to get on the local
authority housing list. The man had very poor sight and couldn’t read
or complete forms independently. His hearing difficulties made using
the telephone difficult.
This client’s situation meant that without the face-to-face help
provided by the CAB adviser – or some other helpful third party – he
would effectively have been prevented from accessing services which he
was entitled to, and which were crucial to his well-being. (In legal
terms, the local authority had failed in its duty to make a reasonable
adjustment which would remove the ‘substantial disadvantage’ faced by
this client).
The same Government is responsible for bringing into effect the
outstanding provisions of the Equality Act 2010.4 From April 2011, The
Act introduces a new single public sector Equality Duty requiring
public bodies to pay due regard to the need to:
*
eliminate unlawful discrimination, harassment and victimisation
and other conduct prohibited by the Act
*
advance equality of opportunity between people of different groups
*
foster good relations between people from different groups.
The Equality Act 2010 also continues the previous duty upon all
service providers – public or private – to make reasonable adjustments
to alter policies and practices that create ‘substantial
disadvantages’ for disabled people in accessing goods, facilities and
services.
The combination of these new legal duties, and the universal drive to
save money by providing services online, makes this a critical time to
reinforce awareness of the need to provide inclusive services for all
users. Citizens Advice believes that a shift in mindset is required to
comply with the new duties, which requires service providers to ask
not ‘What is wrong with this person?’ but ‘What is wrong with my
service if this person cannot access it?’
Many organisations have started to address the issue, and commonly use
the term ‘vulnerable’ for people who need extra support. A common
approach is to make a list of people who might be considered
vulnerable because they have a certain characteristic – such as
blindness, deafness, or being of a certain age – or are living in any
of a range of circumstances – for example, as a lone parent, recently
bereaved, or homeless.
This is probably a reasonable starting point, but it is far from a
complete solution. While these characteristics and circumstances are
likely risk factors for vulnerability, providers must acknowledge that
people may be vulnerable for reasons which are not associated with any
of these circumstances, and also that such circumstances do not
necessarily lead to vulnerability.
A Hampshire CAB saw an 86 year old client, who was registered blind
and used a signature-only debit card. He had regularly used it in a
particular store in his home town, but in August, the till operator
refused to accept it until the supervisor agreed that it was
acceptable. The same situation arose again in September, but on this
occasion the supervisor refused to accept the card without a PIN. The
client refused to leave the store until they accepted his card and
insisted the police were called. When the local policeman arrived and
negotiated between the client and the store, the store staff decided
to accept his card, together with a certificate of disability issued
by Hampshire county council. They also told him that in future, the
only way he could use his debit card with signature would be with this
certificate.
Although the risk factors of age and blindness were present in this
case, the client normally managed them by use of the signature-only
debit card – a product specifically provided by his bank to enable him
to buy goods without using a pin. He only had difficulty accessing the
shop’s service because of the response of the store staff. The
situation was compounded by the fact that the store appeared to have
changed its policy on use of the card, or hadn’t trained its entire
staff appropriately.
Citizens Advice supports this ‘social model’ of disability as opposed
to the medical model. Whereas the medical model of disability (used in
the Equality Act 2010) emphasises barriers arising from a person’s
impairment, the social model emphasises how environmental and
attitudinal factors have a ‘disabling’ impact on people, and creates
barriers to accessing services or products. Those same barriers also
prevent many people from realising their rights.
This report argues the case that service providers should consider the
social model of disability together with a more dynamic concept of
vulnerability, which can be identified through both ‘risk factors’ and
‘behavioural triggers’. This approach is taken by the new BSI standard
for inclusive services, which recognises vulnerability as a dynamic
and transient condition, rather than a fixed state.5
The arguments for providing alternative services are set out in
section 2. Section 3 focuses on case studies which illustrate the risk
factors and behavioural indicators of vulnerability, and the success
of different services in helping people in such circumstances. Some
features and examples of good practice follow in section 4.
SECTION TWO
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The case for inclusive access
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The moral case
Ensuring everyone has the right to equality is a fundamental duty of
any government…
Theresa May, The Home Secretary6
Our cases show a range of CAB clients, with various needs and
lifestyles, who do not always achieve equal access to goods and
services. Difficulties should not be interpreted as a matter of
someone’s ‘ability’ or ‘disability’, but rather as the result of the
service provider’s failure to cater for the needs of all of its
customers.
Public services must be available to all those who are entitled to
them, and yet some service structures, policies and practices can make
it harder for some people to gain access. This may limit how far
individuals can benefit from the service, or it may exclude them
altogether. The impact on the individual depends on the nature of the
service provided and the degree of their need – but all forms of
disadvantage in access to services increase the chances of unequal
outcomes.
A South Wales CAB advised a 26 year old who was unemployed and
suffered from depression, anxiety and agoraphobia. He was in financial
difficulties and wanted to apply for a crisis loan. The local
Jobcentre Plus refused to help him make the application. He couldn’t
afford to maintain a phone line and so had to make calls through a
telephone box, which was particularly difficult for him because of his
agoraphobia.
For this client, a home visit would have been ideal, and without it,
the impact was likely to be further financial difficulty and increased
depression, potentially leading to homelessness if he fell into rent
arrears. Certain services provided by private organisations are
essential to ensure a basic standard of living – such as water, fuel
and financial services. It is therefore imperative that access to
these ‘essential’ services is equitable and appropriate.
A Lancashire CAB advised a client who was deaf, about long running
problems with a water company. The client and her husband, who was
also deaf, and their two children, moved into a property in 2006. They
were under the impression that there was a water meter, but did not
receive any bills. They attempted to contact the water company by
written correspondence, minicom and email but received no response
until summer 2008. The company established that there was no water
meter, and began the process to install the meter. However, there were
many delays and it was not installed until almost a year later. The
clients then started to receive an excessive number of bills. It
emerged that two accounts had been opened for no apparent reason and
some charges were duplicated. The client complained but received only
an apology and a credit for £50.
Disadvantage is especially evident for the most excluded groups in
society. The Joseph Rowntree Foundation annual report, Monitoring
Poverty and Social Exclusion 2009 uses access to services as an
indicator of adult well-being, assessing how ‘people can be
disadvantaged due to the decisions made by private or public sector
service providers’.7
A Lancashire CAB advised a single unemployed 38 year old man, who had
recently been transferred to a care home from a lengthy admission in
hospital. He had schizophrenia/schizoaffective disorder and brain
damage from a head injury. He received income support and disability
living allowance (DLA) and his DLA renewal form needed completing. He
was very unwell and unable to cooperate. His mother was his appointee
and the only person who could help, but she had mobility problems and
could not access the CAB service. The hospital staff managed to
persuade the client to sign his DLA form but they were worried that
the process was causing him significant stress. The client’s mother
was contacted and the CAB arranged a home visit.
Gypsy and Traveller families in the South West often visited their
local CAB. Twelve members of one family visited the bureau for help
over the years, as they were unable to read and write and were afraid
of authority. Their problems covered the availability and succession
of ‘pitch sites’, homelessness, and support into housing benefit
entitlement. Although one of the family members always wore a watch he
was unable to tell the time, so when he had an appointment at the
bureau, he was given a drawing of his watch face with the time marked
on it.
The legal case
The moral arguments for inclusive access are reflected in the
legislative and regulatory frameworks. Self-regulation has recognised
that providers who want to be more inclusive than is simply required
by law, will have to give special consideration to vulnerable users.
On this basis, provisions for vulnerability tend to be voluntary
additions to regular practices, and offered mainly by progressive
bodies or organisations; legislation has been necessary to integrate
and normalise such provision within the policies and practices of all
providers. There are two key new laws that actively recognise the need
for treating all consumers fairly: the Equality Act 2010 (The Act) and
the Consumer Protection from Unfair Trading Regulations (CPRs).
The Equality Act 2010
A number of separate Acts of Parliament relating to discrimination –
for example, the Race Relations Act and the Disability Discrimination
Act (DDA) – have been consolidated by the Equality Act 2010. The Act’s
over-arching purpose is to combat unlawful discrimination. It protects
service users from discrimination because of nine protected
characteristics: age (over 18s only), disability, gender reassignment,
marriage and civil partnership, pregnancy and maternity, race,
religion or belief, sex and sexual orientation.
The Act says it is unlawful for a service provider to discriminate
against a person using – or seeking to use – its services, because of
a protected characteristic. There are a number of ways in which
discrimination can occur, including: not providing the person with a
service, and not providing the service at the same level of quality,
or on the same terms, as they would to another person.
The Act also maintains the previous legal position that service
providers must make reasonable adjustments to their procedures,
policies and practices where those practices put disabled people at a
substantial disadvantage.8 Essentially, this means that providers have
to take positive steps to remove barriers that cause substantial
disadvantages. It is an anticipatory duty, which requires the provider
to anticipate the needs of disabled people, not merely to respond to
their needs when they attempt to use the service.
Evidence from Citizens Advice Bureaux suggests that this is a
necessary provision, as illustrated by the case below when a provider
failed to comply with the requirements of the Equality Act (or the DDA
as it was at the time).
A CAB in Nottinghamshire advised a 39 year old divorced mother of
five, who was profoundly deaf. The bureau had previously helped her
set up a water payment plan but she had defaulted on her payment, and
the company had cancelled the plan; she visited the bureau again to
try and re-instate the plan. Her communication methods included
lip-reading, and regular use of texting and Typetalk. She had tried to
use Typetalk to contact the water company, but had been unsuccessful
and came to the bureau. Initially, the water company’s agent refused
to discuss the client’s account with the bureau adviser, because she
couldn't speak to the client to confirm her permission. The agent
suggested sending a third party authorisation form but this would mean
a delay in resolving the issue, allowing the debt to accumulate. The
agent eventually accepted the adviser’s suggestion to relay each
question to the client, loud enough for the agent to hear, and the
client would lip read the question and speak the answer into the
phone.
The water company was in breach of the legal requirements to make the
necessary adjustments to its services. Such adjustments are often
quite simple, such as making available specialist text phones or
accepting mobile phone texts as a form of communication. An accurate
customer record should have shown that this customer needed
specialised services.
The Equality and Human Rights Commission (EHRC) has developed
complementary Equality Act Codes of Practice. The Services, Public
Functions and Association Code (The Code) aims to help providers to
understand and act on their responsibilities, integrating the
requirements of the Act into their practices and therefore preventing
complaints and discrimination claims.9
Both the newly amended public sector duty, and the duty on all service
providers to make reasonable adjustments, only cover the protected
characteristics, and do not, therefore, compel public authorities or
other service providers to consider and provide for individuals with
other needs or vulnerabilities, even though the failure to do this may
disadvantage the person or cause them detriment.10
The underlying intention, however, is that when organisations examine
their procedures in relation to their statutory duties, equality will
become an integral part of their provision. This ethos is being
reinforced by Government policy: in December 2010, the coalition
Government published an Equality Strategy,11 based on two principles
of equality: equality of treatment and equal opportunity. The Home
Secretary’s foreword states that ‘we need to move beyond defining
people simply because they’ve ticked a box on a form’. This reflects
the premise that inequality should be tackled by attitudinal and
cultural change, rather than by imposing bureaucratic obligations.
The Consumer Protection from Unfair Trading Regulations 2008
Legislation has now enhanced a feature previously recognised in
self-regulation – that is, the need to be fair to all consumers.
Under the Enterprise Act 2002, the Office of Fair Trading (OFT) has
been able to approve self-regulatory codes of practice, guiding the
behaviour of businesses towards consumers. To be approved, such a code
must have met a published set of core criteria. This has included the
requirement that the code ‘shall address the additional effort/ help
to be provided to vulnerable consumers as appropriate to the sector’.12
For example, the British Healthcare Trades Association (BHTA)
represents companies which provide a range of health and disability
related products, of which many are sold to people with special
physical needs in the home. The OFT-approved BHTA code of practice
ensures that members consider how they can protect vulnerable
consumers, such as by encouraging a carer or adviser to be present
during home visits.13
Self-regulation, however, is voluntary, and consumers have continued
to be disadvantaged by poor trading practices. Legislation has
therefore been introduced across the European Union.
European legislation now includes a Directive designed to fill current
and future gaps in consumer protection law and provides specific
requirements for the protection of vulnerable consumers. The Unfair
Commercial Practices Directive is transposed into UK law by the CPRs.
The CPRs are intended to protect consumers from unfair commercial
practices, including practices that are misleading or aggressive. The
regulations apply to ‘business to consumer’ commercial practices, and
define whether a practice is unfair through a two part ‘fairness
assessment’.
A practice is unfair if the conduct of the trader falls short of the
‘professional diligence standard’.14 The practice must also have an
unfair effect, or be likely to produce an unfair effect. This is
indicated by the ‘average consumer’ test: if the practice impairs (or
is likely to impair) the average consumer’s ability to make an
informed decision and leads him/her to (or makes him/her likely to)
make a decision that s/he otherwise would not have made, it is deemed
unfair. Similar assessments are used to judge if the practice is
misleading or aggressive. There are an additional 31 specified
practices which are always prohibited on the basis that they are
inherently unfair.
Fairness is assessed against three types of ‘average consumer’15:
*
The ‘average consumer’ is assumed to be ‘reasonably well informed,
and reasonably observant and circumspect’.
*
The average ‘targeted consumer’ applies when a commercial practice
is directed towards a particular group of people – such as
advertisements for children’s toys. The ‘average targeted’
consumer is considered to be an average member of that group and
is defined by that member’s characteristics.
*
The average member of a vulnerable group of consumers applies
where ‘a clearly identifiable group of consumers is particularly
vulnerable to the practice or the underlying product because of
their mental or physical infirmity, age or credulity in a way
which the trader could reasonably be expected to foresee’, and
‘where the practice is likely to materially distort the economic
behaviour only of that group’.
The CPRs provide greater protection for consumers identified as
vulnerable, by placing the onus on businesses to evaluate their
policies and practices to prevent incidences where a consumer is
treated unfairly.
The legal argument we make in this report is therefore that
organisations are at risk of breaking the law – and are subject to the
associated penalties in law – if they do not comply with existing
legislation.
The business case
In addition to the moral and legal arguments, there is a strong
business case for providing appropriate and inclusive services – not
least because inclusive access widens the customer base for any
product or service, but also because avoidable errors cost more to
resolve later in the process.
Online, automated and telephone systems are efficient and effective
means of delivery for most providers and users, as long as they work
smoothly and are operated accurately. The costs of resolving
administrative problems when any systems go wrong, however, can be
high for the provider, the user and other agencies brought in to
repair the damage.
The Department for Work and Pensions (DWP) estimated that for 2009-10,
administrative error led to £1.1 billion in overpayments (0.7 per cent
of expenditure) and underpayments of £500 million (0.3 per cent of
expenditure). According to the National Audit Office, ‘underpayments
due to administrative error put an unfair burden on people, whereas
overpayments represent a direct loss to the taxpayer as the amounts
are not normally recoverable’.16
Northamptonshire CAB saw an elderly client who was referred by her
social housing landlord. Although she didn’t have any debts, she was
struggling to make ends meet on a low income, made up of attendance
allowance, the state retirement pension and an occupational pension.
As the client was not very mobile and found using the telephone
difficult, the CAB arranged for a home visit for a benefits check. The
adviser assessed that the client should be receiving full housing
benefit and council tax benefit. The council admitted that they had
made an error and had not considered the severe disability addition
when considering her entitlement to pension credit. Subsequently, the
client received a cheque from the council for £4,321 underpayments,
plus ongoing weekly entitlements.
This case also shows successful proactive intervention by the housing
association, which prevented the resident falling into debt and
potentially losing her tenancy.
A CAB in the Midlands advised a client who, after a period of
unemployment, notified the relevant office that he had found a full
time job. The client then received a letter requesting repayment of
£10,400 of overpayment in tax credit. This appeared to have been due
to an error in HMRC paperwork, as the statement correctly indicated
that the client worked 32 hours per week, but stated that his income
was zero. He appealed against the decision but didn’t receive a reply
until five months later, and this was another request for payment. He
was then told that he would be taken to court if he didn’t make
payment within the set time.
The client had kept a thorough record of all paperwork but was
confused with the various statements and changes. He had repeated
telephone conversations with HMRC staff but this failed to resolve the
issue, and there was no opportunity to have a face-to-face
appointment. The client and his family were concerned about the
prospect of the debt and the implications that going to court would
have on his future credit record.
Other CAB evidence shows that if problems are not addressed early,
situations can escalate, until the costs are likely to be considerably
higher than the cost of making extra effort to resolve the initial
problem.
A client came to a CAB in the South West with her support worker,
seeking advice about an unsecured loan, credit card debt and an
overdraft with a major high street bank. She was receiving letters and
phone calls demanding payment, which she felt were threatening and
extremely distressing.
The client had learning disabilities, paranoid schizophrenia and post
traumatic stress disorder. Her health conditions affected her ability
to manage money and assess financial risk. She had no savings or
assets of any kind and relied on incapacity benefit and disability
living allowance as her sole sources of income. She lived in supported
rented accommodation provided by a charity offering housing and
support services to vulnerable people with special needs. When she
took out the credit agreements she was not in a position to understand
her responsibilities or repay the amounts borrowed. Her psychiatric
nurse had tried without success to negotiate with the bank.
The caseworker wrote to the bank and used the Money Advice Liaison
Group (MALG) Good Practice Mental Health Guidelines, the Lending Code
and the unfair relationships provisions in the Consumer Credit Act
2006 to request a write-off of all accounts due.17 After an initial
unsatisfactory response from the bank, an official complaint was made.
A manager from the bank swiftly contacted the caseworker agreeing to
write off all the outstanding accounts, amounting to about £20,000 in
total.
In this case, the bank should not have arranged the credit in the
first place, but should certainly have addressed the situation when
first alerted by the client’s psychiatric nurse. The situation caused
distress for the client, and cost the bank considerable administrative
time, as well as the write-off of the loan. A recent Department of
Health mental health strategy assessed the savings associated with
face-to-face debt advice to be around £300 million.18
A number of initiatives for improving access to a range of services
for potentially vulnerable people have been evaluated to show
significant financial savings:
• The North East Essex Primary Care Trust and CAB worked together to
devise the Tendring Reach Out project, which operated on a ‘people
first’ approach to problem solving, based on gaining trust and working
with individuals and families in their homes.19 Provision of
face-to-face contact was integral to its success, and an evaluation of
the pilot project found that it was ‘excellent value for money’. The
project cost £12,000 and managed 170 cases, equating to a cost of
£70.50 per case. The project outcomes made savings for the local
authority and the NHS while boosting the local economy by maximising
individuals’ incomes, reducing their debts and encouraging them into
work.
The project was nominated for a European Union award for Making Local
Services More Accessible to All and was featured in the Marmot review,
Fair Society, Healthy Lives. Due to the success of the pilot, the
project received funding to extend to other areas over a three year
period.
• Kent’s Total Place Gateway programme is making savings by
co-locating public and voluntary services, sharing resources, and
improving access by offering a choice of contact methods.20
• Westminster City Council’s Family Recovery Project, which targets
multi-agency support on the most excluded families, is calculated to
save £2 per £1 spent (with a range of saving per family from £300 to
£136,000). The Government is planning to develop this model and
Westminster is to be one of the 16 areas piloting ‘community budgets’.
• The Citizens Advice Face-to-face debt advice service – funded by the
Government’s Financial Inclusion Fund – aims to increase the
availability of face-to-face debt advice to financially excluded
adults. An evaluation of the service from 2006-09 found that it had
surpassed targets for the number of people helped.21 The service is
good value for money and generates high rates of client satisfaction.
The number of clients has increased, while the cost per client has
decreased. In 2009/10, target cost was £307 per client, and the actual
cost was £280. This has been attributed to the continuously improving
efficiency of the trained debt caseworkers and the use of trained
volunteers to support specialist money advisers. The debt advice
service will be funded by the new Face-to-face debt advice programme
from 1 April 2011 until 31 March 2012.
SECTION THREE
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Identifying vulnerability and ensuring inclusive services
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In the broadest terms, a vulnerable person may be defined as someone
who is unable to access the product or service they require, or for
whom such access requires a disproportionate level of effort, and that
the lack of access causes them to be disadvantaged. The common
consensus increasingly recognises that vulnerability is a dynamic and
shifting state and that simply listing risk factors will not – on its
own – identify those who need different ways to access services.
Organisations are increasingly recognising the importance of inclusive
services, and several manuals have been published, including Citizens
Advice’s Do the right thing, The Royal College of Psychiatrist’s Debt
Collection and mental health: ten steps to recovery, and the Energy
Retail Association’s Energy Made Clear: Protecting Vulnerable
Customers from Disconnection. An over-arching standard has recently
been published by the British Standards Institute (BSI) – BS 18477:
Fair, flexible services for all.
BSI Standard 18477: Fair, flexible services for all22
The BSI offers a number of standards which consider inclusivity. From
the 2005 standard, BS 7000-6 Guide to managing inclusive design, to
the recently-published BS 18477 Fair, flexible services for all, these
standards aim to encourage providers in the public, private and
voluntary sectors to develop fair, inclusive and ethical practices.
Integrating inclusive practices within the mainstream of delivery is
critical to the fulfilment of the standards.
BS 18477 defines consumer vulnerability as ‘the condition in which a
consumer is at greater risk of mis-selling, exploitation or being put
at a disadvantage in terms of accessing or using a service, or in
seeking redress’. The Standard maintains that vulnerability is a
dynamic and relative condition, and it suggests that ‘a consumer’s
needs and abilities can change with time and circumstance, especially
if the consumer is faced with a particularly urgent or complex issue’.
It recommends that all business systems should be designed to ensure
that they identify and provide for vulnerability, and advocates an
approach to the identification of vulnerability that uses risk factors
and behavioural triggers.
Risk factors are the ‘circumstances that might contribute towards a
consumer’s vulnerability’, which can cause consumers to be at
particular risk of vulnerability for short or long periods, or vary
over time as determined by personal circumstance or context. The
Standard discusses a number of possible risk factors, such as age;
disability or other impairment; mental health issues; low income;
basic skills; inexperience or lack of knowledge; sudden change in
circumstances; complexity and confusion; balance of power; and caring
responsibilities.
The Standard requires that service staff are familiarised with the
most common risk factors and how they may lead to vulnerability.
Crucially, the Standard maintains that staff should also develop an
awareness of ‘triggers’ to help them identify vulnerability when the
risk factors may not be immediately obvious. Triggers are ‘signs that
customers may be having some kind of difficulty and need assistance.
They might be things that the consumer says or does’.
Behavioural triggers
Stated need
There is no excuse for organisations which fail to provide alternative
access, when a person states from the outset that they have extra
needs. Although provision may be written into company policy, it is
equally important that the organisational culture ensures the policy
is implemented. This will require staff training in appropriate
procedures, and may be improved by incentives for quality service.
Organisations should use their knowledge and experiences to
continually improve their practices.
A Dorset CAB helped a client who had congenital deafness and mental
health issues. She wanted to claim a community care grant (CCG) to buy
washable rugs for her four year old daughter, who was incontinent and
had learning difficulties. She also had another child with physical
impairments. The Social Fund agent insisted that the interview for the
CCG was conducted over the phone, even though the client made it clear
that she was deaf and needed a face-to-face interview. The CCG was
promptly refused. It was only after the CAB adviser strongly argued on
the client’s behalf, and reminded the benefits office of its duties
under disability discrimination legislation, that they agreed to
arrange a face-to-face interview at the local Jobcentre Plus. This
approach caused the client unnecessary distress and delayed her claim.
A CAB in Cleveland saw a client who was recovering from brain surgery,
and long telephone conversations could bring on epileptic seizures.
She could not cope with continuous questioning, which caused her to
panic and induced seizures. She telephoned the DWP to ask for an
appointment so that she could claim benefits, and explained why she
could not endure protracted telephone conversations. During the call,
she felt a seizure coming on and had to put the phone down. The DWP
agent had promised to call her back if this happened, but they did not
do so. The client then visited Jobcentre Plus to ask for face-to-face
assistance, explaining her difficulty in providing information over
the phone. She was given a note regarding emergency hardship loans,
told to claim statutory sick pay and directed to the local CAB for
further guidance. The DWP informed her that they couldn’t give her any
help before she telephoned them again to provide details. The client
had made clear from the outset her vulnerabilities and DWP’s decision
to ignore her needs caused her actual harm and delayed receipt of her
entitlements. She expressed her disappointment at this treatment by
the DWP and Jobcentre Plus.
Obvious signs of need
While organisations should clearly have systems to respond to people
who specifically state their need for extra help, the Equality Act
2010 also requires that provision must be made so that all users will
have equal access, rather than provision being purely reactive when a
person presents with extra needs. We believe, therefore, that all
public-facing systems should include mechanisms to alert their staff
to the possibility that any of their users might need different
methods of access.
In some cases, an individual may not specifically say they need extra
help, but there is likely to be information – or detectable signs –
from the initial presentation, that show a high risk of vulnerability.
Organisations with a truly inclusive approach will have mechanisms to
identify and respond proactively to people in this type of situation.
A Thai national, with good – but heavily accented – English,
telephoned the Tax Credit Office to inform them that he was no longer
working and needed to stop claiming working tax credits. He did not
submit any income details. The Office estimated his earnings at
£11,000 and continued to pay him tax credits. He contacted them again
to report his change of circumstances, and was sent a renewal form,
but continued to receive payments. He then visited a Lancashire
bureau, who contacted the Tax Credit Office on his behalf. The Office
told the CAB that they had struggled to understand the client’s accent
and had misinterpreted the information that he gave them.
It would have been clear from the telephone call that there was a
potential for miscommunication, and the agent should have taken
appropriate action either offering an interpreter, or a face-to-face
interview – where it would have been easier to understand the client’s
accent than over the phone.
A man sought advice from a Hertfordshire CAB Welfare Rights Adviser.
He had experienced a big reduction in his benefit, after time in
hospital and subsequent rehabilitation in a care home. The client was
uncomfortable using the phone and wasn’t sure which benefits he had
been receiving before he was admitted to hospital. The adviser rang
the DLA helpline, where it was confirmed that they had records of the
client moving into hospital and then on to a care home and then out of
care back into his own home. The records showed that the DLA had not
been put back into payment as required. There was no clear reason for
this, but the helpline staff suggested that the DLA office might have
asked the care home to confirm the date that the client left the home
but they might not have received the reply.
The adviser then phoned Jobcentre Plus. They were not willing to
discuss the case as the client was not present. The bureau offered to
fax a form of authority but they said that they would have to refer to
another section of the Jobcentre to see if they could accept it via
fax, otherwise it would have to be sent by post. During the
conversation, the official said that a client would lose their severe
disability premium if they changed address (in this case, by going
into a care home or hospital) and that the claimant should be sent a
form to re-apply. The adviser asked whether the client should have
requested the form or if he should have been sent it automatically.
The official replied that she couldn’t answer because of concerns for
confidentiality.
If the organisation had a proactive approach, the information about
the claimant’s change of address should have triggered the system to
ensure that the right action was taken in response, and the subsequent
delays caused by the lack of authorisation could have been avoided.
A West Midlands CAB advised a client who had cancer and whose only
form of income was employment and support allowance (ESA). He
contacted a debt advice agency and received advice over the phone. The
adviser compiled a financial statement and arranged for him to pay his
creditors £51 per month. The client found this arrangement
unsustainable and was having to reduce his expenditure on food to meet
the payments.
He then sought face-to-face advice with a CAB adviser who reflected
upon the situation. It was unclear how the previous agency had arrived
at the payment arrangement, but the CAB adviser judged that a number
of factors associated with communication may have led them to ignore
the additional outgoings and needs of a cancer patient on a very low
income.
The fact that the individual was ill and reliant on benefit payments
to meet his daily living costs and debt repayments, should have
alerted the agency to the need for a more intensive assessment of his
ability to pay.
There are a number of reasons why a telephone conversation may be
inadequate for the assessment of a person’s needs. Primarily, there
may be many reasons why a client may not give complete information
over the phone, and an adviser does not have access to the relevant
paperwork to check the accuracy of the information. Secondly, the
physical distance can limit the client’s sense of engagement with the
process, which may mean they offer less additional information.
Moreover, without face-to-face contact, an adviser is less able to
interpret non-verbal forms of communication, such as body language and
facial expression, which may show distress. In this case, verbal
triggers may have been comments such as “I don’t have much money at
the moment”, “I’ve only got my benefit”, “I’m not very well at the
moment”, or “I’m in and out of hospital for treatment”.
Hidden need
Perhaps the hardest to identify are people who initially show no sign
of vulnerability, but for whom there is an underlying issue which can
make their situation worse if it is not identified and handled
appropriately.
A Kent CAB saw a 70 year old client. She was infirm and lived alone,
but had a helpful family living nearby, and managed in supported
housing. She visited the CAB with numerous non-priority debts,
initially caused by a large loan she had taken out for her sister. Her
sister had only paid a couple of the repayments before breaking all
contact and leaving the client with all of the debt. After borrowing
more money from doorstep lenders, the client eventually visited her
bank to see if she could borrow more, or re-schedule her loan, and was
immediately referred to the CAB for debt advice. She was very ashamed
of her debt, and did not understand how to manage her budget and offer
her creditors what she could. The bureau set up an informal debt
management plan for her, as she had a good income from a pension left
by her husband, and could afford a high level of repayment, especially
of the bank loan.
However, the client returned a few months later, saying she could not
manage. It took several sessions of face-to-face advice before she
admitted that she was a heavy smoker, and the budget wasn’t working
because of the amount she spent on cigarettes. In the meantime, the
bank – which was receiving only slightly less than the contractual
amount to cover the debt – started to call her. She felt that the tone
of the calls was rude and unsympathetic. Even though the bureau had
made sure that the bank was aware of the client’s vulnerability, it
continued to press for the full contractual amount. The client
eventually decided to go bankrupt as she could not deal with the
situation any longer.
The signs of difficulty in this case were that the client had a good
income, but her debt was not decreasing. As she was so ashamed both of
her debt and her smoking, she would not admit to either without a
great deal of coaxing in face-to-face interviews. Her vulnerability
was initially taken into account by the bank, but then disregarded, as
she was pressurised to pay the debt in full. It is likely that a more
consistent approach by the bank would have resulted in her maintaining
her payment plan and repaying most of the debt. As a result of the
bank’s pressure, however, the client chose to go bankrupt, and the
bank lost about £7,000.
Working with an unfamiliar system: In the following case, a capable
client tried to access an unfamiliar system, but was prevented – and
therefore made vulnerable – by the complexity of the process, and a
lack of clear explanation:
A Hampshire CAB advised a female client, who – with her son – wanted
to be appointed as Deputies for the client’s husband who was
physically disabled and lacked mental capacity. The client requested
the forms from the Court of Protection and received two large packs
addressed to her, of non-identical sets of papers. The covering
letters were unclear and the client was totally confused. The CAB
advisers tried twice to contact the Court of Protection helpline, but
gave up without getting through. The client eventually concluded that
one set of papers was for her son, although this was not indicated in
either letter. The notes at one point directed the client to read
their rules, go to their website or ring the helpline. The rules are a
legal document of 70 pages; the website was not clear and could not
respond to personal questions; and the helpline was not answering. As
a result, the client was totally confused and was – at that time –
unable to become a Deputy for her husband.
Similarly, a Staffordshire CAB found that none of a group of 55
refugees had managed to make a benefit claim independently over the
telephone. All of them had needed help from other agencies. The
majority of the group were from Zimbabwe and spoke English, but they
were prevented from accessing the service – and therefore made
vulnerable – because they were faced with an unfamiliar system, and
could not navigate their way through it.23 The benefits and tax credit
system is particularly complex and confusing, and extra effort is
therefore required to explain the system and guide claimants through
it.
Change in circumstances: Many CAB clients find their ability to cope
is dramatically affected by a change in circumstances, such as
divorce, an income shock, or taking on a caring responsibility. People
who have previously been in control of their lives may suddenly be
unable to maintain the same level of engagement with providers. Some
may alert the provider to the change in their circumstances and the
provider should respond appropriately. Others may not directly alert
the provider to the change in circumstance, even when it affects their
ability to manage their commitments.
A problem may not become apparent until the first example of
non-compliance with expected procedures.
An Oxfordshire CAB advised a client whose wife was diagnosed with
dementia. He left his job to become a full time carer. He did not
apply for benefits, nor ask for any assistance. He had stopped paying
his bills and fell into rent arrears. His case was picked up by a CAB
housing caseworker when his case was heard in court, even though the
client did not attend the hearing. A CAB adviser arranged a visit to
his home. The adviser assessed his entitlements and he was awarded
carers allowance, attendance allowance, housing benefit and council
tax benefit. The adviser supported the client through the bankruptcy
process, provided him with details of Alzheimer’s disease support
groups, and flagged his situation to social services.
The client’s absence from the court hearing was an alert to the
housing case worker that the bureau would have to take a proactive
approach to help him. The client lacked confidence and struggled to
express himself over the phone, and the adviser judged that none of
the above would have been possible without face-to-face contact.
An inclusive organisation works on the premise that any form of non-
compliance – or unusual behaviour – may indicate a problem rather than
a deliberate evasion. Many credit card companies take this approach
and will contact the card owner if unusual payment patterns are seen.
We believe that the default position should be that the organisation
takes responsibility to make reasonable attempts to find out the
reason for the behaviour, and then acts accordingly.
Behavioural indicators may be: failure to reply to correspondence,
sudden non-payment of bills, and/or avoidance of contact. Service
providers should be alert to such behaviours – especially if the
person has previously been reliable, or if the behaviour is unusual.
An appropriate response may involve careful questioning and asking the
individual how the service could best help them manage their change in
circumstances.
For example, the DWP has a policy which – in certain circumstances –
requires staff to make extra effort to contact a customer, if there is
information on the client’s record that they have a mental health
problem. However, if there is no information on record, the Department
does not currently have a mechanism to check why the client may seem
to be non-compliant.
Mental health
One in four of the UK population experiences a mental health problem
at some time in their lives. Such problems may – or may not – make
people more vulnerable to detriment and disadvantage when using (or
seeking to use) a service. They may be more at risk of poor decision
making, exploitation, and discrimination. Similarly, the fear of being
stigmatised, or discriminated against, can inhibit an individual from
disclosing their mental health problems. It may not, therefore, be
explicit that a person’s mental health problems are contributing
factors to their vulnerability.
It is important that providers become attuned to the behavioural
triggers which indicate that a mental health problem is affecting the
way that someone interacts with the service.
A number of organisations – including The Royal College of
Psychiatrists and the Money Advice Trust24, the Money Advice Liaison
Group25, and Citizens Advice26 – have researched the impact of mental
health on access to services and have produced useful guidelines for
service providers. In the Citizens Advice guidance, the principles are
simple and are based on ‘normalising’ the issue. The adviser can ask
if the client has any support needs, or if they have a physical or
mental health condition which they would like the service to know
about. The phrasing of the question should avoid conveying negative
connotations, as this could dissuade the client from disclosing their
problems. It is important to avoid statements such as “I’m sorry that
I have to ask you this” or “I’m certain that this won’t apply to you”,
or “this is only for monitoring purposes”.
If a client does disclose a mental health condition, providers should
then establish whether the condition is affecting their interaction
with the service. Rather than assume that a person with a mental
health problem is necessarily vulnerable, service providers should
continue to explore the situation, establish the level of need and
provide the necessary support.
SECTION FOUR
============
Good practice
-------------
The ultimate good practice is for organisations to go beyond the
minimum statutory duties and actively consider the needs of all
potential users. They should offer a choice of access, which will make
the goods or services accessible to everyone, and should be proactive
in efforts to engage users appropriately.
The danger of failing to provide inclusive services is that some users
– or potential users – may not receive universal public services, such
as medical care; or vital financial support, such as welfare benefits;
or essential services, such as utilities or banking facilities. Not
only does this cause detriment and distress for individuals, but it
also results in unnecessary extra costs for providers, and can cause
further problems, such as debt and homelessness.
As providers recognise their statutory obligations and strive to
improve efficiency, examples of good practice are evolving across the
public, commercial and voluntary sectors. Considerable work has been
done recently by financial services and utility providers, while local
authorities are recognising the social and economic value of improving
access to their services. In this section, we offer a number of
examples of good practice from a range of these providers, and
recognise that they are by no means exhaustive.
We consider that the essential factors in inclusive services are:
*
Choice of access method for service users and customers.
*
A preventative approach.
*
Proactive approach to identifying vulnerability.
*
Appropriate support targeted to the user’s needs.
*
An enabling approach to service users and customers.
*
Willingness to help resolve problems.
*
Accurate recording of personal information, establishing follow-up
procedures and early investigation of non-compliance.
*
Respect for and trust in intermediaries/advocates.
*
Appropriate data-sharing to improve customer service.
*
Engaging one agency to coordinate access for very vulnerable
people.
Choice of access method for service users and customers
Evaluations of existing services which operate on a multi-channel
basis suggest that choice of access method is important in providing
an appropriate service.
The Money Guidance Pathfinder project, funded by the previous
government in response to the Thoresen Review of generic financial
advice (2008) was based on Thoresen’s five principles for a money
guidance service, which should be:
‘On my side’ – impartial from the government and the financial
services industry (FSI); supportive – to guide individuals to make
positive steps towards improving their finances; preventative – to
help people budget and plan for today and the future; universal –
available to all and (in the medium term) free to the user; and sales
free – it cannot recommend a product from a specific provider or that
the user varies or disposes of an existing product.
The service was offered online, by phone and on a face-to-face basis.
Between April 2009 and the end of March 2010, the service delivered
over 570,000 Money Guidance sessions to approximately 220,660 people
across the three contact routes, in the North East and North West of
England. There were 542,700 website sessions, 3,811 telephone sessions
and 24,595 face-to-face sessions, and the evaluation found key
differences in the people accessing the service by each channel.
‘The face-to-face channel was reached by the greatest proportion of
people most vulnerable to the consequences of poor financial
decision-making, who were more economically disadvantaged. By
contrast, the website reached a greater proportion of those people
least vulnerable to the consequences of poor financial
decision-making, who were less economically disadvantaged.’27
The Citizens Advice service can now offer advice on the web, by email,
through self-service kiosks, by phone, and face-to-face. In 2009/10
the service advised 2.1 million individual clients and received 10.6
million visits to the self-help website www.adviceguide.org.uk.
A preventative approach
One of the key values of appropriate and inclusive services lies in
the opportunity to prevent problems before they arise. By adopting a
user-focused attitude, organisations will better understand the
barriers to access for particular clients and will be able to pre-empt
potential problems.
As a result of the Citizens Advice report, Do the right thing28, some
60 representatives from the advice and creditor sectors now belong to
the Addressing Financial Difficulties best practice working group
(AFD), which is devising a definitive guide to best practice at
helping people avoid, manage and overcome periods of financial
difficulty. The group will publish a final checklist in spring 2011,
which will consider every aspect of financial difficulty including:
*
the best way to reduce the likelihood of financial difficulties
happening in the first place
*
how best to reduce and deal with consumer vulnerability
*
how people can be encouraged to engage and stay engaged with their
creditors
*
how creditors and face-to-face debt advice providers can work
together as effectively as possible.
Proactive approach to identifying vulnerability
Throughout this report, we stress the importance of organisations
taking a proactive approach to identifying vulnerability in order to
ensure that users receive the most appropriate service as early as
possible in their engagement with the provider.
The Citizens Advice new access procedure begins with an assessment –
known as a gateway assessment – in which assessors listen to the
client’s presenting problem and ascertain what the client needs.
Through careful listening and questioning, the trained assessors also
establish if there are any other underlying issues which the client
has not identified. The adviser then assesses if the client has the
capacity and capability to deal with the issue independently after
receiving guidance or information; if they should be signposted or
referred to other services; or if they require a face-to-face
appointment with an adviser.
An important driver behind the development of the gateway assessment
was to ensure that vulnerable clients are provided with the method of
access most appropriate to their needs and circumstances, while
encouraging efficient allocation of resources. Early assessments show
that the gateway assessment has helped bureaux to increase the number
of clients by 50 per cent, on average, and reduce waiting times by 50
per cent, on average, while Islington CAB reports that 95 per cent of
their clients would use their service again, and 92 per cent would
recommend it to others.
Appropriate support targeted to the user’s needs
Organisations with a proactive approach will seek to understand and
provide the most effective method of meeting the particular needs of
their users. This often involves partnership work with other
providers.
Coventry children’s services Multi Disciplinary Teams (MDT) are
working with Coventry CAB to encourage vulnerable clients to engage
with services and advice. The MDT family support workers, who visit
families in their homes, were faced with complex debt, benefit and
housing issues which they were not trained to deal with. The local
authority judged that it would be more cost efficient and beneficial
to fund the CAB to deliver a benefits and debt advice service.
With the client’s written permission, all information is shared
between both agencies, to ensure that families receive a comprehensive
service which meets all of their needs. This also stops clients from
having to repeat the same information to different agencies, which can
cause frustration and increases the risk of miscommunication.
Coventry CAB says: “The pilot has enabled the bureau to develop
systems that can be replicated for other potential services. This
enables the bureau to access new funding streams and increase
accessibility further”.
Partner organisations such as Macmillan, the Primary Care Trust and
children’s services have expressed their strong support for the use of
CAB expertise in engaging with vulnerable and hard-to-reach groups.
An enabling approach to service users and customers
Successful services enable users to manage their own interaction with
the provider. Many services are complex and difficult to navigate –
especially the current welfare benefits and tax credits systems. We
continue to urge Government to improve the accessibility of its
services, and Citizens Advice is contributing to the plans for the
welfare reforms, based on the new benefit, universal credit. In the
meantime, enabling advice services aim to give clients the confidence
to manage their own affairs.
The Citizens Advice service has outreaches in over 200 children’s
centres across England and Wales, offering generalist advice.
Evaluations of the programmes show how helping families deal with
their immediate problems – most commonly associated with benefits and
debts – often helps to relieve financial concerns and associated
feelings of stress. More importantly, advisers take an enabling
approach, which equips clients with the confidence and knowledge to
deal with their finances in the future. Funding such services is
cost-effective, as this early intervention reduces the need for
expensive remedies later on.
Willingness to help resolve problems
Debt collection is an area which has been notorious for aggressive
practices, and yet there is an increasing recognition that a
willingness to help clients to manage their debt results in better
outcomes for all parties.
Sovereign Housing Association in the South and South West of England
asks residents with rent arrears to attend a pre-court panel, before
they begin court proceedings. The panel includes debt and welfare
benefits advisers, and the resident receives a full benefit check,
budgeting and debt advice. Two thirds of the people who attend the
panels repay their debts without the need for court action. This not
only helps the residents pay their debts and keep their homes, but
also reduces costs for Sovereign Housing Association.
Accurate recording of personal information, establishing follow-up
procedures and early investigation of non-compliance
One of the most valuable measures in active and inclusive services is
for organisations to hold accurate and up-to-date information about
their customers, to establish relevant follow-up procedures related to
that information, and to explore reasons for apparent non-compliance.
Some organisations fail to keep such records at all; some gather the
information, but have no procedures to follow up on it; while others
have procedures to follow up when customers are known to be
vulnerable, but do not automatically explore non-compliance unless the
person is known to be vulnerable. We believe that it is just as
important for providers to take a proactive approach to apparent
non-compliance, and for their procedures to include early
investigation as to why the person has not responded as expected.
In response to the case of a particularly vulnerable client, Taunton
CAB worked with the local authority to develop a Vulnerable Persons
Policy.
The client was 24 years old, and dependent on alcohol and drugs. She
was unemployed and had been accommodated in a one bedroom flat, which
gave her a sense of stability and was necessary to her recovery and
rehabilitation. Unfortunately, her housing benefit was restricted to
the shared room rate which meant that she could not afford to pay all
of her rent and council tax. Even though the local authority knew that
she was vulnerable, they had no policy or system in place to stop
bailiffs being instructed to collect council tax arrears. One visit
from the bailiffs pushed the client away from the services she needed
so badly. Eight months later, the CAB was struggling to re-engage her
and she faced escalating debt and possible eviction.
The CAB held a number of meetings with the local authority, which was
very receptive, and the resulting Vulnerable Persons Policy is now
integral to the collection of council tax arrears. If a client falls
into arrears, the bureau becomes involved, and if the bureau
identifies the client as a vulnerable person, the local authority
assigns a named revenues officer to the client’s account, who works
with the client and the CAB to agree a suitable payment plan.
The local authority was proactive in implementing the policy, and by
December 2010 they had identified 60 users as vulnerable, and referred
them to the CAB for further assistance. The Principal Revenues Officer
gained agreement from the bailiff company that all of its employees
should be made aware of the policy, and if a bailiff thinks a person
might be vulnerable, they are encouraged to flag the case to the local
authority.
The bureau is now in discussion with the benefits department, as well
as Jobcentre Plus at district level, to extend the policy. They hope
to involve other third sector organisations – Age UK, Shelter, and
Compass Disability – in the practice, while the Principal Revenues
Officer is promoting the policy to other local authorities in
Somerset.
Respect for and trust in intermediaries/advocates
For some people, their vulnerability means that they can best access
services only through a third party or trusted intermediary. Inclusive
services will establish the credibility of the intermediary and then
ensure that their procedures facilitate reliable access for the user
through the intermediary.
Mains gas and electricity suppliers are required by law to offer a
number of additional, free services to eligible vulnerable consumers,
for which they use a priority service register (PSR).29 Energy
suppliers have also invested significant amounts of funds in voluntary
social programmes.30
The programmes involve a range of activities designed to support
vulnerable
and fuel-poor consumers, including:
*
Working with third parties such as Citizens Advice, Age UK and the
WRVS to identify and engage hard-to-reach consumers.
*
The six main energy suppliers all operate dedicated telephone
lines for use by Citizens Advice Bureaux and Age UK advisers,
which are staffed by teams with experience in handling issues
relating to vulnerable customers, as well as debt and
disconnection.
*
Social and discounted tariffs, rebates, energy efficiency measures
and grants.
*
Pledging to abide by the Energy Retail Association’s (ERA) Safety
Net for Vulnerable Customers.31 The Safety Net requires member
companies to take measures to ensure that vulnerable customers are
protected from being knowingly disconnected.
Appropriate data-sharing to improve customer service
Data-sharing is a vital element in ensuring that vulnerable users
receive the best services. It can be daunting and disabling for some
people to constantly approach separate service providers, when their
needs are better served by joint provision of associated services.
The Data Protection Act 1998 is often used as a reason not to share
information. Citizens Advice recognises that personal data should only
be shared on the basis that it is proportionate, relevant and
necessary to meeting the client’s needs, and rigorous safeguards must
be in place to guarantee the security of personal data, as well as
compliance with legal requirements. Within those boundaries, however,
there are several examples of service providers simply asking users
for permission to share information, which helps the user, and avoids
duplication for the providers.
An area where the sharing of client information between agencies is
particularly important is in helping people with mental health
problems to address their debt issues. The Royal College of
Psychiatrists and the Money Advice Liaison Group (MALG) have developed
the Debt and Mental Health Evidence Form (DMHEF).32 The DMHEF is a
standardised set of questions used by advisers and creditors to obtain
relevant information from health and social care professionals about a
consenting client’s mental health problem.
The information is used to assess if, and how, the client’s mental
health problem is affecting their debt situation. The assessment and
the evidence then inform the adviser’s or creditor’s decisions on how
they can best provide for the client’s needs.
The DMHEF was developed to address the difficulties that advisers and
creditors commonly encountered when trying to gather information from
health and social care professionals. These included: variability in
the amounts of evidence requested; unclear instructions and
unrealistic expectations; poor quality and unfocused information;
delays; and the refusal to provide evidence.
A range of organisations have used the DMHEF with success since it was
introduced in 2008.
Engaging one agency to coordinate access for very vulnerable people
Research suggests that the most vulnerable people benefit from a
single point of contact to coordinate the different agencies whose
services they need.33
Westminster City Council has developed a multi-agency programme for
extremely vulnerable families, ‘at risk of losing their children,
home, or liberty’.34 Two lead workers for each family gather
information and coordinate support from the various agencies who deal
with the family’s issues, including any or all of the following: adult
mental health, anti-social behaviour, benefits, domestic violence,
education, health visiting, housing, police, children’s social work,
substance misuse and access to training and work.
Eighteen families were given this support in the first year, at a cost
of around £19,500 per family. Success is measured in improvements in
the families’ situations, and estimated avoidance of future costs to
public services. Improvements include increased engagement with health
and mental health services, increased school attendance, avoidance of
eviction, and reduced levels of criminal behaviour. Early estimates of
average cost avoidance per family amount to just over £40,000 in the
year during which the family is engaged. In just one year, some
well-engaged families who had previously suffered from complex and
entrenched problems changed their behaviours to such an extent that up
to an estimated £136,000 in costs had been avoided. As a pilot area
for community budgets, Westminster will be given additional funding to
continue to work with vulnerable families.
SECTION FIVE
============
Conclusion and recommendations
------------------------------
Through examples and case studies, this report has shown that there
are strong moral, legal and business arguments for public-facing
organisations to provide inclusive services. Inclusivity must be
embedded in service design, and supported by comprehensive staff
training. Good practice examples illustrate that multi-channel access,
co-location of services, and proactive attitudes can all contribute to
improvements in customer satisfaction, and savings to providers.
Citizens Advice recommends that:
*
For legal, moral and business reasons, all public-facing
organisations must take responsibility for providing goods and
services on equal and inclusive terms.
*
Organisations should devise mechanisms for identifying people who
need extra help, or alternative methods, to access their services.
Signs may include:
*
explicitly stated need
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obvious indicators
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behavioural triggers.
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Providers should design integrated systems and train all staff to
ensure that all users and potential users have equal access to
their products or services.
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Essential elements of inclusive services are:
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Choice of access method for service users and customers.
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A preventative approach.
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A proactive approach to identifying vulnerability.
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Appropriate support aimed at meeting the user’s needs.
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An enabling approach to service users and customers.
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A willingness to help resolve problems.
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Accurate recording of personal information, establishing follow-up
procedures and early investigation of non-compliance.
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Respect for and trust in intermediaries/advocates.
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Appropriate data-sharing to improve customer service.
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Engaging one agency to coordinate access for very vulnerable
people to provide a holistic problem-solving service.
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All public-facing organisations should consider adopting BSI
standard 18477.
Our aims
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To provide the advice people need for the problems they face.
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To improve the policies and practices that affect people’s lives.
Our principles
The Citizens Advice service provides free, independent, confidential
and impartial advice to everyone on their rights and responsibilities.
It values diversity, promotes equality and challenges discrimination.
Written by:
Lizzie Iron and Christie Silk
Citizens Advice
Myddelton House
115–123 Pentonville Road
London N1 9LZ
Telephone: 020 7833 2181
Fax: 020 7833 4371
www.citizensadvice.org.uk
www.adviceguide.org.uk
Citizens Advice is an operating name of The National Association of
Citizens Advice Bureaux.
Registered charity number 279057
Published March 2011.
Design by wearemash.com
1 Manifesto for a Networked Nation, Race Online 2012, p. 34.
2 Universal Credit: welfare that works, DWP White Paper, November
2010, p.38.
3 Statistical Bulletin: Internet Access 2010, The Office for National
Statistics, August 2010, pages 2–4.
4 The majority of the provisions in the Equality Act came into force
on 1 October 2010. For more information see the Government Equalities
Office website: www.equalities.gov.uk.
5 5 BS 18477:2010 Fair, flexible services for all, British Standards
Institute, 2010.
6 The Equality Strategy – Building a Fairer Britain, HM Government,
December 2010.
7 7 Monitoring Poverty and Social Exclusion 2009, Joseph Rowntree
Foundation, 2009, p. 86.
8 The Act also requires reasonable adjustments to some physical
features and in the provision of auxiliary aids.
9 The Services, Public Functions and Associations Code was expected to
be enforced on 28 February 2011 at the time of going to press. See the
EHRC website: www.equalityhumanrights.com
10 The Public Sector Equality Duty gives public bodies the legal
responsibility to show that they are paying due regard to equality in
relation to eight of the nine protected characteristics covered by the
duty, which will come into effect in April 2011.
11 The Equality Strategy – Building a Fairer Britain, HM Government,
December 2010.
12 Customer Codes Approval Scheme – Core criteria and guidance, March
2008, OFT 390, Content 3L.
13 Health care association gets OFT code approval, OFT press release
111/09, 9 September 2009.
14 Professional diligence is defined under regulation 2 of the CPRs as
‘the standard of special skill and care which a trader may reasonably
be expected to exercise towards consumers which is commensurate with
either – (a) honest market practice in the trader’s field of activity,
or (b) the general principle of good faith in the trader’s field of
activity’.
15 The ‘average consumer’ refers to a notional concept developed
through case law of the European Court of Justice.
16 Minimising the cost of administrative error in the benefit system,
The National Audit Office, 2010.
17 Good Practice Awareness Guidelines for Consumers with Mental Health
Problems and Debt, The Money Advice Liaison Group, November 2009; The
Lending Code is a voluntary code of practice for financial
institutions; the Consumer Credit Act 2006.
18 No health without mental health: a cross-Government mental health
strategy for mental health outcomes of people of all ages. Supporting
document: The economic case for improving efficiency and quality in
mental health, Department of Health, February 2010.
19 Tendring Reach Out Pilot Project Evaluation Report, Tendring CAB,
April 2009.
20 Total Place Pilot Kent – Final Report, February 2010.
21 Over-indebtedness on a low income – Investigation into the impact
of Citizens Advice Financial Inclusion Fund 2006–09, Research Unit for
Financial Inclusion, Faculty of Health and Applied Social Sciences,
Liverpool John Moores University.
22 See www.bsigroup.com
23 Stoke on Trent CAB’s consultation with the refugee and asylum
seeker community, summer-autumn 2010.
24 Debt collection and mental health: ten steps to recovery, Royal
College of Psychiatrists and the Money Advice Trust, November 2010.
25 Good Practice Guidelines: Debt Management and Debt Collection in
Relation to People with Mental Health Problems, the Money Advice
Liaison Group, 2007.
26 Guidance for advisers on asking clients about their mental health,
Citizens Advice, 2010.
27 The Money Guidance Pathfinder. Key findings and lessons learned,
Consumer Financial Education Body, July 2010.
28 Do the right thing –Advisers’ and creditors’ experience of best
practice in debt collection, Citizens Advice, February 2010.
29 See Ofgem’s website: www.ofgem.gov.uk
30 See www.energymadeclear.co.uk
31 Energy Made Clear – Protecting Vulnerable Customers from
Disconnection, Energy Retail Association.
32 The MALG Good practice awareness guidelines for consumers with
mental health problems and debt suggested that a standardised tool was
needed to facilitate the lawful, efficient and sensitive sharing of
data.
33 Making every adult matter – A four-point manifesto for tackling
multiple needs and exclusions, Making Every Adult Matter Coalition,
September 2009.
34 See Westminster City Council website www.westminster.gov.uk
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