This is copied from the Board notes.
Essentially the Trust now has to go back and do what the Sainsbury Centre advisors should have advised it to do in the first place. The roles arent any clearer and there is still a lot of uncertainty , and yes some concern too about what level of representation the workers will get this time round.
Therapeutic Payments Background Changes to the way that Work Services are provided were subject to consultation (‘Building on the Best’) during January to April this year. The results of the consultation confirmed the move to more individualised, locally based employment and social support services and the importance of offering a range of training and community based activities, with most of the services moving to Richmond Fellowship over the course of the year. The programme is on schedule, with around half of the centres having transferred from the Trust. Alongside this transfer, the Trust Board agreed (in January 2006) that the practice of awarding ‘therapeutic payments’ would cease on 31st May 2006. Therapeutic payments (usually totalling £3.00 per day) were given as recognition to those attending. They were not intended to represent payment for work.
In reviewing the impact of ceasing therapeutic payments, the main consideration given was to the impact of National Minimum Wage (NMW) legislation. NMW is currently set at £5.05 per hour (reviewed every October). Applying NMW to the hours for those attending work service activities could adversely impact upon the benefit that people receive. Further, it is unclear where NMW would apply, as people do not attend in order to provide significant output but to undertake training (most work service activities include NVQ assessment), to participate in therapeutic and social activities and, where possible, to prepare for employment. Work service activities are not reliant upon those attending undertaking work and the centres do not create a profit for the Trust.
Other day centres across the Trust have ceased therapeutic payments in line with the Trust Board decision, although the implementation has been phased over a longer timescale.
Areas of Concern
Impact on People attending Work Centres
The cessation of therapeutic payments, especially at the garden centres, has caused considerable concern to some people attending and their families, as well as members of the Trust’s Forum for People who Use Services and their Carers (FoCUS) and members of the public. Further, no assessment has been undertaken to ensure that people attending the Work Services activities are either undertaking paid work (for which NMW would apply) in line with benefit regulations or are attending on a voluntary basis for therapeutic or training activities.
Impact on Service Delivery
Concerns being raised could bring into question the viability of transferring services to external providers, who will not wish to take on any potential liability. Failure to ensure that a proper assessment of activities and individual assessments for people attending could mean that the modernisation in line with the wishes of people we serve (as identified through the consultation feedback) and the commissioners of the service is unable to proceed as agreed.
Advice to the Trust Board In reaching the conclusion that therapeutic payments should cease, the information provided by the Trust’s legal advisors was not interpreted fully for the Trust Board. All work service centres were treated in the same way, but the legal advice regarding four centres (the two garden centres, the printing activity and the travel agent) indicated that some people may indeed be undertaking work in a similar way to people employed in those centres by the Trust. This cannot be determined without further assessment of the activities undertaken and the purpose of attendance at the centres.
The option recommended to the Board to cease therapeutic payments had not been discussed with the Trust’s legal advisors. Further, the advice to the Trust indicated that any decision made by the Board should take into account that the people concerned were very vulnerable and therefore the normal principles of risk management were not appropriate to the decision-making process.
2.4 Wider Impact on the Trust As a result of the decision to cease therapeutic payments, there is considerable concern that the Trust has not treated people well.
Recommendations The Trust acknowledges that the decision-making process and its outcomes have been far from satisfactory and adversely impacted on people who attend work services and their families and carers. The Trust is very sorry that this decision was made and apologises unreservedly for the distress and anxiety caused to those people who have been affected.
The Board is recommended to: Re-instate therapeutic payments across the Trust with effect from 1st June 2006 (or the date on which the payments were stopped).
Write a letter of apology to every individual affected by the cessation of therapeutic payments
Require the Director of Operations (Mental Health Services) and the Director of Services for People with a Learning Disability to develop an action plan which will:
Assess activities undertaken and develop guidelines to differentiate between ‘work’ (for which the NMW or higher will apply), ‘therapy’, ‘training’ or ‘voluntary work’ (for which no payment, other than expenses, will apply).
Undertake individual assessments on those attending in order to ensure that payment for attending ‘work’ does not adversely impact on benefit.
Ensure that the work centres remain viable with any increased cost associated increased payments for work undertaken. Any change will be subject to further consultation.
The plan will be developed in conjunction with people using the services, their families and carers and care workers. Legal advice will be sought on the action plan prior to its implementation.
Fiona Edwards
Chief Executive
September 2006