Fighting fraud in the adult social care sector – download the toolkit today

Fraud in adult social care has historically been underestimated. The loss to the public purse is now thought to be much higher than previously estimated. Fighting Fraud and Corruption Locally (FFCL) has recently released an Adult Social Care Fraud toolkit to raise critical awareness about the issue. Jonathan Dodsworth, Assistant Director for Corporate Fraud at Veritau, and who chaired the FFCL working group that compiled the toolkit, gives us his insight into adult social care fraud and how this crucial document can help.

Adult social care costs in the UK have increased almost every year for the last two decades. In 2005 (shortly after I started working as a fraud investigator) it cost £14 billion to provide care in England. However, by 2022 the cost had risen to over £23 billion. Just like any means-tested benefit, adult social care is subject to fraud – but the size of payments available makes it particularly attractive and lucrative for fraudsters.

As a young(ish) counter fraud manager in the early 2010s, my primary objective was transitioning our growing counter fraud team from investigating housing benefit fraud to delivering a corporate fraud service addressing all fraud against our council partners. Adult social care became a major area of focus for our team, but it took a lot of time and hard work to convince colleagues working in the field that there were substantial levels of fraud in the system and that the counter fraud team could help to address it.

Looking back today, I can see the fruits of our labour. We now work closely with colleagues responsible for care management, financial assessment, direct payments, and safeguarding to help prevent, detect, and deter fraud in this area. Our team investigate a wide variety of frauds that occur within the adult social care sector, routinely detect substantial losses, and work with clients to bring that money back into the public sector.

As our working group was formed with representatives from a number of local authorities, we realised that we all had similar experiences – both positive and negative. Adult social care fraud is one of the highest areas of loss experienced by the councils we work for, however, it is not spoken about anywhere near enough in counter fraud and social care circles.

The challenges adult social care fraud presents

National fraud surveys regularly reported that it was perceived as being a major fraud risk affecting councils, but relatively small amounts of fraud were being detected. The last published CIPFA FaCT survey estimated that only £8.2m of loss due to adult social care fraud was detected nationally. This represented just 3.4% of the £240m of fraud estimated by CIPFA to have been found in 2019/20. The average loss per case was £18k.

These figures felt incongruous with the amount of loss and nature of fraud our group experiences. Our analysis is that the true level of fraud in adult social care is significantly higher than previously thought and there is a considerable gulf between the levels of fraud detected by councils and the amount of fraud within the system. Why would there be such disparity? Our working group pointed to some contributing factors.

People who work in adult social care at all levels have extremely difficult and challenging jobs. They are required to undergo a vast amount of training too. While there has historically been training for social workers, this has tended to focus on safeguarding and how to spot different forms of abuse against the end-user, rather than fraud detection and prevention to protect council funding.

Raising the awareness of fraud with everyone working in this sector is a key recommendation of the group. Local authority counter fraud teams can struggle to investigate these crimes as they are often extremely complex and there are a lack of powers available to compel the provision of financial information. Even if fraud is identified, it can be difficult to recover funds. Many local authorities still make little or no investment in counter fraud services which seriously affects their ability to tackle fraud in an area like adult social care.

Our toolkit contains three template presentations for different types of workers and a pocket guide for all employees which will help to identify fraud and give them the confidence to identify and report fraud.

It has been designed to provide a helping hand to councils who haven’t historically addressed adult social care fraud as well as those that already have a strong counter fraud function.

The working group has also pooled its collective knowledge and experience to produce best practice guidance for the toolkit, such as recommending the use of section 70 of the Care Act 2014 to recover losses due to deprivation of capital which is useful when someone has moved capital to another person in order to avoid paying care fees.

How you can join the fight against adult social care fraud

At a time when local government has to make significant savings, it is especially important that the public purse is protected. We encourage every council with a responsibility for adult social care to consider whether more could and should be done to tackle fraud in this area.

I’d like to thank all the members of our working group and their organisations that have given us their time to produce this toolkit. We encourage all councils who administer adult social care and central government to look at our findings and recommendations and use the free resources included in the document.

Finally, FFCL is an important organisation that gives a voice and platform for counter fraud professionals working in local government. If you haven’t engaged yet, then now’s the time to get involved.

To receive the Adult Social Care Fraud toolkit, email: FFCL@cifas.org.uk