Putting the Dosh Promise into Practice

Putting the
Dosh Promise
into Practice
How Dosh could provide better support
with money by working more effectively
with support teams
Word count: 4,294

Maddy Hubbard, Dosh Financial Advocacy CharityWorks Cohort E
2
Contents
Easy Read Executive Summary………………………………………….3
Introduction and Context………………………………………… …..…..7
Research Focus and Methodology………………………………… ……9
Part A – Working with Support Teams..…….…………………… .…..11
Research Findings……………………………………………… …11
Analysis and Recommendations…………………………… …13
Part B – Understanding the Mental Capacity Act………….……… ….17
Research Findings………………………………………… … …17
Analysis and Recommendations………………………… … …19
Implementation Plan 22
Conclusion…………………………………………………… …… …....23
Bibliography………………………………………………… ……… …..24
Appendixes…………………………………………………… ……..……25
The Mental Capacity 25
Dosh Policies and Practices 26
Capacity Assessment Survey 28
Interview Transcripts with Support Workers 31
Interview Questions for Organisations , 38

3
Easy Read Executive Summary
Dosh wants people with a learning disability to have more
independence and control over their own money.
Dosh is good at thinking about the best way to support
people with their money. Other organisations come to Dosh
to learn about how to support people well.
Dosh listened to how people with a learning disability wanted
to be supported with their money. They used what people
said to write the Dosh Promise.
Dosh advocates try to make sure that everyone gets
supported like it says in the Dosh Promise.
This is difficult because Dosh works with many different
support providers. Dosh does not train the staff who put the
Dosh Promise into practice and support people every day.
Everyone in a circle of support needs to work together for
people to be supported well. Dosh wanted to think about how
advocates could work better with support teams.
Dosh asked advocates what they found difficult about
working with support teams. Dosh wanted to know if this
affected how well Dosh could support people.
Dosh asked support workers how they felt about supporting
people with their money. Dosh wanted to understand what
was important to them and what they found difficult.

4
Dosh asked other organisations how they support people
with their money. Dosh wanted to learn how they train their
staff about good support with money.
Dosh used what people had said to make
recommendations. Recommendations are things that could
change to help Dosh support people better.
Part A: Working with Support Teams
The first part of the research looked at how Dosh could be
better at telling support teams who Dosh are and how to
work well together.
Support workers and organisations said that supporting
people with their money is difficult. Some support workers
found money confusing or scary. They did not want to make
mistakes with money.
Many support workers did not know who Dosh were or how
Dosh think people should be supported with their money.
This was true even if they supported someone who had a
Dosh advocate.
Recommendation 1 is that Dosh should write a guide for
support staff to explain to them who Dosh are, what they do
and how to work well with them.
Recommendation 2 is that Dosh advocates should involve
the whole support team during visits.
This would help support workers learn more about Dosh and
make them feel more confident about money.

5
Recommendation 3 is that Dosh make sure all their forms
are easy to understand so that support workers know why
they are important.
Part B: Understanding the Mental Capacity Act
The second part of the research looked at how Dosh could
help support teams understand the Mental Capacity Act.
The Mental Capacity Act is the law on how people with a
learning disability should be supported.
Support providers said that they give lots of training on the
Mental Capacity Act. They said people are worried about
how to follow the law because they don’t understand it.
Dosh advocates said that some support teams are confused
about the Mental Capacity Act. They said this makes it is
hard to support people to make their own decisions.
Most support workers said they did not know how to do
capacity assessments. Capacity assessments are an
important part of following the Mental Capacity Act.
Some support workers said that it was hard to let people
make decisions if they thought they were bad choices. They
felt they had a duty to protect the people they supported.
Dosh should change how they talk about supporting people
to make decisions so that support workers see the law as
part of what they do every day.

6
Recommendation 1 is that Dosh should be better at
explaining Best Interest Decisions (BIDs). Best Interest
Decisions are how the law says you can make a decision for
someone else.
Dosh should not say Best Interest Decisions are for spending
over £250. Dosh should say that they are for ‘significant’
financial decisions which are different for each person.
Recommendation 2 is that Dosh should think about how to
have a supported decision making process for people who
have the capacity to make a decision.
Supported Decision Making would help Dosh advocates and
support teams follow the law when people have capacity.
They would feel more confident about letting people make
their own choices.
To make big changes Dosh would need to consult with
advocates, people supported and their circles of support. To
consult is to ask how people feel about recommendations.
Dosh advocates should be part of deciding about all the
changes so that they understand them and think they are a
good idea.
Dosh should also talk to support teams about the bigger
things they want to change to make sure that support teams
agree the changes will be good for people supported.
The most important thing is that the changes mean people
with a learning disability get better support with their money.

7
Introduction and Context
Dosh is a small, innovative non-profit organisation which supports
around five hundred people with a learning disability with their finances.
A key challenge for any organisation which supports people with their
money is ensuring a number of priorities are balanced:
 Understanding and implementing the legal requirements set out in
the Mental Capacity Act (2005).1
 Offering people meaningful choice and control over their money,
and therefore other aspects of their life
 Safeguarding money and reducing the risk of financial abuse and
mismanagement
 Balancing the interests and priorities of different groups in peoples’
lives, including support providers, social workers, care managers,
the Department for Work and Pensions (DWP) and family
members
Dosh is at the forefront of developing policies on supporting people well
with their money so that each of these priorities is met. Their vision is set
out in the Dosh Promise, which was produced through a process of
consultation with people supported. The Dosh Promise describes the
1
See Appendix One for a detailed explanation of the Mental Capacity Act (2005).
“It is always a challenge to balance our vision and mission to be person centred while
at the same time complying with the DWP, MCA and also Local Authority
expectations. These often vary across the country and also change especially when
something goes wrong such as a Safeguarding Investigation.” Steve Raw, CEO of
Dosh

8
quality of support that the organisation believes everyone with a learning
disability should receive.2
Figure 1: The Dosh Promise, www.dosh.org/the-dosh-promise
Dosh is one of very few organisations to offer such a person-centred
approach to appointeeship and the organisation prides itself on being at
the forefront of innovating best practice in the sector around good
support with money. As a result there is a constant desire to review
practice and continue to learn about the best way to support people.3
2
See Appendix Two for more information on the Dosh Financial Standards Project (2014) and how Dosh have
translated the Dosh Promise into policies and practices.
3
Dosh’s success in pioneering good practice is evident in their growing number of commissions to provide
training and consultancy, including an extensive programme currently being delivered for Dimensions.

9
Research Focus and Methodology
For Dosh’s policies to improve the lives of people with a learning
disability, their vision needs to be shared with the support teams that put
these policies into practice and provide people with day-to-day
assistance with their finances. Dosh Advocates work with almost 50
support providers across the country which makes managing these
relationships a key challenge faced by the organisation.
Advocates and support teams already successfully collaborate to
support people well in many areas of the country. However, this report
will demonstrate that there are common areas of misunderstanding and
miscommunication which are preventing the Dosh Promise being put
into practice in a consistent way.
In order to reach solutions which meet the needs of Dosh advocates,
support teams and different providers, interviews were undertaken with
each group to understand their experiences, priorities and challenges
when supporting people with their money.
In November and December 2015, face-to-face interviews with nine
support workers were done during the Annual General Meetings (AGMs)
of three different Thera subsidiaries, the support provider of around half
of the people Dosh supports. The support workers were chosen to be
representative of a range of experiences:
 Working in different regions of the country
 Community support and supported living4
 New to support work and experienced
 Those that did and did not work with Dosh
4
Both types of support help people to be independent and a part of their community, but community support
is a lower level of support for someone in their own home, often whilst they still live with their family, and
supported living is more intensive support for someone who lives independently.

10
Interviews were also arranged with people who worked in different areas
of social care to show that the issues and key themes raised were
representative of the sector more broadly. These were:
 Dimensions, a large support provider with close ties to Dosh
through people supported and a programme of training being
delivered by Dosh to Dimensions managers.
 KeyRing, a charity which supports people in their homes which has
never worked with Dosh.
 United Response, a national support provider which is beginning to
work with Dosh in some areas.
 Derby City Council, a Local Authority where Dosh support a
number of people
 A First Tier Tribunal Judge in Social Entitlement
Evidence was also drawn from consultations with Dosh advocates,
observation of a Dosh best practice training session for Dimensions and
a survey across the Thera Group from March 2015 on compliance with
the Mental Capacity Act.
Dosh is a person-centred, collaborative organisation and is therefore not
somewhere that change either can or should be imposed on advocates.
Instead, the research will consider how advocates could be supported
through new policies, practices and resources to engage and
communicate more effectively with support teams.
A number of issues will be identified which require broader changes
across the sector, but the focus of the report will be on areas in which
Dosh could most effectively encourage greater confidence and
awareness around finances so that people with a learning disability
receive better support with their money.

11
Part A – Working with Support Teams
Research Findings
Interviews with support workers raised a number of similar concerns and
questions around money. The same challenges were also identified by
support providers and can be seen as representative of issues around
money faced more broadly by the social care sector.5
 Where does money come from?
Whether or not they worked with Dosh, few Support Workers had even a
basic understanding of the benefits system. Many just described a set
amount of money being put into a wallet or tin each week, either by a
manager if they had Dosh support or by a family member.

 How do you support people to spend their money?
For almost all of the support workers interviewed, their main experience
of giving financial support was taking money from the tin or wallet to
spend with the person supported, and then making sure to count change
back in and keep receipts.
5
For a full transcript of interviews with support workers see Appendix Four. The interview questions for other
organisations are listed in Appendix Five.
“People are just given basic training around the use of money, so staff don’t really
understand benefits. We are working with Dosh because people deserve the best
advice they can get.” Andy Alcock, Area Manager, United Response
“The number of benefit appeals is going up hugely because the system changes so
quickly and people don’t understand what to write on the forms. The massive reduction
in the number of advice agencies and other organisations is making the system
increasingly unfair” First Tier Tribunal Judge in Social Entitlement

12
Many people who worked in Community Support expressed the difficulty
of supporting people to do the things they wanted to if families did not
provide enough money.
For example, one senior support worker talked about the challenge of
supporting someone to do the things they wanted as they had so little
money to live on. He said “I could be an advocate for the person I
support for things they might want to do if I knew more about their
money and what benefits they were entitled to.”
In the past, Dosh has received a number of referrals due to families
exerting an unhealthy or even abusive level of control over money.
 Who are Dosh and what do they do?
Support teams who worked with Dosh in Thera East Anglia where the
advocate is very ‘hands on’ were more likely to be aware of Dosh and to
feel involved in making decisions,
However in other areas many support workers felt that Dosh spoke to
senior managers rather than them, and some who worked with Dosh
were not certain the people they supported even had a Dosh Advocate
or had no idea what Dosh actually does.
Another aspect of this misunderstanding which affects the organisation
is that some Dosh Advocates have found that once a manager starts
“A big challenge for KeyRing is trying to support families to let go and allow people to
make their own decisions.” Kath Heat, Project Manager, KeyRing
“United Response doesn’t know much about Dosh as a tool to support people, and
lots of teams don’t understand who Dosh are or what they do. They can think Dosh
has been imposed on them because they have done something wrong, or are just
making them do lots more paperwork.’ Andy Alcock, Area Manager, United Response

13
working with Dosh they feel that everything to do with money is no
longer their responsibility.
Analysis and Recommendations
There is clearly a wide variety of levels of knowledge and experience
around support with money that varies not only between support
providers but also within support teams. For most people, the only
training they had received in relation to money was about financial
processes and safeguarding. It is therefore important that Dosh does
not assume any knowledge from support teams about good support with
money.
Across the social care sector, a number of organisations reported that
the best way to bring about change is through a person-centred
organisational culture and building staff confidence through good
leadership.
Dosh is unable to use this strategy as they do not employ support
workers directly and do not have the resources to offer training.
Therefore, the recommendations will identify ways to improve support
workers’ knowledge of Dosh and confidence around money, and to
encourage them to see financial advocates as part of the support team
around each individual rather than as outsiders.
“It is really useful to say we can leave it to Dosh. We can say ‘this is your task
now’” Andy Alcock, Area Manager, United Response

14
Recommendation 1 – develop a ‘Dosh Induction Pack’ for support
teams
Current Dosh guidance to support teams is minimal and is split across a
number of different forms, booklets and factsheets. The information
could be collated and presented in an engaging way in a guide for
support teams to refer back to easily.
It is important not to reproduce work that should be done by the care
provider in their finance processes manual or training. Equally, Dosh
cannot assume that a support provider commissioning them has told
their staff anything about the organisation.6
A short accessible guide could include information about who Dosh are,
how they support people, how to work well with your advocate, a guide
to Dosh policies and forms, and a section with FAQs addressing
common misunderstandings.
The guide could be produced in a similar way to the Advocates’
Handbook, with each section written and reviewed by an advocate with
experience and interest in that area, before seeking comments from the
whole Dosh team.
Recommendation 2 – communicate information to support teams
through Dosh Advocates
Dosh currently assume that team leaders pass on information about
peoples’ finances to their support teams, but the evidence from
interviews is that this is clearly not happening in many parts of the
country. Dosh should instead pass information through advocates
directly to support teams.
6
In 2015 around 80% of Dosh referrals came from support providers or social workers rather than individuals.

15
Figure 2: Current chain of communication
Involving support workers during visits would encourage them to see
Dosh as part of an individual’s circle of support and make people more
confident about asking questions and sharing ideas or concerns.
As Dosh is reliant on how each advocate supports people and works
with staff teams, it is vital that they are involved in producing any policy
changes. If advocates understand and believe in the need for new ways
of working they are far more likely to change how they collaborate with
and involve support teams.
Recommendation 3 – make Dosh forms more standardised and
accessible
Dosh support relies on each person’s circle of support working together
and completing a number of forms, but some people find it hard to see
the point of these and can just see them as unnecessary paperwork.
Dosh forms should be made more accessible so that people can learn
how Dosh policies work together as part of the wider process of
supporting someone.
The model for these changes comes from the new cover sheet on the
Best Interest Decision (BID) form, developed in December 2015. It
explains the purpose of the form and includes a clear image explaining
when it should be completed. The updated BID form was tested with
Dosh Advocate Team Leader Support staff

16
managers in Thera North who found it much clearer and thought the
widgits on the first page were really helpful.7
1 2 3 4 5 6 7
Mental
capacity*
Decision
details
Involve
others
Complete
BID form
Submit
Dosh
clears
Arrange
payment
Figure 3: Table from the new Dosh Best Interest Decision form
The changes could be implemented quickly and with minimal cost to the
organisation, and the evidence from the pilot of the BID form suggests
that they would be popular with support teams. The changes could be
piloted in one region of the country and then reviewed before being
presented to all Dosh advocates and rolled out more widely.
1 2 3 4 5 6
Referral
form
Agreem
ent
Money
Plan visit
BID to
agree
budget
Switch
Direct
Debits
Arrange
agreed
transfer
Figure 4: An example of what the new header could look like for the start
of the support process
7
Widgets are images which accompany Easy Read text to make it more accessible and easier to understand for
people with a learning disability.

17
Part B: Understanding the Mental Capacity Act
Research Findings
The second part of the research will focus on how people are supported
to make decisions. Best Interest Decisions are a key area of Dosh
support which relies on support teams understanding how to support
people well but also how to follow the law as set out in the Mental
Capacity Act.8
In order to make a Best Interest Decision, there must be a capacity
assessment which is specific to the time and decision.9
Despite extensive training in the Mental Capacity Act, interviews and the
experiences of advocates suggest that it is misunderstood by many
support teams, both at support worker and team leader level.
The general lack of understanding of the law affects Dosh’s work. For
example, answers to the question ‘How did you involve the individual
with the decision?’ on the Dosh Best Interest Decision form resulted in
answers such as:
 “The person does not have capacity so was not involved”
 “No involvement in choosing car as lacks capacity”
 “Capacity assessment result = no capacity around money”
The lack of time and decision-specific capacity assessments creates
organisational risk for Dosh in the event of future audits, but most
8
For a more detailed explanation of the Mental Capacity Act and how it applies to making decisions on behalf
of people who lack capacity please see Appendix One.
9
‘Making Financial Decisions: Guidance for Assessing, Supporting and Empowering Specific Decision Making’,
Empowerment Matters (2012).
“The statement ‘X lacks capacity’ is, in law, meaningless.” 39 Essex Street
Chambers

18
importantly could indicate that people are not receiving empowering and
person-centred support.
Interviews with support teams highlighted the areas in which Dosh could
communicate its policies around decision making more clearly to help
people feel more confident about implementing the law and giving more
empowering and person-centred support with money.
 Are people supported to make their own decisions?
Although everyone interviewed acknowledged the right of people to
make unwise decisions if they understood the consequences of their
actions (one of the key principles of the Mental Capacity Act), there was
a spread of responses to how this was experienced in real life.
Some felt they had a duty to care for someone if they were making
decisions that could harm themselves, and others felt uncomfortable
with decisions they felt were ‘irrational’ such as buying things the person
already owned, or harmful, such as excessive drinking or gambling.
 Who should do capacity assessments?
Interviews with support workers demonstrated that although most people
understood what capacity assessments were, most felt that assessing
capacity was something that should be done by senior managers.
There was a widespread perception across all the areas in which
support workers were interviewed that capacity assessments were a
bureaucratic process that was very separate from day-to-day support.
“I often get referrals for customers who have capacity but are making bad choices.
This shows a lack of understanding of appointeeship and the Mental Capacity Act.
Taking control of people and making decisions for them is the easy option, but they
should be supported to make good choices” Keith Watkins, Local Authority
Appointee, Derby City Council

19
Indeed, most people expressed no interest in having anything to do with
them whatsoever.
Similar fears and confusion were reported following a programme of
workshops across Thera Trust in autumn 2014 to improve awareness of
and compliance with the Mental Capacity Act. Feedback showed people
felt they didn’t understand the law and generally felt overwhelmed by the
need for more paperwork and record keeping.
A survey the following March across the Thera Group found that in 34%
of cases where managers were aware of the need for Capacity
Assessments or Best Interest Decisions these were not in place.10
Analysis and Recommendations
More widely, a cultural change clearly needs to happen across the
sector so that the Mental Capacity Act isn’t seen as an add-on or a
bureaucratic addition but is just the way of thinking about and giving
support.11
The key way in which Dosh could make a difference would be to help
support teams feel more confident about what needs to be done, and to
ingrain the principles and ways of working set out in the Mental Capacity
Act code of practice in everyday processes.
The recommendations will therefore focus on ways in which Dosh could
explain existing policies and develop them further so that they are fully in
line with legal requirements but also addressing the needs and concerns
of support staff and people supported.
10
See Appendix Three for the full findings and data of the survey.
11
See for example ‘The Mental Capacity Act in Care Planning’, Social Care Institute for Excellence (2014).
“If anything is seen as additional it will be left behind at some point. Changes need
to be built into practices.” Paul Pargeter, Head of Involvement, Dimensions

20
Recommendation 1 – Dosh should describe their Best Interest
Decision process as for ‘significant financial decisions’
As it is currently described in marketing materials, presentations and
guidance to support staff, the Best Interest Decision process sounds as
if it follows a one-size-fits-all ‘over £250’ rule, which is not in line with the
principles of the Mental Capacity Act. In practice, Best Interest Decisions
are often used in a more nuanced and individualised way.
The £250 limit could be retained for auditing purposes, but Dosh
advocates should encourage support staff to make judgements about
what is ‘significant’ to an individual, including smaller purchases,
financial contracts or other commitments.
Recommendation 2 – Dosh should consider Supported Decision
Making for people who have capacity
Supported Decision Making is not a legally recognised process in Britain
but would allow Dosh to support people who are assessed to have
capacity in line with the principles of the Mental Capacity Act. If Dosh
were to develop a process which enabled people to make their own
decisions it could empower people supported and also encourage
support staff to let people make their own decisions, even if they were
unwise, as they could be sure that the process was recorded and the
individual would be safeguarded.12
It would also make Dosh’s service of advocacy without appointeeship for
people with greater capacity around money more meaningful, by
providing the policies and tools to implement this fully. Furthermore, the
12
A Supported Decision Making policy would be at the forefront of developing best practice and has been
advocated in the recent House of Lords Deprivation of Liberty review. It is already a legally recognised process
in Canada and Australia which found it led to a huge increase in ability and wellbeing.

21
policy could allow advocates to encourage people to develop skills and
take on more independence and control over their money.
When colleagues were consulted on this recommendation, they were
concerned that it would cost time and capital to develop, pilot, train staff,
and implement the policy and there could be higher ongoing costs such
as a greater call on advocates’ time. The recommendation is therefore to
research the current solutions that advocates who support people with
higher capacity have reached, share these with the wider team, and
open discussion and consultation on the issue.
Strengths – the policy would be
better for people supported
because:
 Current BID form is not
appropriate for people with
capacity
 Could allow people to learn
new skills and do more things
for themselves
 Would give staff teams
confidence to support people
to make their own decisions
Weaknesses – the risks involved
with this policy are:
 Would require more of the
advocates’ time as the
person is likely to have few
support hours
 Risk that Dosh could be seen
as responsible for capacity
assessments for other people
supported
 Would require a long process
of consultation to develop
Opportunities – the new policy
would benefit Dosh because:
 Help Dosh continue to
develop best practice
 In line with the principles of
the Mental Capacity Act
 Opens up new opportunities
for Dosh to support people
with higher capacity
Threats – the threats to this policy
being successful are:
 Requires support providers to
agree to the new process
 Could increase the need for
lone working
 Could pose a risk were Dosh
to be audited and have
decisions questioned

22
Implementation Plan
Performance
Objective
Duration Action
required
Who will
be
involved
Support
from
Success
Criteria
Review /
Evaluation
Ongoing
Progress
Redesign Dosh
forms
Feb –
March 16
Develop
covering
pages for all
Dosh forms
Maddy
Meike
Dosh
Office
Steve
Sue
Completed and
successfully
tested
Pilot with
managers in
Thera North
Change how
Best Interest
Decisions are
described in
Dosh marketing
and
presentations
March 16 Edit slides
and
marketing
materials
Steve
Meike
Dosh
Office
BIDs are
described in line
with the MCA.
People have a
better
understanding
of Dosh practice
Ongoing
assessment
if further
resources or
a Dosh
guide to the
MCA are
needed
Develop plan
for Dosh
Induction Pack
Feb –
April 16
Consult with
advocates
and support
teams on
what should
be included.
Develop plan
for completion
Maddy
Meike
Dosh
Office
Steve
Dosh
Advocates
Draft ready for
comment at the
Dosh Day in
April
Dosh
advocates
review the
proposal and
agree to
changes
Review policies
around support
for people with
higher capacity
March –
Jun 16
Consult
advocates,
people
supported
and support
teams on
supporting
people with
higher
capacity
Maddy
Meike
Dosh
advocates
Steve
Dosh
understands
how people are
currently
supported and
reviews best
practice in line
with peoples’
needs and the
MCA
New
practices,
policies and
resources
proposed
and
reviewed by
Dosh
advocates
Discussion with
advocates
around
communication
with support
teams
Dosh Day
in April
Consult with
advocates
about
changing
policies
around visits
Dosh
advocate
s
Dosh office
Maddy
Meike
Steve
Dosh advocates
share
experiences
and agree
changes to
policy
Dosh
advocates
understand
and put the
changes into
practice

23
Conclusion
Dosh is a truly person-centred organisation which is constantly seeking
to reflect on its practice and be open to change and innovation. The
recommendations set out in this report have been developed in that
spirit, seeking to identify areas in which Dosh could communicate better
with the fundamental aim of improving how people are supported with
their money.
However, it is important that Dosh advocates do not feel wholly
responsible for ensuring that people are supported in line with the Dosh
Promise. The organisation will always be reliant on support teams to put
their vision of good support into practice. It is important that team
leaders don’t start seeing an increasing list of tasks as the responsibility
of Dosh Advocates. The key, therefore, is to focus on areas where Dosh
could support advocates to work with support teams more effectively
and thereby increase their impact on the lives of people supported.
The recommendations divide into short-term, easily accomplished
changes and longer term alterations of policies and practices which will
take more time to implement. Regardless of whether the changes can be
made quickly by the office team or will require a longer process of
consultation led by a steering group, it is important that all aspects of
change are implemented in a collaborative way with advocates.
The risk of these recommendations taking up more advocate time and
the fact that Dosh does not directly hire or train support staff will
definitely pose challenges to bringing about change. Nevertheless
Dosh’s strength lies in its own culture and values, and these
recommendations will ultimately succeed as they represent what is best
for people supported.

24
Bibliography
‘About’ and ‘The Dosh Promise’ sections, www.dosh.org (accessed
14.12.15).
Beckford, Meike. ‘Dosh Communication and Financial Standards
Project’, Dosh Financial Advocacy (2014).
‘Making Financial Decisions: Guidance for Assessing, Supporting and
Empowering Specific Decision Making’, Empowerment Matters (2012).
‘Mental Capacity Act 2005 Code of Practice’, Department of Justice
(2007).
‘Mental Capacity Act 2005 Post-Legislative Scrutiny’, Select Committee
on the Mental Capacity Act (2013).
‘Putting People First: A Shared Vision and Commitment to the
Transformation of Adult Social Care’, Department of Health (2007).
Springett, Nicky. ‘Group Capacity and Best Interest Decision Survey’,
Thera Trust (2015).
Springett, Nicky. ‘MCA top tips’, Thera Trust (2016).
‘The Mental Capacity Act in Care Planning’, Social Care Institute for
Excellence (2014).

25
Appendix 1 - The Mental Capacity Act
The legal framework for Dosh’s support comes from the Mental Capacity
Act (2005) and the government’s personalisation agenda set out in
‘Putting People First’ (2007).13
Personalisation is the move towards
person-centred services which meet the needs of each individual as
opposed to the standardisation of care that people with a learning
disability experienced in institutions.
The Mental Capacity Act now underpins all practice in the Social Care
sector and is an important framework guiding all Dosh policies and
processes. As appointees, Dosh are legal representatives of the people
they support to the Department of Work and Pensions (DWP). They are
required to report certain things, such as savings and changes of
circumstance, and to follow the Mental Capacity Act Code of Conduct.14
The principles of the Mental Capacity Act state that:
1. A person must be assumed to have capacity unless it can be
proved that they are unable to make the specific decision in
question
2. A person should not be treated as unable to make a decision until
all practical steps have been taken to help them to understand and
make the decision
3. A person should not be treated as unable to make a decision
because they make an unwise decision
4. All decisions made on their behalf must be made in the person’s
best interests
13
‘Putting People First: A Shared Vision and Commitment to the Transformation of Adult Social Care’ (2007).
See also Social Care Institute for Excellence (SCIE)’s report ‘Personalisation: a Rough Guide’ (2008)
14
‘Mental Capacity Act 2005 Code of Practice’, Department of Justice (2007).

26
5. All decisions must be the option that is the least restrictive of the
person’s rights and freedom.15
The Mental Capacity Act is an important piece of legislation, and each
care provider is required to have policies which demonstrate their
adherence to the Act and to provide training.
For example Thera recently circulated the ‘MCA top tips’ to all managers
which included the advice::
 ‘In your day to day support for people always:
o Think before you act- is what you are about to do agreed and
documented in the persons support plan?
o Ask yourself- Can the person make the decision about it
themselves?
o Ask yourself- does the decision need to be made now or can it
wait until I’ve spoken to other people?
o If you believe that the person cannot make the decision for
themselves is it in their best interests?
o Ask yourself- Have I offered all the different choices?
o Ask yourself- Do I know what the person’s wishes and preferences
are?
o Ask yourself- do I need to involve anyone else, for example is it
about healthcare, housing or finance?
o Ask yourself- Are there any risk or concerns and do I need to raise
them with someone else?
o Ask yourself- how will I record what I have done, why I took that
course of action and what the outcome was?
 For more information read your Thera policy ‘Implementing the Mental
Capacity Act’.16
15
‘Mental Capacity Act’ (2005), Chapter 9, pp. 1-2.
16
Nicky Springett, ‘MCA top tips’, Thera Trust (2016).

27
Appendix 2 - Dosh Policies and Practices
Dosh’s policies set out how advocates should go about supporting
people so that each individual receives empowering, person-centred
support which matches Dosh’s values and is in line with the legal
requirements of the Mental Capacity Act (2005).
The Dosh Promise sets out Dosh’s understanding of good support with
money. It was developed following the Dosh Communication and
Financial Standards Project (2014) in which people supported were
consulted about what was important to them and how they wanted Dosh
to support them with their money.
Dosh’s policies are put into practice in a different way by each advocate,
who brings their own interests, expertise and values to the role. Working
directly with people and becoming part of their circle of support relies on
advocates being authentic and free to interpret good support in a way
that suits each individual. Dosh policies set out the framework within
which this happens.
Policy What it is How it helps
Regular visits Everyone supported has their own
advocate who visits them at least
every 3 months
Support is individualised
and specific to the needs
and wishes of the person
supported
Money Plans Each person has a budget for their
expenditure which is accessible
and easy to read
People are supported to
understand and help
create their budget
Transfers policy The amount an individual would
like to and can afford to spend,
based on their Money Plan, is
transferred to a local account on a
day that they choose
Agreed transfers suit the
needs of the individual,
can protect them from
abuse and enable them to
have more independence

28
EasyRead bank
statements
Dosh appointee account
statements sent to people’s house
with an EasyRead cover letter
People can always know
about their money and
understand what Dosh are
doing
Circle of support Dosh advocates become part of
someone’s circle of support and
make sure to involve other people
in the person’s life
Dosh recognises and
respects the importance of
the support of everyone in
the person’s life
Financial profile Dosh assesses someone’s
understanding of money and their
potential to learn more when
setting up a new support and if
anything changes in their
circumstances
Capability, capacity, circle
of support and goals for
the future are all recorded
and can be reviewed if
something changes
Annual review Each year an individual and their
circle meet to discuss their money,
plans for the year and how they
are finding Dosh support
Capability is not seen as
static but something that
can be assessed each
year. Support is person-
centred
Best Interest
Decisions
Significant financial decisions must
be documented, including the
need for a relevant capacity
assessment, evidence of how the
individual and their circle of
support have been involved
No single individual is able
to make decisions on
someone’s behalf if they
lack capacity themselves
Personalised
communication
methods
People can receive information
about their money in different
ways such as monthly summaries,
emails or phone calls
People are able to get
information about their
money in a way that they
understand

29
Appendix 3 - Capacity Assessment Survey
In March 2015 a basic survey was carried out across all Thera
subsidiaries providing direct support. The purpose of the survey was to
get a ‘snap-shot’ of how much progress had been made by asking each
subsidiary how many people they were supporting with mental capacity
assessments and Best Interest Decisions already in place, and how
many were thought to be needed but which had not yet been completed.
The survey was carried out after a number of workshops had been
delivered in the autumn of 2014 across subsidiaries to help raise
awareness of, and improve compliance with the Mental Capacity Act
2005.
Typical workshop feedback included:
1. Lack of clear understanding about when to carry out a capacity
assessment.
2. Unclear about who can complete capacity assessments/ who is
responsible for completing them.
3. Lack of good record keeping where the correct processes have
been followed but cannot be evidenced.
4. A general feeling that ‘it’s another form to fill in’ rather than seeing
the principles of the legislation as being the correct way of working
in all aspects of supporting people every day.
5. Best Interest Decisions are being completed but without clear
evidence that the person lacks capacity or that capacity has been
assessed.
6. A general sense of being overwhelmed by the amount of work
involved in implementing the correct procedures and evidencing
them.

30
The survey provided some useful ‘headline’ information:
 There were two areas of support that had by far the greatest
number of capacity assessments (totalling 43%) and best interests
decisions (totalling 40%) already in place, these were:
o Medication which accounted for 23% of all capacity
assessments and 18% of best interests decisions
o Finance which accounted for 20% of capacity assessments
and 22% of best interests decisions
 In some instances (holidays and vehicles) the number of best
interest decisions outweighed the number of capacity
assessments, which would seem to evidence point 5 above.
 Some of the key areas of support included in the survey had very
low levels of completion which might suggest that these are areas
not routinely considered when thinking about a person’s capacity
to consent to the support being provided, these areas included
complex behaviour (3.5% of the capacity assessments in place),
relationships (3.5%), self-advocacy (0.5%), choosing and
managing staff (1.5%), record keeping (2%) and food and drink
(5.5%)
The survey cannot tell us about the quality of the capacity assessments
and Best Interests Decisions that are already in place. The group has a
range of auditing tools available to check the correct completion of
records and paperwork used in supporting people and the quality of
capacity assessments and Best Interest Decisions should be checked
and addressed though these processes.

31
Appendix 4: Interview Transcripts with Support Workers
Thera AGMs are an opportunity for support teams and people supported
to come together and celebrate their achievements for the year.
Interviews were done at three events in different areas of the country so
that qualitative interviews could be done with support workers in a
relaxed and positive environment.
Interviewee Role Support
provider
Length of
experience
Works with
Dosh?
E SW (CS) Thera 1 year No
T SW (SL) Thera 3 years No
G SW (SL) External 1 month No
L PA (SL) External 2 years No
M SSW (SL
and CS)
Thera 6 years No
A TC (SL) Thera 7 years Yes
F SW (SL) Thera 5 months Yes
R SW (CS) Thera 5 months Yes
K SW (SL) Thera 9 months Yes
Key: SW – Support Worker; SSW – Senior Support Worker; TC – Team
Co-ordinator; PA – Personal Assistant; CS – Community Support; SL –
Supported Living
1. Do you support people with their money?
E – parents sort out the money, putting it in the purse for their relative to
spend. She described making decisions of how to spend that money
together with the person supported

32
T - very comfortable with everyday spending but not big budget stuff.
Felt that this was too much of a risk and responsibility, and would
probably involve lots of paperwork
G – yes (external support worker for a member of the band)
L – yes (external Personal Assistant to a member of the band)
M – yes, although unaware of where money comes from. Money gets
put into the wallet or tin to be spent
A – yes, absolutely
F – yes, with day-to-day spending
R – yes, advising and guiding them
K – yes
2. Have you been given any training or told how your support
provider would like you to support people with their money?
E – had read all Thera policies and completed all Learning &
Development modules. Had also attended meetings to discuss
safeguarding practices i.e. what to do with receipts
T – they are taught to always record everything
G – received training about what to do about checking contents of cash
tin and receipts
L – her organisation have policies about protection and processes for
documenting how decisions are reached
M – received training on how to do the routine of where to put receipts,
record spending etc. but nothing on supporting people with money. He
agreed he’d received Mental Capacity Act training but didn’t necessarily
connect this.
A – no, had never received any financial training
F – no
R – yes, about how to work out a budget with them

33
K – shadow shifts, support plans, risk assessments
3. Do you feel there is a conflict between your ‘duty of care’ and
the emphasis in the MCA on letting someone make unwise
decisions?
E – agreed that anyone can make bad decisions, but worried for welfare
of some of the people supported
T – parental involvement can mean that they stop bad decisions being
made. This protects support teams but also means that the person
continues to be treated like a child
G – if someone is making a bad decision he would try to persuade them
not to
L – there is a duty to give someone all the time and information they
need to make a decision, not to protect them or make them make a
‘good’ decision
M – didn’t feel the Mental Capacity Act had been explained to him in
connection to finance
A – most people she supports don’t have capacity to make any
decisions so it is not something she deals with at the moment, but she
definitely thinks there is a conflict.
F – if people really want something you can’t stop them, but can suggest
a different way of doing things
R – you have to let them make their own decisions but support them to
make the right one
K – need to have a balance. Looks at what they want, their savings,
what is safe
4. What do you think the priority should be for supporting
someone with their money? What is most important?
E – thought that it is good to involve the person but you also need to
protect them

34
T – it’s their money, but she felt less happy if people spent it on irrational
purchases i.e. things they had already
G – biggest worry is about safeguarding people and making sure he
follows the rules i.e. not short changing someone (his supervisor then
added a story about a support worker who had been short changed at
the cinema and had been personally liable for the loss until they had
gone back and recovered the money)
L – the priority should be providing all the information the person needs
and giving them time to make a decision for themselves. There should
be a culture of doing this and sharing information
M – the approach should be based on the individual
A – the priority is to give the person all the information they need
F – the main thing is not to waste money, but they should also enjoy
their life and have holidays
R – giving advice and guidance
K – their choice at the end of the day, but duty to support them in making
not necessarily the best choice, their own choice but one that is safe and
affordable
5. How confident do you feel about doing a capacity
assessment?
E – did not see this as part of her day-to-day role
T – these are done by the Community Support Leader (CSL) and she
would rather not do them
G – had heard of them but never undertaken
L – doesn’t do capacity assessments in a formal way, as these are done
by the management of the private company she works for
M – did many but had never done a capacity assessment for finances
A – very confident, this is something she does often as part of her role
as a CSL. She finds these very bureaucratic, with lots of paperwork, and

35
they have to be done for everything. Her support team are always
involved
F – doesn’t know what this is
R – doesn’t do them now but is able to. Would like to be shown how to
do them the Thera way. Whether you do them and who is involved
depends on who you support
K – don’t do them. Always the CSL. Support workers help the person
making the decision but with the formal process it is the manager who
speaks to Dosh
6. Do you work with Dosh? Has if affected how you support
people with their money?
A – yes. Not at all.
F – yes. It is usually someone more senior who works with Dosh, but
feels included as a Support Worker
R – believes so, at least some of them, but hasn’t had any involvement
with their advocate
K – yes but doesn’t have much involvement, more managers.
7. How has your advocate explained the Best Interest Decision
to you?
A – decisions are made jointly, between the family, care manager and
other people in the circle for big decisions. Day-to-day decisions are
made by people who know the person best.
F – would be someone more senior who did these. Not aware of what a
BID is, as has only been with Thera 5 months
R – seen briefly and read up on it but not had them explained
K – can see them in finance folders but done by managers. Everyone
knows you have to do them
8. Do you ever read things sent round by the Trust?
E – reads everything in case there is something new she can learn

36
T – some of them, the main barrier is if they are available and printed off
to be read
G – N/A
L – N/A
M – yes. Suggested that some people don’t read things as they don’t
think things apply to them
A – yes, particularly Steve’s leadership pack
F – able to read things if they are printed off and brought to the house
R – yes, they get emailed
9. What would you find most useful to learn more about
supporting people with their money?
a. Training days
b. Guides and factsheets
c. Best practice examples
d. Case studies
e. Anything else?
E – all of the above
T – not interested in any more training. Happy with working with money
day-to-day and no interest in learning anything else
G – money should be controlled by the family, he wouldn’t want to be
involved
L – CICS online assessments for carers are good, as are scenarios and
case studies as part of interactive training days
M – enjoys group sessions getting people together and being told things.
Would like to know there was policy and practice about safeguarding,
and also to know where the money comes from. At the moment the
money is just given by the family, so there is no awareness of how much
benefits are coming in. Could be an advocate for the person for things
they might want to do if he knew more.

37
A – likes training days with a bit of everything
F – always good to learn. Would find it easier to have something to read
at the house rather than travelling to a training day
R – best practice examples to read would be good, also likes training
days
K – personally likes sitting in a training day, listening and making notes.
Others prefer to discuss
10. Can you tell me a story of a time you supported
someone well with their money?
E - supports someone to go shopping. The lady enjoys buying clothes
and flowers for her mum
T - supports a lady who enjoys spending a lot of money on dolls. She
was able to help her gain an awareness that spending money on
something she already had would mean she didn’t have money for other
things.
L - supports someone who would happily eat takeaways every day of the
week, but when given enough information about healthy choices and
budgeting he is able to choose for himself whether to make decisions. L
encourages him to be safe and provides reasons why this is important,
but does not force him to make a particular decision
F – always tries to support people in the way that she would want to be
supported based on her private life. For example, she tries to persuade
people not to be wasteful or unhealthy, and feels she has a positive
impact on peoples’ lives in this way

38
Appendix 5: Interview Questions for Organisations
1. What are your organisation’s policies around supporting people
with their money?
2. What challenges have you found in implementing these?
3. Why have you chosen to work with Dosh?
4. Has working with Dosh changed your policies or priorities around
money?
5. What training do you offer support teams around money?
6. How do you train staff to follow your organisation’s cultural and
policies more generally?
7. As well as traditional training sessions, have you found any
positive ways of encouraging staff to follow and engage with
policies?
8. How do you think Dosh could explain what we do better to your
support teams?

Putting the Dosh Promise into Practice

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