Not Protectively Marked – Public Document Fraud in Social Care Attacking the Weak David Kleinberg Assistant Director – Head of the CFID

Who are we? National function, hosted at Thurrock Council in Essex 2014/15 DCLG Grant Funding Multi-Agency collaboration Understanding the threat Disrupt and pursue criminality targeting frontline services 25 public bodies supported in crime reduction activity

Local government landscape £2.1bn Annual Loss (2013) 1,795 Investigators (2014) 104,000 detections of fraud (2014) £2.1bn Annual Loss (2016) 266 Investigators (2017) 75,000 detections of fraud (2017)

Local Government Fraud Local government landscape Local Government Fraud Welfare Benefit Fraud £1.1bn £2.1bn

Local government landscape DWP SFIS Local Government 3,600 897 £1.1bn £2.1bn

Economic Crime in Local Government Appendix 5 Cyber Crime £3bn Procurement Fraud £4.4bn Social Care Fraud £800m Cyber Crime £1.8bn Revenue Fraud £1bn Money Laundering £1bn Housing Fraud £1.8bn Insider Threat £1bn Transport Fraud £48m Economic Crime in Local Government Insurance Fraud £555m Grants Fraud £94m £12.9bn The Threats annually Cost local government Two of these three threats are seen as ‘emerging’ Large amount of the assessment is the maturity of the control framework and ethical conflicts between social care & financial governance Crucially – money laundering is the largest risk area

Economic Crime in Local Government Appendix 5 Cyber Crime £3bn Procurement Fraud £4.4bn Social Care Fraud £800m Cyber Crime £1.8bn Revenue Fraud £1bn Money Laundering £1bn Housing Fraud £1.8bn Insider Threat £1bn Transport Fraud £48m Economic Crime in Local Government Insurance Fraud £555m Grants Fraud £94m £12.9bn The Threats annually Cost local government Two of these three threats are seen as ‘emerging’ Large amount of the assessment is the maturity of the control framework and ethical conflicts between social care & financial governance Crucially – money laundering is the largest risk area

Counter Fraud Dishonest behaviour to: Make a loss; OR Cause a loss; OR Fraud & the Law What is it? Dishonest behaviour to: Make a loss; OR Cause a loss; OR Cause a risk of loss to another BUT No gain or loss needs to actually to have been made Counter Fraud

What is dishonest behaviour? Appendix 5 Fraud & the Law What is dishonest behaviour? False representations Untrue or misleading comments Failing to disclose information A Legal duty to disclose something (something that utmost good faith is expected) e.g. failing to disclose capital, shares, property, Counter Fraud So we must prosecute every time then?....

Counter Fraud Procurement Fraud Risk Profile £4.4bn Legitimate suppliers adding unauthorised costs to invoices Legitimate suppliers conspiring with staff to add costs to invoices Fraudulent suppliers/staff submitting completely false invoices Fraudulent diversion of payments to suppliers to another bank account Suppliers intentionally providing poor quality goods or services Criminals diverting legitimate payments for suppliers to their own accounts Counter Fraud

Counter Fraud Social Care Fraud Risk Profile £800m Around £17bn spent every year on adult social care A person falsely presents their social care needs A person intentionally withholds their true financial status A person does not use care monies for what it was paid for A carer abuses their position by not delivering the care they are paid for A carer steals from a person or submits false claims for work An adult or child is financially abused by a person, stealing or depriving them of their/ or family assets Counter Fraud

Countering Fraud with Controls Social Care Fraud Countering Fraud with Controls Social Care Fraud £800m Adult ‘ongoing duty’ to declare changes Sharing (with consent) agreed packages with providers Front-end intelligence from Social Workers making assessments Auditing of packages agreed and finances ‘Front-ended’ Controls / Lack on-going Back-office compliance Eyes & Ears – reporting back on reviews…. Analysis Financial abuse – knowing your ‘customer’ is a third party required? Who did the worker deal with? MCA? Counter Fraud

Counter Fraud Money Laundering Risk Profile Criminals paying for legitimate debts on behalf of another individual, with illegal proceeds Use of ‘tainted gifts’ from crime proposed as assets Third parties paying care costs Deprivation of assets Abuse of an adults account for laundering Counter Fraud

Our Strategy Prevent Stop individuals becoming involved in fraud or providing support for economic crime activity Protect Create the conditions in which crime prevention against fraud, particularly cyber enabled, mirrors the best aspects of physical crime prevention Prepare Use intelligence to change perceptions and create effective actions against the threats across the council and in its supply-chain Pursue Investigate individuals and groups engaged in fraud disrupting their activities, taking away their finances

Counter Fraud Risk Based Approach Financial Assessment Forms must contain anti-fraud caveats, include ‘sharing with other councils’ Modelling of presented circumstances Risk matrices to determine additional auditing and sampling Council-wide data cleansed against presented circumstances Land Registry – Proprietor Search – PN1 Credit Reference Agency – Equifax £1 Counter Fraud

Counter Fraud Thank You David Kleinberg Assistant Director for Fraud & Investigation Tel: 0300 111 3 444 Email: dkleinberg@thurrock.gov.uk Counter Fraud