Vulnerability calls in civil enforcement

For any company, understanding and identifying vulnerability by a call handler can be crucial in preventing any risk of damage to these people or the organisation’s reputation. However, vulnerability can be difficult to define, and even harder to identify.

Sometimes there will be telephone conversations with people who find it difficult to immediately make an informed decision about the choices offered to them.

What makes someone vulnerable

Vulnerable people may include those who have a diagnosed condition like dementia; those who have an undiagnosed or temporary mental health condition such as severe anxiety; a recent bereavement; those with learning difficulties or literacy issues; or those who have problems understanding the language.

Some groups which might be vulnerable are listed below. However, this list is not exhaustive. Care should be taken to assess each situation on a case-by-case basis.

• Elderly
• People with a disability
• Seriously ill
• Recently bereaved
• Single parent families
• Pregnant women
• Unemployed people
• Those who have obvious difficulty in understanding, speaking or reading English

The above list contains groups or categories of people that may be vulnerable, but just because someone falls into one of these groups does not necessarily mean that they are vulnerable.

Historically organisations have had little understanding of how to pick up on signs of a vulnerable person or how best to handle such situations with care and respect.

Be careful of the vulnerable caller label

Before we go into how to best handle contacts from (potentially) vulnerable people, it’s first important to stress that vulnerability is a controversial label. The vulnerable tag is one that is imposed on people and one that some vulnerable groups will challenge.

Sometimes vulnerable people don’t think of themselves as vulnerable and may be a little embarrassed or even offended if they feel that they're being singled out. People may see the label as unfavourable or disempowering as it insinuates weakness or inability.

Vulnerability is a changeable and complex concept that doesn’t necessarily indicate a lack of competence or comprehension.

Actual vs potential

Actual vulnerability is easier to define and is normally permanent or diagnosed. However, vulnerability may also be transient as a person’s circumstances may vary constantly. Potential vulnerability is an exceptionally broad category and is far more challenging to define and identify.

Lack of appropriate responsive processes by a call handler cannot only heighten tension levels but may also put the person to further detriment and worsen the situation.

For call handlers to effectively engage with vulnerable people it is essential that they can pick up any signals of vulnerability in any interaction so that they may adjust their engagement processors accordingly.

In order to address the needs of vulnerable people correctly, it is important to be able to identify them. In many cases, more than one risk factor is present which increases the person’s vulnerability. Call handlers need to be alert to the signs that the person they are talking to may not have the capacity, at that moment in time, to make an informed decision about the implications of agreements that they may make.

This is not a diagnosis of a condition. It’s just an extension of a call handler’s existing skill of listening, identifying needs, and adjusting their approach accordingly.

The Mental Health Capacity Act 2005 says that a person is unable to make a specific decision if they:

• Cannot understand information about the decision to be made
• Cannot retain that information in their mind
• Cannot use or weigh up that information as part of the decision-making process
• Cannot communicate their decision.

Proceed with CARE

• Comprehend – are they able to follow and understand the discussion taking place?
• Assess – are they able to work out what they are being told?
• Retain – are they able to retain the information you give them? Do you have to repeat what you have said frequently?
• Evaluate – are they able to properly express, explain or communicate their decisions? Are they genuinely contributing to the discussion or merely agreeing with what you are saying?

Be alerted if the caller

• Asks you to speak up or speak more slowly
• Appears confused
• Asks unrelated questions
• Wanders off the point
• Says things that don’t make sense
• Frequently repeat themselves
• Says “yes” to a question they clearly haven’t listened to
• Becomes upset or distressed
• Sounds flustered or out of breath
• Takes a long time to answer questions
• Says “my son/daughter/wife/husband/other deals with these things for me”
• Says “I don’t understand”, or can’t remember a previous conversation or correspondence

When talking to (potentially) vulnerable people

• Do not make assumptions that you know what the person needs
• Do not assume that the person you are talking to is sighted
• Do consider other formats that the person may require e.g. braille, large print or audio
• Do not assume that the person you are talking to can hear everything you say – they may have a hearing impairment
• Be respectful
• Be patient - give people the time they need to obtain details or documents
• Clarify understanding at every point posing the question “is there anything you’d like me to explain?”
• Give the person time to explain fully
• Do not interrupt or show impatience or finish their statement

Consider tone

• Speak clearly and enunciate - don’t shout, be conscious of the pitch and tone of your voice
• Speak at a relaxed pace – do not rush a consumer who may be slow to respond or explain
• Keep control of the call
• Explain how long the call is likely to last
• Guide the call to keep it ‘on topic’
• Offer alternative means of communication:
• Ask if there is a better time to call

Responding to distressed or vulnerable callers

Responding to people that you know, or suspect, are vulnerable or distressed requires empathy, respect, patience, and sound active listening skills. Call handlers should, therefore

Practice empathy

• Endeavour to tune into, understand and be sensitive to the caller’s experiences and feelings. While your experiences may not mirror that of the caller’s, it’s likely you’ve been in a vulnerable position before too. Remembering that experience can help you approach the caller in a more empathetic way.

Active listening

• It can be tempting to want a speedy conclusion. However, handling calls from distressed or vulnerable people requires more time
• Give the caller enough time to describe their query and focus on hearing each word they say. Avoid interrupting or pre-empting what they say – you might be wrong, and they may lose their confidence.
• Repeat critical or relevant points back to them as you heard it, so there is no loss of understanding
• Ask short, clarifying questions to help move the conversation along and build up a rapport with the caller
• Summarise critical points and reiterate any decisions or any actions that result from the call

Set expectations for the call

• If you are already aware that the person is vulnerable or likely to be distressed, it can help them to know what to expect on the call. Tell them how long the call will take, what information you need from the person, and why.

Ask about communication preferences

• An excellent way to put vulnerable people at ease is to ask whether they require assistance on the call from an interpreter, carer, relative, or other third parties. Knowing that they don’t have to go through the call themselves can be a huge relief.

Speak clearly without being patronising

• People know if you are speaking down to them, so don’t oversimplify or speak louder or slower than you would normally. Be mindful that you enunciate each word and avoid acronyms or jargon.

Validate the person’s feelings but don’t react to them

• Regardless of how you view the person’s situation, people have a right to feel concerned or upset. If the person sounds distressed or agitated at any point, acknowledge their feelings and reassure them that you are trying to help them
• Ensure a person isn’t emotional when answering questions of consent or decision making
• For queries where consent is required for using personal information, they must understand their decision
• Always be respectful and caring when dealing with vulnerable people.

TEXAS

Occasionally, a person may offer information that indicates vulnerability. In these cases, the TEXAS protocol, developed by The Royal College of Psychiatrists (UK) and the Money Advice Trust for financial institutions, must be used in order to comply with the legal requirements of General Data Protection Regulations (EU 2016/679) and the Data Protection Act 2018.

T: Thank the caller for the information and advise them that it will help you deal with their issue better.

E: Explain how you will use the information the caller has provided.

X: Obtain explicit consent to use and record the information they have disclosed.

A: Ask questions to get information that will help you understand their circumstances relating to how they communicate with you and if they need help from a carer or relative.

S: Signpost the caller to internal or external help when appropriate, e.g. audio-description services or written material in different languages.

Not all mental health issues impact on decision making

When a mental health issue has been declared a useful tool for structuring a conversation with a vulnerable person to help decide whether or not you should continue is the Compass tool and the acronym IDEA to give you an idea of the extent of the problem.

TEXAS and IDEA mainly deal with vulnerability disclosures from the vulnerable party.

Handling disclosures from carers or third parties

C A R E R S

• Provides a framework for conversations from carers and other third parties
• Focused on data protection compliance

C – Check for authority

• Must have evidence of authority to act

• No evidence - follow steps A to S

C – Check for authority

A – Avoid discussing details - Explain why this isn’t possible

R – Re-assure - Information can be recorded as unverified and investigated

E – Explain – sharing of information

R – Record information

S – Summarise next step

Ensure

• You have checked why the first party is unable to deal with the issue
• You are clear about how the first party’s situation affects their ability to pay
• You have confirmed with the third party what information has been recorded and how long the unverified information will be held

Next steps

• Speak to the first party to verify or establish concern
• Carer may discuss with first part authorisation mandate to act
• Collaborative working (carer and first party) to collect vulnerability evidence

When you have all the evidence at your disposal decide if enforcement action is appropriate. If so, Proceed with enforcement action.

If not, report vulnerability and return with as much information as you can obtain.