9.4 Working with People Living in Poverty

1. Introduction

There are a many different factors that contribute to a person living in poverty. Broadly these can be described as a) personal – meaning they are a result of their individual situation, including employment, opportunities, life circumstances etc and b) universal – meaning factors that affect everyone such as the costs of food, fuel, heating and lighting etc.

This chapter outlines the main issues regarding poverty, how it affects people, how it can additionally affect people with care and support needs and contains details of specialist organisations that can provide support.

2. What is Poverty?

The Joseph Rowntree Trust (JRF) is the leading UK charity which aims to end poverty. It defines poverty simply as being when someone’s resources are well below their minimum needs.

However, it says there is not just one definition of poverty and that it is a complicated issue, and that a range of measures are needed to help us understand the different features of poverty (for more information, see What is Poverty?).

There are two main ways of measuring poverty – absolute and relative poverty.

Absolute poverty:

Absolute poverty is when the income of a household is below a certain level, with the result that it is not possible for an adult or family to meet the basic needs of life including food, shelter / accommodation, safe drinking water, education and healthcare for example. Absolute poverty compares households based on a set income level. This level varies from country to country, depending on the particular nation’s overall economic conditions.

Relative poverty;

Relative poverty is when a household receives 50% less than the average income for a household. While they do have some money coming in, it is not enough money to afford anything above the basic needs of life. This type of poverty changes depending on the economic growth of the country.

Relative poverty is also called ‘relative deprivation’, because people in this category are not living in total poverty. They cannot, however, afford the same standard of living as everyone else in the country. It can be for example TV, internet, clean clothes and a safe home (a healthy environment, free from abuse or neglect).

Relative poverty can also be permanent; people can be ‘trapped’ in a low relative income. Since long-term poverty has an impact on economic and social conditions, persistent poverty is an important concept to remember. For more information see Relative vs Absolute Poverty Habitat for Humanity.

3. What are the Causes of Poverty in the UK?

The causes of poverty are issues that either reduce a person’s financial resources and / or increases their needs and the cost of meeting those needs. Life events and moments of change – such as getting ill, suffering bereavement, losing a job or a relationship breaking down – are common triggers for poverty.

JRF states that some of the causes of poverty in the UK today are:

• unemployment and low-paid jobs which have little prospect of getting better paid and are insecure (or a lack of jobs): many areas in the country have a lot of these jobs or do not have enough well-paid jobs. Low pay and unemployment can also lead to not being able to save or have a pension;
• low levels of skills or education: young people and adults who do not have the right skills or qualifications can find it difficult to get a job, especially one with security, prospects and decent pay;
• the benefit system: the level of welfare benefits for some people – who are either already in work (which is low paid), looking for work or unable to work because of health or care issues – is not enough to avoid poverty, when combined with other resources and high costs. The benefit system is often confusing and hard to engage with, leading to errors and delays. The system can also make it difficult for a person to move into work or increase their working hours. for more information see Benefits A-Z, Community Care Inform;
• high costs: the high cost of housing and essential goods and services (for example gas, electricity, water, Council Tax, telephone or broadband) creates poverty. Some people face particularly high costs because of where they live, because they have increased needs (for example, personal care for disabled people) or because they are paying a ‘poverty premium’ – where people in poverty pay more for the same goods and services;
• discrimination: people can be discriminated against because of their class, gender, ethnicity, disability, age, sexuality, religion or parental status (or even because of poverty itself). This can prevent them from getting out of poverty and can restrict access to services;
• relationship issues: a child who, for whatever reason, does not receive warm and supportive parenting can be at higher risk of poverty when they are older, because of the impact on their development, education and social and emotional skills. Family relationships breaking down can also result in poverty;
• abuse, trauma or chaotic lives: for some people, problematic or chaotic use of drugs and / or alcohol can make poverty worse and longer. Neglect or abuse in adult life can also cause poverty, as the impact on mental health can lead to unemployment, low earnings and links to homelessness and substance misuse. Being in prison and having a criminal record can also make poverty worse, by making it harder to get a job and its impact on relationships with family and friends;
• disability and ill health: these are the main causes of poverty. Disabled adults and families with a disabled child are disproportionately represented in groups which are experiencing poverty

In recent years, worldwide factors have pushed up prices, further impacting on the number of people in poverty and worsening levels of poverty.

4. What are the Consequences of Poverty in the UK?

JRF state that some of the consequences of poverty include:

• ‘health problems;
• housing problems;
• being a victim or perpetrator of crime;
• drug or alcohol problems;
• lower educational achievement;
• poverty itself – poverty in childhood increases the risk of unemployment and low pay in adulthood, and lower savings in later life;
• homelessness;
• teenage parenthood;
• relationship and family problems;
• biological effects – poverty early in a child’s life can have a harmful effect on their brain development.’

In addition, people may:

• be less able or unable to afford:
  • clothing;
  • vital equipment such as oxygen and dialysis machines due to electricity costs;
  • leisure or sports activities;
  • transport (this is particularly an issue for people who live in the countryside and also may result in people not being able to attend social care, hospital and other important appointments);
  • broadband – further limiting their opportunities for finding work or saving money;
  • attend employment / training;
• need to go to food banks;
• need to borrow money either from family or friends, official (banks or credit unions), or unofficial sources such as loan sharks which can result in threats, intimidation and their possessions seized if they cannot afford to repay them;
• have to pay for goods and services on high interest credit;
• resort to crime or sex work to get money to pay bills.

In turn this can lead to increased stress, anxiety and mental health problems.

This guidance is specifically referring to adults. But where there are children living in families suffering from poverty, there are additional issues. See Child Poverty (JRF).

5. How Poverty Affects People with Care and Support Needs?

People with care and support needs are particularly vulnerable to poverty because:

• they may be less able to work, or work in lower paid jobs, due to ill health or having a disability;
• if their health issues have been long term, this may have impacted on their education and training opportunities, which may have resulted in them never being able to get decent paid jobs, or any job;
• their health needs or disability may result in having to:
  • pay for care and support services, such as home carers;
  • regularly buy equipment or supplies;
  • needing adaptations to their house as a result of mobility and other issues;
  • having to move home, if it becomes unsuitable for them as a result of their needs;
  • have the heating and / or lighting on more often;
  • relying on local food shops which may be more expensive / have less choice;
  • buy food for specialist diets;
  • use their own care or pay for taxis if they cannot walk or use public transport due to health issues.

In addition, their carers may also be living in poverty, because:

• they are not able to work / work full time because they need to look after their family member with care and support needs;
• the household income is reduced because they have additional expenses due to their care and support needs.

6. Poverty and Safeguarding

Living in poverty can increase the likelihood of an adult experiencing or being at risk of abuse and / or neglect. There may be safeguarding incidents committed – accidentally or deliberately – by people close to the adult who are struggling as a result of living in poverty. These people include:

• spouses or other family members;
• neighbours or friends;
• carers – paid or unpaid;
• other professionals.

People with care and support needs who are living in poverty are more likely to experience abuse including:

• physical abuse;
• domestic abuse;
• sexual abuse;
• psychological abuse;
• financial or material abuse;
• modern slavery;
• discriminatory abuse;
• organisational abuse;
• neglect.

6.1 Self neglect

In addition, incidences of self-neglect are likely to rise as a result of more people living in poverty due to the reason outlined in Section 5, How Poverty Affects People with Care and Support Needs. Chronic illness and disability increase the risk of self-neglect, both of which are associated with poverty.

See also Self-Neglect and Hoarding chapter.

6.2 Taking action where there are safeguarding concerns

Where there are concerns that a person with care and support needs is experiencing or at risk of abuse or neglect, whether as a result of poverty or not, staff should follow the Trafford Safeguarding Adults procedures (see Safeguarding Enquiries: Introduction).

7. Supporting People who are Living in Poverty

7.1 Practical help

People with care and support needs may need support with specific areas of their lives that are contributing towards them living in poverty.

There are some areas where practical help and advice is available. Whilst social work staff may have knowledge about appropriate interventions for people living in poverty, there are also specialist agencies that can also help. These include:

• employment or education advice: specialist agencies can provide support and advice to people with care and support needs, based on their individual needs and wishes, to help them get into work or education, although it should be acknowledged that this may not be possible for everyone;
• benefits advice: specialist services can work with people, and their carers, to make sure that both are receiving all the benefits they are entitled to and can support them to apply for new benefits, such as carers allowance, personal independence payment (PIP) and attendance allowance. Advisers can also support people who feel their benefits have been unfairly ended or refused. People who are ill and / or disabled are more likely to be missing out on receiving the correct level of financial support from the benefit system. The benefits system is very complex and can be overwhelming, so people will often gain from having expert advice;
• medical and associated professions: where people are receiving care and treatment for specific health issues from doctors, nurses, occupational therapists or physiotherapists for example, they should be supported to make sure that they attend all their appointments and any obstacles, such as transport problems or a clash of appointment times are addressed well in advance to avoid stress for the person or the likelihood of them missing an appointment. If they do miss an appointment, they should be supported to contact the professional to explain what happened and to rebook it, rather than risk being removed from the service. Ensuring people receive the best possible health care can help improve their life circumstances with the goal of being less susceptible to poverty;
• care and support services: where a person is living at home and receiving care and support services, they should be supported by staff to ensure that services from providers run according to the care and support plan, are timely and if any issues arise the person, and their carer, are supported in addressing them. A financial assessment should be conducted to make sure that people are not asked to pay more for services than they can afford;
• equipment, supplies and adaptations: where someone requires equipment, supplies or adaptations to the home as a result of their care and support needs, staff should make sure that they are referred to an occupational therapist, physiotherapist or other service as appropriate, to be assessed and provided with the equipment they need rather than have to pay for it themselves. This includes technology enabled care;
• moving home: if a person has to move home as a result of their changing care and support needs, or for any other reason, staff should make sure that they are given all the available assistance and financial support to enable this to happen. The local authority housing department should be contacted to see if the person is eligible for any financial support for their move and refurbishment of the new accommodation. In certain circumstances, including when a person is fleeing violence or a property needs work because of a person’s disability, housing benefit can be paid on two properties (see Shelter for more information);
• utility bills: if the person is struggling to pay their gas, electricity and water bills, staff should support them to contact the relevant utility company to come to an arrangement about the overdue amounts. This also applies to internet providers, which may be essential for people with care and support needs living at home. If a company is not willing to agree a repayment plan, an adult with care and support needs who receives benefits can ask for payments to be taken directly from their benefits to pay essential bills and contribute to repayment of accumulated debt. Most gas / electric, water and broadband providers have special tariffs to support ill and disabled adults who have a low income. Debt counselling and budgeting support is also available from local and national agencies (see Section 7.2, Local and national organisations);
• leisure and sport: leisure and sport can be essential for mental and physical health. Where people with care and support needs are able and want to take part, staff should help them source free activities, including through social prescribing services, and / or grants to enable them to take part. Local organisations can be key in offering events and activities;
• specialist diets: where someone with care and support needs requires a specialist diet, staff should support them to speak to their GP or dietician to see what support is available, such as prescriptions, to reduce the cost of buying specialist foods;
• prescriptions, dental care, eye tests: people on low incomes may be able to get free prescriptions, dental treatment eye tests and help with other NHS costs, see Get Help with NHS Prescriptions and Health Costs (gov.uk);
• transport: a person with care and support needs who is living in poverty may not be able to afford bus or taxi fares, or able to afford to run their own car. Staff should support them to find out what financial support is available for them. This will be dependent on their particular needs, but will be particularly important for those who cannot walk far or whose mental health affects their ability to travel. The mobility component of the personal independence payment (PIP) can support people with transport costs, blue badge and local travel passes (see What is Personal Independence Payment (PIP).

7.2 Local and national organisations

Poverty can be a very complex and challenging issue for staff who do not have a lot of knowledge and experience in this area. There may be local organisations who specialise in issues of poverty, including food banks, who can work with people with care and support needs. Staff can put the person, or their carer, in touch with these organisations or seek advice on an anonymous basis about specific aspects of supporting someone in poverty. See the Trafford Directory for more information.

There are also a number of national organisations which support people living in poverty. They have lots of information and advice for people. Again, staff can give their details to adults or their carers, or contact them directly for general advice. They include:

• Advice Finder (Advice UK) 
• Maximising Income (Child Poverty Action Group) 
• Get help with the cost of living (Citizens Advice)
• Debt and Money (Citizens Advice)
• Disability Rights UK Resources
• Financial Help if you’re Disabled (gov.uk)
• Advice Finder (Turn2Us) 

8. Further Reading

8.1 Relevant information

Joseph Rowntree Charitable Trust

The Trussell Trust

Anti Poverty Practice Guide for Social work (BASW)

Child Poverty Action Group

Cost of Living Crisis (Mencap Easy Read)