Arranging Support and Services

1. Using this Procedure

This procedure should be used when a final personal budget has been agreed, Care and Support Plan has been signed off and services are to be arranged.

Note: This procedure is used by all of the following teams and services:

• Croydon Adult Support;
• Hospital Discharge;
• Community Social Work (Assessment, Planning and Review);
• Disability Locality Teams and Transition.

2. Commissioning and Brokerage Procedures

This site contains a comprehensive Commissioning and Brokerage Procedures section which details the procedures and processes for arranging all of the following services:

1. Support and Services in the Community;
2. Supported Living;
3. Extra Care;
4. Residential and Nursing Care;
5. Reablement;
6. Shared Lives;
7. Respite; and
8. Carers Services.

Click here to access the Commissioning and Brokerage Procedures.

3. Arranging Services for People who are Self Funding or using Alternative Support

Care and Support in the community

If a person is self-funding or intends to use alternative methods of support to those available from the Local Authority they may decide to:

1. End their Care and Support Plan and involvement with the Local Authority; or
2. Maintain their Care and Support Plan but arrange all of the services without the involvement of the Local Authority; or
3. Maintain their Care and Support Plan and request the Local Authority arrange the services in the plan.

If the person wishes to end their Care and Support Plan click here to access the procedures for ending a Care and Support Plan, including the things you must consider before ending a plan and situations when a plan cannot be ended.

If the person wishes to maintain their Care and Support Plan but arrange their services independently you should explain to them that:

1. The Local Authority has a duty to support them to arrange the support/services in the plan if they request it; and
2. What to do if they change their mind about arranging their own services; and
3. Arrange appropriate measures to monitor the plan and ensure statutory reviews of the plan are carried out.

If the person wishes to maintain the Care and Support Plan but for the Local Authority to support them to arrange the services in the plan you must:

1. Proceed to do so in the same way as if services were being provided by the Local Authority; and
2. Arrange appropriate measures to monitor the plan and ensure statutory reviews of the plan are carried out.

If the Local Authority is requested to arrange services by a person living in the community who is self funding they are legally entitled to charge an administration fee for making these arrangements. The Local Authority's position in respect of administration fees should be clearly set out in the local Charging Policy, which can be found by clicking here.

Care and Support in a care home

Where the Care and Support Planning process determines that the person's needs are best met in a care home setting (including a nursing home) there is no legal obligation for the Local Authority to meet those needs or arrange these services. However, a decision can still be made using powers under the Care Act to do so if:

1. The person requests it and the Local Authority agrees;
2. The person lacks capacity, their legal representative requests it and the Local Authority agrees;
3. The person lacks capacity and has no legal representative or suitable person to arrange services on their behalf;
4. The person has complex needs, or needs that are likely to change (if so it may be beneficial for the Local Authority to arrange their service and maintain a statutory review function);
5. The person's situation is unstable, or at risk of becoming unstable without support from the Local Authority;
6. The likely need for future Local Authority involvement is high if arrangements are not made on the person's behalf.

If you are going to be arranging care home services for a person who is self-funding you should do so using the normal procedures for arranging a care home placement.

Under the Care Act where the Local Authority arranges a care home placement for a person who is self-funding it is preferable that the Local Authority:

1. Commissions the service from the care provider directly; and
2. Seeks full financial reimbursement from the person through the financial assessment process.

If the Local Authority decides to arrange services for a self funding person in a care home they are not permitted to charge an arrangement fee for doing so.

4. Direct Payments

When the Care and Support Plan has been signed off you should proceed to arrange the Direct Payment as set out in the plan.

5. Urgent or Interim Support (including Reablement)

When agreed any urgent and interim support should be arranged using the general Brokerage procedures. Click here to access them.

6. Providing Professional Support

Professional support is on-going support that you intend to personally provide to the person that is outside the statutory requirement to arrange, monitor and review services.

Examples of professional support include:

1. Long term planning and monitoring;
2. Regular Wellbeing visits;
3. Advocacy support;
4. Counselling.

You should discuss and agree the need to provide professional support with your line manager, as often the support may be better provided by someone from within the person's informal networks or a person or organisation with specialist skills.

If you do provide professional support the existence of the support should be clearly visible from the person's records.

You must keep proportionate records of all professional support provided and ensure that the need for professional support is reviewed regularly through statutory review functions and supervision.

7. Arranging Alternative Services

Alternative services are services or methods of support that may be included in a Care and Support Plan to meet eligible needs but are provided outside of adult Care and Support. They include things like:

1. Housing;
2. Welfare benefits;
3. Health provision;
4. Colleges and training centres;
5. Specialist transport services;
6. A community based group or church; and
7. A charitable support group.

Under the Care Act the duty to meet eligible needs is only discharged from the Local Authority when any alternative services in the Care and Support Plan are in place. This means that you must be satisfied that:

1. The person (or their representative) will make appropriate and timely arrangements to meet eligible needs through the alternative services identified;
2. The alternative services identified are available and can be provided in a timely way.

You must also consider any support that the person may need to arrange the alternative service and whether the advocacy duty applies.

Click here to access the advocacy procedures, which include information about the duty and the advocacy referral process.

If you have any concerns that needs may not be met by an alternative service in the time or manner intended you must take steps to:

1. Monitor the situation;
2. Plan and agree what action the Local Authority will take if the alternative service is not provided to ensure that its duty to meet eligible needs is met (this could be the provision of interim support during any periods of delay).

In some situations it may be appropriate and proportionate to support the person to make arrangements to access the alternative service in order to be satisfied that the service is in place and meeting needs as set out in the Care and Support Plan. You can support the person to arrange the service yourself or you could ask another person (such as a carer or an advocate) to do this. If the person is in receipt of paid support from an agency they may also be able to assist.

Any on-going need for support to access an alternative service on a regular basis should have been identified as part of the Care and Support planning process (for example if support is required each week to arrange specialist transport) and appropriate long term arrangements should be in place. If this is not the case you must explore methods for meeting this need with the person (or their representative) from a strengths based approach, and make best use of the services and support already available in the Care and Support Plan (for example the task could be added to the care plan of a domiciliary care agency).

8. Self Funders

When to use this section of the procedure

This section of the procedure should be used when a person with Care and Support needs (or a carer with Support needs) has:

1. Been assessed through a process of financial assessment; and
2. They are able to afford to pay the full cost of services to meet their eligible needs; and
3. The person/carer has asked for the Local Authority to arrange (or arrange and manage) their services; and
4. The Local Authority has agreed (or has a duty to) arrange (or arrange and manage) their services; or
5. The person/carer has agreed to a request by the Local Authority to arrange and manage their services; or
6. If a person lacks capacity, the Local Authority has a duty to arrange and manage services because there is no other appropriate person to do so.

In the case of care home services the Local Authority can decide whether to arrange or manage the services unless:

1. The person with eligible needs lacks capacity; and
2. There is no other appropriate person to arrange and manage the placement on their behalf; in which case
3. The Local Authority must arrange and manage the placement.

Arranging services only

This section of the procedure should be used when:

1. The person/carer has requested the Local Authority arrange their support or services; and
2. The person/carer does not require the on-going support of the Local Authority to manage the support or service once it is arranged; and
3. The Local Authority does not have a duty to manage any services that are arranged.

In this situation your role as a Local Authority practitioner may involve things like:

1. Facilitating communication between the person/carer and a service provider;
2. Communicating with a service provider on the person/carers behalf; and
3. Supporting the person/carer to complete any paperwork required to arrange the service.

A record of the support provided in arranging the service should be made in the person/carer's electronic file.

When the service is arranged you must explain to the person/carer what they steps they should take if:

1. They feel unable to manage their service in the future; or
2. They require further support from the Local Authority to arrange a different service; or
3. Their financial circumstances change.

Charging to arrange services

The Local Authority is legally entitled to charge an administration fee for making arrangements for self funders when:

1. Asked to do so by the person/carer; and
2. The person has capacity to make the request; and
3. The services are not care home provision.

The Local Authority's position in respect of administration fees should be clearly set out in the local Charging Policy, which can be found by clicking here.

Arranging and managing services

If the Local Authority has agreed to (or has a duty to) both arrange and manage support or services you should:

1. Follow the relevant areas of this procedure to arrange the required services;
2. Record the person/carer's financial contribution as the full amount of the services on their Care and Support Plan/Support Plan (and any other electronic record of financial contribution);
3. Follow the procedures relevant to your team in regards to review of the Care and Support/Support Plan.

If at any time the person/carer becomes unhappy or concerned about the manner in which the Local Authority is managing their services you should explain to them their option to manage the service independently, so long as:

1. They continue to be self funding; and
2. There is no legal obligation for the Local Authority to manage the service.

Charging to arrange services

The Local Authority is legally entitled to charge an administration fee for making arrangements for self funders when:

1. Asked to do so by the person/carer; and
2. The person has capacity to make the request; and
3. The services are not care home provision.

The Local Authority's position in respect of administration fees should be clearly set out in the local Charging Policy, which can be found by clicking here.

9. Out of Area Services

Out of area services are those arranged by one Local Authority area but provided in another.

Out of area services are normally arranged when there are no appropriate services available locally. They can also be arranged if the out of area service is deemed crucial to the person’s Wellbeing.

Out of area services can be provided on a permanent or temporary basis, depending on the person’s specific circumstances and needs.

Temporary out of area services

Temporary out of area services are those provided for a short period of time. Examples of when temporary out of area services may be needed include:

1. The person with care and support needs is a University student that spends term time only in another Local Authority area;
2. The person with care and support needs spends regular time with other family members that live in a different area;
3. The person with care and support needs has respite but the only suitable respite placement is in another Local Authority area.

If you know that a person with eligible needs (or other needs that the Local Authority has agreed to meet) spends time in another area, arrangements to meet those needs whilst they are away should be included in the Care and Support Plan.

If urgent needs arise outside of those anticipated or planned for, the Local Authority area where the person is visiting or staying temporarily can use powers in the Care Act to meet those needs.

For further information about these powers, see: Ordinary Residence Procedure.

The impact on ordinary residence

The following is brief guidance to the possible impact on ordinary residence when an out of area service is arranged.

Also see Ordinary Residence Procedure.

Temporary services

Providing any temporary service in another area when the person has no intention of staying there permanently has no impact on ordinary residence status.

Permanent residential care, nursing care, supported living or shared lives

Residential care, nursing care, supported living (including Extra Care) and shared lives are all specified accommodation under Section 39 of the Care Act 2014. This means that, if the Local Authority places anyone into one of these types of accommodation, their ordinary residence does not change.