Actions Following a Reablement Review (START)

1. Changes to Monitoring Arrangements

Following a review of the Reablement Plan there may be a need to change monitoring arrangements.

See: Changes to Monitoring Arrangements.

2. Revising a Reablement Plan

Following a review of the Reablement Plan there may be a need to revise the plan itself.

See: Revising a Reablement Plan.

3. Planning to End Reablement (in all cases)

Situations when reablement should/could end

In the following circumstances plans should be made to end reablement:

  1. It is no longer deemed appropriate through a process of review;
  2. All of the outcomes in the Reablement Plan have been achieved; or
  3. The person no longer consents to reablement (and has capacity to do so).

Reablement may also no longer be appropriate when:

  1. The person has not been able to demonstrate an ability to 'carry over' learning from one day to the next;
  2. The person has not been open to being supported in an enabling way; or
  3. The person has not demonstrated a desire to become more independent.

What must be considered

Decisions to end reablement (including the timeframe to end reablement) must give regard to:

  1. The views of the person about ending reablement;
  2. The impact of ending reablement on the person's Wellbeing;
  3. The views of any carer about ending reablement; and
  4. The views of anyone else consulted or involved in the review process.

The timeframe for ending reablement

The decision about the timeframe to end reablement should take into account:

  1. Whether there are any outstanding outcomes to be met by reablement and how long it may take to do so;
  2. Whether there were any actions agreed in the review for the reablement service to carry out before ending reablement (for example supporting a person to access a community activity or arrange alternative support);
  3. Whether any on-going needs are already being met through an existing Care and Support Plan; and if not
  4. How long it may take to carry out the Care and Support processes required to determine the eligibility of needs; or
  5. How long it may take to arrange urgent or interim Care and Support; and
  6. Whether specific transitional arrangements between reablement and any new service are required.

It may be useful to develop a formal withdrawal plan to monitor outstanding actions and progress towards meeting on-going needs so that reablement ends at an appropriate time.

If the person has no likely on-going needs

If, following review it is clear that the person no longer has any appearance of need at all the duty to carry out any further assessment, determine eligibility and meet eligible needs does not apply.

In this situation you must:

  1. Explain to the person that they do not have an appearance of need so are not eligible for further assessment or support from the Local Authority at this time;
  2. Provide information and advice about what can be done to prevent or reduce the development of needs in the future;
  3. Explain what they should do if their needs change;
  4. Carry out any outstanding actions agreed at review; and
  5. Arrange to end reablement.

All of the above information should be provided in writing when it is originally communicated via telephone.

If the person disagrees

The only ground upon which the Local Authority can lawfully refuse any adult an assessment is where there is no appearance of need. It does not matter whether the appearance of need is likely to prove eligible after any assessment. As such, it is unlikely that many people who request an assessment will be refused.

If the person does not agree with any decision that you have made that they do not have any appearance of need you should discuss this with your line manager to be sure that the decision to refuse an assessment is legally sound.

If the person has likely on-going needs

Note: Under no circumstances must you ignore on-going needs or close the case. The Local Authority has a duty to determine the eligibility of assessed needs and to meet eligible needs and is in a breach of the Care Act if it fails to do so.

If the person has a Care and Support Plan that is meeting all needs there is no further action required, other than notifying the allocated practitioner or service/team responsible for reviewing the plan of the reablement outcome.

If the person has a Care and Support Plan that does not appear to be meeting the person's needs a review of the plan should be requested. This should be made to the allocated practitioner or team with responsibility for reviewing the plan. You should inform the person and seek their consent to make the review request, although even if the person does not consent you should still make the request. This is because the consent of the person is not required to request the review (only to carry it out).

When requesting the review you should provide the following information:

  1. Why the review is being requested and the sense of urgency (specifically when reablement is scheduled to end);
  2. Whether the person has consented to the review;
  3. The information gathered during reablement to support the request;
  4. Whether there is a need to provide urgent or interim support.

If the person (or carer) is not happy about the request to review they should be advised to discuss this with the practitioner who contacts them to make review arrangements.

If the person does not have a Care and Support Plan the national eligibility criteria must be applied and, if eligible a Care and Support Planning process carried out.

Further assessment and planning processes should make effective use of the information gathered thus far and not make the person (or anyone else previously consulted) repeat information unnecessarily.

Ending reablement

You can proceed to end reablement when:

  1. There are no outstanding actions for the reablement service following the review;
  2. The person has been provided with all information and advice required (or that would be beneficial);
  3. Steps have been taken to ensure that any eligible on-going needs for Care and Support will be met from the time that reablement ends (either through urgent/interim services or through Care and Support planning).

4. Providing Information and Advice

The duty to provide good information and advice about Care and Support applies at all times.

See: Providing Information and Advice (which is part of the Care Act 2014) to read more about the duty to provide good information and advice, including the duty to make sure that information and advice is accessible to the person receiving it.

See also: Providing Information and Advice, which includes access to local and national information and advice resources (general and specialist).

5. Accessing Another Prevention Service

Reablement is one of a range of services available where the focus is on the prevention, delay or reduction of needs. However other prevention services may also be beneficial alongside reablement and should also be explored.

Under Section 2 of the Care Act the Local Authority has a duty to prevent needs for Care and Support/Support whenever it identifies an opportunity to do so.

See: Preventing Needs for Care and Support to read more about the duty to prevent needs for Care and Support, including the types of prevention services recognised by the Care Act, when to provide prevention services and how to charge for prevention services.

6. Requesting a Financial Assessment

A financial assessment should be requested if:

  1. Reablement is to be extended beyond 6 weeks and the local policy is to charge; or
  2. The person has likely on-going needs for Care and Support (as long as they consent to a pre-eligibility financial assessment taking place).

See the Financial Assessment Procedure for further guidance.

7. Safeguarding and Deprivation of Liberty

Safeguarding

If, as part of any conversation you have with a person or their family you become concerned that a vulnerable adult or a child is experiencing, or at risk of abuse or neglect you must respond appropriately.

See the Safeguarding Adults Procedure, which also includes information about how to raise a children's safeguarding concern.

If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place you should contact the police by dialing 999.

Where the safeguarding is in respect of the person receiving reablement a decision will need to be made about the need to pause the reablement process to allow a safeguarding enquiry to take place.

There are 2 possible options:

  1. The reablement process continues alongside any safeguarding process; or
  2. Reablement is paused with no on-going intervention by the person whilst a safeguarding process takes place.

Any decision should involve the reablement service, the person who will be carrying out any safeguarding process, the person with Care and Support needs (or their representative) and any carer.

Deprivation of Liberty

You must consider any appropriate action required to authorise deprivations of liberty whenever:

  1. The person lacks capacity to make decisions about the Care and Support provided to them; and
  2. You feel the level of restriction being imposed on the person is depriving them of their liberty; or
  3. You feel the level of restriction required to meet their care and support needs following assessment is likely to deprive them of their liberty.

See: Recognising and Responding to Deprivations of Liberty.

8. Reporting Concerns about a Service Provider

During the review of reablement you may identify concerning practice relating to and organisation providing other Care and Support to the person:

  1. An external provider of reablement;
  2. An organisation providing other Care and Support to the person.

See: Reporting Concerns about a Service Provider.

9. Whistleblowing

The Local Authority encourages you to raise concerns as soon as possible about the practice of any individuals (whether they are employed by the Local Authority or not) that you feel:

  1. Compromises the safety or Wellbeing of a person with Care and Support needs; and/or
  2. Compromises the safety or Wellbeing of a carer with support needs; and/or
  3. Compromises the safety of a child.
This is called whistleblowing. See the Whistleblowing Procedure.