Continuity of Care Arrangements

1. An Introduction to Continuity of Care Arrangements

Understanding continuity of care arrangements

People with care and support needs may decide to move home just like anyone else: to be closer to family or to pursue education or employment opportunities, or because they simply want to live in another area.

Continuity of care arrangements are a statutory requirement of the Care Act. They define the way that different local authorities in England should work collaboratively to provide an undisrupted care and support service and smooth transition from one area to another.

There are 4 clear stages to the continuity of care arrangements:

1. The person is deciding whether to move;
2. The person has decided to move;
3. Preparing and planning; and
4. Moving.

When to use continuity of care arrangements

Continuity of Care arrangements apply when a person with eligible Care and Support needs (who is receiving Care and Support arranged by the Local Authority in a setting other than a care home, shared lives or supported living placement) chooses to move from one Local Authority area to another Local Authority area, resulting in a change to their ordinary residence status.

Where Continuity of Care arrangements apply but the person lacks the mental capacity to make a decision about where they live, they cannot be said to have chosen to move to the new area. In those cases, careful consideration needs to be given to whether that person remains ordinarily resident in the original area or whether ordinary residence has changed to the new area. The key factors will be the strength of the connection to the new area and the reason for the move. If in doubt, always seek legal advice.

When continuity of care arrangements do not apply

Continuity of care arrangements do not apply when the person's ordinary residence status is not going to change.

Neither do they apply when the Local Authority is providing the person with Care and Support in a care home, shared lives or supported living placement because these types of accommodation are all specified accommodation under the Deeming Provisions (Section 39 of the Care Act 2014), meaning that the Local Authority placing them remains responsible for meeting their needs before, during and after the move.

2. Stage 1: The Person is Deciding Whether to Move

When to use this section of the procedure

You should use this section of the procedure if you represent the first Local Authority (the area where the person lives now) and:

1. A person with capacity tells you that they may wish to move to another Local Authority area; or
2. A family member, Deputy or Lasting Power of Attorney notifies you that they may make arrangements to move a person to another area.

If you represent the second Local Authority (the area where a person may be moving to) click here.

The purpose of stage 1

The purpose of stage 1 is to ensure that the person making the decision about moving does so from an informed position, having had access to all of the relevant information and advice they need.

Stage 1 involves:

1. The person (or family member, Deputy or Lasting Power of Attorney) gathering their own information;
2. The first Local Authority providing relevant information and advice; and
3. When contacted, the second Local Authority providing relevant information and advice.

Relevant information and advice

You should support the person making the decision about moving to consider whether the move is something they wish to pursue by providing them with appropriate information and advice to make an informed decision.

Information and advice should be provided:

1. As requested; or
2. Where you feel it is relevant or beneficial to provide.

The following information and advice would normally be beneficial and relevant to provide:

1. Information about ordinary residence;
2. Information about the stages of the continuity of care process;
3. The implications of a move for equipment or adaptations;
4. The likely impact for current services (e.g. whether a current care provider is able to provide support in the new area);
5. If a person employs a Personal Assistant (PA), advice around contractual obligations;
6. The likely impact for professional support e.g. health services; and
7. Where the person has a carer, the implications for the carer.

If the person making the decision has questions about available adult care and support services in the new area you should signpost them to the second Local Authority, who have a duty under the Care Act to provide this whenever it is requested.

All information and advice should be:

1. Provided in line with the statutory requirements of the Care Act; and
2. Given with regard for confidentiality; and
3. Recorded on the person's electronic file.

For more guidance about the information and advice requirements of the Care Act click here. This includes guidance around providing accessible information.

Supporting the person to use information and advice to make a decision

Needing support to make a decision is not uncommon, and you should:

1. Provide support as requested; and
2. Offer support if you feel it would be beneficial; but
3. You must take care not to influence (or appear to influence) the final decision through (or through the appearance of) excessive persuasion or undue pressure; and should
4. Consider the benefit in providing independent advocacy to help the person talk through their options.

Support could include:

1. Support to identify the risks and benefits of moving or staying;
2. Support to weigh up the risks and benefits of moving or staying;
3. Answering any 'what if' questions the person may have (for example 'what if I change my mind?'); and
4. Signposting to any specialist information and advice organisations regarding legal, financial or employment matters.

The outcome of stage 1

The outcome of stage 1 will be either:

1. The person will be moving to the second Local Authority area; or
2. The person will be remaining in the first Local Authority area.

3. Stage 2: The Person has Decided to Move

When to use this section of the procedure

You should use this section of the procedure if you represent the first Local Authority (the area where the person lives now) and:

1. A person with capacity tells you that they have decided to move to another Local Authority area; or
2. A family member, Deputy or Lasting Power of Attorney notifies you that they will be making arrangements to move a person to another area; or
3. You have decided that it is in the person's Best Interests to move (where this is in response to a request by a family member and the person is not going to be living in regulated provision); or
4. The second Local Authority notifies you of an intended move.

If you represent the second Local Authority (the area where a person may be moving to) click here.

The purpose of stage 2

The primary purpose of stage 2 is to ensure that both local authorities:

1. Are aware of the decision that has been made for the person to move; and
2. Agree that the ordinary residence of the person will change; and
3. Can take timely steps to make continuity of care arrangements; so that
4. There is a smooth transition and undisrupted care and support service when the person moves.

Notification by the person, a family member, Deputy or Lasting Power of Attorney

Making a record

A proportionate record should be made of the following:

1. The rational for their decision;
2. The proposed date of the move;
3. Any proposed new care provider; and
4. Whether the second Local Authority has been notified of the decision; and
5. If so, the information provided to the second Local Authority (specifically whether the second Local Authority has been provided with a named contact at the first Authority); and
6. If not, whether they intend to notify them.

You should also consider the need (or benefit) in providing further information or advice, especially if the information and advice provided in stage 1 was limited.

If the person has (or intends to) notify the second Local Authority

If the person (or family member, Deputy or Lasting Power of Attorney) has notified the second Local Authority you should:

1. Monitor correspondence for any communication from the second Local Authority; and
2. If the second Local Authority does not make contact in a timely way, make contact with them.

If the intention is to notify the second Local Authority you should:

1. Arrange to proportionately monitor whether they have been notified; and
2. Monitor correspondence for any communication from the second Local Authority; and
3. If the second Local Authority does not make contact in a timely way, make contact with them.

If the person has not (and will not) be notifying the second Local Authority

If the person has not yet notified the second Local Authority you should ask if they are willing to do so. However, they are under no obligation to notify the second Local Authority and may request that you do this on their behalf.

The preparation and planning stage of the continuity of care process cannot begin until:

1. The second Local Authority has been notified; and
2. The second Local Authority has assured itself of the 'genuine intentions of the move'; and
3. The second Local Authority has confirmed this to the first Local Authority.

If you are requested to notify the second Local Authority you should therefore do so to prevent any unnecessary delays in agreeing continuity of care arrangements.

Click here to access guidance about notifying the second Local Authority.

You have decided that it is in the person's Best Interests to move

You must notify the second Local Authority at the earliest opportunity if the decision for the person to move is made by the first Local Authority (where this is in response to a request by a family member and the person is not going to be living in regulated provision).

Click here to access guidance about notifying the second Local Authority.

Notification by the second Local Authority

If the second Local Authority is notified of the intention to move by the person (or family member, Deputy or Lasting Power of Attorney) they must:

1. Contact the first Local Authority by telephone to notify them; and
2. Gather information from the first Local Authority to assure itself that the intention to move is a 'genuine intention'.

When contacted by the second Local Authority you must:

1. Make a proportionate record of the conversation; and
2. Provide information to the second Local Authority to support them to understand whether 'genuine intentions' exist.

When the second Local Authority has assured itself that the person's intentions to move are 'genuine intentions' they must:

1. Confirm this to the first Local Authority in writing; and
2. Allocate a named practitioner; and
3. Work with the first Local Authority to carry out stage 3 of the continuity of care process.

If the second Local Authority disputes the 'genuine intentions'

By disputing the 'genuine intentions' of the move, the second Local Authority is actually disputing the person's ordinary residence status following the move.

Under no circumstances must disputes about ordinary residence prevent, delay or adversely affect the person wishing to move from one area to another.

Click here to access the ordinary residence procedures, which set out how to manage disputes about ordinary residence.

Notifying the second Local Authority

When to notify the second Local Authority

You should notify the second Local Authority of the decision if:

1. The person (or family member, Deputy or Lasting Power of Attorney) has not, and does not intend to notify them; or
2. The second Local Authority has not made contact after the person (or family member, Deputy or Lasting Power of Attorney) has notified them; or
3. The decision for the person to move is made by the first Local Authority (where this is in response to a request by a family member and the person is not going to be living in regulated provision).

How to notify the second Local Authority

Initial contact should be made with the second Local Authority by telephone, during which you should:

1. Notify them of the person's intention to move (or the Local Authorities intention to move them);
2. Confirm why the move will mean a change in their ordinary residence;
3. Provide the date proposed for the move; and
4. Provide details of any proposed care provider; and
5. Provide details of any carer moving with the person; and
6. Provide the details of the person at the first Local Authority who will be managing the continuity of care arrangements (which may or may not be you); and
7. Request a named contact at the second Local Authority.

The details of the telephone conversation should be recorded and then confirmed in writing, with a letter to the named contact at the second Local Authority. A copy of the letter sent should be retained on the person's file.

Upon receipt of the letter the second Local Authority must:

1. Take steps to assure itself that the person's intentions to move are genuine; and
2. Confirm this to the first Local Authority; so that
3. The next stage of the continuity of care process can begin.

If the second Local Authority disputes the 'genuine intentions'

By disputing the 'genuine intentions' of the move, the second Local Authority is actually disputing the person's ordinary residence status following the move.

Under no circumstances must disputes about ordinary residence prevent, delay or adversely affect the person wishing to move from one area to another.

Click here to access the ordinary residence procedures, which set out how to manage disputes about ordinary residence.

If concerns are raised about a proposed provider

If the second Local Authority raises concerns about a proposed care provider you should:

1. Provide this information to the person (or family member, Deputy or Lasting Power of Attorney) so they can reconsider their options; or
2. If you have made a Best Interests decision to move the person, consider the impact of this upon the decision.

Depending on the nature of the concerns and the response of the person (or family member, Deputy or Lasting Power of Attorney) you may need to consider:

1. Raising a safeguarding concern before the person moves; or
2. Notifying the second Local Authority so they can explore alternative providers during any process of Care and Support planning undertaken.

4. Stage 3: Preparing and Planning

When to use this section of the procedure

You should use this section of the procedure if you represent the first Local Authority (the area where the person lives now) and:

1. A person will be moving to another Local Authority area; and
2. The second Local Authority has confirmed that it has assured itself that the intentions to move are 'genuine intentions'; and
3. The second Local Authority has allocated a named practitioner; and
4. You need to work with that practitioner to ensure that there is a smooth transition and undisrupted care service when the person moves.

If you represent the second Local Authority (the area where a person may be moving to) click here.

The responsibilities of the first Local Authority

The primary responsibilities of the first Local Authority are:

1. To provide information to the second Local Authority; and
2. To monitor progress of the second Local Authority; and
3. To update the person (or family member, Deputy or Lasting Power of Attorney)  of the progress made or any delays encountered;
4. To identify and arrange any specific care and support arrangements for the day of the move; and
5. If the person is employing a Personal Assistant, to provide any information and advice to them around employer responsibilities.

Providing information to the second Local Authority

Information that must be provided

In all cases the most recent Care and Support Plan must be provided securely to the second Local Authority; unless

1. A person with care and support needs has capacity and does not consent to it being shared; or
2. Where the person lacks capacity, a Deputy or Lasting Power of Attorney with authority to refuse consent does so.

If the person (or a Deputy or Lasting Power of Attorney) does not provide consent for a Care and Support Plan to be provided to the second Local Authority you should explain the likely impact of this to them, in terms of delays in completing continuity of care arrangements before the person moves.

If the person has a carer, and that carer will be moving with them (or continuing to provide care when they have moved) the most recent Support Plan should also be provided, unless the carer refuses consent.

Information that may be provided

Any information can be provided securely at the request of the second Local Authority, as long as:

1. It is relevant; and
2. The person consents to it being shared; or
3. The person lacks capacity but a Best Interests decision is made to share it.

Information could include, but is not limited to:

1. A needs assessment;
2. A financial assessment;
3. A Safeguarding Plan;
4. A risk assessment.

You should only:

1. Submit evidence prepared by yourself, or the Local Authority; unless
2. The relevant organisation or person has given consent for it to be shared (for example the ICB).

Monitoring progress of the second Local Authority

Both local authorities share responsibility for carrying out their various roles and functions in a timely way. However, the first Local Authority is responsible for:

1. Advising the person (or family member, Deputy or Lasting Power of Attorney) of progress made by the second Local Authority; and
2. Informing them of any delays and the likely implications of this.

It is therefore prudent that you:

1. Agree timescales with the second Local Authority for different care and support functions to be carried out; and
2. Make appropriate and proportionate arrangements to monitor their progress; and
3. Carry out monitoring activity as agreed; and
4. Review the nature of the monitoring activity as required, ensuring that timely progress is made.

Any arrangements should be clearly recorded and, if delays do occur you should:

1. Seek the advice of your line manager as required; and
2. Consider the need to increase monitoring activity; and
3. Inform the person of the likely implications of the delay.

Click here to access further guidance about roles and responsibilities if the move is delayed.

Updating the person of progress or delays

The first Local Authority is responsible for:

1. Maintaining regular contact with the person (or family member, Deputy or Lasting Power of Attorney); and
2. Advising them of progress made by the second Local Authority; and
3. Informing them of any delays and the likely implications of this.

Any contact with the person should be clearly recorded and, where relevant you should make them aware of their right to complain.

Specific care and support arrangements for the day of the move

On the day of the move itself the person could require:

1. Less care and support than normal;
2. More care and support than normal; or
3. The same level of care and support.

The first Local Authority is responsible for meeting all of the person's care and support needs on the day of the move so it is important that you consider the specific arrangements that may need to be made in a timely way, especially if increased support on the day is likely.

You must apply the general principles and statutory requirements of all Care and Support Planning to:

1. Identify the person's care and support needs on the day of the move; and
2. Explore the available options to meet those needs; and
3. Identify the best way to meet those needs; and
4. Where changes to the current Care and Support Plan is needed, submit a draft revised plan for sign-off; and
5. Where meeting those needs requires a change in the person's personal budget seek an agreement to this.

The following table sets out:

1. Some of the indicators that care and support on the day of the move may need to be different than normal; and
2. The changes in support that could be required to mitigate risk, meet needs or promote Wellbeing.

If the person's move is staggered

5. Stage 4: Moving

When to use this section of the procedure

You should use this section of the procedure if you represent either the first Local Authority or the second Local Authority and:

1. Continuity of care arrangements have been agreed; and
2. The person's move is approaching; or
3. It is the day of the move.

Agreeing a move date

The date of the move should be agreed by:

1. The person (or family member, Deputy or Lasting Power of Attorney); and
2. The first Local Authority; and
3. The second Local Authority.

When agreeing the date you should consider:

1. Any key dates for the person (for example the date they will be starting work or college);
2. How long it may take for the second Local Authority to carry out any care and support functions, and for any new services to be arranged;
3. Whether the second Local Authority needs to arrange for any adaptations to the new home.

On the day of the move

Moving belongings

It is the responsibility of the person (or family member, Deputy or Lasting Power of Attorney) to arrange and fund the removal of furniture and other belongings to the new area.

Care and support

The first Local Authority should provide care and support to the person as agreed in stage 3 of the continuity of care process.

After the day of the move

The second Local Authority is responsible for meeting all of the person's eligible care and support needs after they have moved.

If the second Local Authority has not carried out required care and support functions

There are several reasons why the second Local Authority may not have carried out required care and support functions:

1. The person may have bought forward the date of their move, or declined to delay a move to allow all functions to be carried out;
2. The second Local Authority may have failed to carry out some/all functions in a timely way before the person's move; or
3. The second Local Authority may decide that some/all of the functions would be best carried out after the person has moved.

Regardless of the circumstances if care and support functions have not been carried out the second Local Authority is required to either:

1. Maintain and assume the funding of the care and support services that were in place at the time the person moved; or
2. Arrange for the same level of services to be arranged in the local area; until
3. Care and support functions have been carried out.

If the second Local Authority has not made care and support arrangements

The first Local Authority will doubtless be presented with a dilemma if the second Local Authority has either:

1. Carried out care and support functions; then
2. Failed to arrange services in a timely way; or
3. Not carried out care and support functions; then
4. Failed to arrange (or maintain) services at their existing level.

In this situation it is the recommendation of the Care Act Statutory Guidance that the first Local Authority:

1. Liaises with the second Local Authority to understand the issues they are having and likely timeframes; then
2. Continues to provide the same care and support services; and
3. Agrees reimbursement arrangements with the second Local Authority for services provided (which can include an arrangement fee as well as the cost of the actual services).

Before making such arrangements you should:

1. Seek the advice and agreement of your line manager; and
2. Refer to any local policy about providing services in this situation (including reimbursement policies).

If the move is delayed or cancelled

Click here to access the 'Delays and Cancelled Moves' section of this procedure.

6. Stages 1-4: Requirements of the Second Local Authority

Using this section of the procedure

This section of the procedure should be used when you represent the second Local Authority (the area where a person may be/is moving to). It will support you to understand the role and carry out the functions of the second Local Authority in continuity of care arrangements.

Stage 1: The person is deciding whether to move

You should provide information and advice to the person (or family member, Deputy or Lasting Power of Attorney) as requested, and in line with the Care Act requirements about a range of local adult Care and Support matters, including:

1. Adult Care and Support processes;
2. The choice/types of Care and Support available (including provider details and the costs of services);
3. Direct Payments;
4. The local charging policy;
5. Local health services;
6. Carers services and support;
7. Transition;
8. Housing;
9. Employment or training; and
10. Any other information requested, or that you feel would be beneficial.

When providing information and advice you must take care not to influence (or appear to influence) the person's decision through excessive persuasion or undue pressure.

Stage 2: The person has decided to move

Notification of the decision

As the second Local Authority you could be notified of the decision by either:

1. The person;
2. A family member, Deputy or Lasting Power of Attorney; or
3. The first Local Authority.

When notified you should:

1. Create an electronic record of the person;
2. Make a record of any letter of notification received;
3. Make a record of the proposed date of the move;
4. Make a record of any new proposed care provider; and
5. Make a record of the name of any contact person at the first Local Authority; and then
6. Take steps to be assured that the intention to move is 'genuine'.

If you are notified by the person (or family member, Deputy or Lasting Power of Attorney) you should also consider the need (or benefit) in providing further information or advice, especially if the information and advice provided in stage 1 was limited.

Deciding if the intention to move is genuine

The preparation and planning stage of the continuity of care arrangements cannot begin until the second Local Authority has assured itself that the person's intentions to move are 'genuine'.

By confirming the person has genuine intentions to move the second Local Authority is accepting that:

1. Their ordinary residence will change; and
2. The duty to meet eligible care and support needs will become the responsibility of the second Local Authority.

To help decide whether the person's intentions are genuine you must:

1. Establish contact with them, or the person making the decision for them to move (if the notification came from the first Local Authority); or
2. Establish contact with the first Local Authority (if the notification came from the person or the person making the decision for them to move); and
3. Gather information to understand why the person wishes to move into the area.

Examples of genuine intentions include, but are not limited to:

1. To work in the new area;
2. To access education or training in the new area;
3. To be closer to family or friends;
4. To live closer to a landmark or site of importance to the person;
5. To fulfil a genuine desire to live in the area for any other reason.

If intentions are genuine

If you believe that the person's intentions to move are genuine you should:

1. Make a record of your rationale; and
2. Seek the agreement of your line manager; who should
3. Allocate a named practitioner (which may or may not be you); who should
4. Confirm that the person's intentions are 'genuine' to the first Local Authority in writing; and
5. Work with the first Local Authority to carry out stage 3 of the continuity of care process.

If the 'genuine intentions' are to be disputed

If you do not believe the person's intentions to move to be 'genuine' it is possible to dispute this.

However, by disputing the 'genuine intentions' of the move you are actually disputing their ordinary residence status following the move. As such you must always:

1. Seek support from a line manager; and
2. Consider the need to take legal advice; before
3. Writing to the first Local Authority to confirm your position.

Under no circumstances must disputes about ordinary residence prevent, delay or adversely affect the person wishing to move from one area to another.

Click here to access the ordinary residence procedures, which set out how to manage disputes about ordinary residence.

Stage 3: Preparing and Planning

When stage 3 applies

Stage 3 of the continuity of care process begins as soon as the second Local Authority has assured itself of the person's 'genuine intention' to move.  At this point the second Local Authority should:

1. Notify the first Local Authority of this; and
2. Allocate a named practitioner; and
3. Work with the first Local Authority to carry out stage 3 of the continuity of care process.

When allocating a practitioner the second Local Authority should consider:

1. The likely timeframe in which Stage 3 must be completed; and
2. The practitioner's familiarity with the continuity of care process; as well as
3. All other allocation considerations (i.e. the specific skills of a practitioner to work with the needs of the person); to
4. Ensure that the practitioner allocated is most able to carry out the functions in a timely way.

The remainder of this section is written specifically to support the named allocated practitioner of the second Local Authority.

Information from the first Local Authority

As the named practitioner at the second Local Authority you should request the following information from the named contact at the first Local Authority at the earliest opportunity:

1. A copy of the most recent Care and Support Plan; and
2. Where relevant, a copy of the most recent Support Plan.

The first Local Authority is obliged to provide this information to you, subject to consent from the person or carer to do so.

You should also consider whether the first Local Authority possesses any other relevant information and, if so make a further request. This could include:

1. A needs assessment;
2. A financial assessment;
3. A Safeguarding Plan;
4. A risk assessment.

You must make effective use of the information provided so as to avoid any unnecessary duplication for the person, especially if their needs have not changed.

Establishing needs

As the allocated practitioner you must:

1. Undertake an appropriate and proportionate assessment of the person's care and support needs; and
2. Identify and offer an assessment to any carer; and
3. If required, carry out an assessment of carer's needs.

Comprehensive guidance around the process and statutory requirements of assessment can be found in the 'Establishing Needs' section on your team homepage.

Care and Support Planning

The second Local Authority must:

1. Provide an indicative Personal Budget; and
2. Carry out Care and Support Planning with the person; and
3. Where there is a carer, carry out Support Planning; and
4. Submit any draft Care and Support Plan/Support Plan for sign off.

Under the Care and Support (Continuity of Care) Regulations 2014 all Care and Support Planning (including any interim planning) must have regard to:

1. The Care and Support Plan provided by the first Local Authority;
2. Any Support Plan provided by the first Local Authority;
3. The outcomes that the person/carer was achieving (and wants to achieve);
4. The preferences and views of the person/carer; and
5. The impact of changes in circumstance on Wellbeing (e.g. change in accommodation, services, carers role, access to universal services).

You should access the comprehensive guidance about the process and statutory requirements of Care and Support Planning as required. It can be found in the 'Meeting Needs' section on your team homepage.

Interim Care and Support Plans

If it is possible that the person's need for care and support may change after they have moved you should consider:

1. Preparing an interim Care and Support Plan based primarily on the Care and Support Plan of the first Local Authority; and
2. Monitoring the person's needs and circumstances after they move; then
3. Carrying out a proportionate assessment when needs are stable.

Interim Care and Support Plans must:

1. Be agreed with the person; and
2. Be agreed with any carer; and
3. Have regard for the first Local Authorities Care and Support Plan (and/or Support Plan); and
4. Have regard for the preferences, outcomes and Wellbeing of the person; and
5. Be time limited, with a clear timeframe in which to carry out outstanding functions.

Differences between Care and Support Plans

The personal budget (and the Care and Support Plan) agreed by the second Local Authority could be:

1. The same as that of the first Local Authority;
2. Less than the previous Plan; or
3. More than the previous Plan.

Differences can arise when:

1. Carers will be providing more/less support after the move;
2. The cost of the same type of service in one Authority is less than the cost in the other;
3. Certain services are not available in one Authority;
4. The person's circumstances mean they need less/more support (e.g. if they start work or college).

Any differences must be clearly explained to the person and, if the personal budget is reduced the second Local Authority must ensure that:

1. The budget is sufficient;
2. The manner in which the budget was agreed is transparent; and
3. All of the person's eligible needs are met.

Arranging support and services

When a draft Care and Support Plan has been signed-off (either permanent or interim) you must ensure that services are in place when the person moves.

Click here to access the Commissioning, Contracting and Brokerage procedure, which sets out the range of processes for arranging services.

Deciding to carry out some/all of the required care and support functions after the person has moved

The second Local Authority may legitimately decide to wait until after the person has moved to carry out some/all of the care and support functions, particularly if:

1. The distance between the 2 areas poses significant logistical problems; or
2. The person's need for care and support is likely to change as a result of the person's change in circumstances (for example if they start a new job, attend college or receive less/more carer support); or
3. The person needs to be living in their new home to carry out an accurate assessment, for example to assess the need for a particular adaptation or piece of equipment.

Regardless of the circumstances if care and support functions have not been carried out the second Local Authority is required to either:

1. Maintain and assume the funding of the care and support services that were in place at the time the person moved; or
2. Arrange for the same level of services to be arranged in the local area; until
3. Care and support functions have been carried out.

Delays in carrying out required care and support functions

If, as stage 3 progresses it becomes clear that you are not going to be able to carry out all of the required care and support functions you should:

1. Seek the advice of your line manager as required; to
2. Consider the need to discuss delaying the move with the person; or
3. Consider the need to agree an interim Care and Support Plan (see above); or
4. Consider the need to maintain existing services from the day of the move until the functions have been carried out.

Stage 4: Moving

7. Delays and Cancelled Moves

If the move is delayed by the person

If the move is postponed due to circumstances beyond the person's control (for example ill health) you should:

1. Notify the other Local Authority (if they did not notify you);
2. Maintain contact with the person (or family member, Deputy or Lasting Power of Attorney); and
3. Agree a revised date for the move.

The Care Act recommends that both local authorities 'cut their losses' in regards to any costs incurred as a result of the delay.

If the move is delayed by the second Local Authority

The second Local Authority can only delay the move if:

1. It has not completed required care and support functions; or
2. Has not been able to arrange services in a timely way; and
3. The person (or family member, Deputy or Lasting Power of Attorney) is in agreement to the delay.

In this situation the second Local Authority should:

1. Notify the first Local Authority of the delay; and
2. Agree a revised date for the move; then
3. Carry out outstanding functions, or make arrangements for services in a timely way.

During the interim period the first Local Authority remains responsible for meeting the person's care and support needs.

If the move is delayed by the first Local Authority

The first Local Authority can only delay the move if the second Local Authority has:

1. Carried out care and support functions; then
2. Failed to arrange services in a timely way; or
3. Not carried out care and support functions; then
4. Failed to arrange (or maintain) services at their existing level; and
5. The first Local Authority is not able to continue providing services (for example if the care provider does not work in the new area); and
6. The person (or family member, Deputy or Lasting Power of Attorney) is in agreement to the delay.

In this situation the first Local Authority should:

1. Notify the second Local Authority of the delay; and
2. Agree a revised date for the move; and
3. Monitor progress of the second Local Authority.

During the interim period the first Local Authority remains responsible for meeting the person's care and support needs.

If the move does not go ahead

If the move is cancelled altogether by the person (or family member, Deputy or Lasting Power of Attorney) the second Local Authority is legally entitled to recover costs incurred in stage 3 of the continuity of care process from the first Local Authority.

However, the second Local Authority should:

1. Refer to their own local policy about this; and
2. Consider at what stage the first Local Authority was aware that the person would not be moving; in order to decide
3. Whether seeking reimbursement would be a 'reasonable' thing to do.

8. Equipment and Adaptations

Local Authority Equipment

The Care Act stipulates that any equipment provided to the person by the first Local Authority should always move with them, so long as:

1. The person wants to take it; and
2. The person still needs it (to meet eligible needs); and
3. The equipment is still the most cost effective way of meeting the eligible need.

This is the case:

1. Regardless of the cost of the original item; and
2. Regardless of when the item was provided (for example this could be a few days before the move if that was the time it was needed).

When the first Local Authority should reassess equipment needs

The first Local Authority should complete a proportionate reassessment of need when:

1. There is evidence that the person's needs have changed; and
2. It is likely that they no longer need the equipment provided to them; or
3. It is likely that they will not need the equipment when they move.

If the outcome of reassessment is that there is no need for equipment (either now or when the person moves) the first Local Authority should:

1. Remove the equipment at the point that it is no longer required; and
2. The second Local Authority must assess any needs for equipment that arise in the future.

If the second Local Authority disputes the outcome of the assessment to remove equipment they should carry out their own assessment of equipment need (see below).

Disputes about the need for equipment

The second Local Authority should complete its own proportionate assessment of equipment needs when:

1. The first Local Authority has assessed the person as not needing the equipment after they move; and
2. The second Local Authority does not agree.

During this period it is prudent for the first Local Authority to continue providing the equipment, even if the person moves in the interim.

Following the assessment, and on the basis of all available evidence both Local Authorities should agree whether there is a need for the equipment. If there is, it should remain with the person, and the first Local Authority should not remove it.

Assessing the need for additional equipment

If the person requires additional equipment now the first Local Authority should make arrangements to provide this, and for the equipment to move with the person if it is still required.

If there is evidence that the person may require additional equipment when they move that they do not require now, the first Local Authority should:

1. Advise the second Local Authority of this; and
2. Ensure the original equipment moves with the person; and
3. The second Local Authority should complete a proportionate assessment; and then
4. Arrange any additional equipment required for the day of the move.

Maintaining equipment after the person moves

Where equipment is to move with the person the first Local Authority must ensure that:

1. It is safely and correctly  installed; and
2. Carers possess the skills required to use it safely (especially if there are new carers).

If there is significant distance between the authorities the first Local Authority may seek support from the second Local Authority as required with the above.

The responsibility for maintaining equipment that has moved with the person should be agreed in advance and you should familiarise yourself with available local guidance that confirms who is responsible for maintaining or repairing equipment in a range of circumstances.

Regardless of who assumes responsibility for maintaining equipment, the second Local Authority is responsible for ensuring that the eligible (or urgent) needs of the person are met at all times. This includes making any alternative arrangements to meet eligible needs during periods where equipment is being repaired.

NHS Equipment

Where the person has a piece of equipment on long-term loan from the NHS, the second Local Authority should discuss with the relevant NHS body in its area. Both are jointly responsible under the Care Act for ensuring that adequate equipment is in place when the person moves (this can either be a continuation of the current equipment loan or a new loan for a new piece of equipment).

Adaptations

Adaptations include:

1. Minor works carried out to the home (e.g. grab rails and stair rails); and
2. Permanent fixtures or changes (e.g. a ramp or wet room).

Most adaptations are provided and fitted to the specific measurements and requirements of the person's accommodation, and as such are unlikely to be fit for purpose in a new home, even if it is possible to physically get them there.

The first Local Authority should:

1. Provide information to the second Local Authority about any current adaptations to the person's home; and
2. Provide a view about the adaptations that may be needed in person's new home.

The second Local Authority should:

1. Consider the best time to assess for an adaptation (which could be before or after the person has moved); and
2. Assess any need for an adaptation; and
3. Carry out any minor works to the person's new home; or
4. Support the person to apply for a Disabled Facilities Grant; and
5. Arrange any interim care and support that may be required to mitigate risk.

Repayment of Disabled Facilities Grants

The person may need to repay some of their Disabled Facilities Grant when:

1. They owned the property in the first Local Authority area; and
2. They have moved within 10 years of the works being carried out.

9. Safeguarding

Before the person moves

The first Local Authority has a statutory duty to:

1. Respond to any safeguarding concerns; and
2. Manage any safeguarding enquires; until
3. The person has moved to the second Local Authority area.

Any safeguarding enquiries on-going at the time of the move should be concluded by the first Local Authority, even if the person no longer lives in the area.

After the person moves

After the move the second Local Authority has a statutory duty to:

1. Respond to any new safeguarding concerns; and
2. Manage any safeguarding enquiries relating to those new concerns; unless
3. Those concerns relate to harm or abuse that occurred (or may have occurred) in the first Local Authority area (see below).

Concerns relating to abuse or neglect in the first Local Authority area

If a safeguarding concern relates to neglect or abuse that occurred (or may have occurred) in the first Local Authority area, the first Local Authority is responsible for:

1. Responding to the concern; and
2. Managing any safeguarding enquires; but
3. The second Local Authority may assist them to do so (for example speaking to the person to gather information).

10. Deprivation of Liberty

Deprivation of Liberty Safeguards

If the Deprivation of Liberty Safeguards have been used to authorise a deprivation of liberty in a care home placement in the first Local Authority area, this authorisation will expire on the day that the person leaves the area.

If the person is moving into another care home that new provider is responsible for making a timely referral to the second Local Authority for a Deprivation of Liberty to be authorised where the criteria for doing so is met.

Deprivations authorised by the Court

If the deprivation will be removed

If the deprivation will no longer exist in the second Local Authority area, the first Local Authority practitioner should:

1. Notify their legal support when the person has moved; so that
2. The Court can be notified and any court order authorising the deprivation amended.

If the deprivation will continue

If the deprivation of liberty is likely to continue when the person has moved to the second Local Authority area, it may be possible for the Court that made the order to amend it without the need for a fresh application to be made.

It is the role of legal support to advise both authorities on the best approach, based on the circumstances of the case. This could involve seeking the views of the Court about the matter.

If a new application to the Court is required the second Local Authority should make the application.

If the Court is asked to amend an existing authorisation, the first Local Authority should make the request. However, the authorities should agree suitable reimbursement to be paid by the second Local Authority towards the costs.

11. Carers

If the person moving is a carer

If the person being cared for does not move

Carers are ordinarily resident in the Local Authority area where the person they care for lives. This means that even if a carer moves, their ordinary residence only changes if the person they care for also moves.

Where a carer's ordinary residence does not change:

1. The continuity of care arrangements do not apply; and
2. The first Local Authority remains responsible for meeting their Support needs; even if
3. They now live outside of the first Local Authority area.

If the person being cared for moves

If the carer's ordinary residence is going to change (because the person they care for is moving) the continuity of care arrangements apply for the carer in exactly the same way as they apply for the person unless that carer will no longer be providing care to the person after they move.

If the person moving has a carer

It is the responsibility of the first Local Authority to:

1. Provide information to the second Local Authority about any carers that the person has (when that carer will be continuing to provide care); and
2. Continue to provide support to the carer until, and on the day of the move.

It is the responsibility of the second Local Authority to:

1. Assess the needs of any existing carers before the person they care for moves and develop a Support Plan; and
2. Identify and assess the needs of any other people who may become carers when the person moves.

12. Transitions

If the young person is receiving adult care and support services

If the young person is receiving services from adult care and support in the first Local Authority, the continuity of care process applies in regards to those services.

If the young person is receiving services under children's legislation

If the young person is still receiving services under children's legislation, the continuity of care process does not apply. Instead, you should refer to available children's procedures regarding the procedure when a young person moves.

With full regard to confidentiality, the first Local Authority should still make available to the second Local Authority:

1. Any transitions Assessment; and
2. Any transitions Plan; and
3. Any carers transition assessment; and
4. Any carers transition plan.

13. Legal Services

If the second Local Authority believes that the person's ordinary residence is not going to change when they move they should:

1. Consider the need to take legal advice; before
2. Confirming their position to the first Local Authority.

Under no circumstances must disputes about ordinary residence prevent, delay or adversely affect the person wishing to move from one area to another.

Click here to access the 'Legal Services' procedure, which explains the process for requesting legal support.

14. Joint funding and NHS Funded Nursing Care

Joint funded services

The first Local Authority should provide the named contact at the second Local Authority with:

1. Information about current joint funding arrangements; and
2. The name of the lead health professional at the current ICB.

If the ICB area will be changing

The second Local Authority should:

1. Contact the lead health professional; and
2. Confirm that they have notified the second ICB of the person's move; and
3. Confirm the name of the lead health professional in the new ICB; and
4. Contact them to discuss joint funding arrangements when the person moves.

The lead health professional in the first area ICB should notify and liaise with the ICB in the new area in the same way as the first Local Authority liaises with the second Local Authority.

The ICB in the second area should:

1. Allocate a lead health professional; and
2. Carry out any health needs assessment required; and
3. If the person is eligible for joint funding, work with the second Local Authority to agree joint funding arrangements, and to plan and provide services.

The ICB in the first area should:

1. Provide information to the ICB in the second area; and
2. Continue to provide joint funding with the first Local Authority until, and on the day of the move.

If the second ICB has not carried out required assessments before the person moves they should:

1. Arrange to provide the same level of funding to the second Local Authority as was being provided at the time of the move; until
2. The person's ongoing eligibility for joint funding is assessed.

If the second ICB decides (through assessment) that the person is no longer eligible for joint funding, the second Local Authority will become responsible for meeting the full cost of required services.

If the ICB area will not be changing

If by chance the second Local Authority area borders the first Local Authority and the persons GP registration is to remain unchanged the same ICB will maintain responsibility for joint funding arrangements.

The second Local Authority should:

1. Contact the lead health professional; and
2. Work with the lead health professional to plan and provide the same joint funding arrangements when the person has moved; unless
3. The ICB assesses a change in eligibility.

NHS Funded Nursing Care

It is the responsibility of the second Local Authority, as part of the continuity of care arrangements to:

1. Liaise with the ICB in the second Local Authority area before the person moves; to
2. Request their eligibility for NHS Funded Nursing Care is assessed; and
3. If eligible paid to the new provider when any placement begins.

15. Continuity of Care in Prisons

The Care and Support Statutory Guidance sets out that the relevant stages of the continuity of care process should also be applied to ensure a smooth transition in care and support services whenever:

1. A person with existing care and support needs is to be detained in prison or approved premises outside of the Local Authority is which they are ordinarily resident; or
2. A person with existing care and support needs is going to be transferred from a custodial setting in one area to a custodial setting in another area; or
3. A person with existing care and support needs is to be released from prison or approved premises and intends to live in a different area to that where they are currently detained (and their ordinary residence will be changing).