Actions and Next Steps (Reablement)

1. Using this Procedure

This procedure should be used to action the outcome of a contact or written referral regarding a person with Care and Support needs. It should not be used when the contact or written referral was in regard to a carer.

If the contact or written referral relates to a carer you should use the relevant carer's procedure. Click here to access it.

2. Providing Information and Advice

The Local Authority has a duty under section 4 of the Care Act to provide good general information and advice relating to adult Care and Support wherever it is requested or would be of benefit. This duty applies equally in respect of all local residents regardless of whether the person with Care and Support needs is known to, lives in, or is already receiving services from the Local Authority.

Click here to read more about the duty to provide information and advice under the Care Act, including how information and advice should be provided and the specific information and advice requirements around finances.

Local Information and Advice Resources

Online

Online information is available via The Local Offer.

By telephone

You can speak to Adult Social Care by calling 01793 463333 (option 2).

Swindon Advice and Information Service

Sanford House is a local resource designed to help you find the right information, advice and support for your situation. 

Drop in to talk to one of their information guides, access one of the organisations listed or use the free public access touch screen computers to look up information online. Confidential space is also available if you would prefer to talk through your situation with an advisor.

Sanford House
Sanford Street
Swindon SN1 1HE 

Centre opening hours are: Mon-Fri, 9.30am-4.30pm.

For more information about how to access the centre, email SAASC@swindon.cabnet.org.uk or call reception on: (01793) 466633.

The centre also provides a link to adult health, wellbeing and support services in Swindon and is home to the following organisations: Citizens Advice Service Swindon, Swindon Carers Centre, Alzheimer's Society, Swindon Mind, Swindon Advocacy Movement, Healthwatch Swindon, Entham Trust, Wiltshire Law Centre, DASH, LIFT Psychology, Royal Voluntary Service, Shopmobility.

For information about these organisations see below.

Swindon Citizens Advice Services

Swindon Citizens Advice Services provide free, confidential and impartial advice and campaign on big issues affecting people's lives. They are an independent charity and part of the Citizens Advice network across England and Wales. People come to CAS with all sorts of issues. You may have money, benefit, housing or employment problems. You may be facing a crisis, or just considering your options.

Find out more at their website by clicking here.

The following are a list of Swindon Citizens Advice Services locations, and details of their drop in sessions:

Main Office
Sanford House
College Street Entrance
Swindon
SN1 1HE

Drop in: Monday and Wednesday 9.30am-4pm, Tuesday, Thursday and Friday 9.30am-1.30pm.

East Swindon Citizens Advice
Cavendish Square
Park South
Swindon
SL3 2LZ

Drop in: Tuesday 10am-1pm, Thursday 10am-1pm.

North Swindon Advice Point
Pinetrees Community Centre
The Circle
Pinehurst
Swindon
SN2 1QR

Drop in: Monday 10am-1pm, Wednesday 10am-1pm.

Swindon Carers Centre

Swindon Carers Centre is a charitable organisation, which is part of the Carers Trust Network, and were established to provide help and support to the 21,000 carers in Swindon.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 01793 531133
E-mail: info@swindoncarers.org.uk
Website: www.swindoncarers.org.uk/

Swindon MIND

Swindon MIND provide support and services to empower anyone experiencing a mental health problem in Swindon. They campaign to improve services, raise awareness and promote understanding.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 01793 432031
E-mail: admin@sgmind.org.uk
Website: www.sgmind.org.uk/

Healthwatch Swindon

Healthwatch gives people a powerful voice locally and nationally. At a local level, Healthwatch Swindon works to help local people get the best out of local health and social care services.

Swindon Advice and Support Centre
Sanford Street
Swindon
SN1 1HE

Tel: 01793497777
E-mail: info@healthwatchswindon.org.uk
Website: www.healthwatchswindon.org.uk/

Wiltshire Law Centre

The Wiltshire Law Centre are a registered charity that provides FREE confidential advice on: Housing, Anti Social Behaviour Injunctions, Employment, Welfare Benefits and Debt.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 01793 486926  
Website: wiltslawcentre.org.uk/

Enham Trust

The Enham Trust supports people who are eligible for funding from adult social care. Enham Trust equips vulnerable service users with the tools to live the life they want, regardless of impairments.

Sanford House
Sanford Street
Swindon
SN1 1HE

Website: www.enhamtrust.org.uk/

Swindon Shopmobility

Swindon Shopmobility provide mobility scooters and powered & manual wheelchairs to help people with limited mobility to shop and use other facilities in the town centre.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 07379 689128
E-mail: Shopmobility@vas-swindon.org
Website: vas-swindon.org/services/shopmobility/

DASH (Discovering Autism Spectrum Happiness)

DASH (Discovering Autistic Spectrum Happiness) is an independent local charity whose mission is to improve the quality of life of adults of working age with Asperger's and other high functioning Autistic Spectrum Conditions living in Swindon.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 07554 665 715
E-mail: contactdashswindon@gmail.com

Lift Psychology

LIFT have been providing psychological services to the people of Swindon for the past 20 years and pioneered Primary Care Psychology services within the country.

They offer a high quality service that includes traditional Improving Access to Psychological Therapies (IAPT) interventions plus additional support.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 01793 836836
E-mail: awp.lift-psychology@nhs.net

Royal Voluntary Service

The Royal Voluntary Service is a national charity built on local volunteering, giving support to people who need it in our hospitals and communities.

Sanford House
Sanford Street
Swindon
SN1 1HE

Alzheimer's Society

The Alzheimer's Society are here for anyone worried about or affected by dementia. They provide information and support, fund medical and social research, and campaign for better quality of life for people with dementia and greater understanding of the condition.

Sanford House
Sanford Street
Swindon
SN1 1HE

Tel: 01793485404
E-mail: swindon@alzheimers.org.uk

Swindon Advocacy Movement (SAM)

SAM provides a free, independent and accessible advocacy service in Swindon.

Sanford House
Swindon
SN1 1HE

Tel: 01793 542266
E-mail: info@swindonadvocacy.org.uk
Website: www.swindonadvocacy.org.uk/

National Information and Advice Resources

Sometimes it is helpful to contact a well-known national organisation with a dedicated information and advice service or help-line. Click here for details of some national organisations offering this service.

Some national organisations do not have dedicated information and advice services but can still provide such support upon request. Click here for a wider range of useful national contacts for adult Care and Support.

You can also click here to see the answers to some frequently asked questions around financial assessment, including questions relating to Disabled Facilities Grants.

Understanding Information and Advice

Information and advice must be provided in an accessible way so that the person for whom it is intended can best understand and make use of it.

If you feel the person for whom the information and advice is intended will need support to understand it then you should:

1. Consider whether the person has anyone appropriate who can help them to understand it;
2. Consider any steps that you can take to support them to understand it (for example talking through the information over the telephone or summarising it in a simpler format); and
3. Consider the benefit of independent advocacy.

3. Following up on Information and Advice

Under the Care Act the Local Authority has a duty to not only provide information and advice where it is needed, but to ensure that the information and advice it provides has been effective.

Therefore, when information and advice has been provided you should agree appropriate arrangements to follow up with the person to whom it was given in order to review how effective it has been.

The timescales for this follow up should reflect the individual circumstances and level of risk.

Where you are making arrangements for someone else to follow up on the information and advice you have given (rather than following up on it yourself) you must make sure that you have recorded this in a way that will ensure the person follows up on it at the agreed time.

4. Accessing another Prevention Service

The team is just 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 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.

Click here 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.

5. Minor Adaptations and Low Level Equipment

Sometimes the information gathered at contact, referral or through consultation with others will evidence that:

1. Allocation for further assessment is not required; and
2. The most appropriate and proportionate response is to provide minor adaptations or low level equipment.

When arranging minor adaptations and low level equipment (either directly or through a partner agency) you must ensure that appropriate mechanisms are in place to:

1. Support the person (and any carer) to use the equipment provided safely;
2. Monitor the effectiveness of the adaptation and equipment; and
3. Review the need for further assessment or intervention.

You should refer to available local guidance to confirm which adaptations and equipment can be provided.

Click here to access the minor adaptations and low level equipment procedure.

6. Providing Information about a Person

The Local Authority has a common law and legal duty to safeguard the confidentiality of all personal information. As an employee of the Local Authority you are bound contractually to respect the confidentiality of any information that you may come into contact with. Under no circumstances should such information be divulged or passed to any persons or organisation in any form unless you have authorisation to do so.

All information sharing that takes place must be in line with data protection legislation (namely the UK General Data Protection Regulation and the Data Protection Act 2018) and local policy.

The Caldicott Principles must also be regarded. The Caldicott Principles are a set of principles that apply to the use of confidential information within health and social care organisations and when such information is shared with other organisations and between individuals, both for individual care and for other purposes. For further information, see: The Caldicott Principles.

Any unauthorised disclosure of confidential information may result in disciplinary action of individual prosecution under the Data Protection Act 2018.

For further information and guidance see: Providing Information about a Person or Carer.

7. Transferring a Contact

It is important that the person making contact speaks to the right practitioner at the right time. Sometimes you may find that you are not the most appropriate practitioner to manage the contact.

Transferring a telephone contact

When the person making the contact requests specifically to speak to or be contacted by a particular person you should establish as quickly as possible whether the contact should be forwarded to that practitioner.

You should check available systems to establish whether the person is allocated to the practitioner they have requested to speak to.

You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the person. This will not be helpful to the worker or to the person as they will not be speaking to the right person to resolve the contact.

If the practitioner is not available

If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.

If you know when the practitioner is likely to become available you should:

1. Inform the person of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the person about when to expect a call back;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required should the practitioner be unavailable for more than a few hours;
4. Agree with the person what they should do if the practitioner does not make contact at the expected time; and
5. Make a proportionate record of all the above.

If it is not clear when the practitioner will become available you should:

1. Inform the person of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required; and
4. Agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
5. Make a proportionate record of all the above.

Transferring a written, email or text contact

When a written contact is addressed to a named worker you should establish as quickly as possible whether the contact should be forwarded to that practitioner.

You should check available systems to establish whether the person is allocated to the practitioner that the written contact is addressed to.

You should not transfer a written contact to a named worker if it is clear that the worker is not allocated to the person. This will not be helpful to the worker or to the person as they will not be dealing with the right person to resolve the contact.

Before transferring the contact you should:

1. Confirm that the practitioner the written communication is being transferred to is available within a reasonable timeframe for the action indicated by the contact, or that you have agreed with a manager how the contact will be managed;
2. Where the communication is a letter or an email, whether the practitioner wishes to receive the original contact (if not this should be filed securely); and
3. Where a written response confirming the contact has been received is required or requested, agree who will provide this.

The most secure way to transfer a written contact is to send a message to the practitioner alerting them to the contact and where it can be found on the recording system.

Any original copies of emails must be sent via internal secure email systems only and any original letters must be sent via internal postal services or secure delivery only.

If the practitioner is not available

If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.

If the practitioner is not available within a reasonable timeframe for the action indicated by the contact you should:

1. Leave the practitioner a message alerting them to the contact, where it can be found on the recording system and any action undertaken, including what has been agreed with the person if contact has been made with them;
2. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required and writing any acknowledgement letter to confirm arrival of the contact;
3. When the practitioner is not available within any timeframes indicted in the written contact or for more than a few days inform the person making the contact of this;
4. Agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
5. Make a proportionate record of all the above.

8. Safeguarding Concern

If, as part of any conversation or information gathering you become concerned that a vulnerable adult or child is experiencing, or at risk of abuse or neglect you must respond appropriately by raising a concern.

Click here to access the adult safeguarding 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.

9. Using Independent Advocacy

The Advocacy Duty

Whenever the outcome of a contact or referral is that the person will be involved in any adult Care and Support process (including any assessment, or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person would experience substantial difficulty being fully involved in the Care and Support process without support.

Click here to see a tri.x tool that can support effective and consistent decision making about when/which advocacy support should be made available.

The Local Authority also has a power (but not a duty) to make advocacy available in other situations on a case by case basis if it deems this appropriate and is able to do so. This could include advocacy to support a person to understand information and advice, or advocacy to support a person to explore possible options available to them.

The Difference between substantial difficulty and lacking mental capacity

Having substantial difficulty is not the same as lacking mental capacity.

Click here for information about how to determine substantial difficulty.

Click here to access the Mental Capacity Act 2005 Resource and Practice Toolkit, with guidance about assessing capacity and making best interest decisions.

An appropriate person

An appropriate person for general representation purposes is not the same as an appropriate person for independent advocacy under the Care Act.

Click here for information about the difference and how to establish whether there is already an appropriate person.

The role of the Independent Advocate

The role of an independent advocate appointed under the Care Act is not the same as the role of a general advocate or any other type of advocate (for example an Independent Mental Capacity Advocate or an Independent Mental Health Advocate).

An independent advocate appointed under the Care Act must both facilitate and ensure the involvement of the person with substantial difficulty in the Care and Support process that is taking place.

For information about the ways in which an independent advocate should fulfil their role click here.

Advocacy for people who lack Capacity

People who lack capacity will likely be legally entitled to advocacy under both the Care Act and the Mental Capacity Act 2005.

The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have 2 advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.

There are various factors that should influence this decision (such as existing rapport with an advocate or whether any important decisions are likely to be the outcome of the Care and Support process) and the Local Authority must ensure that whatever it decides, it does not deny the person any of the specialist advocacy skills they need or are entitled to.

Click here to access a tri.x tool that can support effective and consistent decisions about when/which advocacy support should be made available.

Advocacy for people subject to the Mental Health Act

People eligible for an Independent Mental Health Advocate (IMHA) under the Mental Health Act 1983 will likely be entitled to advocacy under the Care Act.

The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have 2 advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.

There are various factors that should influence this decision (such as existing rapport with an advocate or the likely outcome of the Care and Support process) and the Local Authority must ensure that whatever it decides,  it does not deny the person any of the specialist advocacy skills they need or are entitled to.

Click here to access a tri.x tool that can support effective and consistent decisions about when/which advocacy support should be made available.

Making a Referral for Independent Advocacy

The advocacy referral can be made at any time and should be made without delay as soon as the duty applies.

What to do if Independent Advocacy is not available or delayed

Regardless of whether or not independent advocacy is available in the local area the duty to provide it still applies. A failure to do so is a breach of this duty and of the law. It is the role of commissioners to ensure that advocacy services are in place and available when required, and it is the role of practitioners to make timely referrals to advocates to prevent unnecessary delays in the meeting of its duty.

If you are aware that advocacy support is required and is not yet available you must not proceed to carry out any Care and Support process until it is in place.

In some circumstances urgent interim measures may need to be agreed without an advocate in place in order to reduce immediate risk to the person from inaction. However, Care and Support processes that will decide long term and important decisions must not be carried out without advocacy support.

What to do if the person does not want to use advocacy

The duty upon the Local Authority is to make independent advocacy support available to any person who requires it. Once made available the duty is met.

If a person decides that they do not wish to engage in the advocacy support that has been made available to them they do not have to do so, but the Local Authority must still provide it.

10. Maintaining Existing Equipment

You should familiarise yourself with available local guidance that confirms who is responsible for maintaining or repairing equipment in a range of circumstances.

11. Direct Support

Direct support refers to the range of ways that an Occupational Therapy or Hearing & Vision team practitioner works directly with a person or a carer to ensure safe and effective use of equipment, aids or an adaptation.

Direct support includes:

1. Training of informal and paid carers in the safe and proper use of equipment; and
2. Supporting the person to safely and confidently use equipment or adapt to their environment after an adaptation.

Direct support:

1. Builds the person's confidence to use equipment and access their adapted environment;
2. Builds the confidence of any carers to use the equipment;
3. Ensures that people using the equipment are suitably skilled to do so;
4. Ensures that people using the equipment know when it may be faulty;
5. Reduces the risk of unsafe use of the equipment;
6. Reduces the risk of injury from unsafe or improper use of the equipment;
7. Maximises the effective use of the equipment or adapted environments to promote independence or prevent, reduce and delay needs.

12. Allocation for Assessment or Support

When to allocate

Where the outcome decision is for the person's case to be allocated to an individual worker, this allocation should take place in a timely way so as to:

1. Avoid any unnecessary delays to the person;
2. Reduce the risk of a deterioration in the situation; and
3. Maximise the use of measures that will prevent, delay or reduce needs.

Where there are a significant number of people awaiting allocation for further work or assessment there should be a fair and consistent prioritisation process in place that takes into account:

1. The level of risk;
2. The level of need;
3. Current support in place and the sustainability/effectiveness of this;
4. The urgency;
5. The likelihood of deterioration; and
6. The potential for fluctuation.

An element of monitoring should be incorporated into any allocation process to ensure that you remain aware of every person's situation and are able to respond appropriately to any changes or need to re-prioritise allocation.

Delays in Allocation

If a person is likely to remain unallocated for some time you must consider whether:

1. There is appropriate support in place to meet any needs that they appear to have in the interim (either though a carer or an existing Care and Support Plan); and
2. If not, the steps that need to be taken to ensure any urgent needs are met.

If there are unmet urgent needs you must take steps to ensure that these are met.

How to allocate

The Care Act recognises that each worker (regardless of whether or not they have a professional qualification) will possess specific skills, knowledge and experience that will enable them to carry out different Care and Support functions or work with particular people well.

Because of this there is no expectation that a particular role should carry out a particular function; instead the Local Authority should allocate tasks to the most appropriate person for the job.

Allocation decisions should take into account:

1. The skills, knowledge and experience of the worker in carrying out the function or process required;
2. The skills, knowledge and experience of the worker in working with the particular needs of the person (for example health needs or communication needs); and
3. The views and wishes of the person themselves in relation to the skills required of the worker and who they feel would best support them.

Click here to access a tri.x tool that can support consistent decision making when deciding who to allocate work to.

13. Joint Work

The team is an integrated team. As such there is an expectation that practitioners from social work, reablement and Occupational Therapy will work together whenever it would be beneficial to do so. Depending on the needs and circumstances of the person there may also be a need to work jointly with other service areas, teams or professionals (for example housing).

The Care Act recognises this and permits the Local Authority to make any arrangements it deems appropriate in order to facilitate joint working with others.

The duty to co-operate

Where the Local Authority requests another party to work jointly in some way to benefit the person with Care and Support needs that party has a duty to co-operate with the request (unless by doing so they will be prevented from carrying out their own duties under the Care Act or other legislation).

For further information about the duty to co-operate under the Care Act click here.

Responding to a request for joint work

When you have been allocated and asked to work jointly with another service, team or professional you should contact them to confirm your involvement and discuss the most effective way to work together. The things you should establish include:

1. The work they are doing/will be doing/have done and whether they have any information that you need to know or can use to avoid duplication;
2. Whether there are opportunities to co-ordinate systems and processes and, if so how this will be managed;
3. What the expectations are in terms of joint-working (for example will you be expected to carry out a joint assessment, meet with the person together, produce joint records or just consult and share information);
4. What the anticipated outcome of the joint work is (for example joint funding of support, on-going joint-work to monitor);
5. What does the person with care and support needs know about the joint-work to be carried out (and if they don't know who and how should this be explained);
6. Who will be the primary contact for the person (or their representative) to go to with any queries; and
7. Who will be responsible for communicating progress and decisions to the person.

Further practice guidance about effective joint working can be found in the Joint Work procedure by clicking here.

If there are likely to be delays in your commencement of joint work the person who requested the joint work will need to:

1. Consider whether to proceed with their intervention; or
2. Await your availability.

It is the responsibility of the person requesting joint work to make this decision (in agreement with the person and any carer) and to take steps to ensure that any urgent needs for Care and Support are met.

How to request joint work or assessment

Any decision to request joint work should be made with the person (or their representative). Where the person is unable to provide consent to joint work decisions should be made in their best interests.

Joint work requests should be made in the manner preferred by the service, team or professional to which the request is being made. This may or may not take the form of a referral.

The request should explain clearly the nature of the joint work required and any specific skills, knowledge and competence requirements to support allocation.

14. Revising an Existing Plan

Revising a Care and Support Plan

When a Care and Support Plan can be revised

Under the Care Act, when a person is already receiving Care and Support from the Local Authority they may request a change to their Care and Support Plan at any time and the Local Authority must consider the request. Where the request is deemed reasonable the Local Authority has a duty to review the plan.

The review is the mechanism by which the need for a revision is determined. As such, under the Care Act a Care and Support Plan can only be revised following a review.

Where a change is requested to a plan and there is no planned review scheduled consideration should be given to arranging an unplanned review. Any review must be proportionate to the needs of the person and undertaken in a timely way so as to reduce the risk of a crisis developing and needs not being met.

When there is an allocated worker

If the person has an allocated worker this person should carry out the review, unless the review is urgent and the worker in unavailable.

Before transferring the review request you should confirm that the practitioner the review request is being transferred to is available.

If the practitioner is not available you should speak with a manager to establish whether:

1. The request should still be transferred to the allocated worker to action when they become available;
2. Alternative arrangements should be made to carry out the review.

When there is no allocated worker

Where the information gathered at contact suggests there has been no change in the person's needs, and that a change to the personal budget amount is not required it may be possible to complete a 'light touch' review without further allocation.

When the information gathered at contact suggests there has been a change in need or circumstance, and that a change in the personal budget amount is required any review carried out is likely to lead to a proportionate reassessment of need. Because this is a longer term intervention allocation for this should be considered.

Revising a Reablement Plan

Regular monitoring of the reablement plan should be incorporated into any reablement service provided. This is essential to ensure that the service is working as intended, and to make changes required quickly to promote and optimise independent functioning.

The monitoring mechanism in reablement must be responsive and consider any need to hold a review of the plan outside of any scheduled review:

1. Whenever the person whose plan it is requests it;
2. Whenever a carer of the person whose plan it is requests it;
3. Whenever the service providing the reablement requests it; and
4. Whenever new information is provided that indicates a review would be beneficial in optimising reablement.

Click here to access the procedure for revising a reablement plan.

15. Urgent or Interim Support

When urgent or interim support can be provided

Not everyone contacts the Local Authority in a timely way so as to allow for an assessment and exploration of options to take place prior to any initial decisions being made about the need for Care and Support.

For example, some people only approach the Local Authority when they are in a time of crisis, high risk or when there is a sudden or unexpected change in their Wellbeing.

In these cases there may appear to be an urgent need for support that cannot wait for an assessment or review process to be carried out.

The Care Act recognises this occurrence and gives the Local Authority powers to meet such needs without having carried out a formal assessment process.

Click here to see what the Care Act says about meeting urgent needs without an assessment or review.

Having the power to meet needs without an assessment or review means that the Local Authority can decide whether or not to do so, based on the available information and specific circumstances of the person and their situation.

Deciding how to meet interim needs

Under the Care Act, the Local Authority can put any interim or urgent measures in place that it deems appropriate to meet the needs of the person and manage the situation. This can range from a small number of domiciliary care visits to a stay in residential accommodation.

The same legal considerations apply when meeting urgent needs as they do when meeting non-urgent needs:

1. The impact on the person's individual wellbeing;
2. Whether any preventative service can be provided that will delay, reduce or prevent the need for Care and Support;
3. Whether information and advice can be provided to support the person to find their own solution, or to delay, reduce or prevent the need for Care and Support.

It is vital that you understand your duties in relation to the above. Please use the links below to access further information as required.

Click here to access information about the duty to promote individual wellbeing.

Click here to access information about the duty to prevent, reduce or delay needs.

Click here to access information about the duty to provide good information and advice.

In addition, you should be mindful that nobody has yet assessed (or reassessed) the needs of the person and you may be relying on historical information or information from sources currently under significant strain or pressure to act. As such the information presented may or may not be an accurate reflection of the person's needs following an assessment.

Interim support should therefore only be seen as a temporary measure to reduce risk of harm and support the person to a place in time where a needs assessment can be carried out and long term options explored and agreed with them. As such, you should be cautious about providing interim Care and Support that may be problematic to cease following assessment.

Click here to access a tri.x tool to support consistent decision making about the provision of urgent or interim support.

A Strengths Based Approach

Wherever possible, every conversation with a person should be from a strengths perspective. This means that before you talk about service solutions to the presenting issue you must support the person to explore whether there is:

1. Anything within their own power that they can do to help themselves; or
2. Anything within the power of their family, friends or community that they can use to help themselves.

A strengths based approach is empowering for the person and gives them more control over their situation and how best to resolve any issues in the best way for them. The end result may still be that the Local Authority intervenes with an assessment or other support, but this decision will have been reached knowing that it is the most proportionate response available.

Adopting a strengths based approach involves:

1. Taking a holistic view of the person's needs in the context of their wider support network;
2. Helping the person to understand their strengths and capabilities within the context of their situation;
3. Helping the person to understand and explore the support available to them in the community;
4. Helping the person to understand and explore the support available to them through other networks or services (e.g. health);
5. Exploring some of the less intrusive/intensive ways the Local Authority may be able to help (such as through prevention services or signposting).

There is a range of guidance in the Local Resource area that will support you to understand and implement a strength based approach. Click here to access it.

SCIE have also produced clear and practical guidance around how to use a strengths based approach in practice. It can be accessed here. Note:  SCIE requires a login to access resources, but any social care practitioner can create one quickly and easily.

Requesting Funding for Urgent or Interim Support

All funding requests for urgent and interim support should be made in line with available local processes and requirements.

Funding Decisions for Urgent or Interim Support

It can be difficult to make a decision about the level of funding required to meet the urgent or interim Care and Support needs because:

1. There will be no personal budget allocated to the person; or
2. There will be a personal budget but this will not be based on their current needs.

The Care Act does not discuss or set funding limitations in relation to the provision of any Care and Support. This includes urgent and interim Care and Support. Instead, the golden rule of the Care Act when making any funding decision is that 'the amount of funding agreed must be sufficient to meet the needs that are to be met at that time'. Decisions must also be made in a way to ensure that the person will be satisfied the process was fair and robust.

Other than sufficiency, the factors that decision makers must consider are:

1. The views and wishes of the person about how their needs should be met;
2. The availability of other potential options in the marketplace; and
3. The cost of available suitable services in the marketplace.

Other factors that should be considered are:

1. The complexity of the person's needs;
2. The level of risk/sense of urgency; and
3. Whether the practitioner requesting the funding has provided relevant information and advice, whether they have explored prevention services that may be appropriate and whether they have explored how the person's own networks of support could help; and
4. Where the person is not ordinarily resident; if they receive Care and Support already in another Authority the nature of the Care and Support they receive.

Decision makers should also take into account that the Local Authority is also permitted under the Care Act to consider how to balance its legal requirement to maintain universal services to the entire local population with the power to meet the urgent needs of a person or carer. In doing so it must:

1. Not base it's decision on finances alone;
2. Consider things on a case-by-case basis; and
3. Not set arbitrary limits (fixed amounts for a particular type of need or service).

Communicating the outcome

The outcome of the funding decision should be communicated to the person at the earliest opportunity. The method of communication should reflect that requested by the person and any specific communication needs they may have. For the purposes of the Care Act communication about the outcome of a funding decision is subject to the same requirements as the provision of information and advice, and the duty to make it accessible therefore applies equally.

Where communication is provided by telephone a follow up letter confirming the conversation and the funding decision should be sent to the person as a formal record.

When communicating the outcome you should include the following information:

1. The funding decision itself;
2. The rationale for the decision;
3. Any information and advice relating to adult Care and Support, and the prevention, delay or reduction of needs;
4. What will happen next and the timeframes involved;
5. How to complain about any aspect of the decision or proposed outcome.

Recording Urgent and Interim Support

Any funding decision rationale should be clearly recorded in line with local recording requirements.

The Local Authority is not required to record urgent and interim support on a Care and Support Plan because:

1. The support is being provided under the Local Authority's powers (as opposed to duties);
2. The person has not yet been assessed (or reassessed); and
3. There has been no decision about eligible needs.

However, the following must be clearly recorded:

1. The urgent or interim support being provided;
2. The contribution to the cost of the support being made by the Local Authority;
3. The contribution being made by the person;
4. The duration of the support;
5. How the support will be reviewed;
6. What outcomes the support aims to achieve; and
7. The next steps, including timeframes for any assessment.

Arranging Interim or Urgent Support

Under the Care Act the process of arranging to meet urgent and interim Care and Support needs is the same as arranging to meet needs agreed through a non-urgent Care and Support Planning process.

Charging for Care and Support

The Local Authority is permitted under the Care Act to charge any person for Care and Support (including Care and Support provided on an urgent basis) unless:

1. It chooses not to; or
2. The person has been financially assessed as having insufficient funds to contribute; or
3. The support being provided is reablement (up to 6 weeks is non-chargeable); or
4. The support being provided is equipment (up to the cost of £1000 is non-chargeable).

Click here for further information about charging for all services under the Care Act.

Click here to access the financial assessment procedure.

Urgent Support for people who are not ordinarily resident

Where urgent support is provided to a person who is not ordinarily resident contact should be made at the earliest opportunity to the Local Authority in which they live to inform them of the intention to meet an urgent need.

Where the person is already in support of a service from the other Local Authority information should be gathered to support any decisions made about which support should be provided.

Agreement should be reached with the other Local Authority about how any urgent Care and Support services will be monitored, when they intend to assess for eligible needs and how reimbursement of costs incurred can be sought.

Click here to access a tri.x tool to help determine whether a person is ordinarily resident in the area.

16. Transferring a Case

Sometimes it becomes clear that the required intervention would be better carried out or led by a different service area or team. For example if the person has multiple needs that cross into more than one service area and it is felt that a practitioner working in a different area would possess more expertise.

Any process for transferring a person's case between service areas or teams should be as simple and seamless as possible. It should involve the person and the potential services with the aim of reaching a shared agreement. Any transfer should not negatively impact the person or put them at risk through the delay of any Care and Support needs being met.

Though not a requirement, it would be prudent to apply the same criteria that the Care Act requires to be applied when deciding the most appropriate worker:

1. The views and wishes of the person about which service/team would best support them must be regarded;
2. The service/team must possess the skills, knowledge and competence to carry out the anticipated Care and Support functions; and
3. The service/team must possess the skills, knowledge and competence required to work with the particular person in question.

Click here to access a tri.x tool that can support consistent decision making about team suitability.

The service area or team receiving the case should make effective use of the information gathered thus far and not make the person (or anyone else previously consulted) repeat information unnecessarily.