Communicating the Outcome and Next Steps (Carers)

1. Using this Procedure

This procedure should be used following a determination of a carer's eligible needs under the Care Act.

Anyone working with a person with Care and Support needs should refer to the relevant procedure for their team/service.

2. In all Cases

Having made a determination about eligibility, the Care Act requires that in all cases you must give the carer a written record, explaining:

1. The overall eligibility determination (whether or not the carer's overall needs meet the eligibility criteria as set out under the Care Act); and
2. The rational for the decision.

It is important that the carer understands the eligibility outcome and the reasons for it. To this end it should be provided in a format that is accessible to them.

If the outcome has been provided in a format that you know or suspect the carer will not be able to understand you should:

1. Consider any steps that you can take to support them to understand it (for example talking through the outcome over the telephone or summarising it in a simpler format); and
2. Consider the duty to make an independent advocate available.

3. When the Overall Determination is 'Ineligible'

Where the overall eligibility determination is 'ineligible' there is no duty on the Local Authority to meet any needs that the carer has.

When providing the written record of the ineligible determination you must:

1. Explain the eligibility determination;
2. Explain the rationale for the determination;
3. Provide written information and advice about what can be done now to reduce the ineligible needs for support that the carer has; and
4. Provide written information and advice about what can be done to prevent or delay the development of eligible needs for support.

See: Providing Information and Advice, which includes links to local and national resources.

See also Accessing a Prevention Service.

You should also consider:

1. Any need for action under adult safeguarding procedures (for example, if the person being cared for or the carer is at risk of abuse or neglect and is unable to protect themselves); and
2. Any need for action under children's safeguarding procedures (if a child is living in destitution they are a 'child in need' under the Children Act 1989).

See Safeguarding Adults, 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.

Meeting Ineligible Needs

Under the Care Act the Local Authority has a power to meet needs that have not been deemed eligible, normally under the remit of preventing a crisis or longer term needs through a short term intervention. However, this power should not be used routinely or without authority and you should familiarise yourself with the local policy for meeting ineligible needs.

4. When the Overall Determination is 'Eligible'

When providing the written record of the determination you must:

1. Explain the eligibility determination;
2. Explain the rationale for the determination;
3. Where there are both eligible and ineligible needs, provide written information and advice about what can be done now to reduce any ineligible needs for support that the carer has; and
4. Where there are both eligible and ineligible needs, provide written information and advice about what can be done to prevent or delay the development of eligible needs for support.

5. Managing Disagreement about Eligibility

Under the Care Act the Local Authority is responsible for applying the criteria and making the final decision about eligibility. As such this is your responsibility as you are the Local Authority's representative.

There may be times when the carer or another person disagrees with the eligibility determination you have made.

In this situation you should be open to reviewing the available evidence and your rationale to ensure that the determination is robust. You should be open and transparent about the evidence sources you have used and take steps to try and support the carer to understand the determination you have made.

Where ongoing disagreement persists you should:

1. Seek the support and advice of your line manager as required;
2. Make a record of any difference of opinion in the formal record of assessment;
3. Ensure the evidence upon which you have based your decision is robust;
4. Make sure that the regard you have given to the views of the carer (and others) and the impact on their Wellbeing is clear; and
5. Make proportionate records of any conversations you have had to try and resolve the differences.

You must also make the carer aware of their right to complain about the decision that has been made.

6. Next Steps (Eligible Needs)

Under the Care Act there are 2 steps that you must carry out following a determination of eligible need and notification of outcome. These steps should be carried out prior to any formal Support planning process commencing.

Under each step you should ensure appropriate and proportionate recording to evidence:

1. What has been explored or discussed;
2. What has been agreed;
3. The rationale/evidence for any agreement or decision (including the regard that has been given to the thoughts, wishes and feelings of the carer); and
4. Further action required (including any mechanism to monitor or review decisions made).

Step 1: To consider with the carer what can be done to meet the eligible needs they have

The primary purpose of step 1 is to establish the range of ways that the carer could meet their eligible needs, beginning with ways that needs could be met from within their own available resources (for example independently, with informal support or within the local community). This is called a strengths based approach and, wherever possible, every conversation with a carer about meeting needs should be from a strengths perspective. This means that before you talk about service solutions to the presenting issue you must support the carer 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.

Where there appears to be limited or inappropriate options to meet one or more eligible need from within the carer's own networks you will need to provide information about the nature of available services that the Local Authority could provide to meet needs.

Step 2: Establish whether the person needing care is ordinarily resident in the Local Authority area

This is the stage when ordinary residence should be established under the Care Act. Following a determination of eligibility the Local Authority can only meet the eligible needs of a carer if:

1. The person they provide care to is ordinarily resident in their area; or
2. The person they provide care to is present in the area and of no settled residence.

See what the Care Act says about Ordinary Residence, including understanding what ordinary residence is, how/when to establish ordinary residence and how/when to meet the needs of those who are not ordinarily resident in the area.

tri.x has developed a tool to support decision making around ordinary residence.

See: Ordinary Residence Decision Support Tool.

Also see the Ordinary Residence Procedure.

7. Proceeding to Support Planning

When the Local Authority will be meeting some/all needs

If the carer confirms that they wish for the Local Authority to meet some, or all of their eligible needs you must carry out Support Planning. The Local Authority cannot meet needs until a Support Plan is in place and a personal budget agreed (unless needs are urgent).

When the carer is self funding or intends to meet needs through alternative support

If any of the following circumstances apply then Support Planning must take place in the same way as it would if the Local Authority were arranging services:

1. The carer requests it; or
2. You feel it would be beneficial due to the complexity of needs, situation or risk to the carer and the carer consents.

Even if the carer does not request Support Planning you must explain their right to do so and, if they subsequently request it, carry out Support Planning.

The Support Planning process can be a helpful way to support carers to:

1. Explore all of the available options with professional support;
2. Decide the best way to meet needs from the available options;
3. Make the best use of their financial resources for the longest time; and
4. Decide the best method of arranging services.

If the carer decides not to proceed with Support Planning you must:

1. Provide them with the information and advice they request (or you feel would be beneficial) about available appropriate support to meet their needs;
2. Provide them with information and advice about ways they can prevent, reduce or delay the need for support;
3. Provide them with any other information that they request or that you feel will be beneficial;
4. Consider the support the carer may need to explore and arrange their own services and whether the advocacy duty applies;
5. Explain to them what to do if they change their mind about planning or arranging their own services;
6. Explain to them what they should do if their needs change;
7. Explain to them what they should do if their financial circumstances change;
8. Continue to carry out any planned Care and Support processes with the cared for person.

All of the above information should be confirmed in writing.

Where you feel there is a risk that the carer will not make appropriate arrangements to meet their eligible needs you should make proportionate arrangements with them to monitor the situation, as the duty for the Local Authority to meet eligible needs is not discharged until alternative support/services are in place.

When services are in place (or you are satisfied that the carer will make appropriate arrangements) and there is no need to monitor the situation you should consider closing their case.