Monitoring Urgent or Interim Support and Services

1. When to Use this Procedure

This procedure should be used whenever you are monitoring urgent or interim support that has been provided outside of a personal budget. This includes support provided to a person or carer who is:

1. Waiting for an assessment of need;
2. Waiting for a reassessment of need;
3. Waiting for a review of the Care and Support/Support Plan; or
4. Experiencing a short term change in circumstances.

This procedure should not be used when you are carrying out a statutory review of a Care and Support/Support Plan.

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

1. First Point of Contact;
2. Hospital Discharge;
3. Older Adults;
4. Learning Disability;
5. Mental Health.

2. The Purpose of Monitoring Urgent and Interim Support

The purpose of monitoring urgent or interim support is to:

1. Ensure that the support is meeting urgent needs as intended;
2. Establish that the urgent support being provided is still appropriate and proportionate to meet urgent needs;
3. Establish the need for continued urgent support;
4. Offer any information and advice to prevent, reduce or delay the need for Care and Support; and
5. Gather any information to support prioritisation for assessment, reassessment or review.

3. Who should be Involved

In all cases

The monitoring of urgent and interim support should involve:

1. The person or carer with urgent needs;
2. In the case of a person with care and support needs, any carer;
3. Anyone else that the person or carer requests is involved; and
4. Anyone else that you feel needs to be involved (with the person's/carer's consent or in the best interests of a person with care and support needs if they lack capacity).

When the person lacks capacity

When a person with care and support needs lacks capacity you must ensure that they are appropriately represented and that their involvement in monitoring activity is maximised.

You should consider:

1. Who may be able to support them to be involved;
2. The need to provide independent advocacy if there is not an appropriate person to support them to be involved;
3. Consulting with others who may be able to provide information about how the urgent support is working for the person; and
4. Using available evidence that can support you to understand the impact that the urgent support may be having on the person (for example ABC charts and other records that show behaviour changes clearly linked to the support).

All information gathering and sharing should be carried out with regard to the Caldicott Principles, Data Protection legislation and local information sharing policies.

When the person/carer has substantial difficulty engaging

If a person or carer has substantial difficulty being involved in monitoring activity you must take all reasonable steps to ensure their involvement.

You must:

1. Ensure that you have provided information in an accessible way, or that they have an appropriate person to support them to understand it;
2. Arrange to monitor the urgent support/service in an appropriate format so that it is accessible. This is likely to be face to face, unless the person's/carer's difficulty arises when engaging in face to face communication;
3. Consider whether there is an appropriate person to support their involvement and, if not, whether the advocacy duty applies.

4. Monitoring Urgent and Interim Support

When to monitor urgent or interim support

The urgent and interim support should be monitored to the timeframe that was agreed when it was arranged unless there is evidence that this is no longer appropriate or proportionate (for example if the person's/carer's urgent needs or circumstances have changed).

You should use supervision effectively to discuss and agree the need for continued monitoring.

Gathering information and consulting with others

When monitoring urgent support/services you should make effective use of any information that is available about:

1. The effectiveness of the support being provided;
2. The person's needs or circumstances.

Information could include:

1. Records of contact with the person, carer or provider in between formal monitoring activity;
2. Reports from professionals (for example a GP, Psychologist or Teacher);
3. Records relating to safeguarding concerns or enquiries.

The method of monitoring urgent or interim support

The method of monitoring urgent or interim support should be proportionate to the nature of the support being provided, and the needs and circumstances of the person/carer. It could include:

1. Face to face visits (required if a person with care and support needs lacks capacity);
2. A meeting involving the person/carer, any carer and the provider of the urgent support;
3. Telephone contact with the person/carer, any carer and the provider of the urgent support;
4. E-mail communication.

The method of monitoring should be agreed with the person/carer whose urgent needs are being met and, in the case of a person with care and support needs, any carer.

Recording monitoring activity

Any on-going monitoring activity carried out should be clearly recorded. In particular you should record:

1. Whether the urgent support is meeting urgent needs as intended;
2. Whether there have been any issues with the urgent support;
3. Whether the person/carer still has an urgent need for support;
4. What other options have been discussed to meet urgent needs (from a strengths based approach);
5. Whether any changes to monitoring activity are required.

Decision-Making

Whenever a decision is made to increase, reduce or continue urgent or interim support you must consider and record:

1. The rationale for any decision made to continue, increase or reduce urgent or interim support/services;
2. How you have given regard to the person's/carer's views and the impact of the decision of Wellbeing; and
3. In the case of a person with care and support needs, how you have given regard for the views of any carer.

5. Actions and Next Steps

Continuing urgent or interim support/services

1. Check that funding arrangements are in place to continue providing the support; and, if so
2. Confirm on-going arrangements with the provider of the urgent support;
3. Update relevant electronic records; and
4. Agree future monitoring arrangements.

If funding is not in place to continue the support you should use the relevant Urgent or Interim Support procedure to request additional funding.

Increasing urgent or interim support/services

1. Request any additional funding required to increase support; and, if agreed
2. Confirm increased arrangements with the provider of the urgent support; or
3. Make arrangements for urgent Care and Support with the provider;
4. Update relevant electronic records;
5. Notify the team responsible for financial assessment (if support is chargeable and the Local Authority intends to charge); and
6. Agree future monitoring arrangements.

If necessary you should refer to the relevant Urgent or Interim Support procedure for guidance about requesting additional funding.

Reducing urgent or interim support/services

1. Confirm new arrangements with the provider of the urgent support;
2. Update relevant electronic records;
3. Notify the team responsible for financial assessment (if a financial contribution is being made); and
4. Agree future monitoring arrangements.

Changing the provider of urgent or interim support

If the monitoring conversation identifies that the current provider of urgent support is not working as intended you will need to:

1. Explore the issues; and
2. Wherever possible, reach an agreement about how best to resolve them.

This should be done in an open way using a strengths based approach and should involve:

1. The person/carer with urgent needs (or their representative if they lack capacity/have substantial difficulty);
2. In the case of a person with care and support needs, any carer; and
3. The person or organisation to which the issue relates (unless doing so will put a person with care and support needs at risk of abuse or neglect).

If a decision is ultimately made to change the provider you should:

1. Request any additional funding required; and, if agreed
2. Agree an end date with the current provider;
3. Make arrangements for urgent Care and Support with the new provider;
4. Update relevant electronic records;
5. Notify the team responsible for financial assessment (if support is chargeable and the Local Authority intends to charge); and
6. Agree future monitoring arrangements.

If necessary you should refer to the relevant Urgent or Interim Support procedure for guidance about requesting additional funding.

Ending urgent or interim support

Where non-urgent needs exist

1. End arrangements with the provider of the urgent support;
2. Update relevant electronic records;
3. Notify the team responsible for financial assessment (if a financial contribution is being made);
4. Agree future monitoring arrangements; and
5. Explain to the person/carer (or their representative if they lack capacity/have substantial difficulty) what to do if their needs become urgent before any planned Care and Support process begins; or
6. Where urgent support was being provided due to a change in circumstances, explain what to do if their circumstances change again.

Where no appearance of need exists

If the person's/carer's needs have changed to the point where there is no longer any appearance of need they are no longer eligible for Care and Support/Support from the Local Authority.

In this case you should:

1. Agree a date that the urgent support will end;
2. Cancel the urgent service being provided;
3. Provide information and advice about ways to reduce, prevent or delay the development of needs in the future;
4. Notify the team responsible for financial assessment (if a financial contribution was being made);
5. Explain to the person/carer what to do if they have needs for support in the future; and
6. Close the case.

Reprioritising review, assessment or reassessment

There is a need to reprioritise the need for assessment, reassessment or review if:

1. The person's/carer's needs have deteriorated or reduced;
2. The person's/carer's situation has deteriorated or improved;
3. The level of risk has increased or decreased;
4. The person with care and support needs is at risk of abuse or neglect.

Where this is the case you must clearly record what has changed and notify your line manager or the person responsible for prioritising allocations.

Consideration should then be given to the need to reprioritise allocation to carry out the required Care and Support function.

The provision of information and advice

The duty to provide good information and advice and to consider ways to prevent, reduce or delay needs for Care and Support applies at all times.

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

• Promoting Individual Wellbeing for information about the duty to promote individual wellbeing;
• Preventing Needs for Care and Support for information about the duty to prevent, reduce or delay needs;
• Providing Information and Advice, which includes access to local and national information and advice resources (general and specialist).