Changes to Care Act Guidance: chapters 6 & 7 – first contact and identifying needs

April 15th, 2016

Here is the latest in our series of summaries of the changes made to the Care and Support Statutory Guidance.  We have already talked about chapter one and chapters 2-5. Now we’re looking at first contact and identifying needs. As always, I have not included here every change (some of which are very minor or style/formatting), but hopefully this post flags up most of the material differences. 

Chapter 6 – assessment and eligibility

In paragraph 6.3, one of the assessment format examples has been reworded as follows: “a supported self-assessment, which should use the same similar assessment materials as a face to face assessment used in other forms of needs or carers’ assessments, but where the person completes the assessment themselves and the local authority assures itself that it is an accurate reflection of the person’s needs (for example, by consulting with other relevant professionals and people who know the person with their consent)“.

In paragraph 6.7, the following wording has been added about the support provided by social workers and occupational therapists: “Or they may be involved at the point of first contact to advise on whether preventative services would be more appropriate at that time“.

Additional wording has been added to paragraph 6.20: “Where the adult who is or is at risk of abuse or neglect has capacity and is still refusing an assessment, local authorities must undertake an assessment so far as possible and document this. They should continue to keep in contact with the adult and carry out an assessment if the adult changes their mind, and asks them to do so.”

Paragraph 6.48 has been amended in respect of the assessment questionnaire for a supported self-assessment process: “The person should be asked to complete the same  a similar assessment questionnaire that the authority uses in their needs or carers’ assessments, which must assess the person’s needs, their outcomes, and the impact of their needs on their wellbeing. The assessment questionnaire can be the same as the one used by local authority assessors or adapted to cover the same questions but made easier for the person to use and understand. Local authorities must also ensure they fulfil other relevant duties under the Act when supporting and assuring a person’s self-assessment, such as those around independent advocacy. If at any point the local authority suspects that a person is experiencing, or is at risk of, abuse and neglect, it must begin a safeguarding enquiry“.

The trigger for a safeguarding assessment has been re-worded at paragraph 6.54, which now advises that it is important to act swiftly and put in place an effective response where a person is at risk of “abuse or neglect” (instead of “harm or abuse“).

The numbering has changed from paragraph 6.71 onwards, because several paragraphs have merged.

New paragraph 6.119 (old paragraph 6.126) amends the wording  about”being unable” to achieve outcomes, for the carers’ eligibility criterion. One of the circumstances has been revised as follows: “is able to achieve the outcome without assistance, but doing so causes or is likely to cause significant pain, distress or anxiety or endangers“.

New paragraph 6.121 (old paragraph 6.128) now includes the word “as a result of their caring duties” as part of the test for eligibility for carers who are unable to achieve specified outcomes i.e. their caring duties must be the reason why they cannot achieve the outcome in question. In addition, the outcome about the condition of the home has been reworded: “local authorities should consider whether the condition of the carer’s home carer is able to maintain a safe and home which is an appropriate environment to live in and whether it presents a significant risk to the carer’s wellbeing“.

The example in new paragraph 6.128 (old paragraph 6.136) on carers with fluctuating needs has been revised as follows: “For example, a carer could be caring for an adult with a mental illness, which who has been managed their condition well in the past 8 months, but which who could deteriorate, if circumstances in the adult’s life change. In such situations, local authorities must consider what the nature of  how the carer’s needs has been over the past year  change as a result of the fluctuation in needs of the person they are caring for. Authorities must get a complete picture of the carer’s level of need over an appropriate period“.

Various statutory references and links to guidance have been updated.

Chapter 7 – independent advocacy

There is a correction to the case study at paragraph 7.34, where it seems that an important “not” was included by mistake in the previous version: “If the person already has an advocate, whose role so far has been to support the person on matters not under the Care Act, who is able and willing to facilitate their involvement in the assessment, planning and review processes then they may be an appropriate individual to support the person’s involvement and represent them. They would not be acting as an appropriate person rather than an independent advocate under the Care Act. If, however, that advocate fulfils the requirements for an independent advocate under the Care Act then they can be appointed as such.

The beginning of paragraph 7.45 has been reworded: “To prevent potential conflict of interest, the independent advocate must not be working for the local authority, or for an organisation that is commissioned to carry out assessments, care and support plans or reviews for the local authority unless the potential conflict of interests is adequately addressed within the organisation’s structure (for example a different group within a company or through an effective ‘firewall’, as in the banking industry).

In paragraph 7.47, it has been clarified that advocates should not, where practicable, just ask the individual for consent to look at records and talk to carers, family and friends, care and support workers and others. The advocate should also obtain that consent in writing, where practicable.

Words have been added to paragraph 7.48 to clarify when the advocate assists a person to understanding their rights in respect of safeguarding, the advocate should assist them to understand their rights to have concerns “about abuse taken seriously and responded to appropriately“.

Paragraph 7.66 has been amended: “Local authorities do not have to commission one organisation to provide both all types of statutory and non-statutory advocacy. But there may be advantages of working with one organisation providing both or working through one liaison point for a consortium of advocacy providers: it is better for the person receiving the support; it is easier for those carrying out assessment and care planning to work with one advocate per individual rather than two; it is easier for the local authority to manage and monitor one contract rather than 2“.

Various statutory references and links to guidance have been updated.

Rachel Kamm, 11KBW, @kamm11KBW 

 

 

 

 

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