Assessing and Meeting the Needs of Individuals

Aims and learning outcomes This training explores Parts 3 and 4 of the Act and relevant aspects of Part 11 in more detail By the end of the training you will: Understand the aims and ethos of the Act Be aware of the duties and powers under the Act relating to an outcome focused approach to assessment and meeting needs Have explored the cultural shift in the assessment process and how eligibility determination flows from it Have explored key changes related to eligibility and care and support planning Be aware of changes to charging and financial assessment Understand the implications of meeting the care and support needs of people in the secure estate Reflect on the implications of the Act [FACILITATORS NOTE: this slide has animation]

Contents Introduction Assessment principles and process Eligibility Care and support planning Charging and financial assessment Adults and children in the secure estate Summary

Introduction The Social Services and Well-being (Wales) Act came into effect on 6 April 2016 and builds on the policy set out in Sustainable Social Services for Wales: A Framework for Action It repeals and replaces many previous laws It covers adults, children and carers People Well-being Prevention Collaboration [FACILITATORS NOTE: this slide has animation. The bullets on the left appear when the slide opens. The first click will show the box and first bullet point within the box (People). The second click will bring in the second bullet point (Well-being) etc]

The Parts of the Act 1. Introduction 2. General Functions 3. Assessing the Needs of Individuals 4. Meeting Needs 5. Charging and Financial Assessment 6. Looked After and Accommodated Children 7. Safeguarding 8. Social Services Functions 9. Co-operation and Partnership 10. Complaints and Advocacy 11. Miscellaneous and General

The well-being duty Responsibility for well-being must be shared with people who have needs for care and support A person exercising functions under this Act must seek to promote the well-being of people who need care and support and carers who need support [FACILITATORS NOTE: this slide has animation. The picture and quote box will show when the slide opens. The first click will show the top right sentence]

Other overarching duties Views, wishes and feelings of the individual Respecting dignity Participation Characteristics, culture and belief Adults best placed to judge their own well-being Promoting independence Upbringing of the child by the child’s family, in so far as doing so is consistent with the well-being of the child Views, wishes and feelings of those with parental responsibility, in so far as is practical and consistent with the child’s well-being

Human rights

Advocacy Might this person experience barriers in participating fully? Can they be better supported to enable them to overcome barriers? [Reasonable adjustments under the Equality Act 2010]  Provide support and make adjustments Yes Yes Do they still experience barriers in participating fully? Is there an ‘appropriate individual’ – a carer, friend or relative – that can support them to participate fully?  Agree ‘appropriate individual’ Yes [FACILITATORS NOTE: this slide has animation] Yes  Duty to arrange for independent professional advocate No

Barriers to participation Understanding relevant information Retaining information Using or weighing up the information Communicating their views, wishes and feelings [FACILITATORS NOTE: this slide has animation] Is there a need for an advocate? Does the person have capacity?

Links to other legislation Social Services and Well-being (Wales) Act 2014 Well-being of Future Generations (Wales) Act 2015 Regulation and Inspection of Social Care (Wales) Act 2016

Assessment principles and process

Assessing the needs of individuals Personal circumstances Personal outcomes Barriers to achieving outcomes Strengths and capabilities Risks The right to an assessment based on the appearance of need for care and support Regardless of the level of need or financial resources Aims to simplify assessments through a single process for children, adults and carers What matters to me [FACILITATORS NOTE: this slide has animation]

What matters conversations A focus on personal outcomes Sharing power and speaking as equals Exploring what is important to the person seeking care and support

Strength-based approach It is the function of the assessment and planning process to identify the skills capacity support resources available to an individual from within themselves, their family and their community that can be marshalled to meet their care and support needs and promote their well-being

National assessment and eligibility tool National Minimum Core Data Set (NMDS) The NMDS only needs to be completed in its entirety if the individual’s care and support needs are eligible and a care and / or support plan is required Action taken to achieve personal outcomes Analysis of all five elements of assessment Practitioner’s statement on how actions contribute to outcomes [FACILITATORS NOTE: this slide has animation. With each click one of the diagram’s triangles will appear, showing each element of the tool]

Appropriate and proportionate assessment Assessment should be appropriate and proportionate To be appropriate, assessments should meet the person’s communication and cultural needs To be proportionate, assessments should consider fully the assets and barriers identified during the conversation Get the balance right! [FACILITATORS NOTE: this slide has animation]

How to access care and support Advocacy: If people need help to participate in this process ensure assistance or advocacy is available Urgent need and safeguarding Assessments must not delay the meeting of urgent needs. If people need protection then apply safeguarding procedures: Start top left and work clockwise through flowchart Specialist assessments If other specialist assessments need to be undertaken, do so concurrently and build in as required I think I may need care and support Information, Advice and Assistance Service Signpost to preventative services OR start an assessment Contact the… Assessment Does the person have needs for care and support? Assessment Identify whether each need can be met through signposting to preventative services or met in an another way OR whether a care and support plan is required. If the identified need can be met through signposting the need will NOT be eligible. If the identified need can only be met through a Care and Support Plan the identified need will be eligible. I think someone I know may need care and support Preventative Well-being Services Range of services and support available in the community: some of which may be chargeable. If needs are not eligible meet through preventative well-being services Review / re-assessment Care and support plan will be reviewed at agreed point. Re-assessment will be undertaken If circumstances change Care and Support Plan Deliver care and support to meet identified needs. Plan will include reference to any other needs being met outside the care and support plan if applicable. If needs are eligible develop a Care and Support Plan to meet needs

Elements of integrated assessment Common local template that must include, as a minimum, the NMDS Specialist and professional assessments required according to need and circumstance

Combining needs assessments A local authority can: combine a person’s assessment of need for care and support with the assessment of his or her carer carry out assessments jointly or on behalf of another organisation

Carer’s assessment Must assess whether the carer has needs for support Duty to assess applies regardless of financial resources Is the carer able and willing to provide care? Personal outcomes Definition of a carer “A person who provides or intends to provide care for an adult or a disabled child” Professional carers who receive payment should not be regarded as carers for the purposes of the Act, nor should people who provide care as voluntary work. [FACILITATORS NOTE: this slide has animation]

Assessment of children

Safeguarding adults and children Where the assessment establishes an adult or a child is at risk, the local authority must make whatever enquiries it thinks necessary to enable it to decide whether any action should be taken and if so, what and by whom, to protect that adult or child For children there is a link to Section 47 of the Children Act 1989

Analysing risks for children High strength Low concern Low strength High concern Care and support Advice and assistance Information Information and advice

Review of assessments If there is a significant change in identified outcomes, family needs or circumstances Judgement on significant changes made with reference to the 5 elements of assessment Transition from child to adult creates a right to re-assessment An individual has the right to request a re-assessment of their needs [FACILITATORS NOTE: this slide has animation]

Refusal of an assessment Adult Children Parents of a child under 16 Adult lacks capacity and it would be in his or her best interest Experiencing or at risk from abuse or neglect Child lacks capacity and it would be in his or her best interest Experiencing or at risk of abuse or neglect The child is at risk or experiencing abuse or neglect The parent lacks capacity Child can make an informed decision and disagrees with parental view

Eligibility

National eligibility criteria The determination of eligibility will flow from, and is a product of, the assessment process Following assessment a judgement must be made about whether the assessed need is eligible based on the national eligibility criteria for adults, children and carers In each case there are four separate conditions which must all be met for the assessed need(s) to be eligible Local authorities are automatically required to meet needs to protect a person from, or the risk of, abuse or neglect or (for children) harm Local authorities can also decide to meet needs that do not meet the eligibility criteria if they choose to do so

Care and Support (Eligibility) (Wales) Regulations 2015 – adults The need arises from the adult’s physical or mental ill-health, age, disability, dependence on alcohol or drugs or other similar circumstances Ability to carry out self-care or domestic routines Ability to communicate Protection from abuse or neglect Involvement in work, education, learning or in leisure activities Maintenance or development of family or other significant personal relationships Development and maintenance of social relationships and involvement in the community Fulfilment of caring responsibilities for a child As a result the adult is not able to meet that need, either alone, or with support of willing others, or with assistance of services in the community As a consequence they are unlikely to achieve one or more personal outcomes unless the local authority provides or arranges care and support

Care and Support (Eligibility) (Wales) Regulations 2015 – children The need arises from the child's physical or mental ill-health, age, disability, dependence on alcohol or drugs or other similar circumstances, or if the need is unmet it is likely to have an adverse effect on the child’s development Ability to carry out self-care or domestic routines Ability to communicate Protection from abuse or neglect Involvement in work, education, learning or in leisure activities Maintenance or development of family or other significant personal relationships Development and maintenance of social relationships and involvement in the community Achieving developmental goals As a result neither the child, the child’s parents or others caring for the child are able to meet that need, either alone, or with support of willing others, or with assistance of services in the community As a consequence they are unlikely to achieve one or more personal outcomes unless the local authority provides or arranges care and support

Care and Support (Eligibility) (Wales) Regulations 2015 – carers Ability to carry out self-care or domestic routines Ability to communicate Protection from abuse or neglect Involvement in work, education, learning or in leisure activities Maintenance or development of family or other significant personal relationships Development and maintenance of social relationships and involvement in the community For an adult carer, fulfilment of caring responsibilities for a child For a child, achieving developmental goals Their need is one that arises as a result of providing care for either a disabled child or an adult who has needs arising from physical or mental ill-health, age, disability, dependence on alcohol or drugs or other similar circumstances As a result the carer cannot meet the need alone, or with support of willing others, or with assistance of services in the community As a consequence they are unlikely to achieve one or more personal outcomes unless the local authority provides or arranges support for the carer or care for the cared for person

Care and support planning

Care and support planning Local authorities must provide, and keep under review a care and / or support plan for individuals with eligible needs A named individual to co-ordinate the preparation, completion, review, delivery and revision of the plan Restriction of Adoption Reports Regulations 2005 Services provided to deafblind people are appropriate Individuals must be clear when a financial contribution is required as part of the care and support plan [FACILITATORS NOTE: this slide has animation]

Format and content of plans Principles Format of plans Content of plans Well-being, person-centred and outcome-based Clear and concise Safeguarding Integrated Based on NMDS Agreed by the local authority and health Welsh language built in Outcomes Need for support and resources Actions and how monitored Direct payments

Portability of plans When an individual with a care and support plan moves from one authority to another in Wales the plan moves with them until a new assessment is completed This does not apply to plans provided under discretionary powers There is an expectation that good practice will apply when a person moves across national boundaries to minimise disruption of the care and support provided to that person

Review of plans Encourages the individual to continue to maintain control over their support If the plan is not meeting the assessed needs then it must be reviewed irrespective of a review date Review must ensure that the person and / or their carer, family members or advocate is an active participant Authorised persons involved in the review for those who lack capacity In the case of a child the person(s) with parental responsibility and other professionals involved [FACILITATORS NOTE: this slide has animation]

Direct payments Care and support from their local authority Flexibly and innovatively – no unreasonable restrictions Long-term residential settings Care and support from their local authority Paying family members Becoming an employer

Charging and financial assessment

Charging and financial assessment Discretion to set a charge for residential and non-residential care and support for adults – no charge for children Deferred payment agreements Flat rate charge for preventative services for adults – no charge for children No charge for some services for adults

Adults and children in the secure estate

Adults and children in the secure estate Duties for local authorities where adults are in the secure estate Duties for the ‘home’ local authority of children in the secure estate Some exclusions: being a carer, direct payments, choice of accommodation, property protected

Summary

Summary Choice, voice and real control Well-being What matters conversations Secure estate Rights Strengths National assessment and eligibility tool Integrated 5 key elements of assessment Direct payments