1. Assessing and Meeting the Needs of Individuals

2. 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
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3. Contents Introduction Assessment principles and process Eligibility
Care and support planning
Charging and financial assessment
Adults and children in the secure estate
Summary

4. 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
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5. 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

6. 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
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7. 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

8. Human rights

9. 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
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Yes
 Duty to arrange for independent professional advocate No

10. Barriers to participation
Understanding relevant information
Retaining information
Using or weighing up the information
Communicating their views, wishes and feelings
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Is there a need for an advocate?
Does the person have capacity?

11. 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

12. Assessment principles and process

13. 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
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14. 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

15. 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

16. 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
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17. 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!
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18. 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

19. 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

20. 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

21. 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.
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22. Assessment of children

23. 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

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

25. 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
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26. 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

27. Eligibility

28. 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

29. 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

30. 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

31. 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

32. Care and support planning

33. 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
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34. 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

35. 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

36. 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
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37. 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

38. Charging and financial assessment

39. 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

40. Adults and children in the secure estate

41. 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

42. Summary

43. 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