1. CARE ACT SEMINAR ASSESSMENT Correct as at March 2015

2. Promotion of wellbeing Eligibility Ordinary residence Assessment Support planning Review ASSESSMENT PRESENTATION

3. A theme through out the whole Act Has vital importance for Assessment But what is Wellbeing? PROMOTION OF WELLBEING

4. According to the Oxford Dictionary Wellbeing is: The state of being comfortable, healthy or happy

5. Wellbeing relates in particular to: Personal dignity Physical and mental health (emotional wellbeing) Protection from abuse and neglect Control over day to day life Participation in work, education, training or recreation Social and economic wellbeing Domestic family and personal relationships Suitability of living accommodation A person’s contribution to society PROMOTION OF WELLBEING

6. Why is this important? It underpins the whole Act not least the assessment process Applies to the person and their carer/family Can on some occasions apply to children, the carers of children and young carers

7. ELIGIBILITY A national context for eligibility This replaces FACS In NEL the priority framework will still apply

8. ELIGIBILITY An adult’s needs meet the eligibility criteria if: (a)The adults needs arise from or are related to a physical or mental impairment (b)As a result of the adult’s needs the adult is unable to achieve two or more of the outcomes specified in paragraph 2, and (c)As a consequence there is, or likely to be, a significant impact on the adult’s wellbeing

9. ELIGIBILITY The outcomes are: (a)Managing and maintaining nutrition (b)Maintaining personal hygiene (c)Managing toilet needs (d)Being appropriately clothed (e) Being able to make use of the adult’s home safely (f) Maintaining a habitable home environment (g) Developing and maintaining family or other personal relationships (h) Accessing and engaging in work, training education or volunteering (i)Making use of necessary facilities or services in the local community including public transport, and recreational facilities or services, and (j) Carrying out any caring responsibilities that adult has for a child

10. ELIGIBILITY The person is considered unable to meet these outcomes if he is: unable to achieve it without assistance; or is able to achieve it without assistance but doing so causes the adult significant pain, distress or anxiety, endangers his or others’ health or safety, or takes significantly longer than expected.

11. ELIGIBILITY The Care Act introduces a: a statutory requirement for a written record of the eligibility determination and the reasons for it If the person has no eligible needs, they should be given written information and advice on what can be done to meet or reduce the person’s needs, or to prevent or delay the development of needs in the future

12. ORDINARY RESIDENCE Crucial to determine which authority has responsibility Not a new concept has been in use for many years Difference for people and their carers Cannot be used to exclude someone from the assessment process The determination should not delay the assessment process

13. ORDINARY RESIDENCE Questions of both fact and degree Shah v London Borough of Barnet 1983 Voluntary and settled no minimum period When people lack capacity, Mental Capacity Act 2005 applies People without settled residence Placing into accommodation out of County: i) Nursing or care homes ii) Supported living or extra care housing iii) Shared living schemes

14. ORDINARY RESIDENCE S117 Aftercare under The Mental Health Act 1983 People in prison or bail hostels When people choose to change their ordinary residence

15. ASSESSMENT Key component of the care and support system Flexible and proportionate Joint assessments with other people or services Supported self-assessments Right to refuse an assessment Well-being consideration and documentation

16. ASSESSMENT Every adult with an appearance of care and support needs must be assessed Every carer with an appearance of support needs must be assessed Information should be given about the assessment process If necessary an advocate must be appointed Early targeted intervention must be considered All urgent needs must be met as quickly as possible Abuse and neglect must not be overlooked The MCA 2005 still applies to all aspects of assessment

17. ASSESSMENT The person must be central to the process Whole family approach Emphasis should be placed on the persons strengths Take into account fluctuating need Develop a meaningful conversation with the person rather than over reliance on assessment tools Preventative strategies should be used Information and advice on universal services Provide a record of the assessment

18. ASSESSMENT Carers can be eligible in their own right even if the person they care for is not A Carer’s assessment should be flexible and proportionate Need to consider joint assessment when consent is provided All carers should be given the same consideration The impact the caring role has on the carer’s wellbeing must be taken into account

19. SUPPORT PLANNING The person must be involved in drawing up their plan and their ownership encouraged A holistic view that covers aspirations should be taken All eligible needs must be recorded even if these are met by a carer or other individual or agency The plan should detail which needs are intended to be supported by public funds and how The personal budget must be clearly recorded with details of the cost of each element of the plan Direct Payments must be offered and carefully explained to the person and their carer so that an informed choice can be made

20. SUPPORT PLANNING Advice and information must be included to reduce need and prevent or delay further need If a Direct Payment is chosen the plan must detail the exact amount that will be made available to the person and the frequency that this will be paid Maximum flexibility should be looked at when drawing up the plans so they are easily adapted and to reflect creativity For carers the plan should clearly state the outcomes and their wishes regarding providing care, work, education and recreation. All plans must link back to the eligibility outcomes identified and signed as agreed by the person or their representative

21. SUPPORT PLANNING For people who lack capacity to plan their care MCA Act 2005 applies; best interest principle The least restrictive approach must be taken Planned restrictions and restraints must be minimised and consideration for DoLs recorded and reported for assessment as required

22. REVIEW Opportunity to reflect on the plan The process must involve the person and their carer but must be proportionate Consideration should be given to the use of an advocate Identification of change in needs which means a complete revision of a plan will need a reassessment Light touch changes to the plan can be undertaken without review

23. REVIEW Planned reviews – agreed date with the person at time of production Unplanned review – at time of change A requested review – by the person or their carer/family

24. REVIEW All changes must be recorded in full Reviews must be carried out within 12 months with a light touch at 6/8 weeks following creation of the plan The person should be provided with details of the review and how to request a review following a change in circumstance

25. RECAP Promotion of wellbeing Eligibility Ordinary residence Assessment Support planning Review

26. ANY QUESTIONS?

27. Presented by: Christine Jackson Head of Case Management, Performance & Finance (FOCUS) For further comments / queries: NELCCG.workforce-FAQ@nhs.net NELCCG.workforce-FAQ@nhs.net