Care and support planning

Care Act 2014

Outline of content

Introduction Production of the plan Planning for people who are at risk of harm Planning for people who lack capacity Combining plans Sign off and assurance Summary

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Personalisation in social care and health

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The Care Act 2014

Our Health, Our Care, Our Say

Putting People First

Direct payments

Community Care

Reforms

Griffiths Report

Person centred care and support planning

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Person centred planning

Person not services

Emphasis on assets

and capabilities

First person

Person has control

The Care Act and person-centred planning

Care and support planning should put people in control of their care

The person must be actively involved and influential throughout the planning process

Independent advocates must be instructed early in the planning process for those who have substantial difficulty and have no other means of accessing appropriate support to facilitate their involvement

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Person-centred care and support planning

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Production of the plan

Involving the person Key elements Context Further considerations Direct payments Constraints

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Involving the person

The local authority must take all reasonable steps to involve the person, their carer and relevant others

The local authority must instruct an independent advocate if there is no one else that can facilitate involvement

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Key elements of the plan

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Needs and assetsAssessed and eligible

Co produced outcomes

How needs will be met/ reduced

Personal budgetOwn financial contribution

Direct payments

Final plan must include

Context

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Take a holistic approach

Record needs being met by carer

Consider a combined plan to meet both the person’s and carer’s

needs

Consider universal services and

community-based and/or unpaid support

Further considerations for the plan

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Be proportionate but compliant

with rules

Take account of fluctuating

needs

Make sense to the person

Must be agreed with

the person or their

representative

Direct payments

The local authority must inform the person which, if any, of their needs may be met by a direct payment

The person should be provided with appropriate information and advice concerning the usage of direct payments and how they differ from traditional services

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Constraints

There should be no constraint on how assessed, eligible, unmet needs are met as long as this is reasonable

The local authority has to satisfy itself that the decision is an appropriate and legal way to meet needs

Limited list of prescribed providers must be avoided

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The person prepares the plan jointly with the local authority

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Person’s Best

Interests

Secured Information

Appropriate people

Planning for people who are at risk of harm

The person will have been subject to and/or remain at risk of abuse or neglect

They will have been subject to a local authority section 42 enquiry into their situation and will have an agreed safeguarding plan

The plan must actively involve the person in agreeing what outcomes they want and how they will be achieved

While aiming to meet the person’s outcomes the plan must also balance risk appropriately by using the least restrictive options

The plan will be subject to review under the local multi-agency safeguarding procedures

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Planning for people who lack capacity

The Mental Capacity Act 2005 (MCA) requires local authorities to assume that people have capacity and can make decisions for themselves, unless otherwise established

A person must be given all practicable help to make specific decisions before being assessed as lacking capacity

Where an individual has been assessed as lacking capacity, the local authority must commence care planning under the ‘best interests principle’ within the meaning of the MCA

The duty to involve the person remains throughout the process

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Minimising and authorising deprivation of liberty for people who lack capacity

The Mental Capacity Act 2005 (MCA) provides legal protection for acts of restraint only if the act is:

necessary to prevent harm to the person

a proportionate response to the likelihood of the person suffering harm and the seriousness of that harm, and

in the person’s best interests

If the degree and intensity of restrictions and restraints are so significant that they amount to a deprivation of liberty, this must be authorised under the Deprivation of Liberty Safeguards (DOLS) under the MCA

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Combining plans

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Consider if multiple plans exist

Obtain consent from all parties

Establish a lead organisation

Sign-off and assurance

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Sign off

• Sufficient time has been taken to ensure the plan is appropriate to meet identified needs

Should

• There is consensus on the factors in the plan• Addresses how the needs in question will be met

Occur when

• Includes the final personal budget• Final agreement is recorded

Sign-off and assurance

In the event that the local authority decides that it cannot sign-off a plan, or where a plan cannot be agreed, it should state: the reasons for this the steps which must be taken to ensure that the plan is signed-off

The local authority must give a copy of the final plan to: the person for whom the plan is intended any other person they request to receive a copy their independent advocate if they have one

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Summary

The person must be actively involved throughout the planning process An independent advocate must be instructed at an early stage if a

person has substantial difficulty in engaging in the process The plan must describe what needs the person has, and which needs

the local authority is to meet The plan must include: the personal budget and direct payments The local authority must inform the person which, if any, of their needs

may be met by a direct payment The local authority must give a copy of the final plan to the person and

others requested by the person in an accessible format The local authority has a duty to keep the person’s plan under review

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