Additional Information
Book Details
Abstract
The Care Act 2014 is arguably the most significant piece of legislation for social workers who work with adults, since the NHS and Community Care Act 1990. The intention of this book is to present the information from the act, regulations and statutory guidance in a way that provides social workers with a good understanding of the legislation and how it applies to their role. Making extensive use of case examples that derive from the author’s experience as a social worker, the book highlights the circumstances where professional judgment is required and explores issues that need interpretation such as significant impact on wellbeing.
It covers the key stages of the ‘care and support journey' - first contact, assessment of needs, prevention, consideration of eligibility, charging and financial assessment, care and support planning, and review. In addition, other chapters look at significant issues such as safeguarding and working with NHS colleagues.
This book is intended to contribute to improving the ‘legal literacy’ of social workers, i.e. the connecting of legal rules with professional priorities and ethical practice. The approach used aims to help social workers to better understand the legal framework within which they make professional judgements, and to apply their expertise in interpreting the law for the benefit of people with care and support needs.
The core aims are to provide the following:
- a solid foundation for social work students in developing a critical understanding of the Care Act and its application,
- the material to help experienced social workers with developing the critical reflection necessary to enhance their ability to make professional judgements
- a source of reference which social workers can use to evaluate their local systems, policies and procedures.
Pete is a freelance Care Act consultant and trainer. He has a background of working in many sectors of social care as a social worker, trainer, manager and policy developer. He was a member of the team that developed learning materials for the Care Act for Skills for Care. He is currently providing Care Act training for local authorities and for BASW. He was previously a member of the board of Skills for Care (November 2012 - November 2014). He has written articles on the Care Act published in Professional Social Work, and also ‘The A-Z of the Care Act 2014’ for Community Care Inform.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | Cover 1 | ||
| Half-title | i | ||
| Series information | ii | ||
| Title page | iii | ||
| Copyright information | iv | ||
| Table of contents | v | ||
| List of figures | vii | ||
| Meet the author | viii | ||
| Acknowledgements | ix | ||
| Preface | xi | ||
| Introduction | 1 | ||
| Part I The care and support journey | 5 | ||
| 1 First contact | 7 | ||
| Introduction | 7 | ||
| First contact prior to April 2015 | 8 | ||
| Key terms and definitions | 9 | ||
| The essential features of first contact | 10 | ||
| The gateway to assessment | 10 | ||
| First contact teams | 11 | ||
| Initial assessment at first contact | 12 | ||
| Information and advice | 12 | ||
| Appropriateness and proportionality | 13 | ||
| Difficulties with involvement | 13 | ||
| Meeting urgent needs | 13 | ||
| Ending the assessment | 14 | ||
| Applying the guidance using case examples | 14 | ||
| Mr K | 15 | ||
| Commencing an assessment | 15 | ||
| Concluding first contact | 15 | ||
| Alternative scenario | 16 | ||
| Meeting urgent needs | 16 | ||
| Ms W | 16 | ||
| Commencing an assessment | 16 | ||
| Concluding first contact | 17 | ||
| Mrs O | 17 | ||
| Commencing an assessment | 17 | ||
| Concluding first contact | 18 | ||
| Comment and analysis | 18 | ||
| Commencing an assessment | 18 | ||
| Concluding first contact | 19 | ||
| Conclusion | 20 | ||
| 2 Assessment of needs | 21 | ||
| Introduction | 21 | ||
| Assessment of needs prior to April 2015 | 22 | ||
| Key terms and definitions | 23 | ||
| The essential features of a suggested assessment framework | 25 | ||
| The components of a needs assessment | 27 | ||
| The impact of needs on wellbeing | 28 | ||
| Clarifying desired outcomes and how they can be achieved | 29 | ||
| Involvement of the person being assessed, carers and others | 29 | ||
| Impact of the person’s needs on family members and others in their support network | 30 | ||
| Sustainability of the carer’s role | 31 | ||
| What must be considered when undertaking an assessment | 31 | ||
| Appropriate assessment | 31 | ||
| Proportionate assessment | 31 | ||
| Fluctuating needs | 32 | ||
| Methods | 32 | ||
| Face-to-face versus online/telephone | 32 | ||
| Combined assessment | 32 | ||
| Joint or integrated assessment | 32 | ||
| Transition assessment | 33 | ||
| Supported self-assessment | 33 | ||
| The outputs of assessment | 34 | ||
| Preventing, reducing and delaying needs | 34 | ||
| The duty to consider what else can assist in meeting outcomes | 35 | ||
| Recording formats and duties | 36 | ||
| Knowledge and skills needed to undertake assessments | 36 | ||
| Applying the guidance using case examples | 37 | ||
| Mr K | 38 | ||
| Summary of first contact | 38 | ||
| Impact of needs and clarifying outcomes | 38 | ||
| Person-centredness and methods of assessment | 39 | ||
| Concluding the assessment | 40 | ||
| Ms W | 40 | ||
| Summary of first contact | 40 | ||
| Impact of needs and clarifying outcomes | 41 | ||
| Person-centredness and methods of assessment | 42 | ||
| Concluding the assessment | 42 | ||
| Mrs O | 43 | ||
| Summary of first contact | 43 | ||
| Impact of needs and clarifying outcomes | 43 | ||
| Person-centredness and methods of assessment | 44 | ||
| Concluding the assessment | 44 | ||
| Comment and analysis | 44 | ||
| Impact of needs on wellbeing and clarifying outcomes | 44 | ||
| Person-centredness and methods of assessment | 45 | ||
| Concluding the assessment | 46 | ||
| Conclusion | 47 | ||
| Reference | 48 | ||
| 3 Eligibility determination | 49 | ||
| Introduction | 49 | ||
| Eligibility framework prior to April 2015 | 50 | ||
| Key terms and definitions | 51 | ||
| The essential features of eligibility criteria | 52 | ||
| The national eligibility criteria for adults and national eligibility criteria for carers | 52 | ||
| Eligibility criteria for adults | 52 | ||
| Physical or mental impairment or illness | 54 | ||
| Specified outcomes | 54 | ||
| Unable to achieve an outcome | 54 | ||
| Significant impact on wellbeing | 54 | ||
| Eligibility criteria for carers | 55 | ||
| Needs that arise as a consequence of providing necessary care | 57 | ||
| The carer’s physical or mental condition | 57 | ||
| Specified outcomes | 57 | ||
| Unable to achieve an outcome | 57 | ||
| Significant impact on wellbeing | 57 | ||
| Needs met by a carer | 58 | ||
| Safeguarding | 58 | ||
| Non-eligible needs | 58 | ||
| Urgent need | 59 | ||
| The final decision | 59 | ||
| Recording formats and duties | 59 | ||
| Applying the eligibility criteria using case examples | 60 | ||
| Mr K | 61 | ||
| Summary of assessment | 61 | ||
| Desired outcomes and specified outcomes | 62 | ||
| Fluctuating needs | 62 | ||
| Needs deriving from physical or mental impairment or illness | 62 | ||
| Relationship between impairment/illness and specified outcomes | 62 | ||
| Needs deriving from providing necessary care | 63 | ||
| Applicability of the specified outcomes | 63 | ||
| Determining if the ‘unable’ condition is met | 63 | ||
| Significant impact on wellbeing | 64 | ||
| Alternative scenario | 65 | ||
| Excluding what the carer is doing | 65 | ||
| Involvement of the adult and carer, explaining the eligibility determination and next steps | 65 | ||
| Ms W | 65 | ||
| Summary of assessment | 65 | ||
| Desired outcomes and specified outcomes | 67 | ||
| Fluctuating needs | 67 | ||
| Needs deriving from physical or mental impairment or illness | 67 | ||
| Relationship between impairment/illness and specified outcomes | 67 | ||
| Applicability of the specified outcomes | 67 | ||
| Determining if the ‘unable’ condition is met | 68 | ||
| Significant impact on wellbeing | 68 | ||
| Involvement of the adult, explaining the eligibility determination and next steps | 68 | ||
| Mrs O | 69 | ||
| Summary of assessment | 69 | ||
| Desired outcomes and specified outcomes | 69 | ||
| Fluctuating needs | 70 | ||
| Needs deriving from providing necessary care | 70 | ||
| Relationship between necessary care and carer health or specified outcomes | 70 | ||
| Applicability of the specified outcomes | 70 | ||
| Determining if the ‘unable’ condition is met | 71 | ||
| Significant impact on wellbeing | 71 | ||
| Involvement of the adult and carer, explaining the eligibility determination and next steps | 71 | ||
| Comment and analysis | 71 | ||
| Desired outcomes and specified outcomes | 72 | ||
| Fluctuating needs | 72 | ||
| Needs deriving from physical or mental impairment or illness | 73 | ||
| Relationship between impairment/illness and specified outcomes | 73 | ||
| Needs deriving from providing necessary care | 73 | ||
| Relationship between necessary care and carer health or specified outcomes | 74 | ||
| Applicability of the specified outcomes | 74 | ||
| Applying the ‘unable’ criteria | 75 | ||
| Significant impact on wellbeing | 77 | ||
| Excluding what the carer is doing | 79 | ||
| Involvement of the adult and carer, explaining the eligibility determination and next steps | 79 | ||
| Conclusion | 80 | ||
| References | 81 | ||
| 4 The duty and power to meet needs | 82 | ||
| Introduction | 82 | ||
| Making decisions about meeting needs prior to April 2015 | 83 | ||
| Key terms and definitions | 84 | ||
| Essential steps | 85 | ||
| Limitations on meeting eligible needs | 85 | ||
| Application of the ordinary residence requirement | 85 | ||
| Adults subject to immigration controls | 86 | ||
| Conditions and constraints on meeting eligible needs | 86 | ||
| Agreement by the individual to needs being met | 86 | ||
| Needs being met by a carer | 87 | ||
| Care and support needs being met by other services | 87 | ||
| Charging and the duty to meet eligible needs | 88 | ||
| The power to meet non-eligible needs | 89 | ||
| Requirements that apply when needs are not going to be met | 89 | ||
| The timing of the financial assessment | 90 | ||
| Applying the statutory guidance using case examples | 90 | ||
| Mr K | 91 | ||
| Summary of assessment and eligibility determination | 91 | ||
| Ordinary residence | 91 | ||
| Agreement by the individual to needs being met | 91 | ||
| Needs being met by a carer | 92 | ||
| Charging and the duty to meet eligible needs | 92 | ||
| Meeting non-eligible needs | 92 | ||
| Requirements that apply when needs are not going to be met | 92 | ||
| The timing of the financial assessment | 93 | ||
| Ms W | 93 | ||
| Summary of assessment and eligibility determination | 93 | ||
| Ordinary residence | 93 | ||
| Agreement by the individual to needs being met | 94 | ||
| Care and support needs being met by other services | 94 | ||
| Charging and the duty to meet eligible needs | 94 | ||
| Meeting non-eligible needs | 95 | ||
| Requirements that apply when needs are not going to be met | 95 | ||
| The timing of the financial assessment | 95 | ||
| Mrs O | 95 | ||
| Summary of assessment and eligibility determination | 95 | ||
| Part II Safeguarding | 197 | ||
| 8 Safeguarding enquiries | 199 | ||
| Introduction | 199 | ||
| Summary of the system prior to April 2015 | 200 | ||
| Key terms and definitions | 200 | ||
| The scope of safeguarding enquiries | 202 | ||
| Aims, principles and definitions | 202 | ||
| The aims of adult safeguarding | 202 | ||
| The six key principles | 203 | ||
| Making safeguarding personal | 204 | ||
| What constitutes abuse and neglect | 204 | ||
| Options for protecting the adult | 205 | ||
| Carers and safeguarding | 205 | ||
| Safeguarding enquiries and safeguarding plans | 205 | ||
| Inputs, process and outputs | 206 | ||
| Purpose and objectives | 208 | ||
| Involvement, empowerment and consent | 208 | ||
| Proportionality | 209 | ||
| Partners | 209 | ||
| Safeguarding plans | 210 | ||
| The role of social workers | 211 | ||
| Record-keeping | 212 | ||
| Sharing information and confidentiality | 213 | ||
| Applying the guidance using case examples | 214 | ||
| Mr P | 215 | ||
| Details of the safeguarding concern | 215 | ||
| Decision to undertake a safeguarding enquiry | 215 | ||
| Views and wishes of the adult and their family | 216 | ||
| Assess the needs of the adult for protection, support and redress and how they might be met | 217 | ||
| Make decisions as to what follow-up action should be taken with regard to the person | 217 | ||
| Enable the adult to achieve resolution and recovery | 218 | ||
| Section 42 enquiry record | 218 | ||
| Mrs J | 219 | ||
| Details of the safeguarding concern | 219 | ||
| Decision to undertake a safeguarding enquiry | 220 | ||
| Views and wishes of the adult and their family | 220 | ||
| Assess the needs of the adult for protection, support and redress and how they might be met | 221 | ||
| Make decisions as to what follow-up action should be taken with regard to the person | 221 | ||
| Enable the adult to achieve resolution and recovery | 222 | ||
| Section 42 enquiry record | 222 | ||
| Mrs B | 223 | ||
| Details of the safeguarding concern | 223 | ||
| Decision to undertake a safeguarding enquiry | 224 | ||
| Views and wishes of the adult and their family | 224 | ||
| Assess the needs of the adult for protection, support and redress and how they might be met | 224 | ||
| Make decisions as to what follow-up action should be taken with regard to the person | 225 | ||
| Enable the adult to achieve resolution and recovery | 225 | ||
| Section 42 enquiry record | 225 | ||
| Mr Y | 227 | ||
| Details of the safeguarding concern | 227 | ||
| Decision to undertake a safeguarding enquiry | 227 | ||
| Views and wishes of the adult and their family | 228 | ||
| Assess the needs of the adult for protection, support and redress and how they might be met | 229 | ||
| Make decisions as to what follow-up action should be taken with regard to the person | 229 | ||
| Enable the adult to achieve resolution and recovery | 229 | ||
| Section 42 enquiry record | 229 | ||
| Comment and analysis | 231 | ||
| Details of the safeguarding concern | 231 | ||
| Decision to undertake a safeguarding enquiry | 231 | ||
| Views and wishes of the adult and their family | 232 | ||
| Assess the needs of the adult for protection, support and redress and how they might be met | 233 | ||
| Make decisions as to what follow-up action should be taken with regard to the person | 234 | ||
| Enable the adult to achieve resolution and recovery | 235 | ||
| Safeguarding plan | 235 | ||
| Conclusion | 236 | ||
| References | 236 | ||
| 9 Safeguarding – types of abuse, SABs and SARs | 237 | ||
| Introduction | 237 | ||
| The types of abuse and neglect | 237 | ||
| Physical abuse including | 237 | ||
| Domestic violence including | 238 | ||
| Sexual abuse including | 238 | ||
| Psychological abuse including | 238 | ||
| Financial or material abuse including | 239 | ||
| Modern slavery encompasses | 239 | ||
| Discriminatory abuse including forms of | 239 | ||
| Organisational abuse | 239 | ||
| Neglect and acts of omission including | 240 | ||
| Self-neglect | 240 | ||
| Domestic abuse | 240 | ||
| Financial abuse | 240 | ||
| Further information | 241 | ||
| Safeguarding Adults Boards (SABs) | 241 | ||
| Policies and procedures | 242 | ||
| Training | 242 | ||
| Prevention | 243 | ||
| Safeguarding Adults Reviews (SARs) | 243 | ||
| Part III Involvement – difficulties and disputes | 245 | ||
| 10 Substantial difficulty in involvement | 247 | ||
| Introduction | 247 | ||
| Advocacy arrangements prior to April 2015 | 248 | ||
| Key definitions in the legislation | 248 | ||
| Similarities between lack of capacity and substantial difficulty | 250 | ||
| The four areas of substantial difficulty | 250 | ||
| The four areas of mental capacity | 250 | ||
| Substantial difficulty in involvement | 251 | ||
| Making the judgement about substantial difficulty | 251 | ||
| Circumstances where a substantial difficulty judgement must be made | 251 | ||
| Some examples | 252 | ||
| Lack of mental capacity | 252 | ||
| Circumstances where a mental capacity judgement must be made | 252 | ||
| Assessment | 253 | ||
| Care and support plans | 253 | ||
| Safeguarding | 254 | ||
| Young persons | 254 | ||
| Support for people who lack capacity and/or have substantial difficulty | 254 | ||
| The combined mental capacity and substantial difficulty pathway | 254 | ||
| Independent advocate or appropriate person | 255 | ||
| The role of the independent advocate | 257 | ||
| Supporting the individual | 257 | ||
| Challenging decisions on behalf of the individual | 259 | ||
| The relationship between the local authority and the independent advocate | 260 | ||
| The IMCAs | 260 | ||
| Applying the guidance using case examples | 261 | ||
| Mr K | 261 | ||
| Mrs B | 262 | ||
| Mr Y | 263 | ||
| Comment and analysis | 264 | ||
| Conclusion | 264 | ||
| Reference | 265 | ||
| 11 Disputes | 266 | ||
| Introduction | 266 | ||
| Effective involvement | 266 | ||
| Managing disagreements | 266 | ||
| Complaints | 267 | ||
| Unarticulated disagreement | 267 | ||
| Appeals | 267 | ||
| Conclusion | 268 | ||
| Part IV Co-operating with partner organisations | 269 | ||
| 12 Working with the NHS and housing | 271 | ||
| Introduction | 271 | ||
| Working with the NHS and housing prior to April 2015 | 272 | ||
| Key terms and definitions | 272 | ||
| The care and support journey | 274 | ||
| Prevention | 274 | ||
| Assessment | 275 | ||
| Eligibility determination | 276 | ||
| Care and/or support planning | 276 | ||
| Boundaries between local authorities and the NHS and housing | 277 | ||
| NHS | 278 | ||
| Housing | 278 | ||
| NHS Continuing Healthcare | 278 | ||
| Hospital discharge | 280 | ||
| Assessment notices | 281 | ||
| Discharge notices | 282 | ||
| Timescales | 283 | ||
| Advance notice | 283 | ||
| Minimum periods | 283 | ||
| Delayed transfer of care (DTOC) | 284 | ||
| Applying the guidance using case examples | 285 | ||
| Mr K | 285 | ||
| Background | 285 | ||
| Acute episode | 285 | ||
| Assessment, eligibility and care and support planning | 285 | ||
| Alternative scenarios | 288 | ||
| Ms W | 288 | ||
| Background | 288 | ||
| Assessment, eligibility and care and support planning | 288 | ||
| Mrs J | 289 | ||
| Assessment, eligibility and care and support planning | 289 | ||
| Comment and analysis | 290 | ||
| Hospital discharge | 290 | ||
| Joining-up assessments and combining plans | 290 | ||
| Boundary issues with the NHS | 291 | ||
| Conclusion | 291 | ||
| NHS Continuing Healthcare | 291 | ||
| Integration | 292 | ||
| What next? | 293 | ||
| 13 Modifications and additions for young people and prisoners | 294 | ||
| Introduction | 294 | ||
| Young people in transition to adult care | 294 | ||
| Definitions | 295 | ||
| Significant benefit | 295 | ||
| Consent | 295 | ||
| Prisoners and persons in approved premises | 296 | ||
| Definitions | 296 | ||
| Ordinary residence | 296 | ||
| Exceptions | 297 | ||
| Preference for accommodation | 297 | ||
| Direct payments | 297 | ||
| Safeguarding | 297 | ||
| Limitations | 297 | ||
| Conclusion: Implications for professional judgement | 298 | ||
| Introduction | 298 | ||
| Duties, powers and suggestions | 298 | ||
| Care Act duties | 299 | ||
| Duties specified in the regulations | 300 | ||
| Duties specified in the statutory guidance | 301 | ||
| Powers | 301 | ||
| Suggestions in the statutory guidance about applying duties and powers | 302 | ||
| The mandate for social work and professional judgement | 303 | ||
| Roles that social workers should and could undertake | 303 | ||
| Preventing, reducing, or delaying needs for care and support | 306 | ||
| Significant impact on wellbeing | 307 | ||
| Meeting non-eligible needs | 307 | ||
| Sufficiency of the personal budget | 307 | ||
| Substantial difficulty in involvement | 308 | ||
| Conclusion | 308 | ||
| References | 310 | ||
| Index | 311 |