Assessing and Meeting the Needs of Individuals

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

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 • People • Well-being • Prevention • Collaboration • The Social Services and Well-being (Wales) Act will be implemented from 6 April 2016 • It replaces many previous laws and gives effect to the policy set out in Sustainable Social Services for Wales: A Framework for Action • It brings in new duties and covers adults, children and carers

5. The Parts of the Act

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 andcarers who need support

7. Other overarching duties

8. Human rights

9. Assessment principles and process

10. Assessing the needs of individuals • 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

11. Changes to culture and practice

12. 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

13. 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

14. 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!

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

16. Barriers to participation Is there a need for an advocate? Does the person have capacity?

17. 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. Ifpeople 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 willNOT be eligible. If the identified need can only be met through a Care and Support Plan the identified need will beeligible. 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 eligiblemeet 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 tomeet 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

18. National assessment and eligibility tool National Minimum Core Data Set (NMDS) Analysis of all five elements of assessment Action taken to achieve personal outcomes Practitioner’s statement on how actions contribute to outcomes

19. Recording and sharing personal information • The NMDS ensures local agencies have a common baseline of information collected in all assessments, and individuals do not have to repeat the same details • 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 • Systems must be in place between local organisations to enable them to share information safely • Individuals must understand their rights to consent or refuse sharing of their personal information

20. 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

21. 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

22. Carer’s assessment 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.

23. Assessment of children

24. 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

25. Analysing risks for children

26. Review of assessments

27. Refusal of an assessment

28. Eligibility

29. 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

30. 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

31. 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

32. 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

33. Care and support planning

34. Care and support planning

35. Format and content of plans

36. 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

37. Review of plans

38. Direct payments

39. Charging and financial assessment

40. Charging and financial assessment

41. Adults and children in the secure estate

42. Adults and children in the secure estate

43. Summary

44. The approach to assessment and eligibility is changing 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