Working together to support disabled parents
The policy and legislative frameworks - The responsibilities of adults' social services
Adults' social services have responsibilities laid down by community care legislation and children's legislation.
- Assistance with daily living
- Adults’ social services’ responsibilities concerning children
- Direct payments
The Chronically Sick and Disabled Persons Act 1970 and the Chronically Sick and Disabled Persons (Northern Ireland) Act 1978 require local authorities to make available information about the services they provide for disabled people and to ensure that disabled people know about local authority services and relevant services provided by other organisations. Whether or not someone is eligible for help from adults’ services, the local authority must provide information about other sources of support and advice.
Fair access to care services policy guidance also requires that local authorities make available information about assessment and eligibility criteria, including information about direct payments. (16) (17)
Part 3 of the Disability Discrimination Act 1995 gives disabled individuals the right to 'reasonable adjustments’ to be made in the way information is provided, so that it is accessible to them. The Disability Discrimination Act 2005 places a responsibility on public bodies to ensure that disabled people generally have equal access to their services (including the provision of information).
Adult community care legislation and guidance lays down a framework for the assessment and meeting of needs for daily living. Adults who come within the definition of disabled person within community care legislation, or who 'appear to be in need of community care services’ are entitled to an assessment of their needs. (18) (19) (20)
LAC(93)10* set out clearly that, when assessing whether someone is eligible for community care services, councils have a general duty not to '… fetter their discretion …’ and to consider each individual’s circumstances. This has been confirmed by subsequent case law.(21) Operating blanket policies in community care services would breach the duty to assess an individual’s need for services. General exclusions, using a particular level of IQ for example, are unlikely to be lawful.
*Note: Department of Health, 1993. Approvals and directions for arrangements from 1 April 1993 made under schedule 8 to the National Health Service Act 1977 and sections 21 and 29 of the National Assistance Act 1948, LAC(93)10, London: Department of Health
Fair access to care services policy guidance states that assessments should be '… rounded and person-centred …’ and take into account housing, health and other needs.(22) (23) The assessment should include what support is required to fulfil family roles and responsibilities. The assessor should recognise that '… individuals are the experts on their own situation and [should] encourage a partnership approach to assessment’. During the assessment process, the person being assessed should be given every opportunity to express their views and, if necessary, assistance (such as an advocate) should be provided to enable them to do this.
Fair access to care services also sets out the framework for determining eligibility for services. Family roles and responsibilities must be taken into account in all four eligibility levels set out in the guidance. In determining eligibility, for example, 'critical’ level includes '… vital family and other social roles and responsibilities cannot or will not be undertaken’, while the 'substantial’ level includes '… the majority of family and other social roles and responsibilities cannot or will not be undertaken’.(24)
When determining eligibility, social services should take into account any risks in the short- and long-term to the ability of the parent to carry out family roles and responsibilities. This consideration should cover not only risks to a parent in not being able to fulfil their parenting roles but also risks to children and other family members and carers. Adults’ services are therefore required to take into account the possible effects of not meeting levels of need which currently do not qualify as 'critical’ or 'substantial’. 'The council should have satisfied itself that needs would not significantly worsen or increase in the foreseeable future for the lack of help, and thereby compromise key aspects of independence, including involvement in … parenting responsibilities.’(25)
If adults’ services decide that someone is eligible for help a care plan must be written showing how eligible needs will be met. Services/direct payments should be provided in good time to prevent problems arising.
If an adult is receiving specialist mental health services, an assessment of needs and coordination of health and social services should be carried out using the Care Programme Approach.(26) This means:
- applying systematic arrangements for assessing all aspects of the person’s needs
- implementing a care plan which identifies the ways in which assessed needs will be met
- appointing a key worker to keep in close touch with the service user and to monitor and coordinate care
- regularly reviewing and, where necessary, agreeing changes to the care plan.
Direct payments guidance states that assessments of whether someone should pay anything towards the cost of a service/direct payment should be accompanied by welfare benefits advice and that service users should be provided with assistance in completing benefit claims and follow-up action.(27) (28) (29)
When responding to a referral for community care services, adults’ social services have a statutory responsibility to check whether the person has parenting responsibilities for a child under 18 and if so to explore any parenting and child-related issues in accordance with the Framework for the assessment of children in need and their families.(30)
The Children Act 1989/Children (Northern Ireland) Order 1995 places a corporate duty on local authorities to safeguard and promote the welfare of children. Fair access to care services affirms this by requiring adults’ services to address their duty to safeguard and promote the welfare of children when determining eligibility for adult community care services. 'Where appropriate, councils should consider the use of the Framework for the assessment of children in need and their families to explore whether there are any issues relating to children in need and their parenting. The assessment framework should be used if it appears that there are children in need. On occasions, within one family, it may be necessary to concurrently assess the needs of an adult parent using the appropriate format for adult assessment, and the needs of the children and related parenting issues using the assessment framework’.(31)
Direct payments guidance states that where someone has been assessed as having eligible needs for support then direct payments must be offered as an alternative to services to anyone '… who appears to the council to be able to manage them (either alone or with help)…’ (32) Payments can be made directly to the person who needs the assistance, or to someone who will manage the payments on their behalf.(33) For Northern Ireland see Direct payments: legislation and guidance for boards and trusts.(34) For Wales see Direct payments guidance: Community care, services for carers and children’s services (direct payments) guidance.(35)
The direct payments guidance also states that 'Councils should not make blanket assumptions that whole groups of people will or will not be capable of managing direct payments’ and that any judgement about whether someone is capable of using a direct payment should be made on an individual basis, taking into account the views of the individual and the help that may be available to him or her. Where an individual does not agree with the council’s judgement, they should have access to advocacy and, if available, arbitration, to ensure that their arguments are properly considered, or access to the council’s complaints procedure.’(36)
Fair access to care services practices stresses that 'Councils should ensure that needs assessments for disabled adults include parenting responsibilities’(37) and that direct payments can also be given in lieu of services provided under the Children Act 1989: 'In the interest of the family and to avoid duplication, local councils should ensure the assessment process is streamlined and coordinated between adult and children’s services and other relevant departments such as education.’(38) Fair access to care services practice guidance states that 'It will be important for children and family teams to have agreed policies and protocols with adult teams on how to respond to the needs of families where the parent is disabled.’(39)
Advice and support services should be available to assist a person to decide whether they want direct payments and to provide any help they may need in using them.(40) These support services should be accessible, taking into account particular needs of people with learning disabilities (41) and advocacy services should also be available for those who need them to use direct payments.(42)
If a person is receiving at least £200 week (or the equivalent in services) from their local council and they receive the higher rate of Disability Living Allowance care component, they can apply to the Independent Living Fund for a grant to meet any additional needs that they have for personal assistance.
Housing needs should be covered in a community care assessment and, if appropriate, adults’ services should involve the housing authority in the assessment and care plan.(43) Parents and children may be entitled to help with accommodation if they cannot stay where they are living because of violence, if they are staying with family/friends, they cannot live with all members of their normal households in their current accommodation, or their current housing conditions are damaging their health.(44) For Northern Ireland, see the Housing (Northern Ireland) Order 2003.
Households with a disabled adult or a disabled child may be entitled to assistance with adaptations to their property, through the Disabled Facilities Grant system and the Chronically Sick and Disabled Persons Act 1970/Chronically Sick and Disabled Persons (Northern Ireland) Act 1978. Section 23 of the Housing Grants, Construction and Regeneration Act 1996 lists the purposes for which a Disabled Facilities Grant must be approved, subject to the provisos laid out in the Act. The provisos include making sure that the disabled person is able to care safely for anyone who relies on them for care. A guide on housing adaptations sets out the relevant legislation and guidance, and recommends good practice.(45)