Fair access to care services (FACS): prioritising eligibility for care and support
Initial contact - Signposting, information and advice
... everyone should be able to access high-quality information and advice to point them in the right direction for help.(‘Introduction’, DH, 2010, para 11)
Mrs Evans’ story – information, advice and signposting to the NHS and third sector
Mrs Evans is aged 75. Her daughter uses the newly opened call-in centre in the shopping mall to ask for information about falls. After a recent fall her mother is becoming less confident about walking. The worker provides information about the falls clinic and a third sector organisation for older people. She says that Mrs Evans can refer herself to the third sector organisation, but will need a GP referral to the falls clinic. Her GP will also identify whether any other action is necessary.
A theme throughout ‘Prioritising need’, reinforced in the White Paper and the Care Bill, is the importance of providing information, advice and signposting to people, whether or not they are eligible for publicly funded services. People approaching the local authority in this context are seeking sound, up-to-date information and advice to enable them to negotiate the complexities of the care, health and housing systems.
Many with the financial resources to permit self-funding report feeling totally abandoned, if the only response from the local authority is that their financial circumstances make them ineligible for support. Providing good information and advice is in the interests of individuals, carers and families, as well as the local authority in its responsibilities for prevention. Without good advice, self-funders can make poor financial and care choices (e.g. premature admission to a care home). If they run out of funds as a result, they become a charge on the local authority.
To provide high quality information and advice when people first make contact, staff need to:
- know how to access the wide-ranging information and advice that might be required in their job role, share this knowledge with people seeking support and with carers, and explain how people can access information for themselves in different formats and through a variety of media
- understand that what is familiar information to them is not necessarily known to individuals and carers, and that complex information can be harder to take in when people face new or increasing levels of need, uncertainty and anxiety
- encourage and enable individuals to make the most effective use of universal services, in conjunction with their own strengths, capabilities and resources, to live as independently as possible
- avoid screening individuals out too early on the basis of their ability to self-fund or other factors. Staff should ensure that signposting to other sources of support is clear and robust, and encourage people to come back if their circumstances change or their needs remain unmet
- challenge inappropriate, inaccurate and discriminatory information
- ensure that statutory advocacy (e.g. Independent Mental Health Advocates and Independent Mental Capacity Advocates) is available to those who qualify.
The Care Bill 2013, subject to parliamentary approval, will place duties on local authorities:
- to provide an information and advice service to help people understand how the care and support system works, what services are available locally, and how to access the services they need now and might need in the future
- to put in place universal services, which are aimed at preventing, reducing or delaying care and support needs
- to ensure that services are integrated locally to remove gaps and build services around the needs of people.