Fair access to care services (FACS): prioritising eligibility for care and support
Review - Personalisation and the review process
Councils should be prepared to be flexible about the way in which reviews are carried out. Individuals should be consulted about which way works best for them. Councils might wish to ask service users where they would like to have the review and who else they would want to be involved.(‘Reviews’, DH, 2010, para 145)
Deidre’s story, part 2 – from joint review with GP, revised package of support
When Deidre’s condition deteriorated, her daughter wanted a review to consider her mother moving to a care home. Deidre wanted to stay at home. To achieve this, the review changed her care plan to four shorter visits a day. Discussion with her GP led to a personal health budget, telehealth, and visits to a local health centre. This coordinated action stabilised the situation.
The section on ‘Reviews’ in DH 2010 Guidance ’Prioritising need’ acknowledges that individual needs are likely to change over time and regular reviews of support plans are required. The review should cover key aspects of the person’s circumstances and the working of the support plan, including changes to outcomes, needs, risks, requirements, finances and coordination arrangements, as well as scope for widening the contributions the individual is making to family/community life. These changes may reflect improvement or deterioration in the individual’s or carer’s physical or mental health, requiring the expertise and advice of health professionals and NHS bodies. If people’s wellbeing is being promoted, their needs and levels of dependency may reduce or change over time, and they may therefore need less help and support.
Staff undertaking reviews must:
- Ensure the review process is proportionate, open and transparent, promotes the participation of individuals and carers, is correctly recorded and conforms to relevant council procedures and inter-agency agreements
- meet any additional needs of individuals or carers for support to participate in reviews, including those arising from a person’s limited capacity or communication difficulties
- recognise signs and symptoms of deterioration because of physical or mental health factors or emotional difficulties, and ensure the appropriate involvement of health care professionals and NHS bodies
- work with the individual, carers and relatives on managing the effects of any reduction or withdrawal of services or personal budgets resulting from the review process
- ensure the record of the review is in an accessible format and language, and is compliant with council and inter-agency agreements
- ensure that individuals, and where appropriate their support networks, have copies of the review, know how to raise any queries or concerns and know when the next review will take place
- promote positive relationships with individuals with low and moderate needs to ensure that if their needs change they are able to renew contact before problems reach a crisis
- in reviews for people with mental impairments, consider whether the Mental Capacity Act applies, including the involvement of an Independent Mental Capacity Advocate where appropriate
- have due regard to potential Deprivations of Liberty and refer to the Deprivation of Liberty Safeguards where staff think a Deprivation of Liberty may have occurred.
The White Paper sees personalisation as being achieved when a person has real choice and control over the care and support they need to achieve their goals, to live a fulfilling life, and to be included and connected with society. The Care Bill identifies the general duty of a local authority to promote the individual’s wellbeing. Health, wellbeing, independence and rights of individuals are at the heart of care and support. The Bill aims to ensure that there are timely and effective interventions to enable people to enjoy a good quality of life for longer.