Care and support planning Care Act 2014

Outline of content  Introduction Introduction  Production of the plan Production of the plan  Planning for people who are at risk of harm Planning for people who are at risk of harm  Planning for people who lack capacity Planning for people who lack capacity  Combining plans Combining plans  Sign off and assurance Sign off and assurance  Summary Summary 2

Personalisation in social care and health 3 The Care Act 2014 Our Health, Our Care, Our Say Putting People First Direct payments Community Care Reforms Griffiths Report

Person centred care and support planning 4 Person centred planning Person not services Emphasis on assets and capabilities First person Person has control

The Care Act and person-centred planning  Care and support planning should put people in control of their care  The person must be actively involved and influential throughout the planning process  Independent advocates must be instructed early in the planning process for those who have substantial difficulty and have no other means of accessing appropriate support to facilitate their involvement 5

Person-centred care and support planning 6

Production of the plan  Involving the person  Key elements  Context  Further considerations  Direct payments  Constraints 7

Involving the person  The local authority must take all reasonable steps to involve the person, their carer and relevant others  The local authority must instruct an independent advocate if there is no one else that can facilitate involvement 8

Key elements of the plan 9 Needs and assets Assessed and eligible Co produced outcomes How needs will be met/ reduced Personal budget Own financial contribution Direct payments Final plan must include

Context 10 Take a holistic approach Record needs being met by carer Consider a combined plan to meet both the person’s and carer’s needs Consider universal services and community-based and/or unpaid support

Further considerations for the plan 11 Be proportionate but compliant with rules Take account of fluctuating needs Make sense to the person Must be agreed with the person or their representative

Direct payments  The local authority must inform the person which, if any, of their needs may be met by a direct payment  The person should be provided with appropriate information and advice concerning the usage of direct payments and how they differ from traditional services 12

Constraints  There should be no constraint on how assessed, eligible, unmet needs are met as long as this is reasonable  The local authority has to satisfy itself that the decision is an appropriate and legal way to meet needs  Limited list of prescribed providers must be avoided 13

The person prepares the plan jointly with the local authority 14 Person’s Best Interests Secured Information Appropriate people

Planning for people who are at risk of harm  The person will have been subject to and/or remain at risk of abuse or neglect  They will have been subject to a local authority section 42 enquiry into their situation and will have an agreed safeguarding plan  The plan must actively involve the person in agreeing what outcomes they want and how they will be achieved  While aiming to meet the person’s outcomes the plan must also balance risk appropriately by using the least restrictive options  The plan will be subject to review under the local multi-agency safeguarding procedures 15

Planning for people who lack capacity  The Mental Capacity Act 2005 (MCA) requires local authorities to assume that people have capacity and can make decisions for themselves, unless otherwise established  A person must be given all practicable help to make specific decisions before being assessed as lacking capacity  Where an individual has been assessed as lacking capacity, the local authority must commence care planning under the ‘best interests principle’ within the meaning of the MCA  The duty to involve the person remains throughout the process 16

Minimising and authorising deprivation of liberty for people who lack capacity  The Mental Capacity Act 2005 (MCA) provides legal protection for acts of restraint only if the act is:  necessary to prevent harm to the person  a proportionate response to the likelihood of the person suffering harm and the seriousness of that harm, and  in the person’s best interests  If the degree and intensity of restrictions and restraints are so significant that they amount to a deprivation of liberty, this must be authorised under the Deprivation of Liberty Safeguards (DOLS) under the MCA 17

Combining plans 18 Consider if multiple plans exist Obtain consent from all parties Establish a lead organisation

Sign-off and assurance 19 Sign off Sufficient time has been taken to ensure the plan is appropriate to meet identified needs Should There is consensus on the factors in the plan Addresses how the needs in question will be met Occur when Includes the final personal budget Final agreement is recorded

Sign-off and assurance  In the event that the local authority decides that it cannot sign-off a plan, or where a plan cannot be agreed, it should state:  the reasons for this  the steps which must be taken to ensure that the plan is signed-off  The local authority must give a copy of the final plan to:  the person for whom the plan is intended  any other person they request to receive a copy  their independent advocate if they have one 20

Summary  The person must be actively involved throughout the planning process  An independent advocate must be instructed at an early stage if a person has substantial difficulty in engaging in the process  The plan must describe what needs the person has, and which needs the local authority is to meet  The plan must include: the personal budget and direct payments  The local authority must inform the person which, if any, of their needs may be met by a direct payment  The local authority must give a copy of the final plan to the person and others requested by the person in an accessible format  The local authority has a duty to keep the person’s plan under review 21