Adult Social Care Law ELIIBILITY & FACS 1. Assessment & Need 2.“Fair Access to Care” (FACS 2003 Guidance) 3.Consultation on FACS ( 2009) 4.Future Aspirations Mike Ogley - March 2010

Assessment and Need The extent to which needs are met,depends on whether the LA has a duty or power to meet that need POWER discretionary - does not oblige LA to act (“may”) DUTY obliges LA to act (“shall”) Note > Duties can be General/Specific… the latter are immune from £ Crisis Need What people want or like, may not be the service a LA will provide Need is a dynamic concept, and varies over time in relation to: Changes in Legislation and Local Policy Availability of Resources Patterns of local demand

Need and FACS Key Assessment factors: 1.Nature +extent of person’s disability 2.How will quality of life be improved by Services 3.The cost of the service Fair Access to Care Services ( Guidance – Eligibility Criteria) 2003 National framework suggesting X 4 bands of seriousness to risk of individual independence if problems/issues are not addressed: CRITICAL SUBSTANTIAL MODERATE LOW

FACS Attempt by DH to achieve national consistency, as regard to use of limited resources The FACS focus is > consideration of Risk/Consequence to the person, if Services are not provided. Essentially a risk assessment which can priorise need CSCI regard FACS as a simple rationing devise. Concerns at exclusion of those on lower bands. How do individuals get support for basic tasks such as housework/gardening/shopping FACS has led to poor quality life experinces for those deemed ineligible ( “Lost to the System” 2008 )

Guidance on Eligibility Criteria for Social Care July 2009 (consultation stage) Recognition of FACS problems: Focus on greatest need Conflicts - ethos of “Putting people First” 2007 Ignores overall well being of community Services not integrated; confusing for Users Eligibility for Social Care 1. Greater clarity/transparency for the public 2. Higher thresholds( without prevention) results in higher demand

Eligibility Criteria 3. Definition Eligibility criteria describe the eligible needs that will be met by councils, taking their resources into account 4. Once assessed, councils decide if a person’s needs call for provision of community care services ( Use FACS eligibility framework of X4 Bands) 5. P.44 Guidance suggests councils consider people at “all levels of need”-regardless of eligible need to reduce or eliminate their dependency on social care support 6. P.46 –47 Emphasise areas of needs and outcome to considers 7. Emphasis on support being made available to sustain the caring role = independence and well-being

Eligibility Criteria Assessment > Good practice : Provision of Information Participation + Options +Choice Advocates: Supporters : Interpreters Person -centred ( Individuals are expert on their situations) Carers. Full consultation and support Assisting those not eligible : 1.Self Funders = highly isolated and vulnerable ( Advice and Information) 2.Exercise “caution and sensitivity” when withdrawing support. Provide signposting and support planning information

Eligibility Criteria Commissioning By 2011 development high quality services Twin development > Preventative Services + High Level need Services = flexible and tailored to meet needs and aspirations Monitoring - via Quality Care Commission 1. implementation of independence/well-being 2. High needs 3. The voice of citizens 4. Outcomes for the vulnerable 5. Effective publicity + advice Training –Workforce 1. Access to training/development 2. Organisational Culture of independence/choice/control 3. Skilled person -centred assessments 4. Proportionate Risk awareness 5. Attention to diversity and values 6. Ensure other agencies participate

References M Henwood Hudson B “Lost to the System.The impact of FACS” January 2008 CSCI (2008) “Cutting the Cake Fairly” D.H. (2009) “Prioritising need in context of Putting people first: A whole system approach to eligibility for social care” Guidance on Eligibility Criteria( consultation) Brammer A 2007 “Social Work Law” 2 nd Ed Pearson Brayne H Carr H 2008 “Law for Social Workers” 10 th Ed Oxford Clements L Thompson P 2007 “Community Care & The Law” 4 th Ed LAG Mandelstam M 2009 “ Community Care practice & The law” 4 th Ed JKP Mike Ogley