1. Meeting needs LA arranging care and support Universal services: Preventive services, information and advice, community services First contact Needs assessment Carer’s assessment Eligibility determination Financial assessment “Personal plan”: Information and advice on meeting and preventing needs Duty/power to meet needs Independent personal budget Care and support plan/ Support plan Personal budget Care AccountReview Direct payment Individual arranging care and support Local authorities must put in place universal services, available to everyone in the community. This will include an information and advice service, and services intended to prevent, reduce or delay needs. LAs must also support the development of the market of local services, and understand the variety of services in the area. Safeguarding enquiry Individuals may access these universal services directly. Access to some services may be subject to an assessment or screening to ensure suitability. Some types of preventive service may be subject to a charge. For most people, the first contact with the LA will be through a contact centre or referral from another organisation. LAs will adopt different ‘triage’ processes, to determine the most appropriate response, based on the person’s needs and circumstances. If the person has needs which can be met by a universal service available locally, they will be given information on how to access it. If the person has needs for care and support, then they will be entitled to an assessment. The LA must carry out a needs assessment, or a carer’s assessment, where the person appears to have needs for care and support. The assessment must focus on needs and the outcomes the person wants to achieve, and the LA must involve the person, any carer, and anyone else nominated. During the assessment process, the LA must consider whether the person would benefit from any universal service, or anything available locally. The LA may extend the process to allow for any short-term services to be put in place (e.g. reablement). After completion of the assessment process, the LA must determine whether the individual has eligible needs. The LA must also determine the person’s ordinary residence status at this point. If the person has no eligible needs, the LA must nonetheless provide personalised information and advice on how to meet the needs they do have, and how to prevent or delay future needs. If the person has eligible needs, the LA must ascertain whether the individual wants the LA’s support (whether practical or financial) to meet those needs. This should include signposting and supporting access to services available locally, including universal services arranged by the LA. If the person does want the LA’s support to meet their needs, then the LA must consider what types of care and support might be appropriate, and whether those services are chargeable. If the person wants LA support, and the type of service being considered is chargeable, then the LA must carry out a financial assessment. The financial assessment will determine how much the adult, and how much the LA, will pay towards the cost of meeting the needs for care and support. If the person does not want LA support, then the LA must provide an independent personal budget, which sets out the notional cost of meeting their eligible needs. Along with the IPB, the LA must also provide personalised information and advice on how to meet their needs and to prevent or delay future needs. During the financial assessment, the LA should inform the adult where relevant of their right to a deferred payment agreement. The LA should also help the person to identify and access independent financial advice, where needed. If the adult has financial resources below the limit set out in regulations, then the LA will contribute towards these costs. The LA will be under a duty to meet the adult’s eligible needs. If the adult has financial resources above the limit, the LA will not pay towards the costs. But, if the adult asks the LA to meet their needs nonetheless, the LA will be under a duty to do so. The person will pay an admin fee in addition to the care costs. The person may decide that they do not want to undergo a financial assessment. The LA may accept a self-certification that they are able to pay the costs, and use its power to meet their needs. If the person decides after the financial assessment that they do not want LA support, then the LA must nonetheless provide an independent personal budget. If the LA is under a duty to meet the person’s eligible needs, or has decided to exercise a power to meet their needs, then it must help the person decide how their needs are to be met, through the preparation of a care and support plan (or support plan). The care and support plan must describe what needs the person has, and which needs the LA is to meet. The LA must seek to agree with the person how the needs are to met, including what types of care and support they may want. The care and support plan must also include the personal budget, to help the person make decisions about how to meet their needs. All adults with assessed eligible needs for care and support will also have a care account, to set out the notional costs which they have accumulated to date towards their cap on care costs. This could be part of the care and support plan, where the LA is meeting needs, or provided separately, alongside an IPB. After completing planning process, care and support will be put in place to meet the person’s needs. Adults with IPBs will arrange their own care and support. Adults with a care and support plan will have chosen how much control they wish to take over the arrangement of their care. The LA may hold the adult’s personal budget and arrange care and support for the adult, following their wishes. The adult may choose to take a direct payment to arrange their own care, which will be some or all of their personal budget. The LA will be under an ongoing duty to keep the adult’s care and support plan under review, to ensure that the needs continue to be met. The LA will review the plan periodically, involving the person and agreeing any necessary changes. The LA will also be required to review an IPB regularly, to ensure that the costs set out continue to reflect the adult’s needs. In both cases, the adult may ask the LA to carry out a review at any time. The review may lead to a revision of the care and support plan, including the personal budget, if changes are required. If the adult has an IPB, the review may lead to a revision of the care costs in the IPB. If the LA thinks that the person’s needs or circumstances have changed, it may carry out a new assessment of needs, or a new financial assessment. If there is no change, the needs will continue to be met as before (whether by the person or LA) The LA will also carry out a review when the person reaches the cap on care costs. If they have previously had an IPB, the LA may carry out a new needs assessment and a financial assessment. The LA will be under a duty to meet the eligible needs, but the adult may still pay for daily living costs (if the adult is in a care home) and any additional costs for more expensive care. If the person wants LA support, and the type of service being considered is provided free of charge, then the LA will be under a duty to meet the eligible needs, and no further financial assessment is needed. The LA will also be required to review the adult’s IPB or PB and update their care account annually, to reflect changes to account for indexation of care costs. The LA must write to the adult to inform them of changes to their IPB, PB and accrued costs in their care account, as well as changes to their cap on care costs. Safeguarding intervention Well-being principle: the local authority must promote the individual’s well-being in all decisions taken or activities performed in relation to them. 10 9 7 6 5 4 3 21 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 8