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 disability2. How will quality of life be improved by Services3. The cost of the service

Fair Access to Care Services ( Guidance – Eligibility Criteria) 2003National framework suggesting X 4 bands of seriousness to risk of individual

independence if problems/issues are not addressed:CRITICAL

SUBSTANTIALMODERATE

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 2008CSCI (2008) “Cutting the Cake Fairly” www.csci.org.uk

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” 2nd Ed PearsonBrayne H Carr H 2008 “Law for Social Workers” 10th Ed OxfordClements L Thompson P 2007 “Community Care & The Law” 4th Ed LAGMandelstam M 2009 “ Community Care practice & The law” 4th Ed JKP

Mike Ogley