Actions and Next Steps (Occupational Therapy)
Amendment
In August 2024, this chapter was reviewed and updated with some text amendments. The Dementia Support Service was changed to the Memory Support Service in Section 1, Providing information and advice and a link was added. Information about the Motability Scheme was removed and replaced with a link to Motability in Section 3, Accessing another Prevention Service.
The Local Authority has a duty under section 4 of the Care Act to provide good general information and advice relating to Adult Care and Support wherever it is requested or would be of benefit. This duty applies equally in respect of all local residents regardless of whether the person with care and support needs is known to, lives in, or is already receiving services from the Local Authority.
See: Providing Information and Advice to read more about the duty to provide information and advice under the Care Act, including how information and advice should be provided and the specific information and advice requirements around finances.
Good information and advice plays a role in preventing or delaying people’s need for care and support, enabling people to make well-informed choices, to take control of their care and support and how they fund it.
This is about more than providing leaflets or factsheets; it is about good quality conversations with people as well as providing the right amount of information at the right time.
What is on offer:
Information and advice for Lincolnshire residents, their carers and families, and professionals about:
- Community support and providers;
- Activities and events;
- Venues, buildings and facilities in Lincolnshire;
- Home care agencies;
- Care homes; and
- Mental Health.
Who is it for:
Anyone can visit the website, view directories of helpful community organisations, and create a booklet of information.
How to access:
Tel: 0300 303 8789
Email: CTSL@ageuklsl.org.uk
Website: lincolnshire.connecttosupport.org
There is a range of printable factsheets and guides available in the ‘Leaflets, Booklets and Customer Information’ section of the Local Resource Library
The factsheets are intended for electronic use, e.g. viewing online or attaching PDFs to emails or for local printing/photocopying where people need a paper copy.
You can ask for information and advice to be sent out by Business Support. This will save you time and ensure the person is getting the information and advice they need. To make a request, there is a correspondence step in Mosaic which can be used at any time. This step can be left open to allow the allocated practitioner to use the step if further information and advice is required to be sent out. The correspondence step will need to be completed when the case involvement ends.
If the person is facing a difficult health decision or just does not know how to find out about available support, Healthwatch Lincolnshire can help.
Tel: 0205 820892 (9am to 3pm Monday to Thursday; 9am to 12pm Friday)
Email: info@healthwatchlincolnshire.co.uk
Website: www.healthwatchlincolnshire.co.uk/advice-and-information
The Mental Health helpline is a joint initiative across health, social care and the third sector providing free and confidential emotional support, advice and guidance across Lincolnshire.
Who is it for:
People feeling low, anxious or stressed who might benefit from speaking to someone, can speak to a highly trained and experienced support worker who will be able to provide appropriate support.
Tel: 0800 001 4331 (People can also self-refer by calling the 24/7 helpline)
Website: www.mhm.org.uk/ and www.lincolnshiretalkingtherapies.nhs.uk/how-we-can-help
A network of people and organisations which can help people to connect with the services and support that will most effectively meet their needs and enhance their lives. Support for carers and anyone with mental health problems.
Tel: 01522 300206
Email: info@shinelincolnshire.com
Website: shinelincolnshire.com/
A family of websites that bring together everything in the local community that boosts wellbeing.
Website: www.haylincolnshire.co.uk
An informative website with links to free to download apps and advice from the NHS, easy to access, tools and support that anyone can use to quit smoking, lose weight, get active etc.
Website: www.nhs.uk/better-health
Contact between person and Adult Care practitioners should be seen as an opportunity to identify issues of poverty, debt, and financial wellbeing. All practitioners should offer information and advice about benefits maximisation and debt support where required.
See: Welfare Benefits (Connect to Support Lincolnshire)
See: Benefits and financial support if you are caring for someone (LCC website)
People can also be supported by the following organisations to work out what benefits or tax credits they, or someone the care for is entitled to:
- Citizens Advice;
- Law Centres;
- Macmillan benefits advisors for people affected by cancer;
- Age UK benefits advice for older people;
- Gingerbread Single Parent Helpline;
- Money Helper – other free help and advice.
If someone is experiencing significant debt issues, they may be eligible for the Debt Respite Scheme.
See: Debt Respite Scheme (Breathing Spaces) Procedure
Mobility benefits and transport provision
Mobility benefits should not prevent people using a personal budget to fund transport costs associated with meeting needs to access their community. For example, accessing the community requires a car, a driver, fuel cost, and escort costs. Access to transport provided through mobility benefits and schemes such as Motability may enable the personal budget to be adjusted accordingly, based on what the benefit/Motability vehicle may reasonably enable the person to achieve. However, personal budgets should take into account additional costs over and above the vehicle required, to meet need.
Carers First provides information, advice and statutory services to carers.
See: Carers First
Lincolnshire County Council has teamed up with Carers UK to offer a Digital Resource for Carers in our area with digital products, online resources, local information and support for carers on a single platform.
Sometimes it is helpful to contact a well-known national organisation with a dedicated information and advice service or help-line. See: National Organisations with Information and Advice Helplines for details of some national organisations offering this service.
Some national organisations do not have dedicated information and advice services but can still provide such support upon request. See: National Contacts for Adult Care and Support for a wider range of useful national contacts for adult Care and Support.
You can also see the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment, including questions relating to Disabled Facilities Grants.
Information and advice must be provided in an accessible way so that the person for whom it is intended can best understand and make use of it.
If you feel the person for whom the information and advice is intended will need support to understand it, you should:
- consider whether the person has anyone appropriate who can help them to understand it;
- consider any steps that you can take to support them to understand it (for example, talking through the information over the telephone or summarising it in a simpler format); and
- consider the benefit of independent advocacy.
If the person has a diagnosis of dementia, it may be appropriate to make a referral to the Memory Support Service. They can help the person to understand information provided to them and to navigate the care system.
Under the Care Act, the Local Authority has a duty to not only provide information and advice where it is needed, but to ensure that the information and advice it provides has been effective.
Therefore, when information and advice has been provided, you should agree appropriate arrangements to follow up with the person to whom it was given in order to review how effective it has been.
The timescales for this follow up should reflect the individual circumstances and level of risk.
Where you are making arrangements for someone else to follow up on the information and advice you have given (rather than following up on it yourself), you must make sure that you have recorded this in a way that will ensure the person follows up on it at the agreed time.
Occupational Therapy is one of a range of services available where the focus is on the prevention, delay, or reduction of needs. However, other prevention services may also be beneficial alongside Occupational Therapy and should also be explored. These could include health services, reablement or Telecare.
Under Section 2 of the Care Act, the Local Authority has a duty to prevent needs for care and support/support whenever it identifies an opportunity to do so.
See: Preventing Needs for Care and Support to read more about the duty to prevent needs for Care and Support, including the types of prevention services recognised by the Care Act, when to provide prevention services and how to charge for prevention services.
All health and care professionals should be aware of frailty and identify where people would benefit from assessment and planning that minimises the impact of frailty on people’s wellbeing.
Triggers are:
- Are you older than 85 years?
- Are you male?
- In general, do you have any health problems that require you to limit your activities?
- Do you need someone to help you regularly?
- In general, do you have any health problems that require you to stay at home?
- In case of need, can you count on someone close to you?
- Do you regularly use a cane, a walker, or a wheelchair to move about?
A person hitting three or more of the seven triggers should be referred to their primary care team to request a full frailty assessment is undertaken. This referral should be made using the Lincolnshire Frailty Pathway Letter, which is available in Mosaic.
For more information about the Lincolnshire Frailty Pathway, including resources and a practice toolkit see: Lincolnshire Frailty Pathway.
The Wellbeing Service is a countywide service supporting adults across Lincolnshire and is delivered by a partnership of all seven Lincolnshire District Councils, known as Wellbeing Lincs.
The key principles of Wellbeing Lincs are to:
- enhance wellbeing;
- improve people’s access to support services;
- reduce and delay escalation to statutory services;
- provide direct support and signpost access to community resources.
The Wellbeing Service can support people with:
- loneliness and social isolation;
- disability;
- changes to financial circumstances;
- lack of family support;
- ill health;
- bereavement; and
- changing medical needs.
For further information and to find out how to make a referral see: Processes for Arranging All Support and Services Procedure.
What is on offer:
Go Smoke-free, Lose Weight, Move More, and Drink Less.
A free healthy lifestyle service helping Lincolnshire residents achieve or work towards improving their health, wellbeing and resilience.
Various offers of support are available in each of the four pathways and are currently provided through a hybrid model of onsite and remote delivery, via telephone for people who have difficulty accessing technology or web-based programs, such as seated exercise, weight management groups and yoga available if the person is eligible (see below).
Who is it for:
LCC staff, carers, and Lincolnshire residents aged 18+ (aged 12+ for smoke free) who have an interest in changing to healthy behaviours:
Smoke-free – any worker or resident in Lincolnshire who wants to stop smoking. They are up to four times more likely to quit smoking with support from OYL which offers nicotine replacement therapy combined with behaviour change.
Lose weight and eat well – BMI 30+ or 27.5+ for Black, Asian and Minority Ethnic (BAME) individuals. (NHS BMI calculator)
Move More - for anyone doing less than 150 minutes of physical activity per week.
Drink Less – for people consuming more than 14 units per week who want to reduce their alcohol intake.
How to refer: (Temporarily - self-referral)
Tel: 01522 705162
Email: hello@oneyoulincolnshire.org.uk
Website: www.oneyoulincolnshire.org.uk/lincolnshire-residents
The Motability Scheme is a simple method of leasing a new car, scooter or powered wheelchair. The scheme enables disabled people to use their government-funded mobility allowance to lease a new car, scooter or powered wheelchair every three years, or a Wheelchair Accessible Vehicle (WAV) every five years (for new WAVs) and three years for nearly new WAVs. For information about the scheme, see: Motability Scheme | Lease a car, WAV, scooter or wheelchair.
Useful Contacts
Personal Independence Payment and Disability Living Allowance Support
The Local Authority has a common law and legal duty to safeguard the confidentiality of all personal information. As an employee of the Local Authority you are bound contractually to respect the confidentiality of any information that you may come into contact with. Under no circumstances should such information be divulged or passed to any persons or organisation in any form unless you have authorisation to do so.
All information sharing that takes place must be in line with data protection legislation (namely the UK General Data Protection Regulation and the Data Protection Act 2018) and local policy.
See: Information Handling Policy
The Caldicott Principles must also be regarded. The Caldicott Principles are a set of principles that apply to the use of confidential information within health and social care organisations and when such information is shared with other organisations and between individuals, both for individual care and for other purposes. For further information, see: The Caldicott Principles.
Any unauthorised disclosure of confidential information may result in disciplinary action of individual prosecution under the Data Protection Act 2018.
For further information and guidance see: Providing Information about a Person or Carer.
It is important that the person making contact speaks to the right practitioner at the right time. Sometimes you may find that you are not the most appropriate practitioner to manage the contact.
When the person making the contact requests specifically to speak to or be contacted by a particular person, you should establish as quickly as possible whether the contact should be forwarded to that practitioner.
You should check available systems to establish whether the person is allocated to the practitioner they have requested to speak to.
You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the person. This will not be helpful to the worker or to the person as they will not be speaking to the right person to resolve the contact.
If the practitioner is not available
If the practitioner is not available, you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.
If you know when the practitioner is likely to become available, you should:
- inform the person of this;
- leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the person about when to expect a call back;
- undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required should the practitioner be unavailable for more than a few hours;
- agree with the person what they should do if the practitioner does not make contact at the expected time; and
- make a proportionate record of all the above.
If it is not clear when the practitioner will become available, you should:
- inform the person of this;
- leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person;
- undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required; and
- agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
- make a proportionate record of all the above.
When a written contact is addressed to a named worker you should establish, as quickly as possible, whether the contact should be forwarded to that practitioner.
You should check available systems to establish whether the person is allocated to the practitioner that the written contact is addressed to.
You should not transfer a written contact to a named worker if it is clear that the worker is not allocated to the person. This will not be helpful to the worker or to the person as they will not be dealing with the right person to resolve the contact.
Before transferring the contact, you should:
- confirm that the practitioner to whom the written communication is being transferred, is available within a reasonable timeframe for the action indicated by the contact, or that you have agreed with a manager how the contact will be managed;
- where the communication is a letter or an e-mail, whether the practitioner wishes to receive the original contact (if not this should be filed securely); and
- where a written response confirming the contact has been received is required or requested, agree who will provide this.
The most secure way to transfer a written contact is to send a message to the practitioner alerting them to the contact and where it can be found on the recording system.
Any original copies of e-mails must be sent via internal secure e-mail systems only and any original letters must be sent via internal postal services or secure delivery only.
If the practitioner is not available
If the practitioner is not available, you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.
If the practitioner is not available within a reasonable timeframe for the action indicated by the contact, you should:
- leave the practitioner a message alerting them to the contact, where it can be found on the recording system and any action undertaken, including what has been agreed with the person if contact has been made with them;
- undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required and writing any acknowledgement letter to confirm arrival of the contact;
- when the practitioner is not available within any timeframes indicted in the written contact or for more than a few days inform the person making the contact of this;
- agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
- make a proportionate record of all the above.
If, as part of any conversation or information gathering, you become concerned that a vulnerable adult or child is experiencing, or at risk of abuse or neglect you must respond appropriately by raising a concern.
See Safeguarding Adults, which also includes information about how to raise a children's safeguarding concern.
If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place, you should contact the police by dialling 999.
Whenever the outcome of a contact or referral is that the person will be involved in any Adult Care and Support process (including any assessment, or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person when:
- there is no appropriate other person to support and represent them; and
- they feel that the person would experience substantial difficulty being fully involved in the Care and Support process without support.
tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.
See: Advocacy Decision Support Tool
The Local Authority also has a power (but not a duty) to make advocacy available in other situations on a case by case basis if it deems this appropriate and is able to do so. This could include advocacy to support a person to understand information and advice, or advocacy to support a person to explore possible options available to them.
Having substantial difficulty is not the same as lacking mental capacity.
See: Determining Substantial Difficulty for information about how to determine substantial difficulty.
See the Mental Capacity Act 2005 Resource and Practice Toolkit, with guidance about assessing capacity and making best interest decisions.
An appropriate person for general representation purposes is not the same as an appropriate person for independent advocacy under the Care Act.
See: An Appropriate Other Person for information about the difference and how to establish whether there is already an appropriate person.
The role of an independent advocate appointed under the Care Act is not the same as the role of a general advocate or any other type of advocate (for example, an Independent Mental Capacity Advocate or an Independent Mental Health Advocate).
An independent advocate appointed under the Care Act must both facilitate and ensure the involvement of the person with substantial difficulty in the Care and Support process that is taking place.
For information about the ways in which an independent advocate should fulfil their role, see: The Role of an Independent Advocate.
People who lack capacity will likely be legally entitled to advocacy under both the Care Act and the Mental Capacity Act 2005.
The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have two advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.
There are various factors that should influence this decision (such as existing rapport with an advocate or whether any important decisions are likely to be the outcome of the care and support process) and the Local Authority must ensure that whatever it decides, it does not deny the person any of the specialist advocacy skills they need or are entitled to.
tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.
People eligible for an Independent Mental Health Advocate (IMHA) under the Mental Health Act 1983 will likely be entitled to advocacy under the Care Act.
The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have two advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.
There are various factors that should influence this decision (such as existing rapport with an advocate or the likely outcome of the care and support process) and the Local Authority must ensure that whatever it decides, it does not deny the person any of the specialist advocacy skills they need or are entitled to.
tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.
The advocacy referral can be made at any time and should be made without delay as soon as the duty applies.
The process
All referrals to the Advocacy service should be made via the VoiceAbility website which can be accessed on the following link: VoiceAbility | Advocacy and involvement.
Practitioners should start the mandatory ‘Adult Advocacy Monitoring’ step in Mosaic Once a referral has been submitted online, you will receive a copy of the completed referral from VoiceAbility.
This should be uploaded onto the Adult Advocacy Monitoring step.
The monitoring step asks Practitioners to record basic referral details and is a quick and easy way to ensure key information is captured.
The form asks:
- The details of an advocate if they are already involved;
- The date of referral;
- The type of advocacy service requested (drop down list);
- Closure reason (the form remains open until the Advocate has ended their involvement).
The form also allows you to:
- Upload the advocacy referral form to the step;
- Upload any closure documents to the step.
This is a simple way to keep all evidence related to advocacy in one place.
About VoiceAbility
VoiceAbility provide an independent advocacy service in Lincolnshire designed to help people gather and understand the information they need in order to express their needs and desires, and to support people to express those needs and desires. VoiceAbility use person centred techniques to ensure the service meets the needs of each person and time is spent developing methods which best suits the person requiring the service.
The types of advocacy provided by VoiceAbility in Lincolnshire include Care Act Advocacy, NHS Complaints Advocacy, Independent Mental Capacity Advocacy (IMCA), Independent Mental Health Advocacy (IMHA), Relevant Person’s Representative, Rule 1.2 Representative, Children and Young People Advocacy and Non-Statutory General Advocacy.
VoiceAbility Lincolnshire will help people to:
- have their feelings and opinions heard, respected and responded to;
- be involved in health and social care decisions made about them;
- have the support and confidence to question decisions;
- have their issues resolved as far as is possible;
- have support to access sources of advice and information;
- make an informed choice and take control;
- be supported in times of crisis;
- be supported to challenge discrimination and poor standards of service.
Referrals will be accepted from a wide range of sources including:
- in person, by telephone, correspondence, email;
- from a third party with the person’s consent (subject to agreed protocols);
- by a person acting in the best interests of a person who lacks capacity (subject to agreed protocols);
- Adult Care professionals;
- Health professionals;
- Safeguarding teams;
- Deprivation of Liberty Safeguards Team;
- Healthwatch Lincolnshire;
- Lincolnshire Partnership Foundation Trust (LPFT) staff;
- Local Authority and NHS complaints departments.
Additional information is available to Adult Care staff through the Advocacy and Involvement page on Lincolnshire County Council’s intranet.
Regardless of whether or not independent advocacy is available in the local area, the duty to provide it still applies. A failure to do so is a breach of this duty and of the law. It is the role of commissioners to ensure that advocacy services are in place and available when required, and it is the role of practitioners to make timely referrals to advocates to prevent unnecessary delays in the meeting of its duty.
If you are aware that advocacy support is required and is not yet available, you must not proceed to carry out any Care and Support process until it is in place.
In some circumstances urgent interim measures may need to be agreed without an advocate in place in order to reduce immediate risk to the person from inaction. However, care and support processes that will decide long term and important decisions must not be carried out without advocacy support.
The duty upon the Local Authority is to make independent advocacy support available to any person who requires it. Once made available the duty is met.
If a person decides that they do not wish to engage in the advocacy support that has been made available to them they do not have to do so, but the Local Authority must still provide it.
The Local Authority is expected under the Care Act to support the person to understand the role of an advocate and promote its benefit to them, so as to reduce the likelihood that they will not engage.
You should familiarise yourself with available local guidance that confirms who is responsible for maintaining or repairing equipment in a range of circumstances.
In Lincolnshire we have an integrated equipment service (LCES) and the current provider is NRS.
Where equipment maintenance is not the responsibility of the Local Authority you must remain mindful that meeting the person's needs remains the duty of the Local Authority at all times. There could therefore be a need to support the person to get the equipment maintained (for example, by contacting the repair service on their behalf) or to provide interim equipment or an alternative measure to meet the need whilst any equipment maintenance is carried out.
Direct support refers to the range of ways that an Occupational Therapy practitioner works directly with a person or a carer to ensure safe and effective use of equipment, aids or an adaptation.
Direct support includes supporting the person, informal and paid carers to safely and confidently use equipment or adapt to their environment after an adaptation.
Direct support:
- builds the person's confidence to use equipment and access their adapted environment;
- builds the confidence of any carers to use the equipment;
- ensures that people using the equipment are suitably skilled to do so;
- ensures that people using the equipment know when it may be faulty;
- reduces the risk of unsafe use of the equipment;
- reduces the risk of injury from unsafe or improper use of the equipment;
- maximises the effective use of the equipment or adapted environments to promote independence or prevent, reduce and delay needs.
Equipment and adaptations are usually provided following an allocation and assessment in the individual's own environment. The exceptions to this are:
- when adequate information has been gathered at point of contact, referral or through a duty conversation; and
- a decision has been made to provide equipment or minor adaptations; and
- arrangements are in place to appropriately review the safe use and effectiveness of the equipment or adaptations.
Where the outcome decision is for the person's case to be allocated to an individual worker to carry out an assessment (or other intervention) this allocation should take place in a timely way so as to:
- avoid any unnecessary delays to the person;
- reduce the risk of a deterioration in the situation; and
- maximise the use of measures that will prevent, delay or reduce needs.
Where there are a significant number of people awaiting allocation for further work or assessment there should be a fair and consistent prioritisation process in place that takes into account:
- the level of risk;
- the level of need;
- current support in place and the sustainability/effectiveness of this;
- the urgency;
- the likelihood of deterioration; and
- the potential for fluctuation.
An element of monitoring should be incorporated into any allocation process to ensure that you remain aware of every person's situation and are able to respond appropriately to any changes or need to re-prioritise allocation.
The Care Act recognises that each worker (regardless of whether or not they have a professional qualification) will possess specific skills, knowledge and experience that will enable them to carry out different care and support functions or work with particular people well.
Because of this, there is no expectation that a particular role should carry out a particular function; instead the Local Authority should allocate tasks to the most appropriate person for the job.
Allocation decisions should take into account:
- the skills, knowledge and experience of the worker in carrying out the function or process required;
- the skills, knowledge and experience of the worker in working with the particular needs of the person (for example, health needs or communication needs); and
- the views and wishes of the person themselves in relation to the skills required of the worker and who they feel would best support them.
tri.x has developed a tool that can be used as required to support allocation decisions.
Please refer to the LCC OT duty guide for detailed guidance and processes to follow.
Case screening
The Duty Manager (OT Team Manager or LP) is responsible for ensuring that all requests for a further conversation assessment or review are screened and that decisions are taken on the required response.
The Duty Manager should ensure that there is oversight of the teamwork box each working day.
All requests should be screened within 24 hours of being received. Where there is insufficient information on which to base a further conversation or allocation decision, further information should be sought by the Lead Practitioner, supported by their team. Where insufficient information is due to the quality of information gathering at the point of contact, area teams should feed back to the point of contact to remedy this, but will continue with the information gathering.
Safeguarding and risk
Any cases where there are safeguarding concerns including MARAC or an immediate risk of harm should trigger additional information gathering. In such cases where our involvement pre-dates electronic record keeping, historic files should be retrieved from storage and reviewed. Retrieving historic records should not delay allocation; however, any relevant information sought should inform whether any further action or alternative allocation is required.
Cases involving significant risk issues should continue to be marked using the warnings available in the Adult Care recording system.
Case allocation
All case allocation decisions should be made by the OT Team Manager or Lead Practitioner. The allocation decision should be made with consideration of:
- screening and review of the information available in the person's records;
- a judgement of the presenting risk issues, known or anticipated complexity of the casework required;
- the skills, experience and qualification of the practitioner needed to address the presenting situation; and
- the urgency of the case and the capacity and workload of the allocated practitioner.
OT Team Managers and Lead Practitioners should maintain a good understanding of capacity within the team.
Pending allocation: Pre-allocation letter
In all cases where screening and additional information gathering has determined that a practitioner is required to visit, but it is not possible to make an allocation, the person should be sent the "Adult Care pre-allocation letter" available within the Adult Correspondence – General work step from the Start menu in Mosaic.
This step is intended to notify Business Support to send out a letter on the team’s behalf.
This letter is a mandatory element of adult care procedure intended to:
- acknowledge that the request has been received and screened;
- advise that we will allocate a worker as soon as possible;
- provide assurance that cases awaiting allocation are being monitored;
- advising the person or their representative to contact the relevant team directly (rather than CSC) should there be any change in need or urgency of their situation.
This step can be used at any time and can be left open to allow the allocated practitioner to use the step if further information and advice is required to be sent out. The correspondence step will need to be completed when the case involvement ends.
Pre-assessment information and advice
The Adult pre-allocation letter is also intended to provide information and advice to people waiting for allocation for a further conversation, aid in their preparation for that, and consider how they would like to have their conversation undertaken.
Practitioners using this step can request that Business Support include relevant factsheets about what to expect, which will enable people to start the process of making notes for their next conversation or enable them to submit information that they feel will be important.
Sometimes it becomes clear that the required intervention would be better carried out or led by a different service area or team.
Any process for transferring a person's case between service areas or teams should be as simple and seamless as possible. It should involve the person and the potential services with the aim of reaching a shared agreement. Any transfer should not negatively impact the person or put them at risk through the delay of any care and support needs being met.
Though not a requirement, it would be prudent to apply the same criteria that the Care Act requires to be applied when deciding the most appropriate worker:
- The views and wishes of the person about which service/team would best support them must be regarded;
- The service/team must possess the skills, knowledge and competence to carry out the anticipated care and support functions; and
- The service/team must possess the skills, knowledge and competence to work with the particular person in question.
tri.x has developed a tool that can be used as required to support consistent decision making about team suitability.
See: Team Suitability Decision Support Tool
The service area or team receiving the case should make effective use of the information gathered thus far and not make the person (or anyone else previously consulted) repeat information unnecessarily.
Occupational Therapy (OT) Team boundaries are aligned to the district council areas. There are three OT teams:
East OT team: covers postcodes that fall within East Lindsey, Boston Borough and South Holland.
West Lindsey and Lincoln OT team: covers postcodes that fall within West Lindsey and Lincoln City.
North and South Kesteven OT team: covers postcodes that fall in North and South Kesteven.
Care should be taken with people living on the county border, as this convention does not always ‘respect’ county boundaries, and the postcode list is not designed to determine whether the person is a Lincolnshire resident or not. It is necessary to determine whether the person is resident in Lincolnshire prior to using the list, i.e. to which District Council do they pay Council tax, and then use the postcode list to determine which Lincolnshire OT Team is responsible for the case. As an example, a Lincolnshire resident with NG23 5** will be the responsibility of North and South Kesteven OT Team and a Lincolnshire resident with NG23 7** will be a West Lindsey and Lincoln OT case.
The postcode list is available in the Local Resource Library under Access to Information, Advice, and Services.
Occupational Therapy is often an integral part of many other Adult Care and Support interventions. As such many referrals will require an element of joint working, for example, when made by:
- a social work service carrying out a needs assessment;
- a health professional (for example, a community nurse);
- a service provider (for example, a domiciliary care provider or a day service);
- a reablement or rehabilitation service.
The Care Act encourages joint working within organisations and across organisations, permitting anyone carrying out a care and support process to make any arrangements it deems necessary in order to facilitate joint working.
Note: Neighbourhood working should be used where people with complex or long term conditions would benefit from a joint assessment and planning.
Where the Local Authority requests another party work jointly in some way to benefit the person with care and support needs, that party has a duty to co-operate with the request (unless by doing so they will be prevented from carrying out their own duties under the Care Act or other legislation).
For further information about the duty to co-operate under the Care Act, see: Co-Operation.
When you have been asked to work jointly with another service, team or professional you should contact them to confirm your involvement and discuss the most effective way to work together. The things you should establish include:
- the work they are doing/will be doing/have done and whether they have any information that you need to know or can use to avoid duplication;
- whether there are opportunities to co-ordinate systems and processes and, if so how this will be managed;
- what the expectations are in terms of joint working (for example, will you be expected to carry out a joint assessment, meet with the person together, produce joint records or just consult and share information);
- what the anticipated outcome of the joint work is (for example, joint funding of support, ongoing joint-work to monitor);
- what does the person with care and support needs know about the joint work to be carried out (and if they don't know who and how should this be explained);
- who will be the primary contact for the person (or their representative) to go to with any queries; and
- who will be responsible for communicating progress and decisions to the person.
See: Joint Work for further practice guidance about effective joint working.
If there are likely to be delays in your commencement of joint work, the person who requested the joint work will need to:
- consider whether to proceed with their intervention; or
- await your availability.
It is the responsibility of the person requesting joint work to make this decision (in agreement with the person and any carer) and to take steps to ensure that any urgent needs for care and support are met.
Any decision to request joint work should be made with the person (or their representative). Where the person is unable to provide consent to joint work, decisions should be made in their best interests.
Joint work requests should be made in the manner preferred by the service, team or professional to which the request is being made. This may or may not take the form of a referral.
The request should explain clearly the nature of the joint work required and any specific skills, knowledge and competence requirements to support allocation.
Last Updated: August 12, 2024
v135
