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Actions Following a Reablement Review

Amendment

In February 2024, this chapter was updated.

February 8, 2024

Following a review of the Reablement Plan there may be a need to change monitoring arrangements.

See: Changes to Monitoring Arrangements.

Following a review of the Reablement Plan there may be a need to revise the plan itself.

See: Revising a Reablement Plan.

You may need to consider changing reablement provision when:

  1. it has not been possible to resolve issues with the current provider of reablement through monitoring or review; or
  2. the current reablement provider confirms it is no longer able to provide the service.

Before changing you must take all reasonable steps to resolve the issues, as delays associated with changing provider will doubtless affect the progress made thus far.

If the current service is being ended because you have concerns about the provider, you have a responsibility to:

  1. take any appropriate action under safeguarding; and
  2. raise general concerns.

See Safeguarding Adults.

Also see: Reporting Concerns about a Service Provider.

The reablement service should be ceased/arranged in line with local processes and requirements.

In the following circumstances plans should be made to end reablement:

  1. It is no longer deemed appropriate through a process of review;
  2. All of the outcomes in the Reablement Plan have been achieved; or
  3. The person no longer consents to reablement (and has capacity to do so).

Reablement may also no longer be appropriate when:

  1. the person has not been able to demonstrate an ability to 'carry over' learning from one day to the next;
  2. the person has not been open to being supported in an enabling way; or
  3. the person has not demonstrated a desire to become more independent.

Decisions to end reablement (including the timeframe to end reablement) must give regard to:

  1. the views of the person about ending reablement;
  2. the impact of ending reablement on the person's wellbeing;
  3. the views of any carer about ending reablement; and
  4. the views of anyone else consulted or involved in the review process.

The decision about the timeframe to end reablement should take into account:

  1. whether there are any outstanding outcomes to be met by reablement and how long it may take to do so;
  2. whether there were any actions agreed in the review for the reablement service to carry out before ending reablement (for example, supporting a person to access a community activity or arrange alternative support);
  3. whether any ongoing needs are already being met through an existing Care and Support Plan; and if not
  4. how long it may take to carry out the care and support processes required to determine the eligibility of needs; or
  5. how long it may take to arrange urgent or interim care and support; and
  6. whether specific transitional arrangements between reablement and any new service are required.

It may be useful to develop a formal withdrawal plan to monitor outstanding actions and progress towards meeting ongoing needs so that reablement ends at an appropriate time.

If, following review, it is clear that the person no longer has any appearance of need at all, the duty to carry out any further assessment, determine eligibility and meet eligible needs does not apply.

In this situation you must:

  1. explain to the person that they do not have an appearance of need so are not eligible for further assessment or support from the Local Authority at this time;
  2. provide information and advice about what can be done to prevent or reduce the development of needs in the future;
  3. explain what they should do if their needs change;
  4. carry out any outstanding actions agreed at review; and
  5. arrange to end reablement.

All of the above information should be provided in writing when it is originally communicated via telephone.

If the person disagrees

The only ground upon which the Local Authority can lawfully refuse any adult an assessment is where there is no appearance of need. It does not matter whether the appearance of need is likely to prove eligible after any assessment. As such, it is unlikely that many people who request an assessment will be refused.

If the person does not agree with any decision that you have made that they do not have any appearance of need, you should discuss this with your line manager to be sure that the decision to refuse an assessment is legally sound.

Note: Under no circumstances must you ignore ongoing needs or close the case. The Local Authority has a duty to determine the eligibility of assessed needs and to meet eligible needs and is in a breach of the Care Act if it fails to do so.

If the person has a Care and Support Plan that is meeting all needs, there is no further action required, other than notifying the allocated practitioner or service/team responsible for reviewing the plan of the reablement outcome.

If the person has a Care and Support Plan that does not appear to be meeting the person's needs, a review of the plan should be requested. This should be made to the allocated practitioner or team with responsibility for reviewing the plan. You should inform the person and seek their consent to make the review request, although even if the person does not consent you should still make the request. This is because the consent of the person is not required to request the review (only to carry it out).

When requesting the review, you should provide the following information:

  1. Why the review is being requested and the sense of urgency, specifically when reablement is scheduled to end;
  2. Whether the person has consented to the review;
  3. The information gathered during reablement to support the request;
  4. Whether there is a need to provide urgent or interim support.

If the person (or carer) is not happy about the request to review, they should be advised they can discuss this with the practitioner who contacts them to make review arrangements.

If the person does not have a Care and Support Plan, you will need to seek their consent to transfer their case to a more appropriate service/team so that eligibility can be determined and, if eligible, a Care and Support Planning process carried out.

Any process for transferring the case to another service area or team 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:

  1. The views and wishes of the person about which service/team would best support them must be regarded;
  2. The service/team must possess the skills, knowledge and competence to carry out the anticipated care and support functions; and
  3. The service/team must possess the skills, knowledge and competence to work with the particular person in question.

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.

You can proceed to end reablement when:

  1. there are no outstanding actions for the reablement service following the review;
  2. the person has been provided with all information and advice required (or that would be beneficial);
  3. steps have been taken to ensure that any eligible ongoing needs for care and support will be met from the time that reablement ends (either through urgent/interim services or through care and support planning).

The duty to provide good information and advice about Care and Support applies at all times.

See: Providing Information and Advice (which is part of the Care Act 2014) to read more about the duty to provide good information and advice, including the duty to make sure that information and advice is accessible to the person receiving it.

See also: Providing Information and Advice, which includes access to local and national information and advice resources (general and specialist).

Reablement 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 reablement and should also be explored. These could include health services, Occupational Therapy or Technology Enabled Care (including 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.

Information about local prevention services can be found in the Actions and Next Steps Procedure.

See: Actions and Next Steps (Reablement)

A financial assessment should be requested if:

  1. Reablement is to be extended beyond 6 weeks and the local policy is to charge; or
  2. the person has likely ongoing needs for care and support (as long as they consent to a pre-eligibility financial assessment taking place).

See the Charging and Financial Assessment Procedure for further guidance.

If, as part of any conversation you have with a person or their family, you become concerned that a vulnerable adult or a child is experiencing, or is at risk of, abuse or neglect you must respond appropriately.

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.

Where the safeguarding is in respect of the person receiving reablement, a decision will need to be made about the need to pause the reablement process to allow a safeguarding enquiry to take place.

There are 2 possible options:

  1. The reablement process continues alongside any safeguarding process; or
  2. Reablement is paused with no ongoing intervention by the person whilst a safeguarding process takes place.

Any decision should involve the reablement service, the person who will be carrying out any safeguarding process, the person with Care and Support needs (or their representative) and any carer.

You must consider any appropriate action required to authorise deprivations of liberty whenever:

  1. the person lacks capacity to make decisions about the care and support provided to them; and
  2. you feel the level of restriction being imposed on the person is depriving them of their liberty; or
  3. you feel the level of restriction required to meet their care and support needs following assessment is likely to deprive them of their liberty.

See: Recognising and Responding to Deprivations of Liberty.

During the review of reablement you may identify concerning practice relating to:

  1. an external provider of reablement;
  2. an organisation providing other care and support to the person.

See: Reporting Concerns about a Service Provider.

The Local Authority encourages you to raise concerns as soon as possible about the practice of any individuals (whether they are employed by the Local Authority or not) that you feel:

  1. compromises the safety or wellbeing of a person with care and support needs; and/or
  2. compromises the safety or wellbeing of a carer with support needs; and/or
  3. compromises the safety of a child.

This is called whistleblowing. See the Whistleblowing Procedure.

Last Updated: February 8, 2024

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