Contact and Referral Adult Care and Support Procedures

Referrals for adult care and support interventions cannot be taken unless:

1. the person or carer the referral relates to is making the referral;
2. the person or carer the referral relates to has given their consent to the referral; or
3. the person that the referral relates to lacks mental capacity to make a referral and a decision has been made under Best Interests that a referral should be made; or
4. the person that the referral relates to is at risk of harm from abuse or neglect.

Requests for a review of an existing Care and Support/Support Plan can be made by anyone who has a concern that a plan may not be working as intended or a person's needs have changed. However, the person or carer whose plan it is must be consulted when deciding how to respond to the request, so it is important that wherever possible they know the request is being made from the outset.

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 and create a booklet of information, and view a directory of helpful community organisations.

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 NHS 111 telephone service includes support for Mental Health - ring 111, and select option 2 for Mental Health.

This service is available 24 hours a day, 7 days a week for all ages, and people can use this number if they have an urgent mental health concern themselves or about someone they know.

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 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 people 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.

Sometimes it is helpful to contact a well-known national organisation with a dedicated information and advice service or helpline. 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:

1. consider whether the person has anyone appropriate who can help them to understand it;
2. 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
3. consider the benefit of independent advocacy.

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.

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:

1. Are you older than 85 years?
2. Are you male?
3. In general, do you have any health problems that require you to limit your activities?
4. Do you need someone to help you regularly?
5. In general, do you have any health problems that require you to stay at home?
6. In case of need, can you count on someone close to you?
7. 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 minute 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.

The scheme is available to anyone who receives one of the following and has at least 12 months’ award remaining:

• the Higher Rate Mobility Component of the Disability Living Allowance (DLA);
• the Enhanced Rate Mobility Component of Personal Independence Payment (PIP);
• the War Pensioners’ Mobility Supplement (WPMS);
• the Armed Forces Independence Payment (AFIP).
• the Higher Rate Mobility Component of Child Disability Payment (Scotland) as of July 2021.

Motability Car Leases and Wheelchair Accessible Vehicles 

A standard Motability car lease can be taken out for three years and is a regular car that is available through the scheme.

Motability Scheme leases generally run for five years for new Wheelchair Accessible Vehicles (WAV) and three years for Nearly New WAVs. A WAV is a vehicle that enables a disabled person to travel as a passenger whilst seated in their wheelchair. Other vehicles that allow the disabled person to drive from their wheelchair are also available, which enable people to drive without needing to transfer to a seat.

Every lease includes:

• insurance;
• servicing and maintenance;
• full breakdown assistance;
• replacement tyres;
• replacement batteries for scooters and powered wheelchairs;
• 60,000 mileage allowance for over three years, or 100,000 over five years for a WAV;
• annual Car tax;
• windscreen repair/replacement;
• many adaptations at no extra cost.

Leasing a car or Wheelchair Accessible Vehicle (WAV) will also cover:

• 20,000 mileage allowance per year of lease;
• window and windscreen repair or replacement;
• a choice of adaptations, many at no extra cost.

Vehicles are available at a number of different costs, some of which are lower than the weekly allowance, but with some more expensive cars an additional payment, known as the Advance Payment, will be needed to cover the cost of the lease.

Adaptions to vehicles are also available through the Motability Scheme in order to support a person’s needs as effectively as possible, as well as providing them with a high level of safety and comfort. Adaptions include:

• vehicle access;
• equipment loading;
• driving adaptations.

Motability Scooter and Powered Wheelchair Leases

Motability Scheme leases generally run for three years from the date that you took delivery. Included with the wheelchair and lease are:

• a new scooter or powered wheelchair of the person’s choice every three years;
• help from specialist dealers;
• breakdown assistance from Motability Assist;
• replacement batteries and tyres;
• servicing, maintenance and repairs;
• insurance equivalent to fully comprehensive cover;
• weatherproof storage cover for when the product is not being used.

Useful Contacts

Motability

Personal Independence Payment and Disability Living Allowance Support

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:

1. there is no appropriate other person to support and represent them; and
2. 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.

See: Advocacy Decision Support Tool

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.

See: Advocacy Decision Support Tool

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 provides 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 uses person centred techniques to ensure the service meets the needs of each person and time is spent developing methods which best suit 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.

See: Advocacy and Involvement

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.

The purpose of consultation and information gathering is to ensure that the response of the Local Authority is a proportionate and appropriate one to the person's situation and level of need. Only information relevant to this purpose should be gathered during consultation.

All information gathering should be carried out with regard to the Caldicott Principles, Data Protection legislation and local information sharing policies.

The method of consultation and information gathering used should reflect the individual circumstances of the case. Depending on the level of urgency, risk and need, consultation and information gathering can be formal or informal in nature.

For example:

1. a telephone conversation;
2. an email or letter; or
3. a face to face meeting.

Where the method of consultation is not face to face you should be satisfied that the information you share will only be seen by the person for whom it is intended.

The Care Act is clear: Apart from cases where the level of risk is paramount you must consult with anyone that the person has asked you to consult with before making any outcome decision.

Examples of paramount risk could include:

1. where urgent action is required, that if delayed to allow consultation would place the person at imminent risk of abuse or neglect leading to serious harm;
2. where the person to be consulted is deemed to be the perpetrator of abuse and neglect and consulting with them at that time would place the person (or another vulnerable adult or child) at imminent risk leading to serious harm;
3. where urgent care and support provision is required, that if delayed to allow consultation would place the person at imminent risk of harm through the non-meeting of essential needs.

The person should be told why consultation has not occurred, and long term decision making should be avoided until such time when consultation is possible.

Where the person is known to have a carer, the Care Act expects you to consult with them before making any decision regarding care and support for the person.

The purpose of doing so is:

1. to gather information about the support they provide to the person; and
2. to understand the needs of the carer and fulfil the duty to meet them.

Where the person with care and support needs does not consent to you consulting with their carer, you should explain to them that you must still do so for the purposes above. However, the consultation should be limited to that purpose and other information about the circumstances of the person should not be shared or discussed.

You should proactively identify anybody else that it may be appropriate to speak with in order to gather comprehensive information upon which to decide the most appropriate outcome. This could be a family member, a health professional, another Local Authority or an organisation (such as a care and support provider).

With the consent of the person, the Local Authority is permitted under the Care Act to consult with anybody it deems it relevant to consult with, and anybody contacted by the Local Authority has a duty to co-operate with requests for information or support.

See: Co-Operation to read more about the duty to co-operate under the Care Act.

If there are concerns that the person may lack capacity to consent to you gathering information from or consulting with others, then a mental capacity assessment must be carried out to determine whether this is the case. This should be carried out by the Local Authority because it is the Local Authority who wishes to consult.

If the person has capacity to consent following the mental capacity assessment, their consent must be obtained before consulting others.

If the person lacks capacity to consent following the mental capacity assessment, then a Best Interest Decision must be made to confirm that consulting with others will be in their Best Interests. This decision should be made by the Local Authority because it is they who will be consulting.

See the Mental Capacity Act 2005 Resource and Practice Toolkit, with guidance about assessing capacity and making best interest decisions.

If you have received information that indicates a person may be at risk of abuse or neglect, you will need to consider the measures that you (or others) can take to protect them.

Where a safeguarding concern has not been raised already, you should raise a concern without delay.

See Safeguarding Adults

If you have received information that indicates that a person may pose a risk to others, you will need to consider the measures that you (or others) can take to reduce the risk and protect others.

See: Risk Assessment

If the risk assessment indicates that a vulnerable adult or child may be at risk of abuse and neglect, you must ensure that you raise a safeguarding concern without delay.

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.

Not everyone contacts the Local Authority in a timely way, so as to allow for an assessment and exploration of options to take place prior to any initial decisions being made about the need for care and support.

For example, some people only approach the Local Authority when they are in a time of crisis, high risk, or when there is a sudden or unexpected change in their wellbeing.

In these cases there may appear to be an urgent need for support that cannot wait for an assessment or review process to be carried out.

The Care Act recognises this occurrence and gives the Local Authority powers to meet such needs without having carried out a formal assessment process.

To see what the Care Act says about meeting urgent needs without an assessment or review, see: The Power to Meet Needs.

Having the power to meet needs without an assessment or review means that the Local Authority can decide whether or not to do so, based on the available information and specific circumstances of the person and their situation.

Under the Care Act, the Local Authority can put any interim or urgent measures in place that it deems appropriate to meet the needs of the person and manage the situation. This can range from a small number of domiciliary care visits to a stay in residential accommodation.

The same legal considerations apply when meeting urgent needs as they do when meeting non-urgent needs:

1. The impact on the person's individual wellbeing;
2. Whether any preventative service can be provided that will delay, reduce or prevent the need for care and support;
3. Whether information and advice can be provided to support the person to find their own solution, or to delay, reduce or prevent the need for care and support.

It is vital that you understand your duties in relation to the above. Please use the links below to access further information as required.

• Promoting Individual Wellbeing for information about the duty to promote individual wellbeing;
• Preventing Needs for Care and Support for information about the duty to prevent, reduce or delay needs;
• Providing Information and Advice.

In addition, you should be mindful that nobody has yet assessed (or reassessed) the needs of the person and you may be relying on historical information or information from sources currently under significant strain or pressure to act. As such, the information presented may or may not be an accurate reflection of the person's needs following an assessment.

Interim support should therefore only be seen as a temporary measure to reduce risk of harm, and support the person to a place in time where a needs assessment can be carried out and long term options explored and agreed with them. As such, you should be cautious about providing interim care and support that may be problematic to cease following assessment.

tri.x has developed a tool that can be used as required to support consistent decision making about the provision of urgent or interim support.

See: Urgent or Interim Support Decision Tool

All funding requests for urgent and interim support should be made in line with local processes and requirements.

It can be difficult to make a decision about the level of funding required to meet the urgent or interim care and support needs because:

1. there will be no personal budget allocated to the person; or
2. there will be a personal budget but this will not be based on their current needs.

The Care Act does not discuss or set funding limitations in relation to the provision of any care and support. This includes urgent and interim care and support. Instead, the golden rule of the Care Act when making any funding decision is that 'the amount of funding agreed must be sufficient to meet the needs that are to be met at that time'. Decisions must also be made in a way to ensure that the person will be satisfied the process was fair and robust.

Other than sufficiency, the factors that decision makers must consider are:

1. the views and wishes of the person about how their needs should be met;
2. the availability of other potential options in the marketplace; and
3. the cost of available suitable services in the marketplace.

Other factors that should be considered are:

1. the complexity of the person's needs;
2. the level of risk/sense of urgency; and
3. whether the practitioner requesting the funding has provided relevant information and advice, whether they have explored prevention services that may be appropriate and whether they have explored how the person's own networks of support could help; and
4. where the person is not ordinarily resident; if they receive care and support already in another Authority, the nature of the care and support they receive.

Decision makers should also take into account that the Local Authority is also permitted under the Care Act to consider how to balance its legal requirement to maintain universal services to the entire local population with the power to meet urgent needs. In doing so it must:

1. not base it's decision on finances alone;
2. consider things on a case-by-case basis; and
3. not set arbitrary limits (fixed amounts for a particular type of need or service).

The outcome of the funding decision should be communicated to the person at the earliest opportunity. The method of communication should reflect that requested by the person and any specific communication needs they may have. For the purposes of the Care Act, communication about the outcome of a funding decision is subject to the same requirements as the provision of information and advice, and the duty to make it accessible therefore applies equally.

Where communication is provided by telephone, a follow up letter confirming the conversation and the funding decision should be sent to the person as a formal record.

When communicating the outcome, you should include the following information:

1. the funding decision itself;
2. the rationale for the decision;
3. any information and advice relating to adult care and support, and the prevention, delay or reduction of needs;
4. what will happen next and the timeframes involved;
5. how to complain about any aspect of the decision or proposed outcome.

Any funding decision rationale should be clearly recorded in line with local recording requirements.

The Local Authority is not required to record urgent and interim support on a Care and Support Plan because:

1. the support is being provided under the Local Authority's powers (as opposed to duties);
2. the person has not yet been assessed (or reassessed); and
3. there has been no decision about eligible needs.

However, the following must be clearly recorded:

1. the urgent or interim support being provided;
2. the contribution to the cost of the support being made by the Local Authority;
3. the contribution being made by the person;
4. the duration of the support;
5. how the support will be reviewed;
6. what outcomes the support aims to achieve; and
7. the next steps, including timeframes for any assessment.

Under the Care Act, the process of arranging to meet urgent and interim care and support needs is the same as arranging to meet needs agreed through a non-urgent Care and Support Planning process.

The Local Authority is permitted under the Care Act to charge any person for care and support (including care and support provided on an urgent basis) unless:

1. it chooses not to; or
2. the person has been financially assessed as having insufficient funds to contribute; or
3. the support being provided is reablement (up to 6 weeks is non-chargeable); or
4. the support being provided is equipment (up to the cost of £1000 is non-chargeable).

For further information about charging for all services under the Care Act, see: Power of the Local Authority to Charge.

See the Charging and Financial Assessment Procedure for further guidance.

Where urgent support is provided to a person who is not ordinarily resident, contact should be made at the earliest opportunity to the Local Authority in which they live to inform them of the intention to meet an urgent need.

Where the person is already in support of a service from the other Local Authority, information should be gathered to support any decisions made about which support should be provided.

Agreement should be reached with the other Local Authority about how any urgent care and support services will be monitored, when they intend to assess for eligible needs and how reimbursement of costs incurred can be sought.

tri.x has developed a tool to support decision making around ordinary residence.

See: Ordinary Residence Decision Support Tool

Also see the Ordinary Residence Procedure for further information.

Under the Care Act, when a person is already receiving care and support from the Local Authority, they may request a change to their Care and Support Plan at any time and the Local Authority must consider the request. Where the request is deemed reasonable, the Local Authority has a duty to review the plan.

The review is the mechanism by which the need for a revision is determined. As such, under the Care Act, a Care and Support Plan can only be revised following a review.

Where a change is requested to a plan and there is no planned review scheduled, consideration should be given to arranging an unplanned review. Any review must be proportionate to the needs of the person and undertaken in a timely way so as to reduce the risk of a crisis developing and needs not being met.

If the person has an allocated worker, this person should carry out the review, unless the review is urgent and the worker is unavailable.

Before transferring the review request, you should confirm that the practitioner the review request is being transferred to is available.

If the practitioner is not available, you should speak with a manager to establish whether:

1. the request should still be transferred to the allocated worker to action when they become available;
2. alternative arrangements should be made to carry out the review.

Where the information gathered at contact suggests there has been no change in the person's needs, and that a change to the personal budget amount is not required, it may be possible to complete a 'light touch' review without further allocation.

When the information gathered at contact suggests there has been a change in need or circumstance, and that a change in the personal budget amount is required, any review carried out is likely to lead to a proportionate reassessment of need. Because this is a longer term intervention, allocation for this should be considered.

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 to 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:

1. inform the person of this;
2. 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;
3. 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;
4. agree with the person what they should do if the practitioner does not make contact at the expected time; and
5. make a proportionate record of all the above.

If it is not clear when the practitioner will become available, you should:

1. inform the person of this;
2. leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person;
3. 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
4. agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
5. 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 they have addressed the written contact 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:

1. confirm that the practitioner the written communication is being transferred to 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;
2. 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
3. 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 to 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:

1. 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;
2. 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;
3. 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;
4. agree with the person what they should do if the practitioner does not make contact within an agreed timeframe; and
5. make a proportionate record of all the above.

Sometimes it becomes clear that the required intervention would be better carried out or led by a different service area or team. For example:

1. if the person has multiple needs that cross into more than one service area and it is felt that a practitioner working in a different area would possess more expertise; or
2. if the person was referred to a long term intervention team but after consultation it is felt that a prevention service may be more appropriate.

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:

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 required to work with the particular person in question.

tri.x as developed a tool that can be used a 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.

Adult Frailty and Long Term Conditions Teams

Adult Frailty and Long-term Conditions Team locality boundaries are determined by a person’s postcode. The system uses the first section of the postcode and the first digit of the second section.

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 Team is responsible for the case. As an example, a Lincolnshire resident with NG23 5** will be the responsibility of Grantham and a Lincolnshire resident with NG23 7** will be a Lincoln South / Hykeham case.

The postcode lookup list is available in the Local Resource Library under Access to Information, Advice and Services (Section 3).

Learning Disabilities Teams

Learning Disabilities Team boundaries are detailed in the postcode lookup list, which is available in the Local Resource Library under Access to Information, Advice and Services (Section 3).

The boundaries for Learning Disabilities Teams are aligned to Lincolnshire’s ward boundaries, as follows:

• Grantham / Stamford and Bourne – covering all South Kesteven District wards;
• Sleaford / Spalding – covering all South Holland District and Southern wards of North Kesteven District;
• Lincoln / Hykeham – covering Lincoln City and northern wards of North Kesteven District;
• West Lindsey – covering all West Lindsey District wards;
• Boston / Skegness – covering Boston Borough and south-eastern wards of East Lindsey;
• Louth – covering north and western wards of East Lindsey.

The Intake Team covers the whole county and is responsible for initial work with new people coming into Learning Disabilities services.

Mental Health Teams

LCC commissions the delivery of statutory adult Mental Health services to Lincolnshire Partnership NHS Foundation Trust (LPFT) under a Section 75 Agreement – there are 3 LPFT S75 Social Care Teams split between North, South and West.

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.

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 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.

When you have been asked to work jointly with another service, you should contact them to confirm your involvement and discuss the most effective way to work together. The things you should establish include:

1. 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;
2. whether there are opportunities to co-ordinate systems and processes and, if so how this will be managed;
3. 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);
4. what the anticipated outcome of the joint work is (for example, joint funding of support, ongoing joint work to monitor);
5. 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);
6. who will be the primary contact for the person (or their representative) to go to with any queries; and
7. 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:

1. consider whether to proceed with their intervention; or
2. 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.

Some areas of joint work are specialist in nature. The procedures for these pieces of work can be found in the Specialist Procedures section of this manual. The following are examples of the procedures that can be found there:

1. NHS Continuing Healthcare;
2. Continuity of Care;
3. Cross Border Placements.