Providing care in practice: Is 5 minutes enough?

13 Aug 2019

The National Institute for Health and Care Excellence (“NICE”), the Government’s advisors, have recently proposed that care workers should stop conducting “flying care visits” to vulnerable people who rely on their help and instead stay for at least half an hour. These proposals have received widespread media attention.

Thul Khan, specialist community care solicitor at Osbornes solicitors discusses how the Care Act 2014 (“the Act”) can help carers and service users to have their needs reassessed if either party feels that they do not have enough time to meet the needs of individuals.

NICE wants to see an end to short and rushed visits where individuals have to choose between getting washed or dressed.  If adopted, the NICE proposals would transform the way vital care is given and protect an individual’s safety, health and welfare, they could also avoid individual’s falling ill and ending up in hospital thereby reducing pressure on the National Health Service.

Under the Act, service users and now carers can request a reassessment of their needs if they feel that they do not have enough time.  The reassessment should look at what tasks an individual can carry out and what they would like to do but are unable to.

Meeting ‘needs’ is an important concept under the Act which moves away from the previous terminology of ‘providing services’. As each individual’s needs are specific to themselves, there are many different ways in which their needs can be met. The intention behind the legislation is to encourage this diversity, rather than point to a service or solution that may not be either what is best for an individual nor what the individual wants. The purpose of the care and support planning process is to agree how an individual’s needs should be met, and therefore how the local authority will discharge its duty, or its power.

The process should be centred around the individual and the guidance refers to this as “person-centred”. It involves taking all reasonable steps to agree the plan with that individual. The local authority must take into consideration the individual’s preferences. The authority should consider the individual’s goals as well as the level or nature of support desired. Where the individual wishes to take more control over their own care and support, this should be reflected in the route taken. Similarly, where the individual asks for more local authority support (e.g. because they lack the skills or confidence to engage with the provider market), the authority should respond accordingly in the decision taken about how needs will be met.

The care plan must set out and explain how needs will be met and should show how the outcomes that the individual wishes to achieve day-to-day in the assessment process will be met. It should also explain how they have complied with the wellbeing principle in the Act. In particular, it should set out where reasonable the individual’s wishes, needs, aspirations and what is important to and for them. This process will provide individuals with choice and control over how their needs are met. The guiding principle therefore is that the person be actively involved and is given every opportunity to influence the planning and subsequent content of the plan in conjunction with the local authority, with support if needed.

There should be no restriction or limit on the type of information that the plan contains, as long as this is relevant to the individual’s needs and/or outcomes. It should also be possible for the individual to develop their plan in a format that makes sense to them, rather than this being dictated by the recording requirements of the local authority.

Where the person has substantial difficulty in being actively involved with the planning process, and they have no family and friends who are able to facilitate the person’s involvement in the plan, the local authority must provide an independent advocate to
represent and support the person to facilitate their involvement.

Individuals and the carers should keep a record of the time spent from the visits and what type of care has been missed.  It is important that the social worker and health care professionals are kept up to date with the care provided to ensure that it is continually reviewed and revised where necessary.  Individuals should ensure that they agree with the type of help the local authority says they require in the assessment and any concerns they raise are actioned.

Whilst many local authorities excuse their action by pointing to a cut in social care funding, they need to understand that they cannot avoid their legal duties and must ensure a full assessment is carried out and is consistent with the actual care that is provided, as well as being as “person centred” as possible.

Osbornes Solicitors have a large community care department and assists clients in challenging adult social care assessments and the provisions of services for adults and young people in care.

If you would like to discuss an issue you are currently experiencing with Thul Khan, you can contact him by calling us on 020 7485 8811 or by filling in our online enquiry form.

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